This gives makes surrel the return to the “normal” and the beginning of the pull from the doldrums of the pandemic which range from loss of jobs to disrupted school calendars. Months after the Pfizer’s and Moderna’s vaccine showed efficacy in control of the coronavirus, the Kenyan Ministry of Health has received doses of the AstraZeneca vaccine.

 The endgame of these vaccines will be to bring an end to the pandemic. However, the existence of an anti vaxxer brigade in Kenya threatens the effective roll out of the vaccines to the public since many Kenyans may refuse to take the jab. Such a case can best be illustrated by the resistance to the Polio vaccine in Kenya in 2014.

An Ipsos poll in 2014 on the polio vaccine indicated found that around 45% of Catholics and 65% of Christians of other denominations felt that the vaccination drive was intended to depopulate the nation. 77% of Kenyans in the former North Eastern province were against the administration of the vaccine on similar grounds.

Raila Odinga, a top Kenyan politician, is on record for calling this polio vaccination drive a targeted mass sterilization program in 2017. With almost similar sentiments having being aired in the social media for the past few months regarding some the coronavirus vaccines, fears arise that such misinformation may hamper the uptake of vaccines by Kenyans. This will result in failure to effectively control the spread of the virus yet vaccines will have been administered.

This can be averted through several means. Firstly, there will be need for effective public awareness programs on the importance of the jab. This should be done in all corners of the country and even in local languages in instances where they are most appropriate. Leaders and health workers must also be at the forefront of receiving the jabs and can take pictures of themselves doing so and share them on social media. This will help dissipate the notion that the vaccines are unhealthy and are meant to control populations.

It is noteworthy that a section of Kenyans believes that COVID 19 is unreal and is only a ploy by some government officials to hoodwink Kenyans that a disease exists so that they may get an avenue to siphon public funds though the initiatives that strive to tame the virus. Such a public that has become increasingly skeptical government initiatives will have to be reassured that the vaccination drive is for their own benefit and that none of the government officials benefit financially from the vaccination process.

The public also needs to be informed of how the vaccines have been transported and stored beforehand. This will help in convincing those who doubt the cleanliness and purity of the vaccines to take the jabs. The mode of administration should also be communicated in order to fritter the rumor that the vaccines have something to do with marks associated with end times among Christians.

There will be need to reinforce the trust that people have in vaccines if the vaccine drive is to succeed. This can be done through explaining to the public how vaccines have been critical in eradicating diseases like polio from the face of the earth and how the same can happen if they are all vaccinated against COVID 19.

People’s attitudes to vaccines can be changed through the emphasizing on the effects of refusal to be vaccinated to the general public. As such, the vaccination drive must be seen by anti vaxxers as an activity that seeks to save humanity from annihilation by an invisible enemy. Explaining to the seriousness of the symptoms that COVID 19 and the number of lives it has taken across the will also play a critical role in changing the minds of individuals who may be opposed to taking the jab.

There will also be need for the media to play a critical role in offering factual information on vaccines in cases where misinformation arises. This can be done through fact checker sections of newspapers and news programs.

Tedros Adhanom, the WHO Secretary General, recently said that no one is safe from COVID 19 till the virus is defeated everywhere. COVID 19 can only be defeated everywhere if anti vaxxers are sensitized on the critical aspect of the vaccines and those who are targeted by the Ministry of Health to be vaccinated are actually vaccinated. Only then will the COVID 19 pandemic be defeated.

When menstruation starts, many girls find it difficult to open up about what is happening to them, they may not have the knowledge of period calculator to know when the next menses and hence when the next period comes, it may happen in the school parade, when out playing sports or when going back home for lunch. The shame that comes with period makes many girls to drop out of school because they get taunted especially by males. In addition, poverty may make parents unable to buy sanitary pads for their daughters, in some cases even mothers themselves cannot afford sanitary pads in the first place and make do with pieces of cloth. There are also reported cases of girls using papers[1] , furthermore many vulnerable girls depend on educational institutions to provide these important reproductive health materials but with the closure of schools, many school girls can no longer access sanitary pads. In different parts of Africa, women and girls face a variety of challenges during their menstruation. These range from costs, cramps, lack of privacy, water and sanitation.

In Kenya, the story of menses reflects the sad reality and an everyday challenge for many women and girls. Due to period shame and the resultant humiliation due to menstruation, a 14-year-old girl committed suicide because of being singled out by her male teacher due to soiling her uniform[2].When a girl menstruates in school, many a times she gets mocked by males, this makes her feel humiliated and loses confidence. In the long run this form of humiliation has a great impact on girl’s education and  in some cases may make the girl drop out of school. Other factors that make the cost of pads unaffordable include costs. A packet of Always sanitary pads goes for Kshs 85; the purchase of pads also depends on how heavy one flows. Sometimes the menstrual flow can be heavy, this means more than 1 packet of sanitary pads at a given time. Woe unto you if there is no money at home to purchase pads for you. It means either this girl will stay at home during her menses or use pieces of clothes which sometimes may not be clean and has the danger of making the transferring infections to the reproductive organs. Access to clean water during menstruation is very important, however this become a challenge in places where there is no clean running water and there is also risk of infections especially in congested neighbourhoods where families have to share bathrooms and toilets. Additionally, the lack of access to clean, running water makes it a challenge for girls to bathe properly during menstruation.

Due to inability to afford pads, some young girls are forced into transactional sex in order to access pads. This further put them at an increased risk of Sexually Transmitted Infections and unplanned pregnancy.Some organisations providing re-usable pads, however, they are still not accessible to many girls and women who need them.

Despite the challenges faced by girls and women in accessing sanitary pads, all is not lost. In Nairobi, one young person namely Alfred Abuka   – a student at Kenyatta University is taking it upon himself to make life a bit bearable for girls in informal settlements and other  pockets of poverty in relation to menstruation. Armed with an idea known as the 10 Bob Challenge where an equivalent of Kshs 10 is mobilised among friends and family members to buy sanitary pads and then distribute these to vulnerable girls across different communities in Nairobi. Since the start of the challenge, 400 girls have been reached with information on sexual and reproductive health including confidence building that menstruation is not shameful. Given that the 10 Bob challenge is being spearheaded by a male youth makes it even more valuable and interesting. This is because many a times when females soil their clothes be it in the market, in a bus, in a classroom, it is males who humiliate her more. The 10 Bob Challenge is anchored on the fact that it is possible for males to make a difference even in the smallest way possible and transform people’s attitudes towards things seen shameful. It helps give a humane face to menstruation, to be able to consider it as an important and acceptable part of growing up that one should be excited about not ashamed of. The beauty of the 10 Bob Challenge is that other organisations are reaching out to support the initiative through buying sanitary pads or providing other forms of material support towards the initiative.

Yes, we can teach our brothers, uncles, nephews and sons  that menstruation is not shameful and it is about time families more so in Africa stop treating menstruation as something shameful but as something to be proud of  one’s gender , that is being  a WOMAN.

[1] https://www.nation.co.ke/kenya/gender/poor-samburu-girls-use-rags-as-sanitary-towels-307150

[2] https://www.standardmedia.co.ke/article/2001341516/girl-kills-self-after-teacher-chides-her-over-period

This story was submitted in response to Supporting Our Girls.

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Since the first case of Covid-19 was reported in Wuhan-China in 2019, the world has in many ways come to a standstill. Jobs have been lost, families have buried their loved ones, police brutality has spiked up and many are nursing injuries brought about by domestic violence at the hands of their spouses. The state meanwhile, has introduced various measures to contain the spread of Covid-19. These include Legal Notice No 50 on restriction of movement of persons in Kenya, quarantine, distribution and sale of face masks among others. But have these measures met communities at their points of need? And in what ways are communities better organising themselves to bridge the gap between their needs and measures implemented by the state?

Some people claim Covid is an equaliser because the affluent can no longer travel abroad for medical check-ups and treatment as has been the norm, as most countries [in the west] have closed their borders. However, for poor Kenyans who depend on daily wages, Covid being considered an equaliser is a fallacy because the restrictions on movement, the imposition of curfews and the ever present fear of police brutality during enforcement of the curfew have pushed many of them deeper into an already worrying and precarious existence. Reality is that the most impacted by Covid-19 in Kenya are the poor and those living in pockets of poverty.

Covid has fundamentally changed the way Kenyans interact. With the stay at home directive as part of containment of Covid 19, many workplaces, both formal and informal, have been closed over the last three months – some for good. Over 1 million people have lost their jobs[1]. For many in informal settlements who depend on wage labour as a source of livelihood, the closure of businesses and loss of job opportunities in sectors such as construction (popularly known as mjengo) or doing laundry (mama fua) means that daily cash flow into households are disrupted.

Furthermore, the closure of schools to contain Covid has disrupted learning for 17 million learners since March, and proposed shifts to online learning have brought to the fore the digital divide in access to education. While some students can afford to continue attending classes via zoom or alternative online platforms, many children and students from informal settlements and other pockets of poverty are unable to do so and will have to stay at home until some form of normalcy is established to continue with their schooling. The digital divide in education is also experienced by students in university and other institutions of higher learning. When the administration of the University of Nairobi proposed digital learning in May for instance, students came out to express disapproval and inability to adopt online learning through the hashtag #UONboycottonlineclasses. Some had travelled back to their rural homes where they have no electricity, others did not have access to laptops or desktop computers, while for others it was too expensive to buy enough data bundles to undertake 2-3 hour learning sessions.

One student succinctly captured this situation in a tweet, “I am from Baringo and there is poor network and no electricity in my area. I need to walk for 3kilometres to access 2G network. How am I supposed to attend online classes?” Reality is that it still is not automatic that university students have access to a laptop or a desktop computer. For some students, especially those from humble backgrounds, digitalisation remains a mirage – except when they are within the university compounds. This is why many make use of libraries where access to university Wi-Fi is assured, or cyber cafes which remain expensive and unsustainable.

With the many economic and social disruptions, Kenyan households have increasingly become zones of violence, as evidenced by a sharp spike in incidences of domestic violence during this Covid period in comparison to the pre-Covid period. This increase can be attributed to shattered sources of livelihoods and the inability to afford basic necessities such as food and shelter, lack of mechanisms to psychologically cope with the aftermath of the pandemic, poor communication at family level among other reasons. Many cases have been reported of families sleeping out in the cold for lack of rent for example in Kayole[2] , while recent evictions in Kariobangi[3] left over 5000 families homeless and at an increased risk of infection by the coronavirus and other respiratory diseases because that demolition happened in the middle of the rainy season.

State response and community organising during the pandemic

Quite fundamentally, the support being availed by the state in informal settlements and other pockets of poverty has not done much to address the plight of the poor, and has further dehumanized the people. Over the past few months, the media has been awash with incidences of people getting injured in stampedes during food distribution like in Kibera[4], or through incidents of police brutality like we saw at the ferry in Mombasa. There have also been multiple incidences of people fleeing from quarantine facilities[5] and the inherent stigma that comes with Covid infection.

It is against this bleak backdrop that communities in informal settlements are organising to survive in the wake of Covid-19. Some are sewing masks and distributing them to fellow community members, while others are making soap or mobilising food and other forms of support for vulnerable households. Young people are utilising their creativity and are for instance creating talking walls in different informal settlements. The Social Justice Centre Theatre Group is packaging information on Covid-19 and creating awareness in informal settlements to protect communities by enabling them access to much needed information. In other places, Mpesa has been used to mobilise resources to buy food, pay rent for families on the verge of being evicted by landlords or sleeping hungry. Others are educating the young in their communities on the dangers of unsafe sex and distributing sanitary towels to vulnerable women and girls. With disrupted sources of income, getting 85 shillings to buy a packet of sanitary pads is a challenge for many Kenyans – for despite closure of airspaces and travel, or cessation of movement, menstruation among women and girls has not stopped due to Covid.

Community organising is a process, and change does not come overnight. While Covid 19 has reawakened the spirit of creativity and humanity within informal settlements and pockets of poverty, these creative and humane efforts must give cognisance to the fact that community organising is a pathway through which people come together to collectively address issues affecting them. When communities come together, new ideas emerge, new solutions are created and new skills acquired. It is a process of having one’s eyes opened to existing capabilities and alternatives. For community organising to be effective, it must originate from the level of the concerned communities. This is because it is the community that understands the problem they are going through. You cannot talk about lack of jobs when you have never been without a job, or understand what it means to have no food if you have always had something to eat. In addition, individuals who’ve had to sleep in the cold at some point because of non-payment of rent for instance, are better placed to understand the pain and agony that comes with forceful eviction. The issues our communities organise around must thus be reflective of the lived realities and conditions of the people. These conversations must be anchored on the people.

Community mobilising is an integral part of community organising. Mobilising communities to take action means that they are ready to respond to the issue(s) at hand. It is of fundamental importance for communities to continue organising post-Covid because it seems Covid will be with humanity for a long time to come. We must also celebrate the various strategies being adopted at the grassroots to ensure survival in an uncertain environment and the many unsung heroes and heroines who are contributing to making life bearable in informal settlements.

Examples of mental illness include bipolar, suicidal tendencies, depression, eating disorders (bulimia and anorexia nervosa), panic attacks, suicidal tendencies and anxiety among others. Death by suicide has been experiences across many Kenyan families and it has left a sad trail in its wake. The World Population Review ranks Kenya at position 114 among 175 countries with the highest suicide rate., additionally, Kenya’s suicide rate is at least 6.5 suicides per 100,000 people, a figure echoed by the World Health Organisation.[1]

Mental illness is one of the most misunderstood conditions in Kenya and across different parts of Africa. It is also a condition that brings with it a lot of stigma and discrimination. Those who suffer the most are the directly affected as well as their families. In some family’s persons with mental health are condemned, kept away from other people more often in darkened rooms, locked up not to interact with others and often viewed as “troublesome”. Additionally, access to mental health services is very expensive and a long term processes. The high cost of mental health services also deters majority of people from accessing these services.

It is worth noting that half of all mental health illnesses begin by age 14, though most cases go undetected and untreated. Furthermore, in this age group, depression, anxiety, conduct disorders and attention deficit/ hyperactivity disorder (ADHD) are the leading cause of ill health for this age group, if left unattended to, these illnesses continue into adulthood and negatively affect work, relationships and overall quality of life.[2]

Isolated and abandoned, excluded and silenced, many people with mental health problems face daily challenges in their lives. For others, mental issues are mirrored in a happy face because society does not accept admittance that one is not okay, more so having mental health challenges. In some cases, people refuse to go for counselling because of society’s judgmental attitude. Society becomes aware that someone is suffering mental health issues when they get to the extremes either when one commits macabre murder or commits suicide. That is when you see an outpouring of “grief”” with some saying why didn’t he /she tell us what was going on? why didn’t they talk to someone? Why didn’t they seek help? But alas many a times it is too late. The lack of understanding of what mental health is and the negative perspective given to counselling among many people leads to suffering in silence. It is not easy for a person to take themselves to a counsellor, they have to be forced. Counselling is also associated with the stigma of madness. Many people do not want to accept that they have problems. This bring out the importance of peer counselling where an individual can share their problems in a safe environment and not be judged. Society, with its expectations of machismo also makes males not to admit when they have problems. In many communities in Kenya and across Africa, males are not expected to express weakness, to say one is suffering is an admission of weakness. This can explain the high rates of suicides among men than women.

The damage of mental illness sometimes takes time. And when the mental illness becomes visible, family members start chaining the ill and hiding them away. It is not uncommon to hear of cases where a mentally ill family member is chained to a tree, or left in a dark room alone. Mental illness is compounded by the fact that there are very few mental health service providers in Kenya, this emphasises the importance of prevention and care before a case becomes severe. For example, there are an estimated 100 psychiatrists in Kenya and most are based in Nairobi, Kenya’s capital city. Outside Nairobi, there is one psychiatrist per 1 million people. Additionally, there are 12 neurologists in Kenya and all practice primarily in urban settings of Nairobi, Kisumu and Mombasa and are primary found in private practice settings.[3]

Mental illness is a silent epidemic, that warrants an urgent intervention. To complicate matters, mental illnesses may not present visible symptoms such as for illnesses for example headache, fever and diarrheas, making detection another hurdle that families have to cope with Many people suffer from mental illness in Kenya and the rest of Africa, but sadly there is lack of adequate awareness on mental illness. This is also coupled with the various beliefs that exist. The difficulty in detection of mental illnesses creates a fertile environment for misinformation to thrive.

In many African community’s mental illnesses are deemed to be caused by evil spirits[4]  or by witchcraft. In such cases the mentally ill person is taken to a religious institution for exorcism of the evil spirits. For example, for example, a study done in Ethiopia found out that Ethiopians were highly to attribute psychological illness to paranormal causes such as oaths or non-physical control (Tefera & Shire 2012)[5].This is partly because of lack of information about mental health and the resultant stigma that comes with mental illness. And of course mental illness in a family member more often means drastic changes in the family’s way of life. Hence, to successfully treat these illnesses, the therapies should be both solid like herbal treatment and divine.
Research carried out in Uganda publicised that the word ‘depression’ is not entirely culturally acknowledged (Ocelli & Ebla 2006). Similar research in Nigeria established that people react with fear, evasion and irritation towards individuals’ mental illness. The stigma related to mental sickness can be ascribed to lack of education, fear, spiritual thinking, and over-all bias (Arboleda-Flo’rez 2002).[6]
In addition to this, there is an innate fear in seeking help for persons with suspected mental illness because of fear of being diagnosed as mentally ill and lack of resources. Furthermore as noted by Boldero and Fallon(1995), health seeking behaviour of a person  with mental illness depends on the sternness of the sickness and its cause effects. This line of thinking is also echoed by James & Peltzer (2012), who observe that the reliance on traditional medicine is also due to the trust that ailments are caused by a supernatural strength as well as the belief that traditional cures are more effective.

Health budgets in many countries in sub-Saharan Africa are underfunded. For example, despite mental health accounting for 14 % of all global health conditions, mental health has a budgetary health allocation of about 1% in many countries’ health budgets. For example, Kenya has 427 psychiatric nurses who handle mental health illnesses, additionally, the budgetary allocation for mental health is only 0.5% of the entire health budget[7].This  makes mental health processes overstretched in the country.

It is therefore upon each and every one of us to pay attention to mental health issues. It is only when we become more attentive to mental health issues and change our attitude towards mental illness that many people suffering mental ill-health will be able to come out and feel accepted.

 We all need to realise that it is OK not to be OKAY and break the SILENCE and stigma on mental ill-health.

[1] https://www.theelephant.info/data-stories/2019/07/19/counting-the-dead-suicide-rates-in-kenya-2006-2017/

[2] https://www.ncbi.nlm.nih.gov/books/NBK350312/

[3] ibid

[4] https://www.psychologytoday.com/us/blog/why-we-worry/201412/spirit-possession-and-mental-health

[5]http://erepository.uonbi.ac.ke/bitstream/handle/11295/97525/Mbuthia_Attributions%20of%20mental%20illness%20among%20young%20people%20s

[6]http://erepository.uonbi.ac.ke/bitstream/handle/11295/97525/Mbuthia_Attributions%20of%20mental%20illness%20among%20young%20people%20seeking%20psychiatric%20treatment%20in%20Kenyatta%20National%20Hospital%20in%20Nairobi.pdf?sequence=4&isAllowed=y

[7] https://uonresearch.org/vvc/article/the-state-of-mental-health-in-kenya/#:~:text=unfortunately%2C%20Kenya%20has%20only%2088,health%20budget%20thus%