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Field Notes

Inside the Children’s Ward at Accra Psychiatric

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By Jocelyn Edwards

I’m just sitting down for an interview in the children’s ward at the Accra Psychiatric Hospital when the girl throws her arms around my neck. 13-years-old, she’s wearing a white and blue bathing suit that serves as underwear and a bulging diaper. She puts her arms around me, hugs me and won’t let go. 

“She’s very friendly,” says one of the nurses. “She likes white ladies.” 

Praise*, who has severe autism, is one of the many special needs children at Accra Psychiatric who have been abandoned by their families and left in the care of an overworked and under-resourced staff. 

It was the dire situation of these children that students from the Ghana Institute of Journalism recently chose to focus on for a project on people with disabilities in the country.

Along with two students from the school’s JHR chapter I visited the children’s ward of the hospital late last month. What we found there was a staff struggling to care for children with severe special needs, often without the essential tools to do their jobs properly and safely. 

The hospital, which is the main referral centre for country of 25 million, currently houses 14 special needs children like Praise. Abandoned at an orphanage outside of Accra, the 13-year-old girl was brought to the hospital two years ago by Roman Catholic nuns. 

Her story of abandonment is not atypical in a highly religious society that associates disability, both mental and physical, with evil. Children with disabilities are often shunned and rejected. Many of the other children at Accra Psychiatric have also been abandoned by their families.

The children who come to Accra Psychiatric are often found at various public places around the city and then brought to the hospital by police. “People dump them at our main gate, at the OPD (Out Patient Department) or at lorry parks,” says Margaret Owusu, the principal nursing officer of the hospital’s children’s ward.   

Even when the children’s relatives can be located, they often don’t visit or assist in caring for their children. Kofi, a 13-year-old boy, hasn’t received a visit from his mother since early last year.

The boy, who has what the nurses refer to as “severe mental retardation,” sits at a table in the courtyard of the hospital, staring off into space. Brought to the hospital in 2010 by his mother, he has since been discharged by doctors. However, despite the nurses’ persistent calls, she has still not come to pick him up. 

“(Families) don’t come at all when you call them,” says Owusu. “Sometimes they will (even) insult you.” 

Similarly, 14-year-old Ama, who was discharged from the hospital two years ago, has not yet been collected by her parents. “We called the father last year, but he told us he is now at the prayer camp praying for us to take good care of her,” says Owusu. As we conduct our interview, the girl, who has what has been diagnosed as “mental retardation and epilepsy,” wanders aimlessly around the courtyard. 

As a result of their abandonment, nurses must meet the children’s every basic need themselves. Since the hospital is severely under resourced, it is a task they often struggle with. 

The children’s ward often suffers from a shortage of essential equipment, according to Owusu.  

While the ward has a big box of rubber gloves the day that we visit, that’s not always the case, explains the nursing officer. Sometimes, they don’t have any gloves. It is a situation is stressful for nurses who often have clean up after children who have soiled themselves.

“If there are none (gloves), we use a rubber (plastic bag) to tie our hands,” says Owusu, who adds that without gloves, nurses worry about infecting themselves with disease.  

Sitting in a corner by the door of the ward is a jug of water and a small bottle of hand sanitizer. It’s what the nurses use to clean their hands after bathing the children and even after changing their diapers. The ward is currently out of disinfectant, according to Owusu. 

As for the diapers themselves, while the hospital often receives donations from individuals and companies, sometimes they aren’t exactly what’s needed. In the middle of our interview, a nurse comes out of a store room holding an enormous diaper that looks like it was made for a 300 pound man. Nurse Owusu shows her how to tie it in order to make it child-sized.

This dire lack of resources is not unique to the children’s ward. Elsewhere in the hospital patients sleep on the floor because there are no mattresses, and the pharmacy has only a three month supply of medicine on hand. 

It’s a situation that’s unlikely to change until government follows through on its responsibility to protect Ghana’s most vulnerable. Government has disbursed just 280,000 cedis ($144,000) to Accra Psychiatric this year, according to the hospital’s accounting department. That leaves the facilitiy with a budget shortfall of over $3.8 million.

* Children’s names have been changed.

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