The use of non-biomedical methods to treat mental disorders in developing countries, like Ghana, has long been acknowledged. The World Health Organisation (WHO) estimates that about 80% of people who need mental health care in developing countries go to indigenous or faith healers for care.
Some studies have been done to explain the popular use of non-biomedical health care alternatives, and various reasons have been suggested. These include an alignment of the illness beliefs of patients and healers, easier or more flexible accessibility, and cost.
But many of these studies of non-biomedical health care systems in Africa tend to assess the healers as one homogeneous group of practitioners. In our study, we argued that different types of healers may hold different worldviews. These in turn influence how they conceptualise or think about different disorders.
We conducted interviews with 36 participants from four different categories of non-biomedical healers in Ghana’s capital Accra. The categories of healers were herbalists, Pentecostal Christian faith healers, traditional medicine men (also called shrine priests) and Muslim clerics/healers.
Using case vignettes, we examined the healers’ notions about three different types of mental disorders – schizophrenia, depression and post-traumatic stress disorder (PTSD). We examined their ideas about the nature and perceived effects of the different disorders, as well as their thoughts on the causes.
Understanding the different beliefs about different disorders is important in efforts to improve mental health care in developing countries. In particular, with increased calls for collaboration between biomedical and non-biomedical health care systems, it’s important to understand how the different groups of healers think about different conditions.
Different views on different conditions
Our data suggest that indigenous and faith healers’ views on psychotic illness were similar to biomedical notions. But they held different views on depression and PTSD. These views were fluid, and obviously influenced the choice of treatments they offered patients.
All the healers readily identified the case vignette of schizophrenia as an example of mental disorder. This was often described as “madness” by the healers. Some local names that the healers used included “abɔdam”, “εdam” and “sεkε”. These names are often used to describe people whose behaviour is perceived as disruptive, disorganised or overtly dysfunctional.
Although the participants believed spiritual factors like witchcraft and curses could cause such a condition, they were also aware that certain physiological processes (such as traumatic brain injury) as well as abuse of drugs and alcohol could account for it. They all considered it to be a severe condition which required urgent intervention.
So for this psychotic disorder there weren’t major differences in the views of the various categories of healers, and their views were similar to biomedical understanding of psychotic disorders.
But this wasn’t the case for all the disorders.
For example, most of the healers were quite firm in their views that post-traumatic stress disorder was not a mental disorder. Rather, they considered it to be a normal reaction to a traumatic experience. The healers thus endorsed more psychosocial explanations for PTSD.
Depending on their orientation, they described different causes for the symptoms of PTSD. For example, pastors, described PTSD as being due to the presence of a “spirit of fear”. Some herbalists also believed the symptoms were physiological manifestations of “thinking too much”.
Given these different notions of cause, their recommended treatments also varied. However, all the participants emphasised the need for some form of counselling. In most cases, the healers believed that PTSD could develop into full-blown “madness” (ie disruptive/psychotic behaviours) if left untreated.
There was a great deal of difference between the healers when it came to depression. Most of the herbalists had physiological explanations for the symptoms and did not consider depression to be a mental disorder. For their part, the traditional medicine men viewed depression as a milder form of mental illness. Some pastors did identify the condition as depression, while the Muslim clerics saw it as potentially resulting from Jinn possession.
As expected, the recommended treatments were based on the identified cause. For instance, the herbalists mostly recommended treating the underlying physiological condition through herbal remedies. The pastors advocated biomedical care as well as spiritual interventions like prayer and fasting.
In many African countries traditional and faith healers are viewed as community leaders and their views are likely to reflect those of their patients. Consequently, biomedical professionals who treat patients who are also seeking help from indigenous and faith healers, would benefit from understanding the different beliefs about different disorders. This can then form an important part of clinical training and practice.
In addition to this, the healers’ positions of influence within their communities is a unique opportunity to enhance the reintegration and monitoring of patients once they return to their communities. Their influence can also play a key role in fostering patient behaviour change and treatment compliance, as well as eliminating stigma.
But this can be done only through appropriate collaboration with community-based healers. It can only work effectively if there’s an appreciation of the different views of different healers. Understanding this diversity of approach may be crucial in developing a framework for collaboration amongst different types of healers (including biomedical practitioners) to improve mental health care.
Ghana sold $2 billion worth of dual-tranche Eurobonds with 10- and 30-year maturities on Thursday and it will pay issuer-desired yields, government and transaction sources said.
The West African sovereign sold $1 billion each of the 10-year notes maturing in 2029 and a 30-year with 2049 maturity at 7.625 percent and 8.625 percent, respectively.
It set guidance for the May 2029 bond at 7.75 percent to 7.875 percent while the May 2049 was in the 8.75 percent to 8.875 percent range. The notes were first marketed in the low 8 percent area yield and low 9 percent mark.
Total books passed $5.5 billion, evenly split between the two tranches, lead advisers said.
“It’s a marked success for Accra because they got a low yield and a bigger size,” a sovereign debt market watcher told Reuters. “The pricing revision may have aided the deal and left investors unhappy.”
It was Ghana’s sixth sale since a 2007 debut. Lead advisers for the sale were Bank of America Merrill Lynch, Citigroup, JP Morgan and Standard Chartered. Ghana is rated B3/B-/B
The government plans to use some of the proceeds to refinance debt and up to $750 million as revenue for its 2018 budget. Ghana, which exports cocoa, gold and oil, is in its final year of a $918 million IMF credit deal to narrow fiscal deficit, inflation and public debt which hit 69 percent of gross domestic product in December.
The Thursday sale by Ghana followed similar big transactions by continental peers Angola, Kenya and Nigeria.
Marriott Hotels has announced its debut in west Africa, with the opening of Accra Marriott Hotel.
Owned by African Hospitality, the hotel is strategically located opposite the Kotoka International Airport. Set in the heart of Airport City, a burgeoning urban development, the Accra Marriott Hotel is just a few kilometres outside of the central business district providing easy access to major corporate businesses, government entities and well-known city landmarks.
“We are thrilled to open the Accra Marriott Hotel, a highly anticipated addition to our Africa portfolio and a significant milestone in our journey,” said Alex Kyriakidis, president, Middle East and Africa, Marriott International.
“Accra is the heartbeat of Ghana, a dynamic city bustling with energy.
“A commercial, manufacturing, and communications centre with great shopping and excellent nightlife, it makes an interesting travel destination both for business and for leisure.
“The Accra Marriott Hotel will add to the city’s maturing hospitality scene, inspiring guests with more forward-thinking experiences and aesthetically inspiring spaces that speak to their inventive nature.”
With 208 well-appointed rooms, three = dining venues, 800 square meters of meeting space, a pool and a fully equipped fitness centre, Accra Marriott Hotel offers state-of-the-art business facilities.
By John P. Frinjuah and Josephine Appiah-Nyamekye
Corruption is a wicked problem that permeates every fabric of Ghanaian society, especially the public sector. Over the years, Ghana has fared dismally in its fight against corruption. In fact, the country has dropped consistently in recent years in rankings by anti-corruption and transparency bodies, including Transparency International and the Ibrahim Index of African Governance. If we do not see a renewed commitment to the fight against corruption – especially political corruption – the country risks reversing the gains made over the years in democracy, good governance, and development.
What do Ghanaians say about corruption?
The latest Afrobarometer findings on popular perceptions of corruption in Ghana mirror those of Transparency International’s Corruption Perceptions Index 2016 and the Ibrahim Index of African Governance 2017. Overwhelming majorities of Ghanaians see “some,” “most,” or “all” public – and private – sector officials as corrupt. The perception is worst for officials in the public sector, with the police seen as the most corrupt group: 92% of citizens say at least “some” police officials are corrupt, including 59% who say “most” or “all” are corrupt. The president and his office do better than other public officials, but still, more than three-fourths of citizens perceive at least some corruption there (see Figure 1).
This leadership morass is not limited to state officials. Even traditional and religious leaders are seen as corrupt by substantial numbers of Ghanaians – a surprise given the trust society places in them and the moral high ground on which they are expected to stand.
Figure 1: Perceived corruption in the public and private sectors | Ghana | 2017
Although popular perceptions of the overall level of corruption in the country have increased since 2014, a majority (60%) of Ghanaians now express approval of the new government’s efforts to combat corruption, a significant improvement compared to the 25% recorded in 2014 (see Figure 2). This approval could be explained as a combination of people’s hope that the new NPP government – which came to power on a ticket of anti-corruption and economic resuscitation – checks the menace of corruption and honours its electoral promise to the people.
Figure 2: Government’s performance in fighting corruption | Ghana | 2002-2017
Media reports and personal conversations suggest that the Ghanaian electorate and burgeoning middle class are increasingly unhappy about the high level of corruption, lack of accountability, and economic mismanagement that have bedeviled the country. Afrobarometer data confirm that they are eager to see stiff punishment meted out to perpetrators of such acts. Almost two-thirds (64%) of Ghanaians want corrupt officials prosecuted and, if found guilty, forced to return stolen funds, jailed, and publicly named and shamed. About one-fifth (22%) favour government retrieval of stolen funds without prosecution, while one in 10 (9%) would opt for prosecution without retrieval of stolen funds (see Figure 3).
Figure 3: Appropriate punishment for corrupt officials | Ghana | 2017
In its one year in office, the NPP government has taken some steps in that direction, including the setting up of the Special Prosecutor’s office. Ghanaians want more than just lip service. With alleged fraud cases[ii] such as the BOST premix scandal, arson of the Central Medical Stores in an attempt to cover evidence of fraud, and the Ministry of Special Development Initiative’s 800,000 cedi website saga, government will need to live up to its pledges to crack the whip of justice against corrupt officials, irrespective of their political inclination.
[i] Links to corruption perceptions rankings:
[ii] Links to stories on corruption cases:
The Square Kilometre Array (SKA) is the world’s largest radio telescope project, which will collect data over one million square kilometres from radio astronomy telescopes on the African and Australian continents. In the long run the two-phased SKA could possibly help scientists answer questions in astrophysics, cosmology and fundamental physics.
Phase one of the project entailed setting radio telescopes in South Africa and Australia. Phase two will include more telescopes being added by partner countries, New Zealand and the eight African countries namely: Botswana, Ghana, Kenya, Mauritius, Madagascar, Mozambique, Namibia and Zambia. The full array should be up and running by 2030, but the first phase is expected to be operational by 2023. The launch of Ghana’s radio telescope is a critical part of this process. Dr Bernard Duah Asabere explained its significance.
How did Ghana get involved in the project and how does it fit in?
Ghana has had a redundant satellite communication antenna in Kutunse – a suburb 25 kilometres north-west of the capital, Accra.
Between 2011 and 2017 this antenna has been undergoing refurbishment for use as a radio astronomy telescope. At the end of the first engineering phase, the refurbished telescope is capable of participating in global network observations using a technique known as Very Long Baseline Interferometry (VLBI). It also be used in single dish or standalone operational mode.
Interferometry is a technique in which collections of telescopes scattered over a large area function as a single radio telescope. The Very Long Baseline Interferometry technique is most well-known for:
imaging distant cosmic radio sources,
tracking spacecraft, and
for applications in astrometry.
But the technique can also measure the time differences between the arrival of radio waves from separate antennas to the same source in the sky. This helps astronomers get a better image resolution of an object or a region in the universe.
Put simply, if different telescopes at different locations are all tuned to observe the same source in the sky at the same time, astronomers can get fine details of the specific object being observed.
The countries that make up the African SKA project are each building their own radio telescopes or converting redundant telecommunication dishes so that they function as a network known as the African VLBI Network (AVN).
Ghana now becomes the first country in the African SKA partners besides South Africa to have a telecommunication antenna converted to realise the African VLBI Network. With Ghana’s telescope now operational, it means that South Africa and Ghana will be able to do joint observations. When the other seven African SKA partner countries get theirs ready, they will join the African’s network.
Kenya, Mozambique and Zambia are contending to add the next telescope to the network.
How did we know the Ghanaian telescope was ready and what will it do?
Across the globe there are several very long base interferometry networks: Europe has one, as does Australia and America. Any telescope across the world is able to join an observation in one of these networks.
After Ghana re-engineered the antenna into a functional radio astronomy telescope, it needed to do a science commissioning of the facility to see if the refurbishment was successful and it could track and observe astronomical sources in the sky and join international observations.
When Ghana tested its telescope it was able to detect methanol masers, observe pulsars and also succeeded in participating in an observation with 15 other telescopes which form part of the European very long base interferometry network.
Until now South Africa has been the only country on the continent that had been joining in VLBI observations with other countries’ networks because it was the only country with a radio telescope on the continent.
With radio telescopes in Ghana and South Africa, an African network is now given birth to. Aside being a part of the African network, Ghana could join other telescopes on the globe to do science observations.
What is the significance of Ghana’s telescope for astronomy in Africa?
There are many celestial objects to observe in the Universe: planets, masers, galaxies, meteorites, stars and even regions in the sky. And there are global questions that astronomy community is interested in addressing. This includes questions like: is there any life outside earth? Are there other stars that are as prominent as the sun? How did the universe come into being? These are questions that the SKA will attempt to address.
If Africa has its own network, astronomers on the continent can choose what celestial objects and regions it wants to observe.
If we look at most of the existing telescopes across the world, there has been a hole in Africa. Telescopes situated in the Northern hemisphere are unable to see the region of the sky in the southern hemisphere. With an African very long base interferometry network set up, astronomers in Africa can now observe both the northern and southern hemispheres of the sky from the continent.
What is Ghana bringing to the party and what does it hope to get out of this SKA collaboration?
The facility at Kutunse will be used as a science instrument but also as a training facility. Ghana will help the other seven countries that form part of the African network refurbish their unused antennae.
Although this technology is not new and has been done in Australia, Peru, Japan and the UK, no other country in Africa has done this.
For Ghana, developing the skills, regulations and institutional capacity in the partner countries is a vital part of building the square kilometre array on the continent over the next decade. This is because it will optimise African participation in the SKA.
Ghana will build it robust research community in a field never before accessible to the country.
But there is also the prospect of improving the radio astronomy capacity in the country. Ghana’s radio astronomy development strategy forms part of the broader Ghana Science, Technology and Innovation Development Plan.