When I think of Kenya, I play a silent movie, slow frames of the boy running from the naked woman. Maybe seven years old, shaved bald like all Luo children, his eyebrows raised high into his forehead, his mouth open so far I saw the bright semicircle of his teeth, the boy was trying to get out of his skin. His body twisted, legs turned forward to run as fast as they could, but his torso turned back so he could look behind, his arms paddling the air. He tripped on the legs of other people running away, grownups pushing the grownups ahead of them, some grownups smiling, some children with eyes like the boy’s, and he fell, and she was coming, this naked woman.

The out-of-body boy, the people running, our car driving toward the people, we were behind the woman and her naked body, her movement making the crowd run, the dust of so many feet on the dirt road, the dry-grass smell, always the bitter scent of burning hardwoods and charcoal, the cooking and heat, and as we passed the running and shoving, the woman’s jangling breasts, her gray hair matted, the spear she rattled were flashes out the window of our car. Everything about this woman shook, her lips, her hair, her raised fists. And just as we passed, she yelled something and trotted toward the crowd.

It was market night, the one night a week when people brought their millet or papaya or bananas or charcoal or t-shirts donated by well-meaning Americans, all goods to sell in tin kiosks or plywood shacks or on bicycles, on tarps, on the ground. This town was near Kisii, in the Nyanza province with the highest HIV/AIDS infection rate in Kenya. In every town we sped through, there was the lineup of general store, church, HIV/AIDS clinic, and coffin maker.

No one else in the car saw what I saw.

We were making a ten-hour roundtrip to deliver children to a special boarding school for kids with HIV. We were on the way home when I saw the boy. I remember his face.

And I remember parts of the woman, the naked woman we saw from behind. Her skin was smooth from her shoulders to her calves, except for patches of light flakes. Around her waist there was a thin belt, something woven or leather, with a feather dangling on her right side. The feather was a few inches long, and another one, the same type, hung from her spear which she held in her right hand. As we passed, I could have sworn she yelled, “Bugga-bugga-bugga,” like a Bugs Bunny episode from the 1940s, “All This and Rabbit Stew,” a real woman acting out the quintessential racist stereotype from Hollywood, in my head, half mocking the idea of an African native, half mocking the idea of crazy, and half crazy itself. In other words, there was much more than her sheer nakedness scaring the boy, much more shaping my memory of that moment.

The next day at the Dominican mission in Kisumu, where I volunteered for a few weeks, I asked a young Kenyan woman, Mary Juma, to explain. With her eyes looking down, she said, “She was mad,” as quietly as she might have said, “She has AIDS.” Kenyans don’t acknowledge mental illness. They believe birth defects and mental illness and twin babies are retribution for bad deeds. The woman, naked and running to the market, was probably kicked out of her family who believed she had “wronged God” and brought bad luck to the family. Millions of Kenyans living with mental illness are abandoned or locked up by loved ones. The mentally ill have no place to go.

In 1982 in New York City, with its mobs of people shoving and packing the streets, I saw a place for the mentally ill to go. My cousin in her late twenties had recently tried to burn the alligators swimming out of her apartment curtains, and her psychotic break revealed her schizophrenia and ended her career in journalism. At the time, wards were “open,” meaning all levels of mentally-ill patients were housed and treated together. When I arrived at the hospital, I asked the large woman drinking coffee at the front desk for my cousin, and she said, “Fifth floor.”

The elevator was the size of a small closet and smelled like worn socks. The door had a porthole in it, and when I arrived at the fifth floor, all I could see was mauve. There was no desk to check, no one to check with, so I wandered down the hall. I passed patients ranting at doorjambs, and old men shuffled in plaid pajamas. One young woman with hair, slick and sweaty, pointed at me and said, “I know you know. I know you. You know I know.” And I nodded, and she pointed.

At the end of the next hall, a young woman rocked herself as she sat in a large window frame. Her long hair was hanging in her face, and her hospital gown was light yellow, stained, and hanging open except where the belt was tied in a loose bow. She had blue slippers, and she was turned to the window, talking to the face that looked back at her in the glass.

“Excuse me,” I said, “I’m looking for my cousin.” My voice sounded high and young.

The girl in the window turned to me, and her face was sand trying hard to become glass.

“Kate?” she said. Tears spilled down her face, and she jumped to her feet, grabbed the robe, pulled it around her, and ran away from me. “Oh, oh,” she said, “I didn’t know. I’ll be right back,” and she disappeared down the hall. I stood where she left me, and ten minutes later, after patients had wheeled and sauntered and shuffled by, someone with a name badge came to tell me that my cousin, Emma, would see me in a few minutes, that it was hard, she was surprised to see me, surprises were not good for someone in her state of mind.

And in a few minutes, I entered her room and sat on the hospital bed, the hard mattress and stiff white sheets, the light blue blanket, the walls mauve, the linoleum dull. There was nothing else in the room, no wall-hangings, no curtains, no mirrors. But my cousin, her hair pulled back, her thick glasses magnifying her eyes, was my cousin again. Her voice had inflection that matched hand gestures. When she said, “Therapy’s a gas, a total gas. I get to talk about myself all day long,” she clapped her hands and laughed her deep, scruffy laugh, her voice a lot like Anne Sexton’s, loving everything about smoking.

My cousin still smokes. Thirty years later she lives independently and talks on the phone to family every day, many times a day. We talk every few weeks. She teaches Spanish classes for mentally-ill people, she writes and edits a newsletter for people transitioning out of mental institutions, she walks three miles a day, and she tells me, “My life just gets better and better.” Sure, she’s tried suicide twice, lots of medication, and goes in for electric shock therapy (ECT) every other month, but her illness does not scare her or others, especially not her family.

My father’s mental illness was entirely different, and instead of hallucinations and inflicting pain on himself, he smelled weakness in others and preyed on it. His rage was unpredictable and savage. As adults, my siblings have admitted that as children at night, we hovered, full-bladdered, behind our bedroom doors, listening for our father before opening the door to run as quickly and quietly as possible to the bathroom. If he heard us, he grabbed us, or worse.

What if we had turned our father out? What if we had a belief system that said that he had wronged God and his illness was retribution, and we did not owe him anything? The thought of my father’s flabby white butt, a spear in his hand with a feather matching the feather tied to a string around his waist, my father running naked toward a village, his white belly and breasts and flaccid penis jiggling, his bald head and enormous hands and the gap in his smile from a tooth knocked out in a fight. The idea comes closer to a Bugs Bunny cartoon, half funny, half hysterical, than what I actually saw. Maybe that’s why the image sticks: it’s half horror, half absurd.

And if my father had been turned out of our house, if our town had cast out my father, as he should have been cast out, he might not have shattered my mother like quicksilver, he might not have wound my oldest brother like the inside of a golf ball, or sucked the core out of my other brother, or beaten down my sister so that she ate and ate to weigh so much that no one would ever pick her up off her feet again. And maybe he wouldn’t have ruined every naptime and the rest of my sleep.

If my father had been turned out, I might have been that little boy, had a crowd to run into, a way to be with other people when fright and flight took me out of my body. Instead, my father’s illness was undiagnosed, kept indoors, and he moved quietly at night, and grabbed each one of us kids when we opened our doors, and he hunted us during the day, our rank scent.

It’s easier in an instant to judge what you see outside a speeding vehicle, in a culture that is represented to your culture through racist cartoons. When I think about that boy running out of his body, I taste sulfur in my mouth. His fear is something bigger than seeing a naked woman, something insidious and social, like stigma. When I remember him, I am that boy. When I remember the scream I didn’t hear coming out of his mouth, I fill his throat with my voice, and sound the alarm I never used.

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Teaching at Clackamas Community College for 20 years, Kate Gray tends her students’ stories. Her first full-length book of poems, Another Sunset We Survive was a finalist for the Oregon Book Award in 2007 and followed chapbooks, Bone-Knowing (2006), winner of the Gertrude Press Poetry Prize and Where She Goes (2000), winner of the Blue Light Chapbook Prize. Her unpublished novel, Skin Drag, is an attempt to look at bullying without blinking and will be published by Forest Avenue Press in 2014.