Social risks, economic dynamics and the local politics of COVID-19 prevention in Eldoret town, Kenya.

A steady and consistent national and local government leadership is crucial in times of crisis. The trust in government - which can be so fragile - was strong in Eldoret town, a large municipal in western Kenya widely known for ethnic conflicts. In our interviews with 20 business people and 30 community members from Eldoret town, we found that the trust built early in the pandemic was broken due to individual leaders who eventually dismissed public health promotion and engaged in politics and corruption of funds for COVID-19 relief. When leadership was strong, locals in Eldoret town (and especially business owners) engaged in public health prevention measures for the greater good. But when leadership slipped, people complained and eventually ignored public health prevention measures at home, on the bus, and in businesses around town, causing the intensification of outbreaks. This was most common among those engaged in the formal economy as those in the informal economy were more likely to mistrust the government altogether. We show who falls through the cracks when government policy targets viral threats and suggest how local government and public health agencies might work to control COVID-19 infections while ensuring that all Eldoret residents are cared for.

Factors that influence the choice of psychiatry as a career by medical students at the School of Medicine, College of Health Sciences, University of Nairobi.

The aim of this paper is to assess the particular factors facilitating and those hampering the choice of psychiatry as a career by medical students at the University of Nairobi in a cross-sectional population study of medical students at the University of Nairobi, College of Health Sciences, School of Medicine using self-administered questionnaires. A total of 31 students (13%) said they would like to be psychiatrists while 44 (18%) were neutral and 170 (69%) did not want to become psychiatrists. The factors that made psychiatry interesting for the students included the view that the problems presented by psychiatric patients were often particularly interesting and challenging and the fact that mental illness presented the field of medicine with one of the greatest challenges. Discouraging factors articulated by the students included views that psychiatry was a vague and speculative speciality, psychiatry was not an important part of the curriculum in medical schools, and psychiatric patients tend to make more emotional demands on their doctors than other patients. There was a negative view of psychiatric patients who most of the students thought were strange, dangerous and incurable, although they were curious to know more about them. Most of the negative influence in psychiatry is due to the misconceptions that students have about its prestige and scope, the rewards it offers in terms of job satisfaction and opportunities and the negative views towards psychiatric patients. Integration of psychiatry into the curriculum may address these misunderstandings.