It was during the early-evening rush hour in Nairobi that Tracey Doyin, 23, was raped by two men as she walked home from a grocery shop near one of the city’s main roads. Forced off the street into a deserted spot, they took all her belongings and attacked her at knifepoint. Two hours later, when it was dark, they let her go. She made her way to the house of a friend, who accompanied her to a police station to file a report, and later to a nearby hospital. It marked the start of a long and exhausting journey trying to get help she should be entitled to under Kenyan law. Doyin, who has shared her ordeal on TikTok, says she experienced a rapid decline in her mental health since last year’s attack, going from being cheerful, sociable and outspoken to feeling reclusive, anxious and drained. But according to the Survivors of Sexual Violence Network in Kenya (SSVKenya) and Physicians for Human Rights (PHR), mental health provision is in a dire state. The organisations used PhotoVoice – a charity that encourages survivors to reflect on and document their experiences using cameras and recordings. The 223 photos and 99 WhatsApp voice notes that came back highlighted significant barriers to mental health services, including cost, stigma, a lack of privacy where therapy is offered and a lack of compassion and sensitivity from poorly trained medical staff. At least 13% of women and girls aged 15 to 49 have experienced sexual violence, according to last year’s Kenya Demographic and Health Survey. The true figure is likely to be significantly higher, as many cases go unreported, partly due an expectation that rape will not be successfully prosecuted. On one TikTok post, Doyin describes facing a barrage of questions from police when she went to report her attack, such as what she had worn and why she was out at that time. “Ironically, I had worn a dera [a loose kaftan-like dress] and a trenchcoat,” she says, dismissing the “harmful” notion that clothing can invite violence. Rights groups say rape survivors can be seen as having “lost their dignity”. Some women are left by their partners, especially if they keep a child conceived from rape. One female officer warned Doyin not to tell her boyfriend about the attack. “I think that was the point I just gave up,” Doyin says. She left them the clothes she was wearing when she was attacked and her mobile phone details. She never heard from them again. Doyin says the most difficult part comes after reporting the case. “You’re done moving up and down, and now it’s just you, and the memories of the whole thing. Now you have to seek therapy, plus patient therapy costs around 5,000 shillings [£28].” Doyin scoured the internet looking for online support services. Most were unavailable in Kenya or too expensive. “It made the help that I needed feel so far away from me,” she says. “I have so many numbers that I called just trying to look for help. But I wasn’t getting any at all.” The insensitivity she experienced in private and public hospitals made Doyin unwilling to return to either for mental health support. The private facility kept her waiting in line for two hours in her clearly traumatised state. “My hair was messed up, my nails were broken, my clothes were torn, and I had sand in every place in my body,” she says. She was finally examined and put on PEP (post-exposure prophylaxis) to prevent HIV infection, but was then told she would have to go to a public hospital to have DNA samples taken and her post-rape care forms stamped, all of which are needed to bring a prosecution. “We need to find a way to merge the process between the police station and the hospital, to make it simpler for the survivors – this is a person who has just been through a traumatic experience.” She says “proper” and “humane” mental health support should be integrated into the process. Naitore Nyamu-Mathenge, head of PHR’s Kenya office, says health practitioners tend to focus on the physical impacts of sexual violence. “More often than not, you’ll see a number of clinicians and nurses will indicate ‘nothing observed’ [in the post-rape care form], because either they do not have the capacity to assess the impacts, don’t know how to fill it out or that’s not a priority to them,” she says. PHR and SSVKenya want the government to invest in mental health services. In particular, they are calling for health workers to be better trained, including documenting the psychological impact of rape. Doyin was told by one counsellor that cases such as hers were “very common” – and she was kept waiting for hours once again, as key personnel spent much of the day in an “important” meeting, prompting her to barge in and demand medical attention. “What I could read is that, for them, this was a normal occurrence. That’s why they wouldn’t treat the case with the speciality it needs. But we don’t get sexually assaulted every day – for us, it’s life-changing.” The attitude stretches far beyond hospitals, though. On the street, “not a single person” asked if she was all right or offered help as she stumbled along after the attack. In Kenya, jokes or misogynistic comments trivialising sexual assault are commonplace. Last week, David Ole Sankok, a member of the East African Legislative Assembly, part of the regional East African Community, stirred online outrage over comments he made promoting a tree-house “lovers’ nest” at a country lodge. In a video, he declared that once romantic partners were settled inside, the ladder would be removed so no one could change their minds and the man could “get the value for his money”. Rights groups hit out, saying that such comments implied that women did not have to give consent and normalised the idea that women were obliged to provide sex for financial favours. In 2021, a woman was allegedly thrown off the 12th floor of a building by a man after she refused his sexual advances on their first date. Three radio hosts were sacked for “victim-blaming” comments about the case. “I think as a country we are at a place where we’ve numbed out our emotions,” says Wangu Kanja, convener of SSVKenya. “There are too many negative things happening, so we have kind of normalised things that are not normal as normal. We need to change.”