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Doctor passionate about helping patients of mental illness, post-traumatic stress

 Professor Lukoye Atwoli, the Dean of students Moi University and also a consultant psychiatrist during the interview. [PHOTO/STANDARD]

Does the body rule the mind, or does the mind rule the body?

The relationship between mental and physical symptoms is key in understanding human behaviour. Prof Lukoye Atwoli is among less than 100 psychiatrists in Kenya, a medical practice marred by suspicion and prejudice.

“There is a general misgiving and rumours on psychiatry as a medicine specialty but it is an interesting field that goes beyond treating ‘mad’ people,” he says.

He sits at the helm of the Moi University School of medicine and is the youngest dean in it’s two-and-a-half-decade history, after 10 years of teaching and research.

The 38-year-old fell in love with the profession when he was gifted a psychiatry book by Indiana University Exchange programme director Joyce Dobson during his fifth year in Medical School.

And when the time to specialise came, he applied to begin a Masters in Medicine for the psychiatry option at the University of Nairobi, where he was immediately accepted but did not have funds to pay the fee.

He worked for one year as a medical officer in charge of a sub-district hospital in Olenguruoni, in Nakuru County, before the government offered him a scholarship.

Prof Atwoli’s fascination with the human brain was nurtured in medical school during an elective neurosurgery rotation at the Indiana University School of Medicine in the US.

However, this was dampened because surgery undertaken by trainees on other parts of the body took longer before graduating to study the brain.

“During our neurosurgery rotation, we spent most time working on the back and repairing prolapsed spinal discs and I couldn’t wait to get to know how the human brain functions,” Atwoli told The Standard on Saturday in an interview in Eldoret.

Develops suddenly

One of the most gratifying moments in his psychiatry practice is treating patients with conversion disorder using psychotherapy and successfully restoring functionality in about 45 minutes.

Conversion disorder is a mental health condition where a person may develop blindness, paralysis, or other nervous system symptoms that cannot be explained by medical evaluation.

Atwoli says the condition develops suddenly after a stressful event or trauma, whether physical or psychological with the physical symptoms are thought to be an attempt to resolve the conflict the person feels inside.

One of the highlights of his one and a half decade career is a young man aged 28 years who had been neglected by his family due to schizophrenia, a condition that affects how a person thinks, feels and acts and may experience hallucinations.

Unkempt, his family had let him wander off in the streets because he had been labelled ‘mad’.

But after sessions with Atwoli, he was placed on treatment and the change awed the family. “He came for his third appointment, adorned in clean clothes, clear state of mind and coherent speech,” he recalls.

Atwoli has intensively studied, undertaken research and published 29 journal articles, at least 23 conference papers and is an author of several book chapters.

He admits that the greatest challenge in research is funding. “Universities need to focus on the dual goal of training both specialists in respective fields and also nurture researchers to drive local solutions to our problems,” Atwoli says adding that those externally funded studies focus on the sponsor’s interest that the student has to concentrate on to receive the grant.

Some young researchers get discouraged along the way and drop out and concentrate on other gratifying ventures like medical practice rather than combine it with research.

Over the years, his medical research has centered on explaining mental health conditions among Kenyans to create a better understanding of a society with little knowledge on this rarely researched specialty.

In one of his 2010 papers titled, General medical conditions among patients with mental illness, published in the East African Journal, Atwoli showed patients with severe mental illnesses suffer from a huge burden of general medical conditions like HIV and Aids, congestive heart failure and diabetes.

“Mental illness makes people less likely to take precautions or seek early treatment whenever they are exposed to infectious agents, and mentally ill patients often present late when the infection is more advanced,” he notes in the research. He notes that the relatively high occurrence of these medical conditions among the mentally ill is the constraint in provision of mental health services until it is too late and complications have set in.

“If their mental disorders seriously affect communication and social interaction, these patients may not receive medical health services,” he said calling for integration of mental health care, the investigation and treatment of these medical conditions.

One of his most intriguing research papers was his Master’s thesis, which was a 2006 study on post-traumatic stress disorder among Mau Mau concentration camp survivors in Kenya of 181 survivors aged 58 and 97 years. The study found out that seven of ten survivors interviewed had Post Traumatic Stress Disorder for life with six out of ten of them still experiencing symptoms.

“Better screening of these survivors and other war veterans of armed service is necessary to diagnose and manage any psychiatric and other health problems they may have,” read excerpts of the study with recommendations that special Veterans’ Service be established to address these issues.

Titled, An overview of suicidal behaviour in Africa, In Contemporary Psychiatry in Africa: A Review of Theory, Practice and Research, Atwoli authored a chapter in a book whose editor is respected Kenyan psychiatry researcher Prof David Ndetei.

Other books he has contributed sections to include the African Textbook of Clinical Psychiatry and Mental Health and Your A-Z on Mental Health, whereas his journal publications have touched on post-traumatic stress disorders amongst orphans in western Kenya, nutritional status of orphaned and separated children and adolescents living in community and institutional environments in Uasin Gishu County, amongst others.

His medical students at Moi University in various years of training were also participants of a study looking at the rates of Attention Deficit Hyperactivity disorder (ADHD- a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness) symptoms and had 253 undergraduate interviewees.

“The prevalence rate of self-reported ADHD symptoms among medical students in Eldoret is high and possibly interferes with the students’ social and academic functioning,” the study concluded after finding a 24 per cent prevalence and recommended a detailed research in special populations like schools and colleges. Born in Ebuchero village in Kakamega County, he enrolled in a nursery school near their homestead.

“At four years, I wasn’t contented seeing other children attending school while I stayed at home so I walked to the nearby school, asked the teacher to allow me to sit-in for that lesson and the next. I have not left school till today,” he says.

He studied at Eastleigh Airport Primary school before he proceeded to Jamuhuri High School after scoring 553 marks out of the possible 700 marks.

Atwoli then scored an average of grade ‘A’ in the KCSE examination in 1993. “Studying medicine was my first choice, but I got a shock when my first day at medical school I saw the ‘humble’ buildings that begot this country’s doctors,” he describes his initial day at Moi University.

He is currently pursuing his PhD at the University of Cape Town and cites his mentors in this area of specialty as widely published researchers Prof David Ndetei, Dr Frank Njenga, Prof Karestan Koenen from Columbia University in New York and, Prof Dan Stein from the University of Cape Town.

He also draws inspiration from Prof Norman Sartorius from Croatia on leadership, Nelson Mandela and Mahatma Gandhi for his non-violent protestations of his beliefs.

Atwoli says his conspicuous blot of white hair, is genetic in the male lineage, adding that he looks forward to a silvery look in coming years, similar to that of African literary giant Wole Soyinka. “It helps me fit in especially when I am among older colleagues with more skill and practise,” he says. He is the only medical doctor in a large family with lawyers, a pastor, economists, and international relations experts. That the Central Organisation of Trade Union Secretary General Francis Atwoli is his father settles well with him adding that the pair have both made a mark in their respective areas of specialisation, thus none can lay claim on the advancement of the other.

“He brought us up to fight for what we inherently believe in. For me, mental health activism to improve lives of Kenyans, is my piece of cake and so far, I have seen the improvement in the policy and practise of an area that was largely neglected ten years ago,” he said.

Away from work a game of Chess keeps his brain busy, nurtured from early involvement in the game as a university student.

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