Monday, March 23, 2009

Free yourselves from Mental Slavery - Ghana's Mental Health in Crisis

I’ve been reminiscing about the good ol’ days, during my first few years in Ghana, when I lived an entirely different life… The days of the compound of 54 people, all Ghanaian except me, all living in single rooms surrounding the common space – a concrete square that at one time had a big tree growing out of the centre for shade. (That was hacked down in the rage of one of the adult sisters in the family along the way, no doubt getting back at others for some or other trivial dispute). But that is another story.

We had quite motley crew of family members and random tenants among the 54 of us, and there are definitely stories enough to fill a novel… maybe one day!
Today I remember Sistah Konadu. A sweet and well-meaning girl in her mid-twenties, with a large frame and a tiny voice, she wasn’t actually living full time with us, but apparently had problems with some other members of the family who lived elsewhere, and sought refuge with us many times.

Konadu was slightly ‘mad’ as the family affectionately described her. I found out later, mostly from observation, that she was clinically a schizophrenic. I imagine the medicines in Ghana are expensive or not available, had there even been a proper doctor to make such a diagnosis in the first place.

One afternoon as we sat in our little room, bathed in sweat, fanning ourselves, there came a big noise from the compound. A woman’s voice shouting frantically, “You! Think you can hide in a chicken disguise?! You are the devil! I see you! Evil chicken!” We peered through the dusty slat windows to see Konadu, dressed in her best cloth and jewelry to match, running in circles, chasing some benign neighborhood chickens with the fury of an exorcist. The children were running behind, jostling and poking each other, falling in tiny clumps of laughter. Some of the adults poked their heads out into the yard and called for Konadu’s mother to fetch her to the asylum. It seemed the illness had reached some sort of peak and she was dragged, warning us all of the dangers of the little devils among us, with the help of some strong guys around the area, into a taxi and off to what they called the Asylum. Sounded pretty scary to me. Little did I know.

Konadu disappeared for a few weeks. When she came back she was dull, thin, her skin grayish and the corners of her mouth sagged. She looked highly drugged. The fire in her eyes was gone.

What we didn’t know at the time was that she had been chained by her ankle to a large heavy metal ball on the floor in what constitutes a cell. Some patients are chained to car batteries or any other heavy unmoveable objects.

This is rehabilitation?! The conditions in Accra’s only Psychiatric Hospital – the Asylum – make the horrors at Korle Bu and others look like a hotel. There is even less funding for these hospitals around the country, not to mention a huge stigma. The patients are fittingly referred to as inmates and as I read in an article published on, the regional director of CHRI (Commonwealth Human Rights Initiative) explained:

“the treatment includes chaining, denial of food, verbal and physical abuse, isolation and forced medication. According to her, their research revealed that the incidence of chaining up the mentally disabled constituted a feature of the healing process.”

What is equally disturbing is what I read on the front page of the Daily Graphic (whose website is currently under construction), Ghana’s largest newspaper TODAY. Ghana’s ‘Mental Health in Crisis’. The article goes on to explain that for the 22 million people in Ghana, of whom they figure 30 -40 % will suffer some form of mental health problem during their lives, have 2 – that’s TWO qualified and practicing Psychiatric doctors to attend to them. Statistically that is one doctor per 11 million people. Do I need to write how dismal that is? Apparently there are actually 4 doctors in the country, but two are lecturing at Universities rather than practicing.

So what happens over at the Asylum to the thousands of ‘inmates’? No doubt they are guarded. Doubtfully they are fed, (unless family members come to visit and bring meals to them), but no chance are they being treated by a doctor. And that is sad.
I haven’t seen or heard from Konadu in ages. She had a baby and got married and was on her ‘medicines’ that last I knew. God forbid she relapse and need medical attention.

With all the hue and cry about the atrocities of slavery during the early colonial days, here we are in modern Africa, where citizens are being enslaved, in their minds and by the literal chains that bind them. The treatment of the mentally ill in Ghana is one of those dirty little societal secrets, on the bottom of anyone's list in terms of making changes, and in the dark ages in terms of cultural attitudes. God help them, those who cannot help themselves, for no one else will.

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Anonymous said...

Remembering too that the heroin addicts/wee smokers get subjected to the same treatment Asylum and no seperation is made between them and those with psych problems. Aunti T

Anonymous said...

I visited the asylum once and felt pity about the gruesome fate of the psychologically ill patients and the mentally handicapped children in the children's ward. Some of the mentally handicapped children who lived there got transferred with the help of a Dutch doctor to Nkoranza in the beginning of the nineties. Meanwhile live more than fifty mentally handicapped persons in a community in Nkoranza. And the majority of the people in Nkoranza respect them. The village and the peaceful and joyous atmosphere in this community touches me everytime I visit this place.
I agree with your views on development aid. The project in Nkoranza is more about humanitarian aid.
There is an organization in Bouake/Côte d'Ivoire which free and care for psychologically ill persons which were "mis en bois" that means that they were locked in trunks or chained on the floor. The founder of the project Amis de St Camille worked as a tyre fitter and taxi driver in Bouake and started later caring for these heavily stigmatized persons.
I wanted to tell you about these two organizations because they astonish me so much.

Anonymous said...

Dear Holi
I am a therapist and researcher in mental health and completed 2 years research on mental health in Ghana. I just came across your blog on the web and read it with interest. I share your concerns regarding the treatment of people with mental health problems in Ghana but there were a few incorrect claims and assumptions in your article which I wanted to point out. Firstly mental health care including psychotropic drugs, is free in Ghana. Unfortunately the kind of side effects you describe for Konadu are common, not just in Ghana but everywhere, especially if people are given high doses. The photos you show are not taken in Ghana - I recognise them from another source - I think they are from Sierra Leone. Accra Psychiatric Hospital is overcrowded but the patients do get fed free of charge, and some psychiatrists are working hard to try and improve things. I have never seen any patients chained in Accra Psychiatric Hospital nor at the other two psychiatric hopsitals in Ghana and psychiatrists in Ghana are strongly against this (again you quote from a report which is not about Ghana). The report you quote from CHRI which is about Ghana refers to prayer camps, not hospitals. Although Dr Osei, the chief pyschiatrist is quoted in the press (which very often reports misleadingly) as saying 30-40% of Ghanaians are mentally ill, this is not based on any statistics (there are no accurate statistics available on the epidemiology of mental illness in Ghana)and likely to be an over-estimate. WHO suggests that based on epidemiological data worldwide 25% of people will be mentally ill in their lifetime. This includes less severe forms of mental illness.
People are campaigning to improve mental health care in Ghana such as Basic Needs and the Mental Health and Poverty Project. If you visit their websites you can get more information. The latter has a long report on mental health services in Ghana. Please be careful to check the facts of what you put on your blog. We can campaign more effectively if we have accurate information
Ursula Read, UK

Anonymous said...

Ursula thanks for setting the records straight. As precarious as the behavioral healthcare delivery may be in Ghana, its important that we do not exaggerate the facts. With all due respect, Holi as a global normad that she has become needs to be circumspect. She should try to educate and inform her audience without compromising facts and statistics.

viagra online said...

Greetings The pale observer!
I think the way those black people is treated is like insane. I still don't why some people insist to act in that way. That's such a shame!

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