Accra Psychiatric Hospital

Last week we visited the geriatric wards at the Accra Psychiatric Hospital. HelpAge provides cooked meals to the patients every two months or so. They also offer small financial support and other services to the hospital and its staff and patients. We came with two huge pots of jollof rice and stew, one each for the male and female wards. After weeks of office work I was eager to have some hands-on interaction with the elderly, however minor the role, which in this case was serving lunch. I had been to the hospital once before to speak with the medical director about holding an event with the patients for the UN Day for Older Persons. At that time I had never entered the wards so this was my first opportunity to see the inside of the wards and get a better idea of the conditions at the hospital. Hospitals in general exude a certain smell of sterility, but a hospital in the inner-city of Accra with concrete walls and floors and open windows takes on the smells of its surrounding environment as well as those of its patients. We went to the female ward first and it was indeed damp, musty and the smell of sterility along with urine infiltrated the thick walls. When we opened the door, a woman chewing on fish bones came running at me yelling “obruni” and wanting a hug and than just stared at me blankly and spoke. According to my colleague Francisca, the woman was speaking nonsense. We moved into an adjoining courtyard and began to serve lunch to the women. They were so excited and kept asking for more. Some were very responsive and talked to us while others that I imagine were suffering from dementia didn’t respond to our presence. One woman would not dress and walked around the courtyard nude speaking loudly and pointing at nothing. There was one woman that the nurse informed me had been left there a few days ago and she didn’t speak any dialect that they knew and no one knew her name. When I had served her she replied with “Merci” so the nurse asked me to ask her what her name was in French. Unfortunately, her reply did not yield a name, she was simply babbling. I wondered how a family could simply rid themselves of a family member like her. Maybe she didn’t have any family and someone thought this would be the best place to bring her. However, the nurse informed me of many instances where families leave elderly at the hospital or never come to pick them up after treatment. There remains a strong stigma around mental illness in Ghana, to the extent that people with mental illness are still referred to as “mad”. These attitudes are causing a drain on an alrealy over-burdened health care system where these individuals could be cared for by their families they are left to the care of nurses and doctors.

There is neglect for these individuals, as was evident by the conditions of the hospital. Such an environment will not encourage inclusion into a loving environment, which so many elderly need to fight the isolation that many often experience. Often people think elderly are a drain on the system because they are not contributing to society. However, people often overlook the contributions that these older people made when they were younger and more mentally stable. There was one woman in the ward that embodied this challenge. She used to be a nurse and the patron of the general hospital in Accra. She made me laugh because she introduced herself as Rose, Princess of Wales. I told her it was an honour to meet her. The economist in me knows that individuals discount the future way too much. They cannot place themselves in the shoes of an elderly person to know what it will be like when they age. People prefer to spend now rather than save for later, we attribute the best years of our lives to when we were young, and we neglect to treat the elderly the way we would want to be treated when we have reached their age.

The men’s ward was less lively mostly because the men were watching the Ghana-Spain match, but they also seemed more timid and unsure about us entering their courtyard. Something I failed to observe while I was there was the evident gender inequality that existed in the hospital between the male and female wards. Ebenezer told us later that the female ward receives an immense amount of support from church groups and women’s organizations. They had cots neatly lined with nets and blankets. The men however were not receiving the same treatment. Although women remain marginalized in the world there are instances where work for equality of one group can focus so much on that group that equality between the two groups is forgotten.
When we left, Jody made an important point. Nat asked her how she felt and she said she was sad because we came and went so quickly. What real impact were we having in their lives? What was sustainable about my work? Could that role not have been filled by a Ghanaian to foster self-sufficiency? Whenever my thoughts turn to this inner conflict, I try to bring the situation down to a smaller scale. I remember the smile of the woman when we opened the door to the ward. I remember the woman that wanted her picture taken with me and then pointed at her chest and then mine and said “buddy”. Even if it was just a smile and compassion, there was something I offered that day that changed their day. Perhaps their influence on me was much stronger, because their stories and faces can only strengthen my resolve to advocate for them.

I know this is a long entry but I have a prayer request. The three northern regions and parts of the western region of Ghana are suffering from intense flooding that ravaged the area last week. There are six people confirmed dead and an estimated 400,000 people have lost their homes. Entire villages were flooded, ruining homes, infrastructure and crops. Hundreds of livestock including cattle were washed away in the flood, this along with the loss of crops has posed a critical food security issue in the region. The Ghanaian government is responding with relief items. Please pray that these relief items are reaching those in need. Pray also for the families of the victims of the flood and for general protection and calm for those forced to live with family members or in schools unsure of where their future lies at the moment.