Author Archives: Noah

About Noah

Noah Wernikowski graduated with distinction from the University of Regina’s School of Journalism in 2012. He has been involved with Journalists for Human Rights for two years, and helped with this year’s Speak Magazine. He has experience in both print and broadcast, and worked as a reporter and writer at Newstalk radio in Saskatoon. In his spare time, he enjoys playing squash and chess.

Unavailable and underfunded: mental healthcare in Ghana

The Accra Psychiatric Hospital only has a capacity for 600-800 patients, but currently houses many more.

Like much of the developing world, mental healthcare is lacking in Ghana. Mental illnesses are deeply stigmatized and widely misunderstood, and access to mental health professionals and infrastructure is limited. Although the recent passing of the innovative Mental Health Bill lays the legal framework for the required changes, steep challenges remain.

Ghana spends 2.58 per cent of an already small health budget on mental health. Accordingly, Ghana has only three publically-funded mental health hospitals. The hospitals are all old, overcrowded, and located in the southern part of the country. Consequently, they fail to provide adequate care for the estimated 250,000 people that need treatment in the country.

Pantang Hospital, the newest in the country, was built in 1975 and is located just outside Accra. Ankaful Hospital was built in 1965 and is located in Cape Coast, 150 km outside Accra. The largest hospital, the Accra Psychiatric Hospital, was built in 1906 and is located in the centre of the capital. It only has a capacity for 600-800 patients, but currently houses close to 1,000. It’s a condition that “compromises the comfort and general well-being of patients and constitutes an appreciable strain on [the hospital’s] resources, staff and funds,” according to the hospital’s website.

There are also only twelve psychiatrists working within the government system, many of which perform only administrative duties. There are fewer than 500 psychiatric nurses, more than half of which are located in the mental hospitals, leaving the rest of Ghana wanting.

The result of the widely unavailable care is that many rely on traditional healers, especially in the more rural and impoverished northern parts of the country. Their methods vary from prayers to exorcisms to human rights abuses.

“We’ve seen people who have cuts on their bodies that have festered into sores… It’s all under the guise of treatment,” said Peter Yaro, the Executive Director of BasicNeeds Ghana, an NGO that seeks to “ensure people with mental illnesses and their families live and work successfully in their communities,” according to Yaro.

“We have seen people who are shackled and left in the open, rain or shine for days. We’ve seen people who have been locked in rooms for days, months, and years. They ease themselves there, they eat there, and they sleep there. And nobody bothers to do anything about it until it’s reported to us,” he added.

The garden inside the Accra Psychiatric Hospital.

BasicNeeds has been operating in Ghana since 2002 and has since expanded to six out of Ghana’s ten regions. It strives to improve access to appropriate treatment, teach people with mental health conditions to support themselves, give people suffering from mental illness a political voice, and address the fiend that exacerbates all mental health problems in Ghana – the monstrous social stigma that surrounds the issue.

In Ghana, people with mental health issues are widely misunderstood and mistreated. People view mental illness as anything from a deserved consequence of a spiritual transgression to a contagious condition that will infect anyone who works in the field. As a result, they are discriminated against and marginalized, Yaro explained.

“The moment you are seen as mentally ill you are seen to be less human.… People think you can’t even feel,” he said. There is also little understanding of, or interest in, proper treatment.

“For those who know about the hospitals, they come and dump you there. For those who don’t know about the hospitals, they dump you at the traditional healer so they can move on with their life,” Yaro said.

The social stigma also affects the professionals who work in the field. Unlike other medical specialties, psychiatry is not prestigious. “It’s not attractive. It has no status, socially,” said Yaro. Because of this, and the fact that many people still think mental illness is contagious, few choose careers in the field.

The Mental Health Bill – the government’s plan to address these pressing issues – was finally passed on March 2, 2012. Originally drafted with help from the World Health Organization, the Bill meandered through parliament for eight years.

It emphasizes community based treatment over institutionalization. This is very important because up until the Bill was passed, the legislation that guided Ghana’s mental health service plan had changed little since the colonial Lunatic Asylum Ordinance made in 1888, explained Yaro.

“The national health policy under which mental health services are provided is not only arcane, but very bad,” he said. “We’ve come a long way towards understanding what mental health issues are and the law needs to be retrofitted.”

The Bill also introduces regulations for both public and private care providers need to adhere to, legally protecting patients’ rights. It also calls for a decentralization of care centers and and seeks to battle the stigma through public education campaigns.

It is estimated that more than 250,000 people in Ghana need psychiatric treatment.

The passing of the Bill marked the ratification of the UN Convention on the Rights of Persons with Disabilities. Ghana was one of the original 80 countries to sign the convention in 2007 and activists and mental health care professionals eagerly awaited its ratification since.

“I don’t know how to express my joy. Eight years of anxiety, apprehension and patience- that is how I can describe my feeling now. If we knew that the bill would be passed today, we would have come here with buses full of people and thereafter paraded through the streets of Accra to exhibit our joy and appreciation,” said Dr Akwasi Osei, the Chief Psychiatrist of the Ghana Health Service, at the time of the Bill’s passing.

“The way the Bill is drafted means a revolution,” said Yaro. Although the Bill received Presidential Assent on June 8 and became law, the revolution is still coming.

The massive investment required for the full implementation of what is in the Bill seems unlikely in the near future. Ghana is a Lower-Middle Income country and its economy is largely dependent on foreign aid, which makes up 11.7 per cent of the country’s GDP, according to the Organization for Economic Co-operation and Development. Its public health care system battles both corruption and a “chronic shortage of funding,” according to a 2008 Austrian Centre for Country of Origin and Asylum Research and Documentation (ACCORD) report.

“We have to be optimistic, however one should not lose sight of the [challenges],” said Yaro. In the meantime he is happy with the progress made so far and will continue working with BasicNeeds as Ghana moves forward with its mental healthcare policy.

Slow and unsteady: Ghana’s Freedom of Information Bill

The entrance to the Parliament of Ghana. The Freedom of Information Bill has, in one form or another, been meandering through Parliament since 2003.

July 7th marked the 30th anniversary of the day Canada’s Access to Information Act received royal assent, becoming law. Within a year the law had come into full force and Canada had joined dozens of other countries committed to government transparency and press freedom. As of January 2012, 90 countries have established nationwide laws ensuring the public’s right to request and receive government-held information.

In 2000, South Africa became the first African country to pass Right to Information legislation. Since then, seven other nations, including Nigeria, Uganda and even Zimbabwe have followed suit. Although Article 21 of Chapter 5 in the 1992 Constitution of Ghana states, “All persons shall have the right to information, subject to such qualifications and laws as are necessary in a democratic society,” making one of a few constitutions that guarantee a fundamental right to information, no right to information law exists.

There have, however, been attempts to adopt such a law; the latest of which is sitting motionless in Parliament. The Right to Information Bill, as it was called at the time, was first drawn up in 2003, and went through the drafting and a public consultation process that year. It became stuck in cabinet and lapsed in 2004. The next year the processes had to start again. It wasn’t until 2009 that the second attempt, the Freedom to Information Bill, was finally submitted to Cabinet. It was forwarded to parliament in March 2010, where it has remained, inert.

Such stagnation contradicts a string of political promises. During the 2008 election, the now ruling National Democratic Congress promised Ghanaians that, if elected to government, they would pass the Freedom of Information Bill as soon as possible to demonstrate a commitment to fighting corruption.

The sun sets on Independence Arch in Accra. Ghana’s 1992 Constitution is unique in that it guarantees a fundamental Right to Information.

Parliament Majority Leader, Cletus Avoka, promised that before parliament rises on July 27, 2012 for a three-month recess the bill will be passed. However, he has since reneged, stating in May that “Passage of the Freedom of Information Bill was less important and for that matter, not a priority among various bills currently under consideration by Parliament for passage.”

Now, with only two weeks before a recess that will last until late October, and with only one month of parliamentary sessions left until it dissolves again for December’s election, it is clear the bill will not become law anytime soon.

“They [the government officials] have reservations about the widening transparency and the widening accountability that would come with Right to Information Legislation,” said Nana Oye Lithur, executive director of the Human Rights Advocacy Centre and the convener of the Right to Information Coalition in Ghana. The Right to Information Coalition was created in 2003 and is comprised of journalists as well as members from the National Media Commission, religious bodies, non-governmental organisations, and the Ghana Bar Association. It seeks to mobilize public support for the bill and advocate the government to expedite its passage.

“There’s just no political commitment,” she added.

This is a major problem, as activists and journalists agree Ghana needs the Freedom of Information Bill.

“I think that [the Freedom of Information bill] is a very
positive development which will go a long way to enhance the battle against corruption…it will strengthen the Ghanaian journalist to expose the many corrupt institutions that we have in this country,” said Richard Sky, the parliamentary reporter at Citi FM.

“When it comes to parliament there are so many things that are held out of the public view…once you can have access to information, information is a weapon. Once you have it, you can use it in so many ways to kill this rather monstrous institution of corruption that we have in this country,” he added.

Nana Oye Lithur agrees. The bill will empower Ghanaian journalists and citizens to demand answers and fight corruption.

“It will enhance transparency and accountability. We have serious issues with corruption…[within] every regime we have had some bribe and corruption related cases,” she said.

“Research has shown that with access to information regimes there comes a reduction in corruption… we need to ensure the little resources we have as a country are actually optimized and used to improve the lives of the people of Ghana, and not to go into a few pockets.”

Obruni Chief

Rod McLaren, also known as Nana Akwasi Amoako Agyemen, is dressed in traditional regalia for a funeral. After moving from Canada to Ghana, he was given the esteemed title Nkosuohene. Picture supplied by Rod LcLaren.

Ghana is full of people who came to the country, fell in love with it and its people, and ended up staying.

Rod McLaren’s story is a little different. Like many others, his journey took him back and forth between Saskatchewan, Canada and Ghana, but he’s also received a distinctive accolade – Nkosuohene. He is now a chief in charge of the progress of roughly 200 villages.

After graduating from the University of Saskatchewan with an English degree in 1971, a 23 year-old McLaren went to Ghana on a two-year teaching contract with the then Canadian University Service Overseas, a Canadian development organization.

“When I was nearing the end of my degree I had no idea what I wanted to do with my life and the idea of working overseas appealed to me. I had no idea where I wanted to go, so when the posting came up for Ghana I just took it,” he said.

He finished his contract and headed back to Canada, but returned to Ghana for a couple weeks in 1976 to pick up his future wife and take her back to Canada. They soon were married and had three children while McLaren worked for First Nation’s communities, farmed, and even opened a hardware store.

In 2001 they sold their business and moved back to Ghana to open the African Rainbow Resort in Busua, on the coast of the Gulf of Guinea in southern Ghana.

Three years later, an old friend and Asante chief approached McLaren to offer him the title of Nkosuohene. It is a relatively new position in the ancient tradition of the Akan Chieftaincy – the long-established power structure of the various Akan people that populate the area around Ghana and Ivory Coast.

The Chieftaincy is a pre-colonial institution of governance with judicial, legislative, and executive powers. “The chief of a village or a town was the leader, politically, spiritually, militarily, judicially. He spoke for his people, led them in battle, and heard the cases of his people,” explained McLaren.

Although the traditional chieftaincy is active only in history books in other countries, it exists alongside the presidential system as a parallel political structure in Ghana.

Its survival can be linked to the fact that while the neighboring countries were French colonies or protectorates, Ghana, then the Gold Coast, was British. Because of the British colonial system of “Indirect Rule,” they relied on chiefs and elders to help govern the Gold Coast and the chieftaincy survived.

When the Republic of Ghana was founded in 1957, because of the Chieftaincy’s historical and cultural significance, it was agreed that the chieftaincy system should be respected. Its relevance was again guaranteed in the 1992 constitution.

The chiefs work with sub-chiefs and elders to aid the development of their areas, making provisions for water, education, roads and other infrastructure. It is an especially important role in the more rural areas where the other government has less of a presence. Once a chief dies, the elders select a successor from the region’s old families. Although their role has somewhat diminished, chiefs remain hugely important and powerful people.

“The chief is assumed to be the embodiment of the ancestors. He embodies all his people and all the spirits of the people who have gone before,” explained McLaren.

The position of Nkosuohene was the brainchild of the Asantehene, the king of the Ghanaian Asante people, a sort of chief of chiefs. The Nkosuohene is a “sub-chief” responsible for the development of the region. The title was created to honour someone who does not have to be member of a royal family and is meant to bring in people from outside the area who have a different education and new ideas.

“He [the Asantehene] was trying to incorporate people who were not necessarily members of the royal but whose education and experience who could help the people develop,” said McLaren.

It is a lifetime appointment that comes with prestige but responsibility. Along with the title, McLaren was given the name “Nana Akwasi Amoako Agyemen.” He is charged with overseeing development in the Edubiase Traditional Area, an area comprised of about 200 villages in the Asante Region.

“There’s quite a difference in the expectations on the chiefs in the Asante Region opposed to others. The Asante take the position a lot more seriously and don’t give it out haphazardly,” he said.

The position has been challenging; there was a steep learning curve that he was responsible for overcoming on his own.

“I really thought I’d have a vigorous training and orientation, but I ended up doing almost everything myself,” he said.

He took an active role for the first five years after the appointment, appearing at various functions, attending funerals, meeting every 40 days, and applying for countless grants.

“I tried my best to find them funding, but the proposals have never really gone that far,” he said. “I don’t know if I deserved to get the position at all. Although I’ve worked hard at doing things, I’m not sure I can show any results that can justify the hope that people have had for me.”

However, there have been successes. He says the accomplishment he is most proud of was the successful establishment of a daycare.

Currently, he divides his time between Saskatoon, Saskatchewan and Busua, Ghana.

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“Lutte Traditionnelle:” a photo essay

I’ve never really done sports journalism, so I jumped at the opportunity to go to the Economic Community of West African States (ECOWAS) Games in Accra from the 16 to the 22 of June, 2012. All ECOWAS members were invited to attend, but only eleven countries (Benin, Burkina Faso, Cote d’Ivoire, Ghana, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, and Togo) fielded teams.

The games brought together athletes under the age of 23 to compete in five disciplines: boxing, handball, volleyball, track and field, and traditional wrestling. Traditional wrestling, often called “lutte traditionnelle” because it is most common in French-speaking West-African countries, is often described as West Africa’s oldest sport and has been around for thousands of years. This year the host Ghanaians fielded a wrestling team for the first time, but were swiftly defeated. Although they dominated many of the Games’ other events, the Ghanaians lost to Cote d’Ivoire three matches to two, and then lost to both Benin and Burkino Faso by a score of 5-0.

Each county’s traditional technique differs slightly, but since the 1950s they have been assimilated into one form, making international competition possible. The two fighters compete in a circular ring enclosed by sand bags. As with Olympic free-style and Greco-Roman wrestling, the goal of traditional wrestling is to take your opponent down to the mat. If an opponent is knocked off their feet, the match is over.

Lutte traditionnelle is Senegal’s national sport and, for Senegalese competitors, it is both a physical and spiritual exercise.

“They do the spiritual aspects of it to aid them and help them win their fight. Without [the spiritual elements], they don’t believe it is a traditional fight,” said Daouda Diagna, a member of team Senegal, speaking through a translator.

The Senegalese competitors can be seen looking through a hollowed out bone to “see their future,” as well as dousing themselves with “magic water” before a match.

“They put sand and colours and some other thing in the bottles [of magic water]. The mixture has been sanctified through prayers and they pour it on themselves,” explained Daouda Diagna.

“The wrestling is something very important for everyone in our country. We all love it, even more than football,” he added.

The 2nd biannual ECOWAS games were held at the Accra Sports Stadium from the 16 to the 22 of June, 2012.

Before the fight, Senegalese competitors douse themselves with bottles of “magic water” that have been sanctified through prayer.

A Senegalese competitor observes his teammate’s fight. In line with tradition, he occasionally lifts a hollow bone to his eye to look through.

Three referees officiate the fight. There is one in the ring, and two that sit along the edge.

“The wrestling is something very important for everyone in our country. We all love it, even more than football.”

Habibou Idi of Niger and N’diaye Papa Diabel of Senegal embrace each other in sportsmanship after the fight.

The Burkina Faso coach comforts a competitor after a loss.

Omar Diouane, a competitor from Senegal, celebrates winning the 75 kg weight category while his opponent walks out of the ring.

Athletes and spectators dance in celebration of a Burkina Faso victory.

 

 

Defending sexual minority rights

Homophobia is endemic to much of Ghanaian society.

“Pedophiles or other sexual deviants are not welcome in Ghana.”

The sign loomed over me as I stood, waiting to get my passport stamped, in line at the Kotoka International Airport in Accra. It was my first, and perhaps most jarring, experience with exactly how different the Ghanaian culture is from my own.

In Canada, the prevailing Ghanaian attitude towards homosexuality would undoubtedly be called homophobic. The attitude, however, is characterized less by phobia and more by a vitriolic hatred.

In Ghana, Christian and Muslim communities converge to condemn homosexual activity; a notion that is reflected in social, political, and legal discourse.

Although litigation is rare, homosexual activity is illegal. The Sexual Offences Article 105 in the Ghana Criminal Code reads, “whoever is guilty of unnatural carnal knowledge” is guilty of a misdemeanor, and can be sentenced to up to six months in jail.

Chapter 5 of Ghana’s 1992 Constitution guarantees the protection of all human rights for Ghanaian citizens “whatever [their] race, place of origin, political opinion, colour, religion, creed or gender,” but does not mention sexual orientation.

There have also been calls to criminalize homosexuality. In June 2011, the minister of Ghana’s Western Region, Paul Evans Aidoo, described homosexuality as “detestable and abominable,” and advocated for homosexuals to be immediately arrested.

Later that same year, President John Atta Mills reiterated his government’s position.

“I, as president, will never initiate or support any attempt to legalize homosexuality in Ghana,” he said in October, 2011.

The leaders’ attitudes reflect that of the citizenry. In March, 2012, a group of young men brutally raided a party with suspected homosexuals, beating them in the Accra neighbourhood of Jamestown.

It is a social climate Samuel, the deputy director of the Centre for Popular Education and Human Rights Ghana (CEPERHG) who used only his first name to protect his identity, is all too familiar with.

“Growing up, I had a lot of friends who are MSM [men who have sex with men]. They faced so many troubles and, knowing their troubles, I was like ‘wow,’” he said.

CEPERGH was established in 2003 to promote sexual minority rights in Ghana. They “envision a liberal society that provides friendly, sexual and reproductive health rights services for all persons regardless of sexual orientation, age, tribe, [and] religion,” according to their mission statement.

Although it now provides a variety of programming, including self-defense courses and HIV/AIDS outreach, CEPERGH started by putting on small, secretive “human rights” workshops for sexual minorities.

“These workshops are aimed at educating sexual minorities on their human rights, to make them feel that they are also humans and that they deserve to live like every normal human being. They have the right to association, they have the right to information… they have the right to live as every heterosexual person lives,” said Samuel.

But it is a very hostile environment in which to advocate sexual minority rights.

In 2006, in a response to a rumour that the group was trying to organise an international gay and lesbian conference in Ghana, one of their staff members was badly beaten. They also had to relocate their head office and, under a constant threat of violence, their director fled Ghana for six months.

“I don’t even want to talk about it… [the people] use such harsh words: ‘they should be broken, they should be killed’ they say,” said Samuel.

“It’s not all that bad though. Over the years, some people have come to be accommodating about the situation. We’ve helped people and we’ve changed some minds,” he added.

“The whole thing is dedication. We are poised to do the work, so no matter what the situation is we will still do our work.”

Ending Ghanaian child labour

A girl sells water while, behind her, other children play soccer. An estimated 6.36 million children in Ghana work.

Working children are everywhere in Accra. They collect the fares for trotros, mini-vans turned into buses. They stand in intersections, balancing baskets full of water sachets on their head. They sell bundles of plantains in the market. Although I’m usually unable to guess a Ghanaian’s age within a decade, these workers are clearly children.

Child labour is on the rise in Sub-Saharan Africa, according to the International Labour Organization (ILO) Global Child Labour Report. Troublingly, one in four children in the region is a child labourer. Although the Ghanaian numbers are better than this average, the problem is endemic to the country.

“Ghana has made some progress, but the challenges are always there. We can do more,” said Stephen McClelland, the Chief Technical Advisor for the Ghana Project of the International Labour Organization.

According to a 2003 Ghana Child Labour Survey, an estimated 6.36 million children, between five and 17 years old, are engaged in economic activities. That means that half of children in rural areas work, and 1/5 of urban children work. However, not all this “child work” is considered child labour – labour performed by a child that directly impedes the child’s education and full development, jeopardizing his or her physical, mental, or moral well-being.

Twenty per cent of all children in Ghana, however, are involved in work that meets this definition of child labour. They work mostly in agriculture, sales, and general labour, but also in ritual servitude or commercial sexual exploitation. Out of these child labourers, over 242,000 work in conditions deemed “hazardous.”

According to McClelland, fighting child labour is about protecting children’s dignity, but is also about national development.

Eliminating child labour is “important for countries that are developing. If you ignore the development of your children, then you are condemning your country to difficult development challenges ahead,” he said. Working children perpetuate a cycle of uneducation and poverty.

The International Labour Organization has declared June 12 the World Day Against Child Labour. In anticipation, Ghana’s Ministry of Employment and Social Welfare outlined their way of combating the problem: the “National Plan of Action for the Elimination of the Worst Forms of Child Labour” (NPA).

The plan admits that Ghana has a problem, but also proudly mentions that Ghana has ratified both the ILO Worst Forms of Child Labour Convention and the UN Convention on the Rights of the Child.

The NPA strives to honour these conventions and eliminate the “worst forms” of child labour by 2015 through enforcing labour laws, improving the education system, extending “social protection measures,” and developing standard procedures and protocols in dealing with child-labour cases.

McClelland says it’s a good plan, but needs to be turned into an action plan. And then into results.

“One thing that has struck me is that Ghana has gone a long way. It has good experiences with building up a policy and legal framework against child labour. I am encouraged [by the progress], but I’m also a realist.  We haven’t got all the solutions,” he said.

He added that, in order to decisively end child labour, Ghana need to make high quality schools readily available and has to better redistribute its new found wealth.

“Undoubtedly child labour is caused by poverty, and some of the best of ways of overcoming poverty is to have a good, comprehensive, social protective system,” he said.

Malaria, the hospital, and Ghanaian health care

At the Labadi Polyclinic in Accra, the queue for insured patients is empty. The vast majority of Ghanaians still pay for their medical care “out-of-pocket.”

There is an odd fear and fascination with Malaria in Canada. To many, it’s an “exotic” and deadly disease. It’s shrouded in misinformation and myth. Travelling to a high risk zone, I fecklessly stocked up on mosquito spray and prophylaxes.

After only two weeks in Ghana, I developed a hellish fever. In a haze, I wandered a few blocks to a small hospital. I was too zoned out to figure out my travel health insurance, so I walked past the line for “insured” patients and joined the much longer line for the “uninsured.” I was diagnosed within a couple hours, immediately treated, and, within 24 hours, felt significantly better.

For me, and anyone else who has easy access to proper treatment, Malaria really isn’t that big of a deal. Amazingly, however, Malaria continues to kill more Ghanaians than any other disease.

The idea for the National Health Insurance Scheme (NHIS) first surfaced as a campaign promise in the 2000, in order to improve access to basic health care services and eliminate the widespread “out-of-pocket” payment for health services. The idea became law in August of 2003, and, in December 2004, the NHIS was established.

Since then, the NHIS has always been on the political radar. In 2009, President Atta Mills and the National Democratic Congress vowed to improve the struggling system, striving to make publically funded basic health care universally available.

The idea is that Ghanaians contribute to a fund so that they are financially supported when they need medical care. Formal workers pay a percentage of their income to the system and informal workers- about 80 per cent of the Ghanaian workforce- pay a flat rate to the NHIS. In return, they qualify to have their basic medical expenses covered by  NHIS. In practice, however, things are quite different.

“The concept is good, but the reality isn’t. It doesn’t really help many people,” one Ghanaian friend told me.

In 2008, there were only 1,500 health care facilities to service the entire Ghanaian population of 24 million people. According to a 2008 Austrian Centre for Country of Origin and Asylum Research and Documentation (ACCORD) report, these facilities are not evenly distributed and the average Ghanaian lives about 16km from a health care centre.

Plagued by chronic funding and personnel shortages, the NHIS doesn’t cover the very people it was designed to serve.

On May 2007, the NHIS covered under half of its targeted people. That’s only 19-65 per cent of the population, depending on the region, said the same ACCORD report.

OXFAM estimates the numbers to be even lower – around 18 per cent. The same 2011 report maintains that most people covered are rich, not the poor who the system was designed to protect from the high user fees.

Whatever the numbers may be, the reality is that most health care spending Ghana continues to be “out-of-pocket.” In 2005, out-of-pocket expenditures amounted for over 65 per cent of all spending on health care, according to the ACCORD report.

The “out-of-pocket” expenditures are not cheap. For my visit, I paid one cedi for my file, eight for my consulting fee, 15 for the blood test, and 10 for the treatment. For me, the total cost was 34 cedis, about $18 USD. The minimum wage in Ghana is only 4.48 cedis per day, about $2.66.

Due to the high cost associated with health care, and the failure of the NHIS to offset this cost, many Ghanaians seek traditional treatments or self medicate. That means people aren’t going to get the same quick, effective malaria treatment I was privileged to: the reason why a curable disease is, sadly, the disease that claims the highest number of victims in the country.

Ghana’s suicide stigma

A policeman stands guard over the scene of last week’s suicide at Trust Towers. It is estimated that four Ghanaians commit suicide each day.

I went to the scene of a suicide on the third day of my internship. The suicide victim, later identified as a former foreign ambassador and a university lecturer, ascended to the ninth floor of Trust Towers in downtown Accra, removed his brown leather sandals, slid open a sticky small double-pane window, and jumped to his death.

According to the Network For Anti-Suicide & Crisis Intervention (NASC), almost 1,600 Ghanaians committed suicide in 2008 – about four people each day.

The actual numbers, however, may actually be much higher. The NASC statistic only includes cases reported as suicide, and experts believe most suicides are covered up because of the repercussions they have for surviving family members.

“Suicide is one of the major pandemics in Ghana,” said Mary Addy, the founder of the local NGO Cultivating Minds which provides suicide prevention services.

Returning to the newsroom, I observed my coworkers’ reaction to the news. There was the expected sadness and perplexity, but also condemnation.

Suicide in Ghana is strongly prohibited and highly stigmatized. A reality, experts say, is actually worsening the problem.

All suicidal behaviour is illegal in Ghana, and attempted suicide remains a criminal offense. According to section 57 of the 1960 criminal code attempted suicide can, and often does, carry a penalty of up to three years in prison.

In addition, “Christianity, Islam, and traditional beliefs all converge to condemn suicide. [Suicidal] people are seen as immoral, cowardly, even aggressive,” Joseph Osafo, a psychologist and long-time suicide researcher at the University of Ghana, Legon, explained.

The comments under the news story on our station’s website reflect this popular stigma.

“Either he fathered a child illegitimately and didn’t want to be alive to see the disgrace, or was entangled in some shady business ventures,” wrote one condemning user.

Curious, I brought up the subject while talking to a Ghanaian friend. “If a friend came up to you and told you he’s suicidal, would you think any less of him?” I asked. “I think I would,” was his response.

The result is that no one wants to openly say that they’re suicidal, and seek the help they need because the condemnation is too harsh, Ofaso said. And suicidal people “are not getting the support of the society, [they] are not getting the support of the powers that be.”

It’s a reality Addy also takes issue with.

“It’s not a shameful act. Anyone can go through [depression],” she, who suffered years of depression, said.