Stress and burn out, the silent killer hiding in Kenyan offices

It is a quiet night in Nairobi and Selina Kemama is fast asleep. She is likely dreaming of friends or work, or a new dish she will cook for her family this weekend.

Suddenly, a shrill ringing pierces the silence; somebody is calling her mobile phone. As she fumbles to find her device in the dark, her eyes meet the glow of a digital clock, which tells her it is 3am.

“ICAS Kenya,” she answers. “My name is Selina.” On the other end of the line, a woman is crying. She cites financial burden and marital conflict as the source of her dismay.

“Talk to me,” says Selina. “I am listening and anything you tell me will be very confidential.”

FINANCIAL BOOM

Selina is the managing director of the Independent Counselling and Advisory Service Organisation (ICAS) in Kenya, which provides personal support programming to corporate clients, 365 days a year. The branch opened its doors in March 2013, and already, business is booming.

“There was need for the employee wellness programmes,” Selina explains. “It’s pretty new... the market... but it’s picking up.”

The reality is that workplace stress is mounting in Kenya and more and more people are seeking a solution to what has been dubbed “the stress epidemic.”

Over the last 10 years, Kenya has blossomed with an average economic growth of 4.8 per cent per year. In 2008, the World Bank estimated more than 17,896 new businesses were registered in the country, up from 6,678 in 2004.

The financial boom may have asserted Kenya’s position as an East African commercial powerhouse, but experts believe it has also led to an explosion in occupational stress.

WORKING LONGER HOURS

Selina blames the source of the new surge on “innovation and competition”, explaining that “there is technology, there are new products coming into the market and because of that, you’ll find the stress levels are quite high”.

In fact, there appears to be little empirical research on occupational stress predating 2007, when Kenya experienced its biggest economic boom within the last decade.

Since then, stress studies have been quite common in academic institutions, including Kenya Methodist University, St Paul’s University, Moi University and the Jomo Kenyatta University of Agriculture and Technology.

Research has revealed work overload, lack of career advancement, difficult co-workers, job insecurity and financial constraints as major contributors to workplace stress.

“Recent trends have made it increasingly difficult for employees to adequately balance the responsibility of their jobs and their families as employees are working longer hours and bringing more work home at night,” states a 2013 report by the University of Nairobi.

VARIETY OF SYMPTOMS

Last year, three of UoN’s business researchers studied 32 corporations listed in the Nairobi Securities Exchange to evaluate the relationship between stress and performance.

Survey participants reported experiencing a variety of physiological symptoms as a result of their stress, including headaches, high blood pressure and poor sleeping patterns.

“Medically, stress affects everything, from your hair to your toes,” says Dr Frasia Karua, the medical practice manager at UAP Insurance Company Ltd, which helps employers implement stress management and wellness programmes.

“We keep pressuring ourselves to work harder so we can achieve happiness, but I think the balance is lacking across the board, whether it’s the gardener at home or the corporate executive.”

Between 2011 and 2013, UAP Insurance’s clientele increased by 45 per cent, with large corporations making up the majority of growth. But stress is not just a corporate problem, Dr Karua explains; no one is immune from this kind of ailment.

“Everyone is affected by stress, so everyone needs a solution,” she says. “I would say every (financial) class has its own specific stressors, but I think family issues and education... that cuts across the board.”

For teachers in Kenya, stress stems not only from a lack of resources, but from high teacher-pupil ratios that create extra work outside the classroom.

WORK OVERLOAD

Ms Pritha Oigara teaches 93 students in Standard One at Olympic Primary School in Kibera, and spends more than four hours every evening preparing lessons and materials at home.

“Sometimes I am so stressed it can lead to headache,” she says, shaking her head. “It makes me sometimes not even want to talk — the more I talk, the more I will be feeling stressed.”

She remembers the year her stress started rising — in 2003 after the implementation of the Free Primary Education programme. Since then, she has taught upwards of 100 students in a single classroom, forcing her and many of her colleagues to burn the midnight oil to meet their performance targets.

“It is not easy to plan for seven lessons every day,” she says. According to a study by the Kenyatta University Department of Educational Psychology, more than 94 per cent of surveyed teachers have experienced work overload and nearly 97 per cent have experienced “burn out” at one point or another.

In 2014, local researchers collected data from 120 primary instructors in private and public schools in Kasarani Division, Nairobi County, and discovered dozens of class sizes exceeding the recommended national ratio of one teacher to 40 students.

PUPILS SUFFER

At the end of the day, it is the pupils who suffer, says Ms Oigara, who is one of 28 teachers instructing 3,247 students at Olympic Primary School.

“The children are innocent; they don’t know what is happening,” she explains. “Sometimes I feel like I am not able to work the way I should work… if you continue you might burst.”

Stress explosion is an event Ms Emily Kamunde-Osoro understands all too well and has taken action to prevent with her employees at Jubilee Insurance.

The Nairobi branch has more than 700 staff members, she says, many of whom have stopped by her office seeking solutions for dealing with stress.

“We received a lot of complaints around work-related stress because of the culture in the organisation,” she explains. “Honestly, I think the amount of workload has increased extremely…. There is competition, there are advanced companies and we also want to catch up.”

LEFT TO COPE ON THEIR OWN

In 2013, Ms Kamunde-Osoro enlisted the aid of workplace counsellors, who have helped mitigate stress levels at Jubilee Insurance. Unfortunately, she says not all employers recognise this need among their staff members, who are often left to cope on their own.

After all, there is no legislation that obligates managers to provide workplace wellness programming in Kenya — at least none that addresses “stress” specifically.

In 2005, the Government created a public sector work policy to address issues around HIV/Aids in the workplace. By 2009, it had given birth to one of the first employee “wellness” programmes in the country — a national code of practice on HIV/Aids that applied to all employers, regardless of size or location.

Today, the Directorate of Occupational Safety and Health Services (DOSHS) is charged with regulating worker health, including “stress management” and “medical examinations”.

NOT A REQUIREMENT

Its measures are widely criticised, however, not only for their lack of enforcement, and but their gaps in promoting mental wellbeing.

“The only requirement is to ensure the workplace is safe and healthy — so windows and ventilation,” says Dr Karua. “There is no push towards wellness because it’s not a requirement.”

In 2013, the International Labour Organisation criticised Kenya’s commitment to workplace wellness, citing “weak systems for implementing a safety and health preventive culture” and a “lack of knowledge on occupational medicine by most medical practitioners”.

It recommended strict implementation of the national Occupational Safety and Health policy, countrywide recruitment of staff to enforce it, and collaboration with other government departments.

Since 2007, various academic institutions have also urged the Government to come up with tighter regulations for stress management and prevention, including policies for flexible working hours, childcare support and extended parental leave.

CULTURAL PERSPECTIVE

ICAS Kenya recently joined the wellness movement march and is calling for more exhaustive legislation from the Ministry of Labour and Human Resources Development.

By 2015, Selina hopes for a policy that will mandate employers to offer thorough employee wellness programmes, including various confidential counselling options.

“That’s what we are trying to put in place,” she explains. “Right now it’s been a challenge, the concept is still pretty new.”

To accomplish this goal, ICAS has enlisted the aid of the Employee Assistance Professionals Association (EAPA) of South Africa, a branch of one of the world’s oldest sources of information and support for the employee assistance profession.

“Once we (meet), we will probably be able to engage the Government,” says Selina. “I’m very ambitious because it’s something that everybody needs.”

But it’s not only legislation that will help Kenya curb the stress epidemic; according to Dr Karua, the country must adopt a new cultural perspective when it comes to the idea of wellness at work.

She says longer working hours, increased expectations and financial burden have complicated the definition of wellness and it’s time to update our office dictionaries.

HASN'T TAKEN ROOT

“Wellness needs to become more than just HIV (programmes) and that is a challenge,” she explains. “It hasn’t really taken root, because you still find that when people are talking about wellness, the first thing they think of is HIV wellness.”

The first step to developing a robust wellness programme, she says, is taking the time to understand what employees go through at home and at work.

A quick needs assessment will quickly reveal staff stressors, which differ from profession to profession.

“Understand your employees,” she begins, “then have a team involving management and members from various areas form a committee that creates a programme that has activities involving everyone.”

It’s about shifting the health paradigm from treatment to prevention, she says, and education will be crucial in encouraging the movement.

“I think one of the things that really empowers people is information,” says Dr Karua. “Whatever habits are introduced in the workplace will change a person’s health outcome, and in the end it means fewer people going to hospitals and needing healthcare services.”