Report from Kenya

Report by Professor Philip and Dr. Nori Graham on their visit as senior volunteers on the Royal College of Psychiatrists scheme to the Department of Psychiatry, University of Nairobi, Kenya, 27 January – 12 February, 2007.

 

Our visit was arranged by Professor Rachel Jenkins, Institute of Psychiatry, who has made several visits to Kenya to support the mental health services in that country. Initially the request was for a child psychiatrist and Philip Graham (P.G.) was invited to visit. However it became clear that it would be advantageous if Nori Graham (N.G.), a psychiatrist for the elderly, could also visit and a joint programme was arranged for the two of us. Our programme was partly arranged before we arrived and partly set up during the visit.

 

The activities undertaken by P.G. during the visit included:

 

  • Advice on curriculum development in child and adolescent undergraduate and postgraduate teaching.
  • Teaching to undergraduates, post-graduates in psychiatry and paediatrics
  • Attendance at out-patient clinics.
  • Attendance at journal clubs
  • Discussion about possible research projects.
  • Grand Round lecture.
  • Talks to special needs teachers in schools.

 

N.G.’s activities included:

 

  • Advice on curriculum development in geriatric psychiatry.
  • Seminars with undergraduates, post-graduates in psychiatry and nurses.
  • Attendance at out-patient clinics and in-patient un its.
  • Ground-work for the establishment of the Alzheimer’s Association of Kenya, now launched.

 

We had a busy programme that included discussions with Dr. David Kiima, Director of Mental Health, Ministry of Health.  As is clear from the report by Dr. Caleb Othieno, Head of the Department of Psychiatry, University of Nairobi, with whom we had many discussions during our visit, there is now a well-established programme in psychiatric teaching in the University. We were impressed with the level of teaching and felt that the undergraduates we met near to the time they qualified had acquired a level of knowledge comparable to that reached by British medical undergraduates at a similar stage. 

 

We would suggest that the following need to be taken into account when considering future volunteer activities of the type we undertook:

 

1.      There are various activities that volunteers might

         undertake eg

 

a)     Clinical teaching

b)     Lectures, preferably interactive

c)      Research advice

d)     Advice on organisational issues

e)     Supporting voluntary organisations.

 

 

2.      Tailoring to need. Countries that might benefit from volunteer visits fall into two main categories.

 

a)     Those, such as Kenya, where there is already an established programme in psychiatry.

b)     Those where there are currently virtually no specialist resources

 

Clearly needs will vary depending into which category a country falls.

 

3.      Types of support likely to be most helpful

 

a)    Lengthy stays of three months or more. Much briefer visits could be helpful for specific purposes eg

       advice with a research project, but note that much short-term help could probably also be provided

       by email.

b)     Attachments from a Department of Psychiatry that can sustain a relationship with a host

       department preferably over several years.

c)     Well-prepared visits when both the host department and visitors are clear about the type of help 

        that is available and there is a good match between what is needed and what can be provided.

 

4.      Cost

 

The cost of visits (fares, subsistence etc) is high and only a minority of potential volunteers are likely to be able to afford to pay for themselves. At present the expectation is that fares will be paid by the volunteer and subsistence provided by the host department. Many host departments will not be able to find the funds for accommodation and alternative sources of funding need to be identified.

 

5.      Other ways of providing help. These might include:

 

a)     Providing ongoing support via email or further visits

b)     Encouraging others to volunteer

c)      Helping to make contacts for specialist advice regarding eg research methodology or clinical techniques.

 

Finally we would like to express our thanks to all those who made our visit so pleasurable and informative. We would particularly like to thank Rachel Jenkins, Caleb Othieno, David Ndetei, Frank Njenga, Fred Owiti, Pius Kigamwa, Rachel Kangethe and many others who gave up their time to talk to us.

© 2011 Royal College of Psychiatrists