Mental Health Care in Nomadic Populations: The Case of Kenya

Abstract

Pastoral nomads are members of a people or tribe that has no permanent abode but move about from place to place usually seasonally and often following a traditional route or circuit according to the state of the pasturage or food supply. For nomadic pastoralists, seasonal movement is a part of their cultural tradition as herders of cattle, camels and smaller livestock and a defining feature of their lifestyle. Kenya is home to many pastoral nomads including the Masaai, Turkana, Pokot, Samburu and others. These groups may be semi- or fully nomadic, with recurrent seasonal migration along traditional routes. Though census data does not indicate the exact number of pastoralists in Kenya, there are over 13 pastoralist districts that host about 7–8 million people.

An audit on mental health situation by the Kenya National Commission on Human Rights estimated that out of every six (6) people with a mental illness, five (5) do not receive any treatment. However among the pastoral nomads, considering their mobile lifestyle, systematic surveillance data on the health status is practically nonexistent. Despite the various challenges involving delivery of mental health services in Kenya, efforts are evident which include the launch of the mental health policy, the drafting of the mental health strategy and the ongoing efforts to review the mental health Act. BasicNeeds Kenya has been intervening in mental health care for more than ten years and has gathered some promising practices in the delivery of mental health services to various populations including the pastoral nomads. Some of the promising practices for this unique population include: training of various care providers (health workers, community health workers, traditional and faith healers, among others), creation of extensive mental health awareness, provision of mental health services at community level, formation of support groups, provision of graduated care, provision of vocational skills trainings and introduction of sustainable livelihoods.

The major barrier to advocacy for mental health in general and for pastoral nomadic communities is the lack of data. Some of the recommendations include: inclusion of a section on mental health in demographic and health surveys to a certain the prevalence, review of the mental health information system as well as advocacy for the implementation of policy actions and program interventions for the nomadic people. Collaborative efforts are an essential and sure way to deliver mental health among this group and hence should be embraced. Such should also include use of technology to deliver mental health services among these very isolated populations.