A case was escalated to a chief in Njoro Sub County,Nakuru County.

A husband complained that his wife does not allow him to enjoy conjugal rights.

In her defense, the wife said she had undergone Female Genital Mutilation (FGM), and hence she is not always in the "mood."

She also complained that the nagging from her husband had also led her to have Mental Health issues since she had no control over it.

FGM refers to the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons.

It is recognized internationally as a human rights violation and a harmful practice that affects the health, dignity, and well-being of women and

girls.

Culturally, in their community, it was an obligation for women to undergo, and men were advised not to marry women who had not undergone FGM.

The Chief advised the man that the procedure could not be reversed, and his community advocated for it despite the Government's efforts to end it.

He asked the man if he was aware the wife had undergone FGM before marrying her, which he said he was aware of and said in their culture, it meant the woman was ready for marriage and those not circumcised were despised.

The Chief explained the health consequences of FGM, which include immediate effects such as Pain, excessive bleeding, infections, and even death, and long-term effects such as Chronic pain, menstrual and urinary issues, complications during childbirth, sexual dysfunction, and psychological trauma.

He further explained the legal consequences and offenses under the Prohibition of Female Genital Mutilation Act, 2011, which forms part of Sustainable Development Goal (SDG) No. 5 on Gender equality.

Other laws include the Marriage Act (2014), the Sexual Offenses Act (2006), the Children Act (2022), and The Constitution of Kenya (2010).

Other measures the Government is using through the National Government Administrative Officers (NGAOs) in responding to the vice include Community education to challenge cultural norms, Legal enforcement to deter practitioners, support and rehabilitation for survivors, and Advocacy campaigns to raise awareness about its harmful effects.

The case was later referred to healthcare workers for further interventions.

This scenario was discussed during a MIDRIFT HURINET-facilitated engagement forum on Mental Health and Violence Prevention with chiefs and Assistant Chiefs from Njoro Sub County, which also served as an observance of the 16 Days of Activism against Gender-Based Violence.

The role of chiefs in addressing mental health is indispensable for creating a supportive environment at the grassroots level.

Their influence ensures that mental health becomes a community priority,breaking barriers to access and fostering resilience among individuals.

As trusted community leaders, chiefs are uniquely positioned to combat GBV through education, advocacy, legal enforcement, and community mobilization.

By leveraging their influence, they can create safe, supportive environments that empower survivors and prevent future violence. Collaboration with health professionals and organizations is essential to ensure impactful and sustainable efforts.

They also leverage grassroots networks to identify individuals showing signs of mental distress or disorders.

During the forum, emerging issues on Gender-Based Violence and Mental Health, such as youth mental crisis, mental health & gendered impact as a result of climate change, technology-facilitated Gender-based violence, economic inequalities driving GBV, intergenerational violence and inadequate legal awareness on laws protecting against GBV formed part of the discussions.

Participants agreed on the need to enhance youth-focused mental health programs, work closely with stakeholders to provide PFA and mediation on resource-based conflict, create awareness on responsible use of digital tools and combat cyberbullying, support women's empowerment initiatives, promote community education on breaking the cycle of violence and create more awareness on legal rights and procedures for reporting GBV.

The role of chiefs in addressing health issues in Kenya has deep historical roots, evolving alongside the country's governance structures and health priorities. Chiefs have traditionally been vital links between the government and local communities, leveraging their influence and leadership to promote public health initiatives.

Below is an overview of the historical nature of their involvement:

In the Pre-Colonial Period, chiefs were community leaders chosen based on age, wisdom, or social standing. Health matters were primarily addressed through traditional medicine and practices led by herbalists, midwives, and spiritual leaders. Chiefs supported these efforts by maintaining harmony and facilitating access to local healers.

In the Colonial Period, Chiefs became formal agents of the British colonial administration under the Native Authority Ordinance. They were tasked with implementing colonial health policies, such as Sanitation Campaigns, controlling outbreaks of diseases like smallpox, malaria, and sleeping sickness through forced vaccinations and quarantine measures, and Promotion of Western Medicine.

In the Post-Independence Era, Chiefs retained their administrative role under Kenya's centralized Government. Key responsibilities in health included Supporting immunization campaigns, Mobilizing communities for maternal and child health programs, and Overseeing public health projects, such as building dispensaries and ensuring water sanitation.

Chiefs worked closely with public health officers to address disease outbreaks, particularly in rural areas.

The emergence of HIV/AIDS shifted the focus of health interventions. Chiefs were instrumental in Awareness Campaigns: Sensitizing communities about HIV transmission and prevention. Stigma Reduction: Encouraging open dialogue and acceptance of affected individuals and Support for Orphans and Vulnerable Groups: Chiefs coordinated support for children orphaned by the epidemic and facilitated access to healthcare and counseling.

With the 2010 Constitution and devolution, chiefs' roles in health have become more collaborative with county governments.

Modern responsibilities include:

Community Mobilization: Chiefs rally communities for health campaigns, such as COVID-19 vaccination drives and malaria prevention programs.

Behavior Change Advocacy: Chiefs address cultural practices that harm health, such as FGM, early marriage, and stigmatization of mental health issues.

Conflict Mediation: Chiefs help resolve health disputes, such as water and land conflicts that disrupt access to clean

resources.

Health Policy Implementation: Chiefs ensure compliance with public health regulations, including sanitation, vaccination mandates, and disease control measures.

Key contributions over time are that Chiefs act as trusted figures who bridge the gap between government policies and local traditions. They use their authority to enforce health regulations, sometimes through punitive measures but increasingly through education and dialogue. Their influence in addressing health issues is bolstered by their intimate knowledge of local contexts, enabling targeted interventions.

Chiefs can lead efforts to create safer, healthier communities by combining their authority with modern tools and partnerships. Their proactive involvement in addressing GBV and mental health issues will promote healing, equity, and resilience at the grassroots level.

They can achieve this by  Keeping records of GBV reports and mental health outreach to identify trends and gaps, Regularly engaging the community to assess the impact of interventions and adapt strategies, and Lobby for the establishment of safe houses, counseling centers, and rehabilitation programs in the community, Request government and NGO support to train chiefs and village elders on handling GBV and mental

health cases, Leverage social media, SMS campaigns, or local radio to spread messages against GBV and raise awareness of mental health resources & use technology to monitor and report GBV cases and mental health crises.

They can also Provide emotional and practical support to survivors, including helping them reintegrate into the community, encouraging people to seek professional help for mental health issues instead of viewing them as a weakness or curse, taking an active role in protecting children from GBV-related practices like FGM and early marriage and Establish partnerships with local hospitals, counseling centers, and legal aid organizations to refer victims and those in need of mental health support.

By

Jacob Karani