We could be heroes and they're all around us

"Remember, I've been fighting alone for decades and we still don't give up. Millions of women are suffering yet we can't keep silent" - Jahmby Koikai.

Two weeks ago, Jahmby Koikai urged President William Ruto to invest in reproductive health and at the time of writing this her long battle with endometriosis has just come to an end. However, her indomitable spirit can live on through anyone battling a chronic illness and fighting for others. We're not free until we're all free.

Here are the main stories in mental health this week:

• Cultural beliefs and no funding delay Vihiga resident's treatment
• Plans for a teachers' wellness centre in motion
• Woman battles depression after HIV diagnosis

TRUE STORY

Seeking treatment amidst religious misinformation

"Many people, including my guardian, believed this [bipolar disorder] was a punishment from God for leaving the priesthood and it required a religious intervention." - Nicholas Odhiambo

"Pray about it" and "God has a plan for your pain" is more of what I heard over the years.

When managing mental illness, particularly one that features symptoms like psychosis, you often question who you are versus the condition. Do you want to be a priest or pursue multiple careers or is it just a manic episode? It's even more common for misinformed people to suggest what they think you need to feel better.

For Nicholas Odhiambo, what started as a desire to pursue priesthood turned into genuine concerns after witnessing purity tests, family politics etc — an internal battle anyone can experience regardless of a bipolar disorder diagnosis. Although he sought a break from the seminary, his request was only approved eight months later and by then depression had worsened as he settled back into his hometown in Kisumu.

While joining high school I didn't anticipate a severe depressive episode eight months later that would make it harder to keep up with schoolwork. This is after years of academic dominance in primary school which made me feel like a failure and worsened things to a point of suicide ideation. I realised I needed more tutoring and after three requests, I finally moved to a school where I dramatically improved my grades.

Thanks to a local priest who nudged Nicholas' family to seek medical help, he received a clear bipolar diagnosis, went on treatment, relocated to Nairobi and joined a support group. "Through the group, I realised many were facing similar struggles. It helped me identify my triggers and develop coping mechanisms."

Last year I also joined a virtual monthly support group run by Bipolar UK. I've finally found a place where it's safe to be a high performer and experience symptoms. Patients go through life stressors just like everyone else and navigating that experience isn't an invitation to assume. Study. Listen. Learn. We're doing the same.

NEWS

The week's top stories

• Cultural beliefs and no funding delay Vihiga resident's treatment: When Edward Asiachi's mother noticed he was suddenly mumbling and erratic, she sought answers from religious shrines to no avail. A well-wisher provided medical support but this ended when Edward exceeded the programme's age restriction. “I cannot afford to take him to any hospital. He spends his nights talking incessantly, like a prisoner in his mind."
• Plans for a teachers' wellness centre in motion: “The male teachers have told us we need a place where we can cry, in private and with no victimisation. The female teachers are saying the battering and gender-based violence is there,” KEWOTA Chief Benta Opande said during a fundraising walk for the centre. Teachers also report that many problems stem from the employer so the government should consider culture reformation.
• Woman battles depression after HIV diagnosis: In form one, Janet was adjusting to ARVs and battling suicidal thoughts. A conversation with her mother and support group helped her navigate stigma at school to eventually build her own family. “Living with HIV is like controlling a visitor in your body, it is not the end. If you have to engage in sex, then use protection because just like me, you can have a loyal partner who someday in their life had a low moment,” she said.

PAUSE

TRIAGE

Self-advocacy with family members

In Form One, Ruth Tengecha almost died by suicide in school. She stayed with her parents for a while then returned to school without professional help. "My parents thought I was throwing tantrums because I did not like the school," she said. She was also bullied at home by a relative which made it harder to manage symptoms.

"I did not speak up at the time because I knew older people should know better. At my age now [21 years], I know that people younger than me could know something that I don't."

Like Ruth, my attempt occurred in high school and I felt a change in environment would help me reset. But it's a teenager's word against well-meaning adults' so here are three things that helped me:

• Making an academic case for the move — with one year to KCSE and teachers on strike, I was behind on the syllabus and a private school would help me catch up.
• School fees — although a private school came with a bigger fee, it would only be one year instead of four school years.
• Bravery — I addressed letters to my caregivers at the time detailing the mental suffering I was experiencing and requesting a dedicated meeting over mid-term. Meanwhile, I packed everything up and would only resume school if we came to an amicable agreement.

I secured the move and excelled in KCSE given my high school journey and in the end, everyone agreed it was the right decision. You may feel young but explore every avenue you think may work in your favor.

You're the most informed person about your dreams and experiences, and that will always be true. So look at it as an opportunity to learn how to fight for yourself early on — I believe in you.

QUICK

One-liners

• Caregiver stress and burnout: looking after an adult son with schizophrenia [Nation]
• Emotional powder kegs: when men choose to suffer in silence [The Standard]
• Rising cases of students grappling with mental health in Kericho [The Star]
• Inside the mind of a mother battling depression after childbirth [Nation]

REGION

Mental Health in Africa

[UG] New psychosocial boss benchmarks trust for mental health integration at TPO Uganda. [Nile Post]

[UG] Civil Society Organizations (CSOs) task govt to increase taxes on tobacco products to discourage use: This comes after less advertising resulted in a decline in tobacco usage among young people from 17.5% in 2018 to 11% in 2023. "These young people asked us to ban tobacco and I'm very hopeful that they will be able to ban it in this country during their time," said Dr Hafsa Lukwata, Assistant Commissioner of Mental Health in Uganda's MoH. [Monitor]

[TZ] How failure to invest in adolescent welfare could have economic effect [The Citizen]

[TZ] How Geita Gold Mine Limited (GGML) is transforming the lives of people with disabilities: Myths like children with disabilities are cursed or that their body parts can attract wealth has seen many parents hide their children. However, through partnerships with children's shelters like Moyo wa Huruma Centre, 156 children now attend technical colleges and special education programmes. [The Citizen]

ACTIVISM

Worth the fight

We just celebrated Madaraka Day honouring those lost in the 43-year fight for Kenya's independence. After years without a clear diagnosis, Jhamby Koikai dedicated her life to advancing treatment for endometriosis.

Jahmby Koikai on Instagram: “There’s serious misinformation going on in regards to treating Endometriosis in Kenya. The only way from my experience to diagnose this disease is through a surgical process known as a laparascopy. The gold standard of treatment is a surgery known as excision. If Endometriosis is manifested in other organs of the body, a multidisciplinary approach with experts in excising the disease should be incorporated. How then do you find out if a specialist is well-versed with excision surgery? I will be sharing more on this. It’s a great privilege and honor to share my experience with gynaecology students in the universities as a patient advocate because I believe real change in regards to treatment of this disease will take root from students who will specialise solely on treating this disease. This Thursday, I will be sharing my experience with the Kenyan health care system for over two decades in finding a diagnosis, my treatment in the US under the specialist care of the @centerforendocare, my recovery journey and I will be sharing my medical reports. I have been invited as a guest at the University of Nairobi, for a department CME at the school of gynaecology from 7am-8am. @kmuthembwa #Endometriosis #Endometriosisawareness #endometriosis #endometriosissurvivor #ThoracicEndometriosis”

jahmbykoikai on October 23, 2023: “There’s serious misinformation going on in regards to treating Endometriosis in Kenya. The only way from my experience to diagnose this...”.

Instagram

Seated here bringing you this newsletter, freedom of speech is my reality because of those fallen soldiers. Sharing parts of my life makes it harder to write each edition but Koikai's courage keeps me going. Somehow, it still feels worth it for a future someone and that could be you today.

Lots to take in from this edition so take a moment and care for yourself after reading it. Thank you for being here.

Until we meet again.

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