Rising suicide rates among Kenyan medics

In a heart-wrenching incident that has shocked Kenya's medical community and the nation at large, Dr Desree Moraa Obwogi, a 26-year-old medical intern at Gatundu Level 5 Hospital, tragically took her own life.

This tragic event has cast a harsh spotlight on a crisis that has been brewing silently within Kenya's healthcare system: the alarming rise in suicide rates among medical professionals.

Dr Obwogi's death is not an isolated incident but part of a disturbing trend that has left the medical fraternity reeling.

While exact figures are challenging to obtain due to underreporting, the Kenya National Bureau of Statistics estimates that about 1,400 Kenyans die by suicide annually.

However, many believe the actual numbers are significantly higher, particularly among healthcare workers.

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The World Health Organization (WHO) reports that globally, approximately 700,000 people die by suicide every year.

In Kenya, the crisis extends beyond the medical field, with suicide being the fourth leading cause of death among 15-29 year-olds globally. However, the medical community has been particularly hard-hit, with anecdotal evidence and social media outpourings suggesting a growing crisis. 

Dr Omondi, a medical professional, expressed his frustration on social media, stating, "Medical interns need to be paid as per the Collective Bargaining Agreement. We cannot have our interns, who essentially run public hospitals, working for over two months without pay. Dr Moraa's death is a stark example of the desperation permeating the medical fraternity."

The case of Dr Obwogi highlights the extreme pressures faced by medical interns in Kenya. Reports indicate that interns often work shifts exceeding 36 hours without adequate rest or meals, contributing to physical exhaustion and mental strain. Financial struggles, including delayed salaries, add to their burden, with many unable to meet basic needs such as rent and utilities.

Dr Elisha Harry Otieno, Secretary General of the Internship Liaison Committee, emphasizes, "Medical interns contribute approximately 30 per cent of the labor in public health facilities, often under inhumane conditions. The mental health implications cannot be overstated."

 Dr Kipkoech Cheruiyot points out a troubling dynamic within the medical hierarchy. "The hard truth is that often, the greatest challenge for a junior doctor is not the oppressive system, but senior doctors themselves," he explains. Dr Cheruiyot describes a cycle of stress and frustration being passed down from management and senior doctors to their junior colleagues.

The crisis extends beyond interns. Recently, a senior lecturer at the University of Nairobi, Dr Samwel Owino Mwanda, died of suspected suicide in Homa Bay County, underscoring that even those in established positions are not immune to mental health struggles.

Dr Chibanzi Mwachonda, a Senior Psychiatry Registrar at the University of Nairobi and Mathari National Teaching and Referral Hospital, sheds light on the psychological challenges faced by medical professionals.

"The medical environment has its challenges that can impact mental health. It's a very highly stressful environment. It's also traumatic in its own way because of what you deal with every day," he explains.

Dr Mwachonda introduces the concept of "moral injury," a psychological trauma that occurs when healthcare workers are unable to provide the care they know is necessary due to constraints beyond their control. This can lead to feelings of guilt, shame, and helplessness, contributing to mental health issues.

The financial aspect of the crisis cannot be overlooked.

"Lack of payment results in financial distress. When you're unable to pay your bills, when you're unable to have a meal, when you have responsibilities that require finances to sort, then that becomes a stressor," he says. 

Despite the growing crisis, suicide remains criminalized in Kenya under Section 226 of the Penal Code.

“Those found guilty of attempted suicide can face up to two years imprisonment, a fine, or both.”

This law has been widely criticized, with many calling for its repeal, arguing that it further stigmatizes mental health issues and prevents people from seeking help.

Dr Davji Bhimji Atellah, Secretary General of the Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU), calls for urgent action: "We need a comprehensive approach to address the root causes of suicide in our society, particularly within the medical community. This includes improving working conditions, providing mental health support, and destigmatizing mental health issues."

The Ministry of Health, led by Cabinet Secretary Dr Debra Mlongo Barasa, has acknowledged the crisis and pledged to implement measures to support healthcare workers' mental health.

In September 2024, the ministry launched national clinical guidelines to tackle mental health challenges during World Suicide Prevention Day.

Dr Simon Kigondu, President of the Kenya Medical Association (KMA), outlines several initiatives the association has undertaken to support interns and medical professionals. These include enrolling interns into various KMA divisions across the country, organizing committees to deal with physician well-being, human rights, and social responsibility, and providing financial support through internship loans.

However, many argue that more immediate and drastic action is needed. Dr. Mwachonda emphasizes the importance of workplace mental health, suggesting the implementation of mental wellness committees, education and awareness programs, and the creation of safe spaces within healthcare facilities where professionals can seek support.