Rising drug abuse, and a surge in alcoholism since the post-election violence, has seen many Kenyan families struggling to cope with the costs of addiction, with only a handful turning to the city's mixed range of clinics and rehabilitation options, @home reports.
Drug addiction has been a rising problem in Kenya for several years, as hard substances, such as heroin, are moved from Asia to Europe via East Africa, often stopping in Kenyan hands. The UN estimates that even in 2007 there were anything from one hundred thousand to 1.3 million East Africans who had used heroin. But treatment clinics concur that numbers have surged sharply this year and last year.
“Kenya used to be just a trafficking route, but now it is both trafficking and using,” says Amalia Mbugua, an outreach co-ordinator from the Nairobi Place Addiction Treatment Centre, in the wealthy suburb of Karen.
Yet, alcoholism is the main addiction treated in Nairobi. According to the Nairobi Place, alcoholics make over 46 per cent of all the 231 patients they have treated since opening in 2004.
It is unlikely the trend will change in the near future. Africa has the second highest growth of beer consumption after Asia, with a compounded annual growth rate of 6.4 per cent over the past five years, according to beer brewer SABMiller’s 2009 annual report.
With economics in play there is little government appetite to stem Kenya’s drinking culture. “Kenya Breweries is one of the biggest tax payers, so no one can do anything,” argues Ms Mbugua.
Within the ambient forest surroundings of The Nairobi Place, a number of professionals are also being admitted for addiction to prescription drugs. With a lax pharmaceutical industry, prepared to turn a blind eye to a lack of a doctor’s note, Kenya’s business classes are increasingly using medicinal drugs to combat stress levels.
“People who have really high powered job positions, such as general managers and chief executive officers, get the stuff and which leads to too many valiums, then after a time they are self medicating.”
As for illegal drugs, cannabis is the most popular, particularly among younger Kenyans. An estimated 4.5 to 9 million East Africans between the ages 15-64 used it at least once in 2007 according to the UN.
By far the coast, a main transit point, is where harder drugs reign supreme. “Just by the fact that it is by the sea most people in Mombasa use designer drugs rather than alcohol…though Nairobi is increasingly becoming a designer drug destination,” claims Ms Mbugua.
Indeed, after alcohol, heroin users were the next biggest segment coming for treatment in 2005. Accounting to nearly 38 per cent of all cases, cannabis was a mere point below, while cocaine accounted for nearly one in ten cases of illicit addiction.
While drugs are cheap and accessible, the treatment for addiction is not. The Nairobi Place makes no qualms that it is a professional centre modelled on successful international rehab programs. It charges Sh426,000 for its eight week program, including medical costs.
The proportion of their patients that stay successfully sober after the program is around 60 per cent for the first three months and 30 per cent for the first year. In America most centres have an average success rate of 2-20 per cent for a year without relapse.
For affluent local families it offers an alternative to shipping their addicted relatives off to more established centres in South Africa or further abroad. Patients come from Europe and pan-Africa to enrol at the Nairobi Place and follow the twelve step Alcoholics Anonymous program, accredited globally as the most successful method in beating addiction.
Most of Kenya’s rehab centres are focused on the support of the immediate and extended family, not only for the financing patient care, but also as an African alternative to the traditional half-way house system for gradual re-entry into the real world.
It allows many families to come to terms with the addicted relative. “[The families] are sicker than the addicted person. When you have an addict in your family your life stops, you become addicted to the addict…they need to get a life outside of the addict,” explains Ms Mbugua.
Treatment is mainly a male affair. Noticeably there was a lack of female patients at most of the centres visited by home.co.ke. Three was the highest number that one facility had ever housed at any one moment. The Nairobi Place had the highest proportion of female patients that had gone through their program, accounting for nearly a third of those treated.
The problem is cultural says Ms Mbugua, a recovering alcoholic herself. Many alcoholic African women are labelled as prostitutes, so harsh is the stigma around female addiction. While men have more leeway to leave the family to get treatment, women are often expected to stay and look after their children, or are hidden away entirely out of shame.
“That really gets to me. The African culture is that women do not drink or get drunk, it tends to hide them. By the time they come in for treatment they have had so much brain damage…in most cases women will die from addiction,” said Ms Mbugua.
A new breed of professional and independent Kenyan women now in their thirties or forties are coming forward for treatment at Nairobi Place, as friends and families become more understanding about addiction as a disease.
But it is a very different story across the city. Outside the plush greenery of Karen, across Nairobi’s heavy afternoon traffic, young boys aged around 10 wearing dirty ragged clothes dodge through the cars, holding semi-concealed pots of glue in their sleeves taking an occasional sniff. Nearby, just North-West of the city centre sits the only state funded centre for drug rehabilitation in Kenya, on the edge of the Mathare slum.
The Mathari Hospital Drug Rehabilitation Centre is a small compounded area, able to house 37 in basic small rooms. There is one group counselling room where the exclusively male patients write poems and sketch artwork about coming to terms with their addictions. No female ever stays there despite there being two wards designated for both sexes. Most women are treated for addiction in the hospitals mental health wards.
That ward is nestled on the edge of one of the most violent slums in Kenya, and home to a large number of drug abusers. Cheaper than any of the private clinics, it is still unlikely that any of the slum dwellers will ever visit the government treatment centre.
After the Sh5,000 deposit, Mathari Hospital charges Sh200 per day for a three month course, Sh1,200 if you don’t have a National Health Insurance Fund card, a luxury item for most in the slum.
“Demand is so high, but it is the cost that prevents people from coming,” says Nancy Nganga, the head addiction counsellor. “If anything [the slum residents] are the majority who really need these services.”
The typical patient is usually a civil servant or a self-employed worker. Cheap local brews, costing as little as Sh10, are the drink of choice for those admitted to Mathari. Patients addicted to cannabis are often referred to rehab from the hospital’s psychiatric wards.
Ms Nganga has seen a rise in the number of addicts this year, blaming increasing unemployment due to Kenya’s poor economic climate. The centre now has 10 new patients a month on average, compared to eight when it opened in 2003, as more turn to drugs in the face of financial hardships.
It is not certain how successful Mathari’s program is, as outpatient service is poor.
“That is where we are failing, they come back for follow ups but they go to different wards that don’t understand their problems.” At least 20 per cent of addicts come back to the clinic after relapsing.
There is also very little collaboration between the hospital and the government National Agency for the Campaign Against Drug Abuse (Nacada).
“How many people know of Nacada? I have been here for a year and they have never visited,” says Ms Nganga.
Yet, speeches and pledges have been made to sort out Kenya’s growing struggles with drugs. “We must build rehabilitation centres and seal the entry paths of drugs,” said Jennifer Kimani, the national co-ordinator for Nacada, in December last year.
According to Ms Nganga there is little being done to improve and expand on the work pioneered at Mathari. Others involved with Nacada’s work told home.co.ke that the agency is only interested in stemming the flow of drugs, not helping exiting addicts.
But the government is failing even at this, says Dr Peter Njagi, founder of the second oldest private rehabilitation centre in Kenya, the Brightside Drug Abuse Rehabilitation and Treatment Centre, which opened in 1998 on the calm and peaceful hills in Kitisuru.
Four years ago Dr Njagi had never treated a case of cocaine addiction, but no more. He has recently seen more cases of hard drug use in the over four hundred patients he has treated.
“There is availability because of poor security after the post-election clashes. The Government have been weak and criminals have found ways to get through,” he says.
Outside in Brightside’s grassy courtyard, around 20 staff and patients sit in shirts, suits and ties in group counselling sessions. In their breaks they laugh as they play pool and watch television.
At Sh1, 500 a day for an average course of four months, the centre caters for Kenya’s distinctly middle-class. Appearances are deceptive; Brightside insists its patients scrub up and look respectable in order to help them clean up their lifestyle. Drug addicts are rarely clean individuals, says Dr Njagi, neither does it matter if they have a job to fund their habits.
“The addicted person will always buy; money is not an issue…most people here are criminals.”
For many Kenyans the criminality that comes with addiction will continue to be untreatable due to money barriers and higher national priorities, such as political stability, food and drought, and general health treatment.
Despite pessimism from many in the sector, Dr Njagi, however, believes that the next few years could see a bigger government focus on drugs and combating addiction.
“Drug abuse treatment is coming of age in Kenya…drugs have become the problem of this century.”
Written by Chris Kay for African Laughter