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As I walked around the
hospital, it had the feel of an old asylum. I had been warned what
to expect, but the wards were still quite difficult to take in. The
level of overcrowding meant that sometimes patients had to sleep on
mattresses on the ground, outdoors on terraces. The male “locked
ward “in particular was full to the rafters (about 35 beds and 220
patients) - this seemed to be the equivalent of our forensic wards
where patients were sent on “court orders”. However, as far as I
could discern from the nursing staff, men arrived here regularly,
but the outward traffic of discharge was much less frequent.
Although there were lots of patients, there were no discernable
outward signs of psychosis or aggression, just lots and lots of
men, milling around looking bored. There was also an
addictions ward, where people were admitted with substance use
problems, mostly “wee” (cannabis) and alcohol. However, apparently
there weren’t any in-patient resources for psychological treatment
of addiction (although there was an AA groups within the hospital)
and it seemed as if the patients were just taken off the streets to
live here instead, out of sight.
I had a chance to spend some
time talking to some of the in-patient staff. As ever, I was
impressed with their professionalism in the face of very difficult
working conditions. They told me of the stigma that mental illness
faces in Ghana, even from within its own medical profession at
times. They said that often they had experienced reactions of
abject horror from their friends and family when they said that
they wanted to work in Mental Health, and that their still remained
a great deal of superstition and fear around psychiatric illness,
with even some educated Ghanaians attributing its aetiology to
spirits and demons. They described the difficulties they often
faced in accessing appropriate medical health care for their
patients. One nurse tells me of an incident where her patient
needed to be taken for a blood transfusion at a local physical
healthcare facility. During the treatment, she heard a member of
their staff say loudly, within earshot of the patient, that this
kind of medical treatment shouldn’t be “wasted on animals”.
Obviously this is not an opinion held by the majority of educated
Ghanaians, but still, it is indicative of the level of prejudice
that exists in some quarters.
Probably the most starkly
difficult part of the hospital to take in was the Children’s ward.
This comprised a large compound which housed about 30 patients with
moderate to severe learning disabilities, aged between about 8 and
35. The staff told me that children with intellectual disabilities
(often with concurrent physical problems) were abandoned at the
gates of the hospital by their families, or sometimes found on the
streets. Once here, most had no further contact with their families
and remained on the ward until their lives ended. The nurses
explained that having a disabled child, particularly a child with a
learning disability, can be very shaming for a family, and that it
is sometimes taken as a sign of some sort of malevolent influence
at work.
There are 2 nurses on duty
and a couple of Ghanaian volunteers who are here three days a
week to help care for the children and who also try and organise
activities such as art or games. But it is very clear that relative
to the individual needs of the children, the wards are critically
understaffed. It is all the nurses can so to keep the children
clean, fed and safe and there is precious little time left to think
about their emotional or learning needs. I noticed some of the
children sitting quietly rocking themselves. For the brief periods
that I have been on the wards, individual children come up, grab on
to you and don’t let go; I left with scratches on the back of my
neck because one little girl was holding on so tightly. I try not
to be the overwrought, overemotional visiting westerner, and fail.
It feels like quite a lot to take in. Currently there is no
available input from speech therapists, physiotherapists or child
psychology.
I spoke to staff and
volunteers to see if there is anything practical we could do, in
conjunction with Challenges Worldwide, the charity that is
supporting me in Ghana. I was thinking of trying to fundraise for
some educational and art materials for the ward and I asked the
staff for a list of things that the children need: although
the list did include toys and art materials, at the top were more
basic requirements such as detergent, gloves, nappies and second
hand clothing. I need to have a think about how best to take
this forward, and I leave feeling a bit numb.
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