I came, I saw, I conquered

"Put your crown on and stop asking other people to make you great" - William Hollis.

After writing last week's edition I needed to pause, deflate and get back on my feet. Sharing my life story still takes a toll but I wouldn't have it any other way. I'm back with another edition covering tattoos and self-harm as I introduce you to an exceptional member of my care team and lots of brave people turning their pain into power.

Here are the main stories in mental health this week:

• Muguka cited as a leading cause of mental health issues in Mombasa
• New Social Health Insurance Fund set to cater for mental health treatments
• Community health worker turns her daughter's death into purpose

TRUE STORY

Explained by Eliamin & I: Tattoos and self-harm, part one

Suicide ideation has been one of the longer battles in my life and self-harm tends to accompany it. In my teenage years, journalling provided relief, I called it "bleeding through the pen" and would write for hours. Over time I discovered tattoo artistry and felt the design process could be healing thanks to New York-based artist Bang Bang.

I looked for an artist with a light touch and attention to detail and a quick Google search led me to Eliamin's life story. Not only does he design custom tattoos but he also paints murals and his collaborative approach is what I think a patient-doctor consult should feel like. It's been one year since he left for Canada and I've been itching for another session so I caught up with him.

Meet my guest

Two weeks of tattooing abroad turned into a year. What's kept you going?

Resisting mediocrity. I asked myself, "What am I going home for? The same level of success?" They may forget my name but my craft speaks for itself and I'm getting even better at it here. I'm always willing to start from scratch, learn everything from my environment and become someone I've never been to get what I've never had. I'm building a reputation to show my team and even you what's possible when you commit to perfecting your craft.

I shared my story with you during our first appointment, how do you create a safe space for clients?

Mine isn't just a shop but a tattoo parlour. From the murals, personalised music selection, drink options, a gaming area and a curtain around my client and me while checking in during the session. I've also trained my team to take care of clients in the waiting area so that being in the parlour is a memorable experience, not just an appointment.

I still consider individual clients as the cornerstone of my business, they are my biggest referral engine despite past big brand partnerships (Red Bull, Safaricom, Guinness) — that's why I always call you "boss wangu" (my boss).

Do clients express an urge to cut themselves and does it differ across Africa & Canada?

Yes, about 45% of all my clients across both regions experience self-harm urges. Many will call me and say, "I'm stressed and I don't want to hurt myself, can I come in for a tattoo?". I keep this in mind when designing each piece so they can associate that heavy feeling with something beautiful. I also listen during the session 'cause I may be the only one they ever share those feelings with.

Five tattoos later, I'm convinced they have long-term healing benefits making tattoo artists caregivers in my books. We'll get more into this in the in a future edition.

NEWS

The week's top stories

• Muguka cited as the leading cause of mental health issues in Mombasa: Muguka is a local stimulant that has seen many residents battle addiction and relationship breakdowns. Dr Janbibi Yusuf, a psychiatrist at the Mombasa Women Empowerment for Mental Health Treatment & Rehabilitation Centre says, "Patients lose self-awareness, sometimes soiling themselves, needing diapers." The centre's founder, Amina Abdallah, has called on the government to join the fight against muguka consumption calling it a pandemic.
• New Social Health Insurance Fund set to cater for mental health treatments: SHIF will cover treatment for chronic drug use, including alcohol, tobacco, cannabis, heroin, mandrax and cocaine. This coincides with (NACADA) order to remove billboards promoting alcohol near schools, " It undermines personal growth by normalising the consumption of alcohol and portraying it as an appealing and glamorous choice," NACADA said.
• Community health worker turns her daughter's death into purpose: Maureen Wauda's daughter succumbed to a mysterious illness she suspects was a high-risk pregnancy but there are no medical records to confirm this. Now she uses the electronic Community Health Information System (eCHIS), a digital platform designed to organise health information. "I used to carry my books from one household to another but eCHIS helps me provide better care." Dr Adrian Ochieng’ says "With eCHIS, aggregated data can help the government identify health trends, respond to outbreaks, and allocate resources appropriately."

PAUSE

TRIAGE

Living with bipolar disorder and adenomyosis

"Do you know why it has been this expensive? No doctor ever told me I had endometriosis. They kept treating me for useless things like fibroids, then I end up spending sh16,000 every month because I'm always in this unexplainable pain. They never take time to think away from certain diagnoses. They could've asked, 'How short is your cycle? Is there pain in your right leg?'" - Rosemary Mwaniki

Endometriosis is a costly affair. I should know, I've been managing adenomyosis, a type of endometriosis, for ten years now and it would be years before I understood the condition in my body. I was diagnosed after my first depressive episode and painful menses can interact with mood disorders, here's how:

• Medication — some contraceptives used to manage painful menses interact with mood stabilisers used to treat bipolar disorder and weaken their effectiveness.
• Symptom — chronic pain is debilitating and triggers low mood increasing chances of recurring depressive episodes.

4 questions 4 your doctor

"I once asked a doctor, if he goes home and thinks about each patient he's seen. He sees 50 women a day with different complications, he has his family and his life, what time will he have to wonder what I have and why I am not getting any better?" - Rosemary Mwaniki

A question on so many patients' minds who have spent years waiting for a clear diagnosis. I found out I had been on the wrong medication for adenomyosis for the first three years of treatment after switching to a different gynaecologist. Self-advocacy is the name of the game so if you're living with bipolar disorder and adenomyosis consider asking your doctor these questions:

• What are the symptoms of each condition? Ask for at least four symptoms and insist they give you a fair basic understanding.
• After your assessment, how do you think these symptoms may interact in my case? To help you anticipate the recovery process and how you can collaborate with them because you know your body better.
• What are my treatment options? Ask for case studies of their previous patients including rare and tough cases. The more you know early on, the better.
• Can we document my treatment journey together (e.g. via an email thread)? It makes it easier to share your patient history with other doctors reducing chances of nasty side effects from other medications.

If you need more tailored support on questions for your doctor reach out to me, I've become a bit of a pro at this point.

QUICK

One-liners

• Nacada orders removal of billboards promoting alcohol near schools [Read]
• Mental health silent and unspoken threat - Seku VC [Read]
• Government measures to prevent gambling addiction in Kenya [Read]

REGION

Mental Health in Africa

[RW] Youth facility in Nyamasheke District helping check drug abuse and teen pregnancies: The centre delivers adolescent, sexual and reproductive health (ASRH) services to youth and equips them with skills such as sewing, shoe making, and hairdressing. “Youth with no educational background are more interested in these centres and eager to learn more about their health,” Ange Uwituze (not real name) who got pregnant at 17 said, noting that she benefited a lot. [Read]

[UG] Unveiling the truths of mental well-being: Next Radio is honouring Mental Health Awareness Month through its programme, “Mind Matters with Next Radio” hosted by Victoria Sibiya. The programme's goal is to raise awareness of mental health as a continuum, ranging from optimal well-being to severe mental illness and advocate for patient support. [Read]

[TZ] Miss Tanzania opens up about battling depression: When the Miss World Competition was cancelled in 2020, Rosey Manfere received a lot of negative online comments which fuelled her to think local. "We're exploring ways to bring more fashion events to Tanzania starting with Miss Tanzania and Miss Kinondoni as our main platforms. There's room to showcase our local talent." Rosey shared. [Read]

ACTIVISM

Worth the fight

In the spirit of being a lifeline for others, Brazilian forward Richarlison inspires other English Premier League players through his battle with depression.

You and I, we've got this. That's it, that's the conclusion. Let me know what you think.

Until we meet again.

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