At the Intersection of Faith and Medicine
By Aastha KC
[dropcap]L[/dropcap]ocated on the second floor above a pink tiled grocery store on Odeneho Kwadaso Road in Kumasi, a plain cemented room has been effortlessly transformed into a makeshift church. Red drapes cover the horizontal space across the room while a two-frame window reveals the construction of the actual church next door. Inside, church goers sit on red plastic chairs as Pastor Bill’s voice pierces through the microphone, and he retells a story about a local Ghanaian woman’s encounter with God. During a moment of pause, Pastor Bill’s cell phone rings. On the other end is a woman who explains that her relative is mentally ill and has been acting strange for the last few days. “In that case,” Pastor Bill begins, “Bring her here.”
Originally a sociology professor at the Kumasi Technical University, Jonathan Bill decided to become a Pastor with the Speaker of Christ International Ministry after a personal revelation with God. While Pastor Bill’s main task remains preaching the bible, he often encounters many Ghanaians who request medical advice specifically for mental illness.
Although Pastor Bill welcomes Ghanaians seeking advice about their health concerns and leads them in prayer, he recognizes that prayer alone cannot sufficiently heal an individual. Yet in confronting sickness, many Ghanaians seek out religious leaders and traditional healers. As Pastor Bill explained, “Ghanaians believe that the earth is ruled by God and that everything that’s on earth has its spiritual roots.” Hence, religions such as Christianity and Islam often combine with traditional beliefs such as animism to give Ghanaians a unique cultural perspective: one that celebrates man’s relationship with nature as well as with past spirits.
Because of their unique culture, Ghanaians have adopted a more holistic definition of health than the western world. “In Ghana, to be healthy means to be physically and spiritually well,” said Atsu Lately, a third year medical student at the University of Ghana.
While physical illness demands a trip to the hospital, the healing process for mental illness begins in prayer camps for many Ghanaians. Estimates show that as many as 90 percent of Ghanaians visit prayer camps to seek advice and alleviate their spiritual problems. Although the exact number is unknown, researchers predict the number of prayer camps throughout both the rural and urban cities of Ghana to be in the hundreds.
Prayer camps, which are lead by spiritual healers pastors or church elders, can serve as a place of spiritual healing for many by encouraging communal chanting congregations for 50 to 500 members for daily or weekly services. Yet, as an institution, prayer camps have been criticised by Human Rights groups for their poor infrastructure including inadequate shelter and lack of access to food and medicine. Poor housing arrangements such as outdoor cots, bamboo canopies or dorm rooms can leave patients exposed to natural conditions and provide little to no personal space. Practices such as fasting, although common among the Pentecostal theology and many Christian churches in Ghana, can often counter recommendations from medical doctors and therefore lead to poor health outcomes. In Ghana, where only two percent of patients with mental illness have access to biomedical treatments, actions such as isolating and chaining individuals further perpetuates the stigma associated with mental disorders, creating obstacles for people to receive adequate medical attention.
Stigma in Ghana, however, is not limited to those with the mental illness; it extends to health care workers. Doctors and nurses are looked down upon as many associate working in mental illness with having the diseases. “Most people think that I must also be crazy for working in psychiatry,” said Jessica Anetsiah, a psychiatric nurse at Accra Psychiatric hospital.
While Anetsiah finds her work rewarding and chooses to ignore these critiques, many healthcare workers find the mental health field unattractive. Medical students at the University of Ghana note that few of their classmates enter psychiatry, owing to stigmatization and low compensation as compared to other specializations such as surgery. Additional mental health workers—the World Health Organizations estimates around 1.18 million workers—are needed to close the mental health treatment gap in low and middle income countries. In Ghana, there are approximately 20 psychiatrists, and 1,100 Registered Mental Nurses for a population of over 25 million.
Although Ghana has taken an important step towards better mental health care by passing the Mental Health Bill—which calls for decentralizing mental health hospitals and integrating mental health care into primary care, as well as increasing health care workers—lack of funding has reduced the potential of the bill. To increase the number of health care workers, Dr. Angela Ofori-Atta, along with the Ministry of Health and the National Service Secretariat, has established Psych Corps, a program that trains young graduates to become community mental health counselors. Their mission is simple: to increase community awareness and accessibility to information and mental health workers. By establishing the Psych Corps, Ofori-Atta and her colleagues aim to change the negative dialogue and stigma surrounding mental illness: “It’s our way of getting people to understand what their minds do and how they function. It’s kind of like a mental health first-aid kit.” Ofori-Atta’s efforts, perhaps, will spark a community conversation about changing the approach to mental health in Ghana while also respecting the cultural and religious structures currently in place.
Ghana is beginning to explore the possible collaboration between the medical and the traditional and faith based healers. Psychologists at the Kore Blue Teaching Hospital in Kumasi suggest that religion should be used as a tool for the mental health treatment process. “One needs to know what’s culturally acceptable and normal for the patient, and then you can further diagnose them,” said Dr. Gordon Donnie at the Korle Bu Hospital.
The possible collaboration between mental health workers and faith based healers can be played out in a system of referrals where prayer camp leaders can advise patients to see doctors and invite professionals to give health lectures to congregations. Further, government investment in the retention of health care workers and accessibility to clinics and hospitals, as well as investment in infrastructure for churches could also facilitate collaboration between medical and faith-based healers in Ghana. While large scale implementation may come at a slower pace, community healers and medical providers remain at the forefront of these collaborations. Pastors often encourage their attendees to visit clinics and hospitals while nurses regularly invite pastors into the hospital to engage in spiritual healing, and, with such continued collaboration, improved mental health and the de-stigmatization of mental health in Ghana are on the horizon.
Aastha KC is a sophomore in Pauli Murray College. You can contact her at firstname.lastname@example.org.