MTRH Nawiri Recovery & Skills Centre Helps Client Thrive
Paul’s* story is a story of hope that proves that access to health care and support may be the difference between having a fulfilling or a miserable life for a person living with a mental health condition.
In Kenya, it is estimated that one in every 10 people faces the reality of living with a mental disorder. The number increases to one in every four people among patients attending routine outpatient services. However, the misconceptions and stigma surrounding mental health issues, often cause people to suffer in silence without seeking help.
Paul was first diagnosed with schizoaffective disorder in 2005. Schizoaffective disorder is a mental illness that is marked by a combination of schizophrenia symptoms, such as hallucinations (abnormal perceptions such as hearing voices, seeing strange things or smelling things in the absence of a stimuli) or delusions (false fixed beliefs), and mood disorder symptoms (being easily provoked, sadness, excess happiness, etc.). The symptoms he experienced were very severe and his records show that he had been admitted to Moi Teaching and Referral Hospital (MTRH) Mental Ward sixteen (16) times. In the year 2021, he had been in the hospital six times with his main triggers being non-adherence to medication and social conflicts. Each time, after the management of the symptoms at the mental unit, he would be discharged but a month would barely elapse before he relapsed and was readmitted. An unending cycle of misery, it seemed.
The ray of hope for Paul was his enrolment in MTRH Nawiri Recovery & Skills Centre last year (referred to as Nawiri). Nawiri is a transitional home for patients struggling with mental health and addiction that provides illness management, recovery training, life skills, and job readiness for the clients. The Centre, which has a capacity for 16 clients, was built with funding from the Astellas Global Health Foundation in partnership with MTRH and Indiana University through AMPATH. In 2019, the Foundation granted AMPATH $1.35 million to provide 400,000 people with access to mental health programming in western Kenya over three years and to build and run the Centre. Paul was the second client as the home opened its doors in August 2021.
An audit of his journey and life with the mental illness by the Nawiri team revealed that his family and social life were troubled. As a tailor by profession, he could not keep up with his trade or fend for his family due to the challenges of this condition. “Even when I was well and able to work, no one would trust me to do any tailoring for them labeling me as ‘the mad man’. I was a subject of teasing from everyone in the community, and even despite being the eldest in our family, I did not command much respect from my siblings.” The constant conflict that Paul was in with people around him affected his relationship with his community and siblings, and sadly caused his family to fall apart. He separated from his wife and his four children had to be hosted by different family members.
Despite the dismal history, Paul optimistically started his three-month therapeutic journey at the recovery home. He went through the Illness Management and Recovery program designed to provide clients with the knowledge and skills necessary to cope with aspects of their mental illness while maintaining and achieving goals in their recovery. Paul was guided on how to understand the illness and all its symptoms, medical adherence, symptom management as well as coping strategies for persistent symptoms.
“I was taught a lot of things that I did not know before and this has been very helpful. Any time I have some symptoms, I know what to do and within a short time, I get better. I also learned the importance of taking my medication on time and I do so without fail,” he said.
Further, family therapy was included to help his family better understand his condition. To everyone’s delight, the family therapy helped him and his wife resolve their differences and eventually get reunited. Nawiri is keen on skill acquisition to help transition back to the community and here Paul polished his tailoring prowess and learned more effective ways of managing his business. He also learned some farming techniques and he makes a decent living by selling seedlings.
Nawiri is a Swahili word meaning “thrive,” and indeed, Paul has started to thrive through the support from Nawiri Centre. He has been able to achieve all the goals he set out at the onset and six months after completing therapy, there has been no need for readmission to the hospital. “I was discharged on November 25th and I have not had any relapse. I can manage my symptoms and I attend my clinic as advised. Indeed, I have thrived. I am grateful that Nawiri helped me understand my illness better and that way I can have a healthy and fulfilling life. I am very happy that I can fend for my family and I no longer feel like a burden,” he continued.
The feeling of hopelessness had been a trigger for the episodes Paul had. However, he now feels like he has taken back control of his life. He lives a meaningful life and contributes to the mental health space. Paul is now a peer educator at the Nawiri Recovery & Skill Centre and tells the story to encourage others struggling with mental health conditions. He is also a devoted mental health advocate back in the community and the radical change in his health shows the difference care and support can make for people living with mental health conditions. Nawiri additionally engages him as a tailoring tutor and gardening instructor at the Centre.
“Mental illness can be very devastating for an individual due to the symptoms of the illness as well as the stigma around it,” said Dr. Edith Kwobah, head of Mental Health at MTRH. “Our role in Nawiri is to restore dignity by helping the clients understand their illness and take charge of their care. We teach patients that they can live a productive life and support them to gain skills that can enable them fend for themselves. Our hope is to impact lives, one client at a time.“
*Name has been changed to protect patient privacy