By Joseph Kabiru

George Oketch is an IOM Psychosocial Counsellor based in Nairobi's Migration Health Assessment Centre. MHAC provides assistance to immigrants, refugees, asylum seekers and mobile populations. With a career spanning 27 years, Oketch has seen it all and has diligently served various categories of migrants - especially refugees that have been approved for resettlement.  Astute, humble, soft spoken and witty, Oketch has played a profound role in  beneficiaries' lives by helping them regain their mental balance amid  violent conditions that tend to cloud their perspectives.

George tells the story of James (not his real name), one of the many whom he has counseled. James was among many applicants in the late 1990's who underwent HIV screening for the purpose of resettlement. He was single when he first tested positive for HIV. But he did not undergo post-test counselling since at that time, professional HIV counselling was not part of the services being offered by IOM Nairobi. James eventually got married and had two children. 

His family had been ailing for some time yet they had no idea  what was ailing them. When James brought his family to IOM for testing, they all tested HIV-positive like him. "I was the bearer of the devastating news. And this was very difficult for me," George recalls. The findings also shattered the family's dreams of resettling in the United States. .

Eventually, however, the US government lifted the HIV/AIDS travel ban and James' family was recalled for repeat medical assessment. James, this time around, was diagnosed with tuberculosis- halting the family's travel plans as he would have had to undergo six months of treatment. He did not take this well and at one encounter threatened to kill the examining doctor. IOM stood by his side and provided James the necessary treatment and psychological support. His two beautiful daughters, meanwhile, who were put on anti-retroviral (ARV) therapy for HIV, were improving day by day. And after undergoing all the required treatment, James and family were finally able to resettle in the United States.

“I have had many inspiring moments – especially when my clients, after counseling, choose to accept their status and choose to soldier on regardless of the prevailing circumstances," Oketch says. “But I am at my lowest when a client dies as a result of opportunistic infections. This has happened twice.”

Establishing counselling in IOM Nairobi was very challenging initially as clients were not open to counselling. The situation is different [now] and counselling is now appreciated by beneficiaries, and has become part and parcel of the health assessment process.

"Human beings are capable of making decisions on their own. But we, at some point, may need some supporting individuals, or an understanding 'shoulder to lean on,'" says George. "Because during crisis, we tend to develop a cloudy mental frame. The responsibility of the psychological counselor is to unlock this cloudiness and offer the aggrieved a mirror for self-reflection; an alternative viewpoint and perspective, which to deep self-awareness and clarity, in a process based on professional relationship."