Heather Susan Ruturi
H.S. Ruturi. Hubert H. Humphrey Fellowship Program, Bloomberg School of Public Health, Johns Hopkins University, United States; Kenyatta National Hospital, Kenya
Objectives: The objectives are to show the state of current substance use in Kenya and to describe what makes it important for Kenyatta National Hospital (KNH) to establish an intensive outpatient treatment center.
Current situation: The National Survey on Alcohol and Drug Abuse conducted by the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) in 2012 indicated that 3.3%, or a total of at least 4 million Kenyans, currently consume alcohol. About 16.8% of the males are current users of tobacco products. Marijuana use is at 1.2%, and the current prevalence rate of cocaine is 0.1% in Kenya. About 1 in 10 Kenyans are either abusers of or dependent on alcohol, 4% are abusing tobacco and 5% are dependent on tobacco use, 2% are abusing or dependent on miraa, while 0.4% are abusing or dependent on bhang.
KNH is the main referral and teaching hospital in Kenya. No staff is trained in motivational interviewing at the A&E Department; neither do we have skills in detecting or differentiating toxicity/withdrawal versus medical conditions. The NACADA rapid assessment survey indicated lack of rehabilitation services. Associated with this is lack of treatment facilities. Current services are provided in two aspects: either government/private health hospitals or rehabilitation centers.
Recommendation: Establish a specialized intervention for substance abuse; a center set aside for intensive outpatient treatment would be most appropriate. Strengths: Established Mental Health Department with psychiatrists and staff trained in psychological care, support from administration to establish a psychiatry ward, strong ties with the University of Nairobi and other institutions of training, and amicable relationship with the government and regional hospitals.
Process: Establishing the center will require the following: (1) Involve stakeholders, that is, the management board of KNH, the government, NACADA, community leaders, interested supporters, and donors among others; (2) train staff and develop the treatment protocols; (3) advertise; and (4) establish an effective referral system with other hospitals and the rehabilitation centers.
Expectations: (1) There will be reduced prevalence of alcohol and drug abuse following availability of treatment; (2) prevention of morbidity and mortality; and (3) opportunity for training and research.
Conclusion: There is need to establish a treatment center at the nation’s referral and teaching hospital.