Dr. Violet Okech is a consultant psychiatrist and counselor at the Kenyatta National Hospital’s (KNH) department of mental health and an honorary lecturer at the department of psychiatry, University of Nairobi. She chairs the KNH adult psychiatry and mental health research services. She previously coordinated training, research, advocacy and outreach work at the KNH gender based violence recovery centre. Additionally, she has represented Kenya internationally in mental health care advocacy and in the professional development of early career psychiatrists on the global World Psychiatric Association Young Psychiatrics Council (WPA-YPC) for four years. This inspiring doctor walks ESTHER KIRAGU through her life.

 It’s a breezy Friday afternoon as I make my way to Kenyatta National Hospital (KNH) in search of Dr. Violet Okech. I was referred to her for this interview by one of her patients who spoke very highly of her. I get lost in this huge hospital that is Kenya’s largest referral hospital. I quickly call a friendly Dr. Okech, who directs me to her office at the department of mental health located next to the KNH dental department.

Despite having just come from a counseling session and feeling fatigued, Dr. Okech engages me in a pleasant conversation. After five minutes of interacting with her, I get the impression that this is one chatty, easygoing doctor who is very different from the staid, stern personality often associated with doctors.

“I have worked at KNH since 1995. I believe my calling is to work at the KNH department of mental health to help bring back the soul into medicine,” she says with deep conviction as we start off the interview.

A brainy child…

Dr. Okech was generally raised by her older siblings. “My late dad, Alfayo Ogol Okech, a pioneer in the postal system, who rose up the ranks to become the first African Postmaster in East Africa, retired from active work as deputy Postmaster General of Kenya, while I was in class two. Mum, Turfena Awuor Okech, had always been a housewife. My primary school years were spent in different schools in my hometown at the Coast and in Nairobi where most of my siblings lived at the time,” she explains. “I managed to become a doctor because of their love and sacrifice.”

From an early age she was a bookworm and recalls borrowing books from the library while in primary school and reading them overnight for amusement. I just enjoyed mopping up knowledge,” she says adding that her late dad’s encyclopedia made an interesting read for her.

Additionally, she loved music and even requested her late dad to buy her a ballet outfit in the hope that she would one day learn ballet, she recalls with much humour. Dr. Okech emerged as one of the top students in the Coast region in the certificate of primary education (CPE), warranting admission to the prestigious Kenya High School in 1982.

At Kenya High, she was an all-rounded student, enjoying music, poetry, drama and sports, as equally as her studies. Probably in recognition of her love for books, she was appointed school library prefect. She also learnt to play the piano and says school was generally bliss for her. It was in high school that her fascination with the human body struck.

“I often wondered what made a human being tick. At around that time, my mum started suffering from high blood pressure and I became curious about how doctors diagnose illnesses and treat patients,” she explains.

Because of her mother’s illness, Dr. Okech wished to study medicine to help her mother and other people suffering from various illnesses but didn’t do as well as she expected in the A level examinations due to constant migraines. She repeated the class and re-sat the examination in order to fulfill her ambition. The second time round she passed very well and got admission to the University of Nairobi to pursue a bachelor’s degree in medicine and surgery. She joined the university in 1989.

Getting into the medical profession…

“Medical school was tough and for the first time in my life I had to work really hard to maintain good grades. Everyone was smart and I was, therefore, competing with very bright students. The first year was particularly difficult and intense that I contemplated quitting and instead studying music and German but my family talked me out of it,” she says.

She soldiered on and by the second year she had found her footing and even created time to study German at the Goethe Institute in Nairobi where she emerged as the top student earning herself a certificate in German as a foreign language.

Dr. Okech successfully completed her five-year medical course and was employed at KNH in 1995 as a general physician. She worked in the casualty and other departments for a few years before moving on to the KNH staff clinic. She was invited to join the psychiatry department of KNH as a medical officer in 1998, an opportunity she took up gladly, feeling psychiatry was more inclined to look at an individual holistically.

“When I was a general physician at KNH my queues were often the longest because I would take a bit more time to get to know about the patient’s general welfare before treating them. I realised my patients’ health improved faster because talking in itself is a form of therapy,” she says.

In addition to working at KNH, Dr. Okech has earned admission rights in various hospitals over the years, where she also treats patients. These include The Mater Hospital, Avenue Hospital, Nairobi Women’s Hospital, Mariakani Cottage Hospital, Coptic Hospital and Chiromo Lane Medical Centre.

Soaring high…

In 2004, Dr. Okech was nominated by the Kenya Psychiatric Association to represent the country at a meeting of the World Psychiatric Association Young Psychiatrists Council (WPA-YPC) in the US. This is a worldwide body formed to bring together early career psychiatrists from various countries to share experiences of mental health care in their countries and how to improve it. She was the only psychiatrist from Africa at the meeting.

“The conference was a great opportunity and I found it so enlightening that upon my return to Kenya, I organised a meeting with early career psychiatrists from Tanzania, Uganda and Kenya to share with them some of the knowledge I had gained from the conference. We then formed the Eastern Africa Association of Young Psychiatrists and Trainees (EAYPT) where I was elected founding president and worked with an amazing team of colleagues to launch the organisation,” she says.

This body has now expanded to include early career psychiatrists from Ethiopia, Rwanda, Burundi and Sudan. They share their experiences on training and research in mental health care in their respective countries, forge ways to improve it and do collaborative research. Many members of the EAYPT are making a difference in mental health care in Eastern Africa.

Over the years, Dr. Okech has done various studies, researches and published articles on mental health care. Her volunteer public mental health service earned her a Fulbright scholarship to the prestigious Johns Hopkins Bloomberg School of Public Health in the US, where she earned a fellowship in Public Mental Health and Policy. She also graduated four months ago with a Master’s in Public Health from the same University and returned to Kenya to use the skills and knowledge acquired to help patients. She attributes her success to God, great family support and outstanding professional mentors like Dr. Frank Njenga, Professor Joshua Kayima, Dr. Margaret Makanyengo, Dr Pius Kigamwa and Dr. John Ong’ech.

She belongs to various membership bodies including the Kenya Psychiatric Association (KPA) where until 2012 she served as the national vice-chairperson, the first woman to hold this position in Kenya. She is also a certified HIV counselor, rape trauma counselor and is one of the first sexual assault forensic examiner’s (SAFE) trained in Kenya.

Not all rosy…

Although Dr. Okech acknowledges that great strides have been made in the health profession in Kenya, she asserts that if everyone played a role then health systems in the country would be much better. “I wish Kenyans would be more proactive in talking about and demanding good health care from public hospitals instead of sitting and grumbling about it at home in hushed tones,” she says asserting that every Kenyan is entitled to good health care.

She recommends private-public partnerships to help improve general health care in Kenya. “I dream that one day we will have initiatives such as ‘Adopt A Ward’,where individuals and corporates partner with public hospitals in adopting a ward and bridging gaps to improve care, as a way of giving back to society,” she says. At the same time she urges the government to empathise more with the needs of medical practitioners and especially nurses who she says are the backbone of care in any hospital.

In the midst of this interview, Dr. Okech discloses that having to deal with living with asthma, chronic fatigue syndrome and depression at a personal level has helped her empathise more with her patients. She had to address her own stigmatising beliefs and those of others in order to accept the need to take medication so as to keep her body, soul and spirit strong and fulfill her calling. She admits that her job is quite demanding because people share with her intimate issues and she therefore goes through therapy to avoid vicarious trauma related to distress as a result of witnessing other people’s suffering and need. This is required of all counselors.

She encourages Kenyans to be more open to the idea of consulting psychiatrists and says that she recognises many people are apprehensive to the idea of spilling one’s gut to a stranger. She is especially interested in improving women’s mental health care and reducing stigma related to HIV. Currently, she is in the process of initiating a support group for people who live with depression.

 Success story…

Dr. Okech urges Kenyans to have faith in public hospitals and especially KNH explaining that there are checks and balances put in place to ensure a patient is taken care of by a set of qualified and accountable medical professionals. She narrates with pride one of the many success stories of her patients.

“Not long ago, a patient was brought to KNH by her family suffering from severe depression. Although she had been treated in various other hospitals for two years, there seemed to be no change to her condition and she had remained bedridden throughout this period. A few months after treating her, her sister came to thank me, saying that the patient had made a tremendous improvement and could now walk, talk and engage in her daily living activities. It is such stories that inspire me to do better, touch at least one life and make a difference in the society,” she says, adding that everyone has their own rhythm and they can make a difference wherever they are.

On family life…

Dr. Okech is engaged to Samuel, an economist. “He is one of the kindest, most loving, principled and generous people I have come across,” she says dotingly. The two plan to walk down the aisle soon. “I look forward to this new chapter of my life as a wife and mom,” she says elatedly.

She says she is privileged to work in the medical profession. “My dream as a Christian and Kenyan doctor is to provide the best medical care anyone would look for in the world, with God’s help,” she says in conclusion.

Published in September 2013