The history of Africa Mental Heath Foundation (AMHF) can be traced to the unique and singular success of the Department of Psychiatry, University of Nairobi in training psychiatrists for Kenya that made Kenya to have the best psychiatrist: population ratio in Africa South of Sahara and outside South Africa. “Singular” because Kenya has only one centre for post graduate training in Psychiatry as opposed to some countries that have several centers. South Africa has nearly ten departments that have a post-graduate program and Nigeria well over 30 training centers. Prof David M. Ndetei oversaw that training and its success against enormous odds.
When time came to reflect on that “success”, it was clear indeed, the success was more apparent than real. The ratio has remained 1:500,000 over 15 years (as compared to 1: over 1 million in the rest of Africa South of the Sahara and outside South Africa) despite all the sustained effort and resources. Due to internal migration in the country, nearly all the psychiatrists are concentrated in the urban areas. Further, a significant proportion of those psychiatrists was and still remains in private practice, providing services to only those who can afford them. In the process, majority of Kenyans were, still are and will remain without access to a psychiatrist. In most regions outside the urban areas there are more than 1 million people without a single psychiatrist. It was also apparent that this situation was likely to persist into the foreseeable future and it is unlikely that it would ever match what is already available in the Western countries.
It would be unethical and even immoral to surrender and abandon the millions of poor people without access to psychiatrists to their fate. Therefore, while continuing to train psychiatrists, it was also necessary to find other ways of meeting the needs of the poor with mental illness. This required the collective effort of mainly philanthropists and well-wishers who would donate their time and expertise to this course – regardless of their stations in life and professional backgrounds – to offer whatever they could offer, depending on their persuasion.
The concept of AMHF was concretized in 2000. The inaugural lecture by Prof. David M. Ndetei (read more) in 2001 provided the opportunity to reflect further on this concept. The problem was how to go about it. As fate would have it, opportunities presented themselves – mainly through the most unfortunate and sad incidents.
There had been high profile incidents such as the Nairobi American Embassy Bomb Blast and a Kenya Airways plane crash that had received high profile response from global mental health fraternity, probably, because there were both financial resources and opportunities for limelight. In 2002 there was a fire tragedy in which 67 school children were burnt to death. However, in the case of that school fire tragedy there were no financial resources available to make a response and indeed the responders in the other incidents remained dormant. We managed to assemble a group of volunteer health workers to make a response and also to document the response and the lessons learnt (read more) . That mental response cost Kshs.5,000,000 million (about 67,000 US dollars that time) – a lot of money that time but this was all donated in kind through expertise and services by various Kenyans through the nascent Africa Mental Health Foundation (AMHF) and mainly by Prof. Ndetei’s students. The University of Nairobi hosted the Launch of that report, which is also available in this website. It was then decided to formalize this loose association that hitherto had only existed as a mental concept, into a Foundation. This came to be in 2004. With that experience, we were able to mount a similar response in a slum area in Kenya following the political clashes after the 2007 general elections. Well-wishers and in particular 50 students from a private university and a smaller number from the public University where I lecture joined hands with us to effect a response without a single cent from public funds.
We have since grown in leaps and bounds. We have this resource centre available to anybody with an interest in mental health. The highest patronage is from students from public and private universities who come to access materials in our collection or meet with a person with certain expertise whether local or foreign. Foreign students come to get exposure into mental health issues in an African setting. We offer free services to the needy who cannot afford services; provide drugs that have been donated in cash and in materials by Kenyans and non-Kenyans who opted to remain anonymous but deposited in a specified pharmacy. More importantly we have moved into research that aims to find the most cost-effective provision of mental health service at grass-root level and up to the family level. The focus also includes substance abuse and neurological disorder.
We have assisted Government bodies and UN agencies to come up with documents that have a mental health component. We are increasingly attracting the attention of other bodies and institutions within and outside Kenya. We were humbled to have been referred to by an anonymous reviewer of one of our papers as “one of the most active groups” in the whole of Africa, I presumed based on productivity as measured by publications. While we appreciate the compliments, that is not exactly what we want to be – we just want to make a difference in the lives of people who otherwise would be resigned to their fate. That is how we would want to define our history.
We have had a most exciting immediate and short history, but most importantly we know where we are going and we also know how to get there and the challenges. Whatever your background and station in life, please come and join us in that walk towards the promise of affordable, available, accessible and appropriate mental health services to all the people.