Undercover: Inside Ghana�s �Mad House�

It is a sad and sorry sight of unimaginable human suffering; of bright lives, powerful brawns and brilliant brains badly bruised and blighted by disease. It is a tale full of terrible and tragic oddities. The Accra Psychiatric Hospital (Asylum Down), Ghana�s leading psychiatric treatment centre is haemorrhaging from serious administrative, operational and ethical lapses that have seen patients living in subhuman and monstrous conditions. One inmate is eating from the upturned bottom of a dirty rubber bowl, rather than from the inside. He says the rubber bowl was given to him the previous day by Queen Elizabeth of Great Britain at a dinner where the two exchanged kisses. Leaning against a wall in another corner, a youthful fellow looks vaguely and forlornly into the sky, mumbling to himself; �I see the moon though it is a bright afternoon.� His shrinking waistline is barely able to keep his trouser firmly on his buttocks; his faded jeans has dropped loose, revealing a not so manly groin bristling with an untidy mass of neglected pubic hair. And over there is a bizarre ritual by a group of four who are full of smiles while slurping some curious liquid that an inmate (Jah) is dropping on their tongues from a goblet he is holding. In fact the officiating �priest� has just urinated into that cup in their very sight and yet, they are licking it with relish! These are but a few of the wild eccentricities that were witnessed at the Accra Psychiatric hospital. Yet, if you find the above narrative about our less fortunate compatriots to be unsettling, then what pertains among some of the supposedly normal, sober and more privileged workers at the facility would outrage you beyond measure. Seven months of investigations by the New Crusading Guide�s Anas has uncovered several malpractices perpetrated by some staff of the hospital against patients of the Accra Psychiatric hospital. Posing variously as a patient, a trader, a baker and a taxi driver as part of the beat, this reporter, has managed to put together a catalogue of hardcore video, audio and still pictorial evidence of both daylight pilfering and midnight stealing by the hospital staff; of the appalling living conditions at the hospital and of regular use and sale of narcotic drugs such as cocaine, cannabis and heroin among patients and staff of the Accra Psychiatric Hospital. Admitted for three weeks at the hospital under the name Musa Akolgo, alias �Don Dada� at the BHC Male Ward with folder number 61919, yours truly got first-hand, face-to-face observation of the several cases of human rights abuses and neglect of patients by nurses, the brisk trade in narcotic drugs, and an ever-growing incidence of alcohol sale and use by the patients; all of which were captured with a hidden camera. On a daily basis, staff of the hospital steal food meant for patients not only for their personal consumption, but also for sale to the unsuspecting, and sometimes, colluding public. It is brisk, cash-and-carry business: private individuals can obtain food items like beans, rice, flour and sugar at discounted prices from the shameless kitchen staff of the hospital. Psychotic drugs such as Largactil� and other sedatives are equally available for sale to the public. Drugs like marijuana, cocaine and heroin virtually litter the wards of the facility for easier picking than the notorious alleys and corners of Tudu or Sodom and Gomorrah in Accra. As a patient of this place, the reporter and his colleagues in BHC Male Ward had very little trouble getting cannabis, heroine and �coke� (cocaine), whether the rock or Thai type. For a little daily tip, some of the workers would run errands buying these hard drugs for the patients. The operation of drug peddlers within the Psychiatric hospital is an open secret among staff and patients. Well-known distribution outlets in Tudu, Sahara and Accra Newtown see and use the Psychiatric hospital as a major hub for local drug distribution. Speaking to this reporter, Clean Face, a drug dealer who plies his trade at the hospital revealed that patients at the hospital form the core of his customer base. �Before they got admitted into the hospital, I was supplying them with these same drugs so what I am doing now is take the market closer to the clients.� Clean Face moves to various drug joints in Accra to put together enough stock for patients at the hospital. When asked why he would not allow patients to undergo their rehabilitation without narcotic drugs, he retorted scornfully, �Who told you they don�t need it after they go mad? If I don�t look for them and sell it to them, how do I make my money? I do not neglect my customer, especially patients in Pantang, where I have my main customers.� It is also common to see hospital staff leave both personal and professional duties in the hands of patients. Many of these patients are made to carry buckets of water to the living quarters of resident staff. Others are often made to perform the duties of kitchen matrons as well as other chores unconnected to the hospital. Patients can be seen cooking, cleaning, washing and even doing work that nurses were supposed to do. One video recording shows a patient who consistently sits on the garbage dump to eat, picking rotten materials and scraps from litter bins and after that dashing straight into the kitchen to help the staff to cook. One morning, this reporter followed the patient equipped with a hidden camera, as he headed for the garbage heap to play and pick rotten and maggot-infested waste with his bare hands. Minutes later, he heads for the kitchen, where he is made to stir with his unwashed hands the pot of porridge that was being cooked for the morning�s breakfast. The neglect, abuse and maltreatment of patients by nurses in the hospital remain one of the most disturbing aspects of life within the hospital. On many occasions, this reporter filmed instances where patients suffering severe fits were left to lie at the mercy of the weather, with nurses totally apathetic. Some nurses were captured beating patients who lay on the ground helpless and writhing in pain. On one occasion, a male patient is seen helping a female patient suffering from epilepsy to get on her feet. After many futile attempts to help the ailing girl, the male patient leaves her on the ground close to a nurse�s office and moves on. Minutes later, a nurse passes by without offering any assistance to the patient. Not far from the patient, three nurses could be seen chatting idly as the epileptic patient lies in pain. When help finally arrives, the patient is beaten mercilessly by the nurses amidst shouts of �get up�, �foolish girl�, �if we beat her she would get up�. The attitude of nurses is generally so outrageous that the hard work and conscientious disposition of Ken Wholley Brantuo, Alex Baah and a few others shone forth like torch in pitch- darkness. Francisca Ntow, a young nurse at the hospital epitomised the spirit of care and love that accompanies nursing. With beaming smiles each day, she tries her best to give attention to patients and to find out their state of being. Her shining example gives hope to the future of psychiatric nursing in the country. Student nurses from Pantang Nursing Training College also helped to put a smile on the faces of patients. This reporter identified nurses like Mohammed Awol Wiqaya, Constance Oppong, Theophilus Martey, Sulleiman Mohammed and Grace Fokoyu, Musa Alhassan, who demonstrated high principles and practices of psychiatry. They engaged patients in a warm and lively manner in the healing process. That notwithstanding, there were also incidents where patients died and their corpses left neglected for too long. In fact the facility is so overcrowded that nurses find it impossible to do a roll call every evening. On one occasion, a patient died in a cesspit tank and the body lay there for weeks before another curious patient drew the attention of Management to the mess, as witnessed by this reporter. A nurse (name withheld), who spoke to this reporter, confirmed these state of affairs at the hospital. �You cannot lie about it. They always blame it on the numbers, but I believe this is a calling that must be pursued with the heart.� Meanwhile, authorities at the Accra Psychiatric Hospital deny knowledge of some of such happenings within the hospital. Dr. Akwasi Osei, Medical Director of the hospital says nobody has given him evidence of such incidents at the hospital, although he admits the rumour mill churns out such stories. Without ruling out the availability and use of narcotic drugs among patients, Dr. Osei tells The New Crusading Guide, �I have heard a few cases of some patients going out to bring cannabis to the hospital. I have had difficulty getting somebody who can point these things out. If you know of any such cases, let me know� he emphasized. On the issue of patients being used as workers in the kitchen and by other workers, Dr. Osei explains that patients actually go to pick their food in the kitchen as a form of occupational therapy. This, he says, �serves as stimulation towards their improvement�, emphasising that these are �patients who are practically well enough to go home�. He however admits that it cannot be a justification for staff to leave their work for patients to do. But our evidence was to the contrary. We found a patient whose mental state clearly undermined his capacity to think through the fairly routine act of self-service: he carried hot rice water on his bare head resulting in the serious burns which caused his scalp to peel off! Meanwhile, The United Nation�s (UN) World Health Organization (WHO) considers mental health critical to human development hence the definition of health as: "A state of complete physical, mental, and social wellbeing and not merely the absence of diseases or infirmity." Again, Article four (4) of the African Union Charter on Human and People�s Rights declares that, �Human rights are inviolable. Every human being shall be entitled to respect for his life and the integrity of his person. No one may be arbitrarily deprived of this right.� These rights are grossly violated at the Accra Psychiatric hospital. The Medical Director of the Accra Psychiatric hospital however blames most of the challenges faced by the hospital on inadequate logistical support. �We have very serious constraints in terms of infrastructure. Although our Psychiatric system is better than that of most countries in our part of the world, we do not meet up in terms of what a Psychiatric hospital is expected to be,� admits Dr. Akwasi Osei. This view was self-evident. The decaying physical structure is one clear proof that the hospital was underfunded. Poor supervision, understaffing and under-trained workers combine to create conditions that encourage patient rapes, beatings, riots and suicides. In several cases, patients suffered grave harm as a result of poor medical oversights or errors. This is in sharp contrast with the state of the art rehabilitation facilities witnessed by this reporter at the St. Goran Psychiatric hospital in Stockholm, Sweden. At the St. Goran hospital, this reporter was greeted by a very hospitable environment, where patients lived without abuse or any form of neglect. At the hospital, there were several doctors and nurses who attended to patients with utmost care. There was an apparent sense of belonging among patients at the hospital; unlike the Accra Psychiatric hospital where most patients lived in fear and wallow under sub-human conditions. In an interview with some staff of the hospital, this reporter was shown so much politeness and later referred to Fredrik Bengtsson, who was in charge of the Hospital�s central unit.