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Stigmatisation, Discrimination and Exclusion of Persons with Intellectual Disability and their families in Ghana
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ON THE LEVEL OF STIGMATIZATION, DISCRIMINATION
AND EXCLUSION OF PERSONS WITH INTELLECTUAL
DISABILITY AND THEIR FAMILIES IN GHANA
REPORT
JULY 2011
REPORT ON THE LEVEL OF STIGMATIZATION, DISCRIMINATION
AND EXCLUSION OF PERSONS WITH INTELLECTUAL
DISABILITY AND THEIR FAMILIES IN GHANA
JULY 2011
i
nclusion Ghana (IG), a member of Inclusion International, is a network organisation working to reduce stigmatization and ensure full inclusion of all persons with intellectual disability and their families by advocating for their rights and needs. IG envisions equal opportunities and inclusion for all persons with I
intellectual disability in Ghana.
Intervention Areas
The four (4) key intervention areas for Inclusion Ghana are:
Training
�Strengthening the capacity and existing institutional and organizational structures of member
organisations to support their quality service delivery to persons with intellectual disability and their
families
Research
�Identifying and promoting research that will improve the lives of persons with intellectual disability
and their families
Education
�Maintaining an authoritative body of intellectual disability information and knowledge
�Supporting proactive community outreach and education of member organisations
�Providing accessible and relevant information that supports stakeholder ability to make informed
choices
Advocacy
�Advocating for inclusion, and participation in all aspects of life for persons with intellectual disability
and their families
�Proactively informing, influencing, guiding and developing public policy at the community, regional
and national levels
�Supporting court action or other initiatives by parents of persons with intellectual disability to demand
their children's rights
For more information about Inclusion Ghana, its work, activities and membership,contact:Inclusion Ghana #24 Feo Eyeo Link, North Industrial AreaP.O. Box GP 20950Accra-GhanaTelephone: +233 (0) 30 224 3291 / (0) 20 815 1523 Email: [email protected]
Website: http://inclusion-ghana.org
PROFILE
ii
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espite numerous conferences and expert consultations on disability and human rights issues, and the passing of the Disability Law (Act 715) in 2006, which prohibits stigmatization, discrimination and exclusion of persons with disabilities, relatively little is done in the area of D
intellectual disability. For this reason Inclusion Ghana conducted this study to measure the level of stigmatization, discrimination and exclusion of persons with intellectual disability (PWID) in Ghana with a view to advocating for their rights and explore areas in intellectual disability in which more research would be beneficial.
Intellectual disability is the most stigmatized disability among several disabilities in Ghana. More than other types of disabilities; strong social, religious and cultural stigma are associated with it. It is estimated that PWID constitute the third (3rd) largest category of Persons with Disabilities in Ghana (Ghana National Disability Policy Document, 2000). In Ghanaian communities, PWID are perceived to be dangerous to themselves and others. Therefore they are often excluded from mainstream society and denied any life opportunity due to a belief that they are dangerous and fully incapable of performing intellectual activities.
This report echoes the challenges Persons with Intellectual Disability and their families go through on a daily basis. The report also highlights various recommendations made by parents and independent leaders on the way forward. The Special Education Division of the Ghana Education Service, with the mandate of providing equitable and quality educational opportunities for all children with special needs and disabilities, supports recommendations made in this report.
It is hoped that the content of this report, if utilized, can serve as relevant and reliable reference material for research, advocacy and other development-oriented policy actions on behalf of persons with intellectual disability. This report may also serve as material for guiding policy formulation and making other regulatory decisions for the future development and integration of PWID into the community.
Thomas Patrick Otaah
Deputy Director (formerly Head of Unit for PWID)
Special Education Division
Ghana Education Service
FOREWORD
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any hearts and minds contributed in diverse ways in making this study a successful one. To all of them we say thank you.M
The dedication and extra working hours put in by the compilation team is acknowledged and highly applauded. We are also indebted to the Board of Inclusion Ghana for their technical input and advice throughout the study.
Inclusion Ghana wishes to express profound gratitude to DANIDA and LEV National Association for their financial and administrative support. We also thank VSO for their support by allocating an International Volunteer named Krista van Weelden to Inclusion Ghana to help in this study.
We would like to register our recognition of and great appreciation for the involvement of field personnel of all of our member organisations who helped us to identify some parents of persons with intellectual disability and independent leaders in the selected study areas namely Upper East, Greater Accra, Volta and the Brong Ahafo Region. The list of independent leaders who were interviewed can be found in annex 3.
Last but not least, thanks goes to parents and families of persons with intellectual disability who took time to talk courageously and share their sometimes emotional experiences with us. Because of the stigma we sensed during the interviews, it was decided to do their interviews anonymously. It is only through their testimonies and accounts that we can begin to understand the level of stigmatization, discrimination and exclusion of their children. It is to them, persons with intellectual disability that this study is dedicated.
Compiled and Edited by:
Auberon Jeleel Odoom
Krista van Weelden
ACKNOWLEDGEMENTS
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ACRONYMS
CDC Center for Disease Control and Prevention
CDD Centre for Democratic Development
CWID Children With Intellectual Disability
DANIDA Danish International Development Agency
ESP Education Strategic Plan
EFA Education for All Agenda
FAS Fetal Alcohol Syndrome
FCUBE Free Compulsory Universal Basic Education
GDP Gross Domestic Product
GES Ghana Education Service
GFD Ghana Federation of the Disabled
GHS Ghana Health Service
GoG Government of Ghana
GPRS Ghana Poverty Reduction Strategy
GSS Ghana Statistical Service
ID Intellectual Disability
IE Inclusive Education
IEP Individualised Education Plan
MOE Ministry of Education
MOH Ministry of Health
NARC National Assessment and Resource Centre
NCPD National Council on Persons with Disability
NGO Non-Governmental Organization
NHIS National Health Insurance Scheme
OPWD Organisations of Persons With Disability
PWD Persons With Disability
PWID Persons With Intellectual Disability
SEN Special Educational Needs
SPED Special Education Division of the Ghana Education Service
UN United Nations
UNESCO United Nations Educational, Scientific and Cultural Organization
VSO Voluntary Services Overseas
WHO World Health Organisation
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TABLE OF CONTENTS
PROFILE................................................................................................................................................................................... i
FOREWORD………………………………………………………………………………………......................................iii
ACKNOWLEDGEMENTS..…………………………………………………………………………………..........……....v
ACRONYMS………………………………………………………………………………………………….......………...vi
TABLE OF CONTENTS…………………………………………………………………………………............………...vii
LIST OF FIGURES…………………….………………..……………………………………….………...........................viii
LIST OF ANNEXES………………………………………………………………………………............………...............ix
EXECUTIVE SUMMARY………………………………………………………………………...........……………….......x
1 INTRODUCTION ................................ ................................ ................................ ................................ ............ 1
1.1 Profile of Ghana .......................................................................................................................... 1
1.2 The Disability Situation in Ghana ............................................................................................ 2
2 RESEARCH QUESTION AND OBJECTIVES ................................ ................................ ............................ 3
3 DEFINITIONS AND LITERATURE................................ ................................ ................................ ............. 4
3.1 Intellectual Disability ................................................................................................................. 4
3.1.1 Down Syndrome ................................................................................................................... 4
3.1.2 Autism .................................................................................................................................. 4
3.2 Stigma, Discrimination and Exclusion .................................................................................... 5
3.2.1 Stigma ................................................................................................................................... 5
3.2.2 Discrimination and Exclusion .............................................................................................. 5
4 METHODOLOGY ................................ ................................ ................................ ................................ ............ 6
4.1 Research Sites .............................................................................................................................. 6
4.1.1 Brong Ahafo Region .............................................................................................................. 6
4.1.2 Upper East Region ................................................................................................................ 6
4.1.3 Volta Region ......................................................................................................................... 6
4.1.4 Greater Accra Region ............................................................................................................ 6
4.2 Sample Size ................................................................................................................................. 6
4.2.1 Independent leaders and Specialists ...................................................................................... 7
4.2.2 Parents/Caretakers of PWID ............................................................................................. ..8
4.3 Research Design ....................................................................................................................... ..8
5 KEY FINDINGS: A grim picture with glimmers of hope ................................ ................................ ....... ..9
5.1 Profile of Parents Respondents and their Children ............................................................. ..9
5.2 Awareness of Intellectual Disability Issues .......................................................................... 10
5.2.1 Causes of Intellectual Disability ......................................................................................... 10
5.2.2 Treatment or Cure of Intellectual Disability ...................................................................... 11
5.3 Inclusion of Persons with Intellectual Disability in Ghanaian Society ............................ 12
5.3.1 Inclusive Education / Special Education ............................................................................ 12
5.3.2 The Health Care System...................................................................................................... 15
5.3.3 Assessment of Persons With Intellectual Disability ......................................................... 16
5.3.4 Employment ........................................................................................................................ 18
viii
5.3.5 Marriage and Family Life ................................................................................................... 19
5.3.6 Social Life & Participation in the Family and Community ................................................ 21
5.3.7 Participation in Church and Mosque activities .................................................................. 21
5.4 Discrimination and Stigmatisation of PWIDs in Ghana ..................................................... 22
5.5 Existence and Implementation of Disability Policies & Strategies targeted at PWIDs .. 23
6 CHANGING ATTITUDES ................................ ................................ ................................ ........................... 26
6.1 The Role of Government ....... .................................................................................................. 26
6.2 The Role of the Media .............................................................................................................. 27
6.3 The Role of Parents .................................................................................................................. 28
6.4 The Role of PWID themselves ................................................................................................ 28
6.5 The Role of NGOs .................................................................................................................... 29
7 CONCLUSION ................................ ................................ ................................ ................................ ............... 30
8 RECOMMENDATIONS: Opening New Doors to PWID and their Families ................................ ... 31
8.1 Meeting the Needs of Parents and Families of PWID ........................................................ 31
8.2 Implementation and Improvement on Government Policies ............................................ 31
8.3 Media Intervention .................................................................................................................. 32
8.4 The Community is key ............................................................................................................ 32
9 FURTHER RESEARCH ................................ ................................ ................................ ................................ . 33
REFERENCES ................................ ................................ ................................ ................................ .......................... 34
LIST OF FIGURESFigure 1: Distribution of interviewees per region........................................................................................... 7Figure 2: Disabilities of Children …………………………………………………………………….……... 9Figure 3: Age of children at diagnoses……………………………………………………………….……... 9Figure 4: Marital Status of Parents………………………………………………………………………….. 10Figure 5: Causes of ID ………………………………………………………………………………………. 11Figure 6: Treatment or Cure of ID…………………………………………………………………….…….. 12Figure 7: Education of PWID ……………………………………………………………………….………. 14Figure 8: Difficulty of getting good education for PWID ………………………………………..………. 14Figure 9: Difficulty of getting good health care support for PWID..………………………….…………. 16Figure 10: The side view of the NARC……………………………….…………………………………….. 17Figure 11: The back view of the NARC………………….………………………………………….……… 17Figure 12: Difficulty of getting employment for PWID …………………………………………….……. 18Figure 13: Parents perception of discrimination in employment............................................................... 19Figure 14: Difficulty of getting marriage for PWID ………………………………………………….…... 20Figure 15: Perception on whether PWID should be able to get married………………………….…… 20Figure 16: Difficulty of participation in Church or Mosque……………………………………….……... 22Figure 17: Perception of discrimination against PWID in Ghana ......……………………………….…. 23Figure 18: Level of awareness of any legislation for PWID ……………………………………..………. 24Figure 19: Improve Inclusion by Government……………………………………………………..………. 26Figure 20: Improve Inclusion by Media……………………………………………………………..…….... 27Figure 21: Improve Inclusion by Parents…………………………………………………………..……….. 28Figure 22: Improve Inclusion by PWID themselves…………………………………………….………... 29Figure 23: Improve Inclusion by NGOs…………………………………………………………….………. 29
ix
LIST OF ANNEXESAnnex 1: Questionnaire - Parents/Caretakers…………………………………………………………36-42Annex 2: Questionnaire - Independent Leaders/ Specialists………………………………...………43-47Annex 3. List of Respondents – Independent Leaders / Specialists………………………...………48-49
Annex 4: List of Special Schools and Integrated Schools……………………………………………..50-51
x
EXECUTIVE SUMMARY
nclusion Ghana (IG), a member of Inclusion International, is a network organisation founded in 2009, working to reduce stigmatization and ensure full inclusion of all persons with intellectual disability and their families by advocating for their rights and needs.I
Persons with Intellectual Disability or ''mental retardation'', as it is called amongst most Ghanaians, are the hardest hit victims of negative labeling when it comes to Persons with Disabilities (PWDs). For example, persons with down syndrome in Ghana are believed to be children given by the river gods, and hence people call them “Nsuoba”, meaning 'water children'. There are many stories about children with intellectual disabilities who are “given back to the water”. In Northern Ghana exists a widespread belief in “spirit children”. It is believed that some children, known as spirits or “Kinkirigo” have been sent to bring harm to a family and are not meant for this world. Following from this religious-cultural thinking about intellectual disability and the lack of initiatives from the government to improve inclusion of PWID in Ghana, they face several barriers and forms of stigmatization, discrimination and exclusion. Traditionally, more focus has been placed on finding out and obviating the causes of intellectual disability and less on improving the living conditions of PWID. This has resulted in the marginalization of PWID and their exclusion from enjoying equal opportunities in all spheres of life.
A lack of data in this area inspired Inclusion Ghana to do a baseline study in four regions in Ghana to measure the level of stigmatization, discrimination and exclusion of PWID and their families. The study involved parents/care takers of PWID, independent leaders and specialists in the field of Intellectual Disability. A total number of 69 leaders/specialists and 53 parents were interviewed in the four regions in Ghana.
This report describes the outcome of the study conducted by Inclusion Ghana. We give an overview of actual data that were measured, outcomes of observations we did and make recommendations to address particular areas of concern.
In all the research sites, significant levels of stigmatization, discrimination and exclusion, both overt and covert, were identified in education, employment, health care, and social life. Widespread and enduring changes in social attitudes are required if we are to make headway against ID-related stigma, discrimination and exclusion. Bringing about such change requires mobilizing many different stakeholders, including parents of PWID, friends and families; religious and traditional leaders, legal and civil rights groups, non-governmental and community-based organizations, the business community and workers' organizations; doctors, politicians, nurses and health-care workers, teachers, youth leaders, women leaders and social workers, and the police. Additionally, links need to be made with broader struggles that address underlying economic, social, cultural and political inequalities. If effective responses to ID-related stigma and discrimination are to be promoted, work has to be done simultaneously on several fronts: communication and education to encourage better understanding of ID; action and intervention to establish a more equitable policy context; and legal challenge, where necessary, to bring to account governments, employers, institutions and individuals.
We are hopeful that this report will contribute to further advocacy for the rights and needs of PWID and their families in Ghana and hope nobody will hesitate to use the information for any activity in this area. If you do so, we would appreciate a referral to this report and Inclusion Ghana.
Inclusion Ghana (IG), a member of Inclusion International, continuous obstacle to the inclusion of PWID in the society, is a network organisation founded in 2009, working to because within such a belief system it is difficult for any reduce stigmatization and ensure full inclusion of all interaction to occur between the “abled people” and persons with intellectual disability and their families by PWID. In many cases, PWID living on the street have been advocating for their rights and needs. rejected by their own families.
One may ask is the mission statement of Inclusion Ghana A lack of data in this area inspired Inclusion Ghana to do a relevant to the Ghanaian society? Yes in Ghana, as baseline study in four regions in Ghana to measure the elsewhere in Africa, traditional beliefs, culture, and social level of stigmatization, discrimination and exclusion of status have interacted and influenced people's perception PWID and their families. This report describes the outcome and attitude towards Persons with Intellectual Disability of the study conducted by Inclusion Ghana. We give an (PWID). Intellectual Disability is often perceived as a curse overview of actual data that was measured, outcomes of or punishment for sins committed by parents of the observations we did and make recommendations to PWIDs. In the Ghanaian society, pregnancy and birth are address particular areas of concern. We are hopeful that highly regarded as a blessing and are characterized with this report will contribute to further advocacy for the rights high expectations. There is no good reason a family can and needs of persons with intellectual disability and their give to explain why a child is born with an intellectual families in Ghana and hope nobody will hesitate to use the disability except that the anger of the gods has been visited information for any activity in this area. on them.
1.1 Profile of Ghana The Republic of Ghana is located on the Southern Coast of Persons with Intellectual Disability or ''mental West Africa. The GDP per capita of Ghana is US $ 1100 retardation'', as it is called amongst most Ghanaians, are (World Bank, 2011), and 40% of the adult population lives the hardest hit victims of negative labeling when it comes on less than US $2 per day. Ghana was the first black to Persons with Disabilities (PWDs). Two tribal groups, the African nation in the region to achieve independence from Ewes and the Gas, refer to them as “Asotowo” (idiot or fool) a colonial power, in this instance Britain. Ghana has a and “Buluus” (reduced mental abilities) respectively. The
2current total population of 24, 223,431 of which more than Akans label persons with intellectual disabilities as “Nea 37 % are under the age of 14 with a life expectancy of 57 wanyin agya n'adwene ho” which means 'feeble minded', years and a child mortality of 18/1000 (< 5 years). which are perceived as offensive and dehumanizing labels,
equated with insults. Persons with Down Syndrome in Ghana's population is concentrated along the coast and in Ghana are believed to be children given by the river gods, the principal cities of Accra and Kumasi. Ethnically, Ghana and hence people call them “Nsuoba”, meaning 'water is divided into small groups speaking more than 50 children'. There are many stories about children with
1 languages and dialects. Among the more important intellectual disability who are “given back to the water ”. In linguistic groups are the Akans, which include the Fantis Northern Ghana exists a widespread belief in “spirit along the coast and the Ashantis in the forest region north children”. It is believed that some children, known as of the coast; the Guans, on the plains of the Volta River; the spirits or “Kinkirigo” have been sent to bring harm to a Ga- and Ewe-speaking peoples of the south and southeast; family and are not meant for this world. and the Moshie-Dagomba speaking tribes of the northern and upper regions. The official language is English, Following from this religious-cultural thinking about however many of the poorest people are illiterate and intellectual disability and the lack of initiatives from the therefore do not understand or use English, the official government to improve inclusion of PWID in Ghana, they language. The different linguistic groups often have their face several barriers and forms of stigmatization, specific beliefs and superstitions. discrimination and exclusion. Traditionally, more focus
has been placed on finding out and obviating the causes of Primary and junior high school education is tuition-free intellectual disability and less on improving the living and mandatory. The Government of Ghana's support for conditions of PWID. This has resulted in the basic education is unequivocal. Article 39 of the marginalization of PWID and their exclusion from constitution mandates the major tenets of the free, enjoying equal opportunities in all spheres of life. compulsory, universal basic education (FCUBE) initiative. Superstition and the cultural belief system thus form a
1 INTRODUCTION
1Agbenyega, 2003
2 Tv3 News: Ghana Statistical Service (GSS) release of 2010 provisional census results
1
Launched in 1996, it is one of the most ambitious pre- PWID, there are often very limited vacancies and they are tertiary education programs in West Africa. Since 1986, located far away from rural communities. Besides these pre-tertiary education in Ghana includes 6 years of facts, special schools are often not known by most of the primary education, 3 years at the junior high school level, Ghanaian population including traditional and religious and 3 years at the senior high school level. Successful leaders. There are only few private schools for PWID and completion of senior high school leads to admission the fees that parents have to pay for their children are eligibility at training colleges, universities and other relatively high. Most children with ID in rural areas and tertiary institutions. The workforce population is around often those in sub-urban areas do not receive any form of 11.1 million, out of which 47.9% are into Agriculture and education at all. fishing; 16.2% into industry and transport; sales and clerical--19.3%; services--5.9%; professional--8.9%; others- The healthcare system does not cater for the specific needs-1.8%. of PWID and the number of specialists with knowledge in
this field is very limited and mainly concentrated in the two biggest cities of Ghana, Accra and Kumasi. Although disability policies are existing on paper, the 1.2 The Disability Situation in Ghana implementation is very limited and awareness of the No accurate national survey has been carried out to Disability Law is low amongst society and the families of determine the disability rate in the country. Although the PWID. Most NGOs working with PWID face challenges in 2010 population and housing census in Ghana formally terms of lack of resources and qualified staff members, involved questions about Persons with Disabilities, it was which limits their ability to meet their objectives. experienced that these questions were often left out in the
interviews and data on the census therefore won't be reliable. The World Health Organisation (WHO) however estimates the disability rate of Ghana to be between 7 and 10 per cent, which equates approximately 1.70 – 2.4 million people in the country. In most developing countries including Ghana, disabled persons constitute an impoverished marginalized group, characterized by lack of access to public health, education, and other social services that would ideally support and protect persons with disabilities. Economically as well as in social terms, disabled persons in developing countries are classified among the poorest of the poor.
Persons With Disabilities (PWDs) in Ghana are often regarded as unproductive and incapable of contributing in a positive way to society, and rather seen as constituting an economic burden on the family and the society at large, which leaves them in a vicious cycle of poverty. In Ghana, Persons with Disabilities are often only weakly represented in civil society. It is estimated that Persons with Intellectual Disability constitute the 3rd largest category of Persons with Disabilities in Ghana (Ghana National Disability Policy Document, 2000).
PWID face many forms of exclusion in the society. Despite government policy of inclusive education, many children with ID are still excluded from any form of education. Although the government opened special schools for
2
Introduction
As the basis of the research the following research question was formulated:
In order to answer the research question, five objectives were established:
�To gather baseline information on the cultural and religious beliefs about PWID and their families
�To gain insight into how negative attitudes towards PWID result in social exclusion of them and their families
�To gather baseline information about inclusion of PWID and their families from the perspective of parents and that of independent representatives (priests, professionals, traditional leaders etc.)
�To gather baseline information about the level of implementation of the national and international law and policies on the rights of PWID in Ghana
�To examine which factors can contribute to forming positive attitudes towards PWID and their families.
RESEARCH QUESTION AND OBJECTIVES
3
2
What are the attitudes of people in the Greater Accra, Volta, Upper East and Brong Ahafo regions in Ghana towards PWID and their families and what can be done to increase positive attitudes towards PWID and their families.
3.1.1 Down SyndromeIn this chapter we will give some definitions to some of the 4Down Syndrome is a set of mental and physical main terms used in this report and also provide some
symptoms that result from having an extra copy of literature on them as a background for the research.chromosome 21. It affects all races and economic levels equally. Approximately 1 in 800 to 1 in 1,000 babies are 3.1 Intellectual Disability
3 born with the disorder. A child with Down Syndrome may Intellectual Disability (ID) is characterized by significant have eyes that slant upward and small ears that may fold limitations both in intellectual functioning and in adaptive over a little at the top. The mouth may be small, making the behaviour as expressed in conceptual, social and practical tongue appear large. The nose also may be small, with a adaptive skills. PWID experience difficulties in one or flattened nasal bridge. Some babies with Down Syndrome more of the following areas: learning, communication, self have short necks and small hands with short fingers. The
care, home living, social skills, community use, self child with Down Syndrome is often short and has unusual
direction, health and safety, leisure, and work. An looseness of the joints. Most children with Down
intellectual disability may become apparent early in life or, Syndrome will have some, but not all of these features. The in the case of people with a mild intellectual disability, may degree of intellectual disability varies widely from mild to not be diagnosed until school age or later. This disability moderate to severe. There is no cure yet for Down originates before adulthood. An individual can be mildly Syndrome, nor can it be prevented. Scientists do not know affected to profoundly affected. There are varying causes why problems involving chromosome 21 occur. Nothing of intellectual disability. Head injuries, diseases, genetic either parent did, or did not do, caused Down syndrome.conditions, birth defects and strokes are all possible causes for intellectual disability. Genetic disorders cause down Children with Down Syndrome can usually do most things syndrome or fragile X syndrome; and environmental that any young child can do, such as walking, talking, factors, such as alcohol intake before birth, also can cause dressing and being toilet-trained. However, they generally Fetal Alcohol Syndrome (FAS). Intellectual disability do these things later than other children. About 30 to 50 caused by certain infectious diseases (such as rubella) and percent of persons with Down Syndrome also have metabolic disorders (such as Phenylketonuria, or PKU) congenital heart defects, and many have some visual and have decreased as the result of widespread use of hearing impairment and other health problems with the childhood vaccines and increased newborn screening. intestines, eyes, thyroid and skeleton. The severity of all of
these problems varies greatly. Down Syndrome is not a Depending on the severity of the problem, a patient can condition that can be cured. However, early intervention live a fairly normal life or a totally incapacitated life. It is can help many people with Down syndrome live important for the level of severity to be properly diagnosed productive lives well into adulthood. Like all children, for the individual to be helped accordingly. Affected children with Down Syndrome greatly benefit from being children sit, crawl, stand, walk, and run later than their age able to learn and explore in a safe and supportive mates. They learn to talk much slower than others. They environment. Being included in family, community, and have difficulty speaking once they learn how to speak, for preschool life will help a child with Down Syndrome instance they may mumble a lot or stammer. These develop to his or her full potential.individuals have difficulty with their memory as well as solving problems, and they do not easily recognize the 3.1.2 Autism
5results of their actions. Some children with ID go to regular It is a pervasive disorder of development characterized by schools and may attend regular classes but many need three distinctive behaviours. Autistic children have special attention to help them in areas where they have difficulties with social interaction, display problems with more trouble learning. Ideally, their parents work with verbal and nonverbal communication, and exhibit teachers and others to come up with individualised repetitive behaviours or narrow, obsessive interests. These education plan (IEP) for the best way for each child to behaviors can range in impact from mild to disabling. learn. The best known ID are Down Syndrome and Autism varies widely in its severity and symptoms andAutism.
DEFINITIONS AND LITERATURE
3 ILO Website: http://www.ilo.org/global/about-the-ilo/press-and-media-centre/news/WCMS_123796/lang--es/index.htm 4 Health Encyclopedia – Diseases and Conditions
http://www.healthscout.com/ency/68/449/main.html5 NIH: National Institute of Child Health and Human Development
4
3
may go unrecognized, especially in mildly affected Stigma attached to PWID and their families is harmful, children or when more debilitating handicaps mask it. both in itself, since it can lead to feelings of shame, guilt and While not specific or universal to the disorder, 50-75% of isolation, and also because negative thoughts often lead individuals with autism exhibit lower than average individuals to do things, or omit to do things, that harm intellectual abilities (APA, 2000, Pellicano, 2007). With no others or deny them services or entitlements. known cure to date, the relationship between autism and developmental indicators (such as poverty) continues to be
3.2.2 Discrimination and Exclusion a knowledge gap. Autism typically affects the most Discrimination occurs when a distinction is made against a fundamental aspects of quality of life, such as the ability to person that results in his or her being treated unfairly and understand what others feel and think, the ability to unjustly on the basis of their belonging, or being perceived communicate your basic needs or socialise with those to belong, to a particular group. Discrimination does not around you and the necessary understanding to process
6 only exist on personal or individual level, but also involves and make sense of emotions . institutional discrimination where governmental bodies do not include the needs of certain disadvantaged groups in their policies and services. Because of the stigma
3.2 Stigma, Discrimination and Exclusion associated with intellectual disability, and the
Intellectual disability-related stigma often leads to discrimination that may follow from this, the rights of
discrimination of PWID and their families. This, in turn, PWID and their families in Ghana are frequently violated.
leads to the exclusion of PWID and their families or other This violation of rights increases the negative impact on
associates. Stigma, discrimination and exclusion create, these individuals and their families. Schools, for example,
reinforce and legitimize each other. They form a vicious may deny PWID education. Or employers may not accept a
circle. person for employment on the grounds of the potential employee having intellectual disability. Families and communities may reject and ostracize PWID. Such acts
3.2.1 Stigma constitute discrimination and violate human rights. At the
Stigma has been described as a quality that significantly level of the individual, for example, it causes undue 7discredits an individual in the eyes of others . It has its anxiety and distress-factors that are known to deepen their
origins deep within the structure of society as a whole, and ill-health. At the level of the family and community, it
in the norms and values that govern much of everyday life. causes people to feel ashamed, to conceal their links with
For example, in Ghana, parents of children with PWID, and to withdraw from participation in more
intellectual disability are often believed to have deserved positive social responses. And at the level of society as a
what has happened by doing something wrong. Often whole, discrimination against PWID reinforces the
these wrongdoings are linked to either “juju”, witchcraft, mistaken belief that persons born with intellectual
drug abuse, alcohol intake or its abuse by the mothers of disability are unacceptable and that they should be
such children. ostracized and blamed.
Self-Stigmatization, or the shame that PWID as well as The family and community often perpetuate stigma and
their families experience when they internalize the discrimination, partly through fear and ignorance, and
negative responses and reactions of others, is also evident. partly because it is convenient to blame those who have
Self-stigmatization can lead to depression, withdrawal been affected first.
and feelings of worthlessness. It silences and saps the strength of already-weakened individuals and communities, and causes people to blame themselves for their predicament.
6 Iovannone et al., 2003, Jordan, 1997, 2005 7UNAIDS Report - August 2001
5
Definitions and Literature
4.1 Research SitesGurma (6.5%). The people of the region originally The study was carried out in four regions namely: Brong practised the Traditional religion. However, over a century Ahafo Region, Upper East Region, Volta Region and the and half ago, with the arrival of Christian missionaries in Greater Accra Region the region, many have converted to Christianity. Of a total population of around 1,635,421, 67.2% are Christians;
4.1.1 Brong Ahafo Region 21.8% practise Traditional Religion and 5.1% are Muslims. With a territorial size of 39,557 square kilometers, it is the second largest region in the country (16.6%). The region is
4.1.4 Greater Accra Region the fourth most urbanized region in Ghana. Christianity The region shares boundaries with the Eastern region in (70.8%) has the largest following, while Islam (16.1%) and the South Eastern, Volta region in the South West and the no religion (7.8%) are the significant others. Large Central region in the South. It has Accra as the capital with followers of Christianity are in all districts. Islam is 10 Metropolitan, Municipal and District assemblies. practised mainly in Kintampo (29.7%) and Atebubu Analysis of the region shows that Greater Accra has (24.4%), where Muslims outnumber the two most remained the most densely populated region in the professed Christian denominations, Catholics (21.4%) and country since 1960. The largest ethnic group in the region is Pentecostals (17.6%). Traditional religion is most practised the Akan, comprising 39.8 percent, followed by Ga-in Sene (18.8%), followed by Atebubu (15.7%) and Dangme (29.7%) and Ewe (18%). The percentage Kintampo (10.0%). More than half (57.6%) of the distribution of religious groups shows the predominance population aged 15 years and older in the region are in of Christians (82.9%) in the region, compared with the marital union. Nearly a third has also never married. The second major religion, Islam (10.2%). Twenty eight per cent proportion of the population not literate in the region is of males are household heads compared to 12.7 per cent of 48.5% females. Where a female is the head of household, it is very likely that it is a single person household or a single parent 4.1.2 Upper East Region household. In spite of the minimum legal age of 18 years It is bordered to the north by Burkina Faso, the east by the prescribed for marriage, there is an indication that Republic of Togo, the west by Sissala in Upper West and marriage takes place among persons aged 12-17 years. the south by West Mamprusi in Northern Region. The total
land area is about 8,842 sq km, which translates into 2.7% of the total land area of the country. Bolgatanga is the capital
4.2 Sample Sizeof the 10 districts. Three main religious groupings are The study involved parents/care takers of PWIDs, found in the region, namely the Traditional (46.4%), independent leaders and specialists in the field of Christianity (28.3%) and Islam (22.6%). Within the Intellectual Disabilities. A total number of 69 Christian religion, the Catholics are in the majority. The leaders/specialists and 53 parents were interviewed in the gap in the educational attainment between the country and four regions in Ghana. the region is still very wide. The lack of education in the
region is not due only to general poverty and cultural practices but also to the very late introduction of education into the region.
4.1.3 Volta Region The region shares boundaries with Togo in the South Western along the coast, Northern region in the North Eastern corridors and Eastern region in the Southern eastern corridors. About four-fifth (78.7%) of the stock of houses are in the rural areas. Eight major ethnic groups are represented in the region and about 62 sub-groups speak 56 dialects. The main ethnic group is the Ewe (68.5%), followed by the Guan (9.2%), the Akan (8.5%) and the
METHODOLOGY
6
4
4.2.1 Independent Leaders and Specialists
8The sample oup .group of independent leaders and specialist consisted of the following gr
Type No. of Persons
8 See Annex 3 for a list of the individuals of this sampled group
7
Methodology
Figure 1: Distribution of interviewees per region
Parents
Leaders/Specialist
Upper East Brong Ahafo Volta Greater Accra
Sample size of the research per region
Consultants 3
Ghana Education Service
12
Government Officials
5
Health Officials
2
NGO Leaders
13
Religious Leaders
5
Social Workers
2
Special Educators
22
Traditional Leaders
5
Total
69
�3 group discussions with independent leaders4.2.2 Parents/Caretakers of PWID�50 semi-structured interviews with parents/care The parents or care takers that were interviewed for the
takers of Persons with Intellectual Disabilitystudy were mostly related to the member organisations of �3 group discussions with parents of children with Inclusion Ghana. This surely had an effect on the level of
intellectual disabilityknowledge on intellectual disability and its causes. �Non-participant observationHowever, it was often felt that parents did not share all
experiences and were trying to give a more positive picture On average it took one (1) hour to finish an interview. For of the situation than actually is the case. Because of the the parents' interviews, locations were selected where the stigma in Ghana, we were not able to interview parents privacy of the participant could be guaranteed as much as that actually hide their children from society and therefore possible. The findings of this report are subjected to some cannot incorporate their level of knowledge in the study. limitations following from the research methods used. The The parents whom we identified as those who hide their research sample was taken from four regions in Ghana and children were not willing to collaborate in the study. is therefore not representative for the whole population of Ghana. Due to the locations of the interviewees especially the parents of PWID and to financial and practical 4.3 Research Designconstraints it was not possible to visit every district in each In order to explore the research question and objectives, region. We chose to select at least two districts per region so the researchers used a combination of quantitative and we can reach out to more parents. At the end of the research qualitative data collection methods to come to a reliable we interviewed people in a total of 11 districts. Researchers report. The following methods of data-gathering were have found that due to a social desirability bias, the used:reliability of the answers of the respondents was sometimes influenced. Therefore, the results of this �Analysis of secondary dataresearch cannot be generalized.�66 semi-structured interviews with Independent
Leaders / Specialists from government institutions, special schools, churches, etc
8
Methodology
40% of the parents who were interviewed had no formal diagnosis of the disability of their child, whereas 32% of the parents have a child that is diagnosed with autism and 17% has a child with Down syndrome. 6% of the parents mentioned epilepsy as the disability of their child. All parents in the Greater Accra and Volta region that were interviewed, were identified via the special (private) schools and the Korle Bu hospital and all had a formal diagnoses of the disability of their child, whereas 50% of the children in Upper East Region and none of the children in Brong Ahafo region were diagnosed by a hospital or an assessment centre.
The sample group was asked when they first suspected an irregularity in their child's development and what the first symptoms were that made them think something was not as it should be. The number of parents that noticed something was amiss at a young age of their child was significant, where not trying to speak or not responding to efforts of contact were mentioned most frequently as the first symptoms. 85% of the parents consulted a doctor whereas 5% said to have first addressed their concern to a spiritual leader.
KEY FINDINGS: A grim picture with glimmers of hope
5.1 Profile of Parent Respondents and their Children
Figure 2 : Disabilities of Children
9
5
Down Syndrome
Autism
None
Other
Which of the impairments is yourchild diagnosed of
Figure 3: Age of children at diagnoses
How old was your child when youfirst suspected the impairment?
Younger than 2
2-4 years
5-7 years
8-10 years
76% of the sample group 'parents and care takers' were biological parents of children with intellectual disabilities, who were living with their own children whereas other care takers were members of the immediate family. It is important to say that in Ghana, it is not unusual that children grow up with the extended family instead of the parents. Logistics (being close to a school or available transport), financial constraints are amongst other reasons for families to decide so.
Figure 4: Marital Status of Parents
67% of the parents who replied to the question what their children are identified with autism or down syndrome marital status is were married or remarried, whereas 21% could only mention or describe that specific type of of the parents were divorced. This does not scientifically disability as what their children have, 28% of the parents prove the assumption that a lot of fathers leave the mothers could also mention another type of ID. It needs to be when they find out about the disability of their child. mentioned that the independent leaders/specialists that However, it was observed and estimated by specialists that were interviewed were mainly people that were in some as many fathers leave the mothers when they find out their way familiar with intellectual disability already. They child is intellectually disabled, same number of mothers were mostly introduced to us by our member also leave the fathers noticing their child has an intellectual organisations, who have done some good work in ID disability. Independent leaders and specialists also education/awareness raising. Therefore it is assumed that mentioned that, also because of the stigma, a lot of parents the sample taken in this research is not representative for fear to share the experience of their broken marriage and the level of knowledge all over Ghana. prefer mentioning that they are still married although they live separately from their husband or wife. Unfortunately a similar interview with a sample of the
Ghanaian population in general was out of scope of this 5.2 Awareness of Intellectual Disability Issues study. 95% of the independent leaders/specialists said they were
5.2.1 Causes of Intellectual Disabilityfamiliar with the term intellectual disability whereas 60%
Three of the parents explained their thoughts about the of the parents know the term. Most descriptions that were
causes of intellectual disabilities with the following stories:given as an answer to the question to describe intellectual
disabilities were pointers in the direction of people that are unable to speak, talk, reason or move like their peers or “My wife left me for another man during her
pregnancy. She was punished by the gods show a slower development than is usual. Autism (42.5%) by giving birth to my autistic son. and Down Syndrome (45%) were mentioned most as She brought me the son and left.”intellectual disabilities people know. Epilepsy and
hyperactivity were also mentioned. Most parents whose
10
Key Findings: A Grim Picture With Glimmers of Hope
Single / Never beenmarried
Married
Separated /Divorced
Widowed
Marital status of parents/care takers
Respondents were asked if they think diseases, accidents, curses/juju and medical errors can cause disability. The graph below shows most of the respondents (66) consider medical reasons and diseases as one of the causes of disability whereas 19 leaders and 6 parents also mentioned accidents as a cause.
In the interviews respondents said that mistakes made by doctors or nurses sometimes result in the disability. There seems to be distrust in some doctors and nurses in Ghana. Some of the respondents explained how their children's disability was caused by such a medical error. As one respondent explained:
Some respondents also explained why they think the disability was caused by a spiritual reason. They explained that some of these children with ID were never ill and all of a sudden they started experiencing the condition and there was no other reason found so it could not be anything else but something spiritual that caused the disorder.
Most respondents mention medical reasons as (one of) the Only one of the respondents believes that PWID are cause(s) of intellectual disability. Amongst the 'other' responsible themselves for their impairment and answers people mainly mentioned that improper care explained this as the fact that they have taken too much during pregnancy, drinking alcohol and abusing drugs drugs. 11% of the parents feel they have a responsibility for during pregnancy were causes of intellectual disability. their child's impairment. Convulsion and failed abortion were mentioned in some
5.2.2 Treatment or Cure of Intellectual Disabilitycases as well. Spiritual causes were frequently mentioned although most respondents refer to the fact that other
“God works in a mysterious way. We have been people think spiritual forces are causing intellectual praying and my son gets better slowly. In the end he will disability and said they did not believe that themselves be cured”, a parent explained when asked about (anymore). In Brong Ahafo region, some independent whether intellectual disability can be cured.leaders mentioned that if parents of this group of children
have money, people believe that income was being generated by using their children for offering ceremonies or other spiritual rites (juju).
11
Key Findings: A Grim Picture With Glimmers of Hope
Figure 5: Causes of ID
What do you believe is the cause of ID
Leaders
Parents
Medicalreasons /diseases
AccidentSpiritual cause
/ juju Medical errorOther
“My pregnancy lasted 11 months. Therefore my daughter has this problem.”
“People who hate you or are jealous of you can “juju” you. They can consult a shrine to see if something good can happen to you in the future for you and your children and when they get to know it, they can cause for example a disability on your child. Thus what happened to our child.”
“The nurse in the hospital delayed to attend to me in the second stage of my labour. I was really suffering then and later I had to go through a cesarean section before my daughter was born. Thus why she has a brain damage.”
Figure 6 below shows the responses of both parents and independent leaders on this subject. Amongst the parents interviewed 69% believes that intellectual disability can be cured whereas 44% of the independent leaders believe same. God is mentioned as the source of cure in a lot of cases and also operations in western countries are believed to be the solution for the problem of PWID. Amongst the independent leaders 54% say that intellectual disabilities can only be managed. Parents indicate that when they first found out their children had the disability, they tried to find all possible ways to cure the disabilities but sooner or later realized they should accept it is not curable. Some parents mentioned that they went to all kinds of spiritual / miracle churches, prayer camps and some to traditional priests for possible cure of their children. All of these parents admitted however that their children were not healed after all the spiritual healing they sought after.
5.3 Inclusion of Persons with Intellectual
Disability in Ghanaian SocietyIn the perspective of this study inclusion was defined as all
. components that influence the integration of PWID in the Ghanaian society. To measure the level of inclusion of PWID, questions about their inclusive education/special education, employment, health care system, attendance in church or mosque and social events were asked.
9
5.3.1 Inclusive Education / Special Education
After independence, successive governments have consistently pursued educational policies aimed at expanding access for disadvantaged groups and limiting exclusion from quality education. Ghana has ratified several international conventions on the right to education including the United Nations Declaration of Human Rights, UN Convention on Rights of Children, UNESCO statement on principles and practices of Special Needs Education, the Education for All (EFA) goals and Millennium Development Goals. These have been incorporated into national laws.
The concept of Inclusive Education (IE) directly and indirectly has been embedded in several Government policies since independence. The aspiration for inclusive education dates back to 1951 when Dr Kwame Nkrumah, in the Education Reform under the Accelerated Development Plan, introduced fee-free compulsor basic education for all children aged five and below sixteen. It sought to expand access to education to all narrowing the gap between, the north and the south, as well as urban and rural areas. The policy was enacted into law under the
Education Act of 1961 (Act 87)
Ghana considers a quality human resource base as very crucial in its development efforts to ensure socio-economic well being of its citizens, and education plays an important role in this regard. Taking this direction, various policies have been initiated to enable citizens, especially children irrespective of their socio-economic background, to have access to formal education to develop their potential and have equal opportunities to contribute to the development of the country. This is based on the fact that the potential of children should be fully developed to contribute their quota towards the country's development efforts.
y
;
9 Achanso, S.A ( 2010). The impact of economic recovery programme on basic education in Ghana. University of Lincoln Thompson, N.M and Casely-Hayford, L. (2008). The financing and outcomes to education in Ghana. RECOUP Working Paper 16. RECOUP, Cambridge
12
Key Findings: A Grim Picture With Glimmers of Hope
Figure 6: Treatment or Cure of ID
Leaders
Do you think intellectual disabilities can be cured
Parents
Don’t know
NoYes
The main legislative instruments which have promoted the Therefore it is estimated that 90 to 95% of the teachers have adoption of Inclusive Education policies in the last 20 years not had any form of education on the special needs for this
12group . In 2005 SPED developed a new curriculum for in Ghana includes:
school that educates Children with Intellectual Disability (CWID). The new curriculum involves 6 years of basic � education, 4 years of pre vocational preparation and 2 p e r s o n s s h a l l h a v e t h r i g h t t o e q u a l years of attachment with service providers. However, this educational opportunities and facilities and with the is still only a pilot project that has been implemented in 2
view to achieving the full realization of this right, basic specials schools in Ghana and the Special Education
education shall be free compulsory and available Division points out that funding of this new policy is a
to all. major challenge. Until the end of 2010 the attention given to this group of children with special needs in the
�The Children's Act (560) of 1998 also enjoins government was low. The former Minister of Education
g o v e r n m e n t t o p r o m o t e t h e p h y s i c a lpromised however to allocate more resources to this area.
mental and social well-being of every child.
The latest available statistics (2011) shows that SPED runs 13 13 special schools for children with intellectual disability,
which focus their education on training in social behaviour and activities for daily living skills. In addition, there exist
14 24 units for special needs children with intellectual disability (Integrated schools). There is however no central records for private schools in Ghana but New Horizon School, Autism Awareness Care and Training Centre and Multikids Academy have been identified as some of the private schools supporting the education of CWID.
According to data provided by the Special Education Division of the Ghana Education Service (GES) in 2011, The Ministry of Education (MOE) has a Special Education approximately 1860 children with intellectual disability Division (SPED), whose objective is to increase access to attended education provided by the government. There is quality education and to train the youth and children with no reliable data that could be retrieved on the total number special educational needs, leading to employable skills for of children with intellectual disabilities that get any form of an economic and independent living. The Education education from private schools. Besides, the number of Strategic Plan (2010-2020) claims that all children with non-children on the waiting lists of the special schools or special severe special education needs will be incorporated into
11 units is high. The SPED has the ambition to open 20 new mainstream schools by 2015. Despite the policy of units for CWID per year but foresee the budget that will be inclusive education, there are still a large number of allocated for that will not be sufficient. children and youth with intellectual disability who are are
not helped from undertaking basic education in regular All respondents to the questionnaire see the value of schools. Also, others with very mild intellectual disability education for CWID. None of the respondents mentioned do not complete basic education due to hostile teaching that no education for them is needed. The opinions about practices adopted by some of the teachers. whether CWID should go to regular schools or special schools were divided. 44% of the leaders thought CWID It is estimated that only up to one percent of PWID have should go to special schools or institutions whereas 64% of access to education in Ghana. It is only in 2007 that the the parents had the same opinion. subject of special needs was incorporated in the subjects
taught at the several teacher training institutions.
10 Article 25(a) of the 1992 constitution states: All “
e
,
,
�The Disability Law (Act 715) of 2006 provides for the establishment of Special Educational schools for children with severe special needs education. Parents and guardians/care givers are to enroll them in schools depending on their level of disability however there should be no barrier to their admission.
�The Education Act (778) of 2007 "Provide for inclusive education at all district levels" (Article 5). It also makes two years kindergarten part of basic education, extending basic education to 11 years.
10 The Republic of Ghana (1992). The Constitution of the Republic of Ghana. Ghana Publishing Company, Accra
11 GFD, 200812 Interview with SPED13See annex 4 for List of Special Schools for Children with Intellectual Disability14See annex 4 for List of Units for Special Needs (Integrated Schools)
13
Key Findings: A Grim Picture With Glimmers of Hope
Some stories parents narrated as their frustration of getting school admission for their wards are as follows:
In general people mentioned it was difficult or very difficult to get good education for PWID in Ghana. Parents that were interviewed whose children were not in school mentioned they don't know about any good school for their children. They had tried but the teacher from the regular school did not see the use of education for their child or the special unit or school was too far from the house. An observation done during the research was also that most respondents apart from specialists in special education were not aware of special schools available in their town, district or region and can therefore not be able to refer people who consult them regarding the education of PWID. This was also a remark often made by leaders as a reason for saying finding good education in Ghana is difficult.
Figure 8: Difficulty of getting good education for PWIDs
14
Key Findings: A Grim Picture With Glimmers of Hope
How difficult is it to get good
education for CWID in Ghana
Very difficult
Difficult
Somewhat difficult
Not difficult
Figure 7: Education of PWID
How do you think PWID should be educated
Leaders
Parents
Regular schoolSpecial school
No educationneeded
“The teacher in the regular school called to tell me it was useless bringing my child to school. He would never learn anything”.
“I sent my daughter to school when she was 5 but the teacher didn't want to teach her. I tried again when she was 12 and now the teachers say she is too old to learn”
During the interviews we were often told that the doctor Teachers also believe that amongst the group of people said he could not do anything about it, or the child would with low income, the interest in education is very low.
“They will miss income if they send their child to school or need to grow out of the problems. Parents often responded to this spend money on transport to school. This counts for children diagnoses by waiting and praying. Most doctors in Ghana, without disabilities, let alone those with intellectual disability. If especially those in rural areas, only seem to have very basic you have 5 children and only a few Ghana Cedis to spend a day, knowledge about intellectual disability. For them the which child will you not allow to go to school to save cost?” diagnoses 'low IQ' is the only thing they will say the child is
experiencing. Parents often do not have the means to visit a specialist in Kumasi or Accra and therefore just accept
15 5.3.2 The Health Care System what their local doctor tells themOne of the main components for securing good health is the
provision of quality health services. The Ghana Health Two parents narrated what some doctors told them when Services under the auspices of the Ministry of Health they took their children to the hospital for diagnosis:(MOH) identifies priority intervention areas for improving the health of children.
In line with the Ghana Poverty Reduction Strategy (GPRS) and to address the problem of financial barriers to health care access, the Government in 2001 initiated a National Health Insurance Scheme (NHIS) to deliver accessible, affordable and good quality health care to all Ghanaians especially the poor and most vulnerable in society. The National Health Insurance Law – Act 650 came into effect in October 2003. Under the National Health Insurance Besides the fact that most doctors in Ghana seem to have Scheme, health care for Persons with Disabilities should be only a basic knowledge about ID and so are not much free but in rural communities most families are not helpful, there are only a few specialists in Ghana who have registered under the scheme. This affects PWID because of experience in supporting families with PWID. Ghana has the higher frequency of illnesses they suffer. A top official for example 6 speech and language therapists of whom 1 is at the National Health Insurance Scheme explained to one retired and is based in Kumasi, all others have their work of our researchers that even staffs working with the scheme places in Accra. The clientele therefore is mainly (around are not often aware of this arrangement. The Disability Act 75%) from the Greater Accra Region whereas a few come 2006 contains provisions that provide for children with from other regions in the country. Only parents who have severe disabilities thus access to free healthcare, but the real dedication to help their child, and in most cases are person has to be able to go to a health clinic and needs to well educated or have travelled abroad know about the know about the contents of this law and ask for added value of speech therapists and seek for their arrangements. The knowledge of these rules is low. services. Doctors in general also do not know about the
support the therapists can give children with intellectual Due to lack of knowledge on ID issues, most families or disability. The therapists get some referrals from doctors in relatives take their CWID to mental hospitals for diagnosis Accra but the number of doctors who know about and treatment. Even though the mental hospitals do offer therapists places and services can be counted on one hand. some help there is lack of specialism in ID. More often than The therapists also have waiting lists for therapy services not, wrong interventions are given. Also at the mental and suffer from a lack of funding to do all the work they
16hospitals, mishandling by unqualified support staff, want to do.torture, physical, sexual, psychological and verbal abuse are the order of the day. Isolation of such persons from There are also specialist doctors that can be counted on one society makes them completely invisible and forgotten by hand, mainly operate in the teaching hospitals in the big all including policy makers. cities and are hard to access for people in rural areas in the
country. There is no data available on how many patients are diagnosed with intellectual disability per year. After
15 Interview with a Doctor at the Korle Bu Teaching Hospital 16Interview with Nana Akua Owusu, a Speech and Language Therapist Korle Bu Teaching Hospital
15
Key Findings: A Grim Picture With Glimmers of Hope
“You wouldn't believe me if I told you that my doctor said that I was the cause of my son's disability. I must have drunk too much alcohol or used drugs”
“My son could still not speak when he was 5. When I saw my doctor he said I just needed to be patient. So I went home”
diagnoses the path way for the parents are usually confused. There is no list of special schools or institutes in Ghana available and the only thing doctors can do is refer families to institutes or schools they happen to know. This means that, if people in rural areas are able to visit the specialists in the main cities in Ghana, they will not be referred to schools or institutions in their areas, if these are in place. Specialists see there is a major gap in the Health Services for PWID. There is no funding for research, not enough specialists that are able to diagnose, no interventions, support or services for families
17of persons with ID.
Figure 9 shows responses given on the question how difficult it is to find good health care for PWID in Ghana. It seems that a lot of the parents accept what doctors tell them in that nothing can be done about the situation of their children. Leaders and specialists in Ghana are, however, less optimistic. 30% of them believe it is very difficult to find good health care for PWID in the country and 38% say it is difficult.
17 Interview with a Doctor at the Korle Bu Teaching Hospital
5.3.3 Assessment of Persons With Intellectual In 2010, NARC assessed 96 children with intellectual
Disabilitydisability (59 boys and 37 girls) and in the first quarter of 2011, the number of assessments done was 31 (22 boys, 9
The National Assessment and Resource Centre (NARC) for girls). The number of yearly assessments is increasing. Staff
Children with Disabilities, based in Accra was established feels that people in Ghana are getting to know the
in 1975 to augment the efforts of the Ministry of Education. assessment centre better and seem to start seeing the value
The NARC has regional branches and its mission is to of education for PWID.
enhance the educational opportunities of children with disabilities and special educational needs, through the
NARC deals with a difficult situation and often does not provision of avenues for early identification and detection,
have the right equipments to assess the different for the promotion of appropriate medical interventions
disabilities of the children. The NARC is formally the only and educational and vocational placements. NARC in
centre for assessment of CWID which means parents from Accra has a work relationship with the psychiatric hospital
other regions with little money would find it hard or nearly in Accra. After a first assessment at the centre where an
impossible to access the Centre. The deplorable state of intellectual disability is suspected, children are referred to
their building may be another sign of how seriously the the hospital for further assessment. Based on the outcome
care for children with special needs is being taken by the of that assessment, NARC advises parents where to take
Ghanaian Government. their child to school.
16
Key Findings: A Grim Picture With Glimmers of Hope
Figure 9: Difficulty of getting good health care support for PWID
How difficult is it to getgood health care for PWID
Leaders
Parents
Verydifficult Somewhat
difficultNot
difficult
Difficult
Don’tknow
Figure 10: The side view of the NARC
Figure 11: The back view of the NARC
17
A parent narrated, “After a lot of effort, the first thing my husband did to support me in my quest about my son's disability was going to the National Assessment and Resource Centre. He was back in the house soon. The state of the NARC was another confirmation for him that people don't take children like that seriously”
Key Findings: A Grim Picture With Glimmers of Hope
types of disability. For the vast majority of PWID, the 5.3.4 Employmentopportunity to engage in work in the general community
By ratifying or signing the United Nations Convention on has been denied them. Yet experience shows that many can 18 the Rights of Persons with Disabilities adopted in 2008 by successfully perform a wide range of jobs and can be
GoG, the rights of persons with disabilities, including dependable workers, given the appropriate training and PWID, have been given some impetus. The Convention support. Work not only helps to provide them and their requires states including Ghana to provide training and families with the means to meet their basic necessities, but
also allows them dignity and self-respect. employment opportunities for PWDs jobseekers alongside
non-disabled workers. Three respondents explained the situation of employment of PWID with the following Families often provide the main support for persons with statements:intellectual disabilities, whether they are adults, children,
or adolescents. The care of family members with “It is hard to find jobs for everyone in Ghana, so it's intellectual disabilities by productive adults means that impossible for people with a disadvantage.”one or more parents are not able to access paid work or
must work fewer hours or give up on job advancement. “I don't know, I just pray that my daughter's situation This exacerbates the family's economic and social will improve and she will be able to find a job when she situation, contributing to a vicious cycle of poverty and gets older.”exclusion.
“It is hard work to find employers who are willing to put Research that has been done in the past focusing on
effort in guiding PWID in their workplaces”. disabilities in general seems not to include PWID. Even the Centre of Employment of PWDs in Ghana, an NGO,
The research showed that 71% of respondents think it is mentions that the number of PWID in their records can be very difficult for PWID to get employment in Ghana. counted on one hand. More than for any other group, Parents were more optimistic than the independent leaders including people with other forms of disability, for PWID, and specialists we spoke to. They referred the questions to unemployment rates and exclusion from employment and the specific situation of their child and often hope they will other services in their communities are high. There is a develop so that they will be able to find employment and general perception that PWID are not capable of doing become financially independent. The 14% of the anything useful, employers are also afraid to lose respondents that were somehow neutral or positive, those customers when they employ such persons. PWID want an who replied with somewhat difficult, not difficult or don't opportunity to be included in a range of life experiences in know were all parents. the same way as the non-disabled or as persons with other
18
18 http://www.ilo.org/global/about-the-ilo/press-and-media-centre/news/WCMS_123796/lang--es/index.htm
Figure 12: Difficulty of getting employment for PWID
Very difficult
Somewhat difficult
Not difficult
Difficult
Don’t know
How difficult do you believe it is for a PWID to get employment
Key Findings: A Grim Picture With Glimmers of Hope
Difference in argument to their answers was that independent leaders mostly look to it from the point of view of the more severe stigma to PWID compared to other PWDs, whereas some parents don't acknowledge the fact that their child has a problem. And again the hope of parents for their child to further develop played a role in their answer to this question.
The research also showed that all independent leaders/specialists agreed with the statement that PWID are less likely to
be hired for a job than those with other forms of disabilities or without disabilities even if they are equally qualified.
Parents were more optimistic about potential employment for their children in future. 23% of them believed that it will
not be challenging for PWID to find employment than for other disability groups. One parent said: “You can't see from the
first moment that my child has a disability whereas it is obvious when someone is blind. Therefore I don't agree with the statement”.
It was observed that parents from the rural areas in Ghana who have a low level of education themselves are more
positive when it comes to the chance for their children with ID to get employment than those with higher education.
Examples of petty trading, farming and carrying loads were mentioned as potential employment.
to investigate each other's family background. They do this 5.3.5 Marriage and Family Life to find out if there is anything that will prevent a successful Marriage is a very important stage in the life of the marriage. They investigate to find out answers to questions Ghanaian. The main aim of getting married is to have such as: are there any communicable or hereditary diseases children. There are different ways of choosing partners. For like tuberculosis (T.B.), leprosy, insanity, autism, or example, in some communities in Ghana, parents choose epilepsy in the family; had there been any criminal record, partners for their children. When a father feels that his son e.g., murder or stealing?; can the man look after a wife?is ready for marriage, he finds a suitable wife for him. In the
past, most parents betrothed their daughters before they From the interviews it became clear that more respondents were old enough to marry. Nowadays, parents who choose perceive it is very difficult for a PWID to marry someone partners for their children seek the children's consent first. who does not have a disability. Some respondents say it is In some cases too, the young people make their own choice better or in a lot of cases only possible for PWID to marry and inform their parents. It is the customary practice for a each other because they will understand each other better man to seek the hands of a woman in marriage. In most and probably non-disabled persons would not want to communities it is a taboo for a woman to propose love and marry a PWID. In some cases money was related to the marriage to a man. In the Ghanaian traditional set-up, possibility of getting married or not and also abuse of girls marriage involves the man and the woman concerned as with Intellectual Disability was mentioned.well as their families. Before the marriage, most families try
19
Figure 13: Parents perception of discrimination in employment
Agree
Neither agree nor
disagree
disagree
PWID are less likely to be hired for job then others
Key Findings: A Grim Picture With Glimmers of Hope
Regarding the way forward for PWID getting married, a question was asked about the ideal state of whether PWID should get married and have children. 72% of the parents think that PWID should be able to get married whereas 42% of the leaders shared the same opinion. Leaders often mention that it depends on the level of disability if a person should be able to get married. 54% of the respondents think PWID should be able to have children, whereas 18% disagreed on that statement.
Figure 14: Difficulty of getting marriage for PWID
Leaders
Parents
Verydifficult Somewhat
difficult Not difficult
Difficult
Don’t know
Figure 15: Perception on whether PWID should be able to get married
Leaders
Parents
Agree
Neither agree
nor disagree disagree
Key Findings: A Grim Picture With Glimmers of Hope
20
5.3.6 Social Life & Participation in the Family and
Community
Regarding the question related to PWID participating in Decision making, some respondents made similar comments saying:
We were able to speak to a few persons with intellectual disability themselves who indicated their friends were not many. It was obvious that these children were not used to
78% of the parents however replied positively to the being spoken to and in one case the father started shouting
question if their child was doing small house hold tasks in at the child that he should hurry answering the question
the house, whereas 22% answered 'no' to this question. and at least look the interviewer in the eyes, whereas this
Reasons that were given as not involving their children in child obviously had problems speaking and needed time to
house work, were that they cannot do it or do not like doing find the right words.
it. Respondents were also asked how they felt about PWID generally. The responses were feeling: Pity (25%),
5.3.7 Participation in Church and Mosque Activities Compassion (25%) and Sadness (24%). Fear, Avoidance In general people believe that it is slightly or not difficult and Insults formed 10% of the answers, whereas 15% for a PWID to be a member of a church. However even answered with other reasons.some parents who said it was not difficult, shared their experience on having to go to several churches before they Regarding the question of PWID having a social life, 73% of found one that accepted the child or had people telling the independent leaders consider PWID having a social life them not to take the children to church or the mosque as difficult or very difficult, whereas parents are more because he /she may walk around and make noises that positive by replying in 35% of the cases that it is not will embarrass them.difficult to have a social life for their children. Many of
these parents refer to the fact that their children are very Some parents also indicated:sociable and therefore make friends themselves. Persons
with down syndrome are seen as very sociable and are “Even in church a lot of people don't want therefore better integrated in social life in Ghana than
to come close to my child.”persons with autism.
“My daughter won't kneel down at prayers, Some parents described the social life of their children with so I don't take her to the mosque.”the following statements:
“Whenever decisions are made, PWID are not involved because nobody values their opinion.”
“At a social gathering, the presence of a PWID make people feel very uncomfortable so who will invite them to a social gathering or ask their opinion about a situation.”
“They cannot do anything meaningful to help in the society and within the family so nobody will invite them for ideas.”
“Yes, my child is included in society but only because I, as his mother, put a lot of effort in telling everybody what they need to know to accept him. If they stare at him I ask them what's wrong and if I can help them.”
“My colleagues don't know about my child's disability.
They may treat me differently and I don't want that.”
“Everybody loves my son, they think he is funny.”
Key Findings: A Grim Picture With Glimmers of Hope
21
5.4 Discrimination and Stigmatisation of PWID in
GhanaIt is known that in Ghana the stigmatization and discrimination of persons with disabilities is significant and it is assumed that persons with intellectual disabilities suffer from more discrimination than people with other types of disabilities. Main cause of the stigmatization is most likely to be the low level of knowledge about the disabilities as well as the traditional beliefs that disabilities are caused by witch craft, a curse of God or so called “juju”.
82% of the respondents agree with the statement that PWID are discriminated in Ghana whereas 9% do not agree. The question as to what extent people believe PWID are discriminated in Ghana shows a different picture. More parents than independent leaders believe the discrimination is only sometimes whereas most independent leaders believe the discrimination is all the time. Clearly, many factors underpin the forms of stigmatization, and discrimination described. Many of these relate to the very real fear of persons with ID that exists among the general public. The sources of this fear are complex and include lack of knowledge and understanding of PWID, as well as the manner in which people believe that when you relate to such a person you shall contract same or you shall give birth to such children in the future when in fact it is not true.
The experiences of some of the parent respondents
revealed the following:
22
Figure 16: Difficulty of participation in Church or Mosque
Very difficult
Leaders
Parents
Difficult Somewhat difficult Not difficult
How difficult is it for PWID to be an activemember of a church or mosque
“I am still very conscious of who to tell about my son's disability and who not. People don't understand.”
“My colleagues don't know about my child's disability. They may treat me differently and I don't want that.”
“My ex-husband didn't like my daughter and so didn't like me. He left us when she was 8 months old.”
“ My wife left me when she realized that our son could not be cured and people were calling her names. She said, 'living with our son would be trouble'. She was very frightened.” “Yes my child is discriminated against in Ghana, not per se by individuals because I don't allow that, but by our government. They leave children like my son out of their policies”
“PWID are the most discriminated against amongst the Persons with Disabilities. The stigma of this group is very serious.”
“He used to go outside the compound of the house but children in the neighbourhood were teasing him and throwing stones at him. So we
Key Findings: A Grim Picture With Glimmers of Hope
Observations during the interviews and talk with respect of PWID, their behaviour and therefore the way specialists in the field showed that parents are often society perceives them. embarrassed to admit they experience discrimination.
5.5 Existence and Implementation of Disability Many also are reluctant to admit that their own efforts at Policies & Strategies targeted at PWIDadvocacy and awareness raising have helped to reduce
In the interviews respondents were asked if they were discrimination against their children. Teachers in the aware of legislations on disability and if so, to mention special unit schools of GES mentioned that thanks to the some of its contents. The majority of the respondents did fact that the special units are amongst regular schools, the not know of the existence of any legislation and the ones discrimination is decreasing although still considerable in who knew of for instance the Disability Law often did not Ghanaian daily life. know what the Act is about. The study shows that the knowledge amongst Parents and Care takers of the During the interviews, the question was asked what can be legislation on disability is low. 41% of the parents are not done to stop discrimination towards PWID. Respondents aware of any legislation whereas only 35% of the parents answered that one way to stop discrimination mentioned can mention the name of the Disability Law. Further by the majority of the respondents is education and questions on the contents of the act gave the impression awareness-raising about the disability, either by NGOs, that out of 35% who mentioned the Act, a maximum of 10% Government, or Churches. Some respondents strongly could mention something about the contents of the Act. If pointed out that education needs to begin from the home, the knowledge is this low, it will be hard to make use of the which means that parents have to treat their children with provisions under the act. intellectual disability with respect and show them that
they are just like anybody else. This will increase the self-
confined him for some time in the room. He used to be indoors always. Now we leave him outside but only in the compound of the house.”
A teacher at a unit for special education needs for PWID in Navrongo in the Upper East Region narrated how he is discriminated against just because he is a special educator for PWID. He told the interviewers that he was called “the teacher of fools” or the “fools teacher”. Again when getting directions from somebody and it happens that the school is used as one of the directional signs, you will hear the one giving the directions describing the school as “ the school for the foolish people”.
23
Figure 17: Perceptions of discrimination against PWID in Ghana
Leaders
Parents
yes, often yes,
sometimes
no, not at all don’t know
Do you think PWID are discriminated againstin Ghana
Key Findings: A Grim Picture With Glimmers of Hope
i. To ensure that law enforcement personnel in cases of The general opinion of independent leaders and specialists arrest, detention, trial and confinement of PWDs is that implementation of the Disability Law needs to be take into account the nature of their disabilitiesgiven more attention by the Government to include PWID
j. To encourage full participation of PWDs in cultural in society.activities
k. To ensure access of PWDs to the same opportunities The Persons with Disability Law was passed in June 2006 in recreational activities and sports as other citizensand guarantees PWDs access to education, employment,
l. To promote CBR Programmes as a means of transportation, public places, and free general and empowering and ensuring the full participation of specialist medical care. The Law addresses all major PWDs in societydisability concerns but does not make provisions for the so-
called hidden disabilities (those that are not easy to detect). The Act also established the National Council on Persons The Act has 12 main objectives and provides guidelines for with Disability (NCPD) with the goal of proposing and the relevant sectors on how they should respond to the evolving policies and strategies to enable PWDs to enter needs of PWDs:
and participate in the mainstream of the national 19 a. To educate Ghanaians on the rights, potentials and development process of Ghana. The Council is made up
responsibilities of both society and PWDs of high-ranking representatives from a number of key b. To generate and disseminate relevant information
ministries as well as from Organizations of Persons with on disability
Disability (OPWDs) and organisations or institutions c. To create an enabling environment for the full working for PWDs. Persons with Intellectual Disability are participation of PWDs in national development
d. To ensure access of PWDs to education and training represented on the board of the council by the Director of at all levels the Autism Awareness, Care and Training Centre, who is
e. To facilitate the employment of PWDs in all sectors also a board member of Inclusion Ghana. The Council of the economy
coordinates overall disability related activities in Ghana f. To promote disability friendly roads, transport, and
and function as advisor to the government on disability housing facilities
issues. The council also monitors the implementation of the g. To ensure access of PWDs to effective health care 20Disability Law. and adequate medical rehabilitation services
h. To ensure that women with disabilities enjoy the same rights and privileges as their male counterparts
Figure 18: Level of awareness of any legislation for PWID
19 UNDP, 2007, p. 130.20 GFD, 2008.
24
No
Are you aware of any legislation for PWID
Disability Act (715)
Yes but can’t name any
Key Findings: A Grim Picture With Glimmers of Hope
Other legislation include the National Disability Policy Under the 1992 Constitution, persons with disabilities Document, December 2000 and the 1992 Constitution. (PWD) are guaranteed protection against all exploitation The National Disability Policy Document which secures and treatment of a discriminatory, abusive or degrading the specific rights of PWD was passed by cabinet in nature by the constitution (Article 29). It also mandates the December 2000. This policy was largely in response to the legislature to enact appropriate laws (Article 37) and UN Standard Rules on the Equalization of Opportunities requires access to FCUBE (Article 38). Provision is also for PWD (UN, 1993). It legislates PWD rights as regards to made for special incentives to be given to PWDs engaged in education, transportation, community acceptance, business and also to business organizations that employ housing and employment (MoESW, 2000). PWDs in significant numbers.
25
Key Findings: A Grim Picture With Glimmers of Hope
The research did not only focus on analyzing the current in the Local Government Act. It is the duty of the District situation for PWID in Ghana but also asked respondents Assemblies to plan and secure implementation of services
with assistance from specialized Governmental Agencies questions about what would improve the situation. and NGOs to enable PWID to go to school, have access to Questions involved contributions of governmental quality health care, secure skills training and support for institutions, NGOs, media, parents and PWID themselves. employment and income generating opportunities and Opinions of both independent leaders and parents on this participate in the social life of their communities. matter are described below:
The answer to the question what can be done by the Most respondents see education and sensitization of the Ghanaian government to improve the situation for PWID public as the answer to the discrimination of PWID in was answered from many different perspectives but Ghana. Leaders often mention that it is thanks to the fact education was often the bottom line. Teachers often that more and more people learn about intellectual mentioned that more teachers should be trained in the disability because of their studies, television programs, special needs for PWID but also regularly mentioned the work or experiences that the situation for PWID is slowly poor salaries for special educators and the lack of teaching improving. The fact that there are integrated schools (units materials, whereas some teachers in regular schools seem for special needs children within the same compound of to have the opinion that the special needs teachers are not public schools) helps children to accept their peers with doing anything useful and should therefore get lower intellectual disability from an early stage. salaries
A parent interviewed as part of the study reported that: 6.1 The Role of GovernmentThe Ghanaian government is a constitutional democracy headed by a President. The parliament has 230 seats, all elected on 4 year terms. The country is divided into 10 administrative regions and 166 districts and 10 metropolitan and sub-metropolitan assemblies. In order to democratize, decentralize state power, and institutionalize decision making at the grassroots level, the 1992 Constitution effectively decentralized political and administrative authority under the District Assemblies. The District Assemblies make and implement decisions It was also noted that the government does not pay enough and engage in activities required to meet the needs of the attention to special education in Ghana. The waiting lists in people in the areas under their jurisdiction in economic, the special school and the small number of special schools educational, health, environmental hygiene, recreation
that are in operation at this moment suggest that further and utility services. This means that the needs of PWID
attention in this field is much needed. have to be administered at the district level, as spelled out
CHANGING ATTITUDES
26
6
Figure 19: Improve Inclusion by Government
What can be done to improve inclusion
of PWID by the government
Imo
e e
uctio
fr
prv
da
no
PWID
mp
emen
tatio
nf La
w
Il
o
E
e
I
ducat
peo
ple
on D
Educte
tea
hers
a
c O
rth
e“The big men in the country give priority to things that are for their own benefit. They often don't even know about the problems PWID face”.
A teacher also indicated:“There is no incentive to become a teacher in a special school although we have a more challenging job than our colleagues in the regular schools”.
People feel that the opportunities for PWID to go to school criticism of government policy. Animated phone-in and to learn are too few, while education of the public on programmes are staple fare on many radio stations. Radio Intellectual Disability also needs urgent attention. is Ghana's most popular medium, although it is being
challenged by increased access to TV. The number of people who have access to the internet grows every day, and mobile telephones are becoming a significant source of news.
The media indeed has an important role to play in the improvement of the situation of PWID in Ghana. Education of the public on ID issues and discussion of the
Amongst the other answers respondents gave, they subject for example on their morning shows were often referred to improvement of the health care system, mentioned by respondents. Some of the specialists education of doctors and nurses and opening special mentioned that the media do not always use the right institutions where PWID could live. source of information or invite someone who is not a
specialist in the area and therefore give wrong information to the public. They advise that the media should be
6.2 The Role of the Media accurate and correct with their information when they Ghana enjoys a high degree of media freedom and the spend time on the subject on television. Some respondents private press and broadcasters operate without significant also mentioned the fact that journalists expect money restrictions. The Commonwealth Press Union has before publishing news on ID in the newspapers has a described Ghana's media as "one of the most unfettered" on negative effect on the number of articles published in the the continent. The private press is lively, and often carries diverse media.
27
Changing Attitudes
Figure 20: Improve Inclusion by Media
What can be done to improve inclusion of PWID by the media
Educate Seek rightresources
Discuss/publishinfo
Advocate
A GES Director indicated: “Before I got this job, I had a different opinion about PWID than I have now. The government should include topics on ID in more studies, so that more people learn about the situation of PWID”
6.3 The Role of Parents
Parents should play important roles in the improvement of lives of PWID in Ghana. Especially those who are well educated and whose children are diagnosed with specific type of disability often do a lot of research in this area and are the best advocates for their children's rights. A considerable number of parents indicated during the interviews that it is thanks to their efforts that their children are being accepted in the community or in society. Most respondents mentioned that parents should show pride and love to their child and support their child in their development. This would help to improve their situation and that of their peers on the longer term.
6.4 The Role of PWID themselves
“The champions of this group of disadvantaged people should stand up and advocate for their rights and show that improvement is a possibility”, an NGO leader indicated.
41% of the respondents believe that PWID cannot play a role in improving their inclusion in society. Socialization (25%) and advocacy (16%) were mentioned as things PWID can do themselves. It needs to be mentioned that socialization was often mentioned from the perspective that the PWID are responsible themselves for exclusion because they do not socialise. A substantial number of parents of children with autism, for example, mentioned this as one of the things their children could or even should do, whereas in a lot of down syndrome cases and as part of their disability, socialization is a way of life.
28
Changing Attitudes
Figure 21: Improve Inclusion by Parents
What can be done to improve inclusion by parents of PWID
t
p
S and u fo
r their r
ights
h
i
Sow prid
e of ch ld
Advoc
te/tlk
aa
Push go
vernme
tn
uSpport
child
renOther
“Parents should be the role models in improving the situation for PWID. If a mother hides her child, how can she expect others to treat the child fairly?” was a statement made by one of the teachers in the special schools
6.5 The Role of NGOsNGOs are often seen as the institutions that should take initiatives to improve the situation for PWID. According to most of the respondents, NGOs support a lot with funding and should therefore use those funds to start more special schools, vocational training schools, hospitals, etc. At the same time there was the assumption of some of the respondents that NGOs use funds given by donors for the wrong purposes and so should be checked.
Education, once again, was mentioned as one of the gaps the government leaves for NGOs to fill, whereas health care and implementation of the law were also frequently mentioned. Amongst other answers given, financial support for parents to pay for schools fees, transport or medical support, was also common.
29
Changing Attitudes
Figure 22: Improve Inclusion by PWID themselves
What can be done to improve inclusion by PWID themselves
Accept disability
Socialise
Speak foryourself/Advocate
Other
Nothing
Figure 23: Improve Inclusion by NGOs
What can be done to improve inclusion of PWID by NGOs
Fill gaps of government
Advocacy Other Nothing
In all the research sites, significant levels of stigmatization, nongovernmental and community-based organizations, discrimination and exclusion, both overt and covert, were the business community and workers' organizations; identified in education, employment, health care, and doctors, politicians, nurses and health-care workers, social life. In Education for example, most professional teachers, youth leaders, women leaders and social teachers even though are not trained in special education workers, and the police. Additionally, links need to be held exaggerated fears about children with ID which made with broader struggles that address underlying profoundly affected their ability to admit such children in economic, social, cultural and political inequalities. their class. Children with ID were often denied the rights to go to school or were segregated from other children. If effective responses to ID-related stigma and
discrimination are to be promoted, work has to be done Widespread and enduring changes in social attitudes are simultaneously on several fronts: communication and required if we are to make headway against ID-related education to encourage better understanding of ID; action stigma, discrimination and exclusion. Bringing about such and intervention to establish a more equitable policy change requires mobilizing many different stakeholders, context; and legal challenge, where necessary, to bring to including parents of PWID, friends and families; religious account governments, employers, institutions and and traditional leaders, legal and civil rights groups, individuals.
CONCLUSION
30
7
In order to reduce levels of stigmatization, discrimination 8.2 Implementation and Improvement on and exclusion associated with intellectual disability in
Government Policies Ghana, a number of interrelated actions are needed. Failure to act now will have the severest consequences. The �Attention should be given to assessments of following recommendations seek to address many of the PWID. When a person is not properly assessed, points made in the study and to establish the grounds for support given may not be relevant and can even proper dialogue about how to effectively challenge do harm.stigmatization, discrimination and exclusion of PWID in
�Promote inclusive education for the children with Ghana:“mild” disorders, and integration of special units in compounds of regular schools, using the same playground.
8.1 Meeting the Needs of Parents and Families of �Promote training of teachers and the inclusion of PWID
intellectual disability issues in curriculum of �A more enabling environment needs to be created teachers, nurses, social workers, etc.
to increase the visibility of PWID and to facilitate �Create vocational training for PWID and advocate the formations of parents self help groups so that
for employment via employers stigma, discrimination and exclusion can be challenged collectively. �Increase number of Unit Schools for Intellectual
Disability, also in rural areas, improve �There is a lack of knowledge and a need for infrastructure and provision of tools and inform education of parents about the rights of their key players about these schools. children and about how to get help to challenge
discrimination they face in schools, health care �Within the health-care setting, ensure that settings. Sharing experiences in parents self help intellectual disability is taught within professional groups would be a way to deal with both issues. training curricula especially for community
nursing so that such children or persons with ID �More education on the laws, rules and regulations will easily be identified.and access to the justice system to address
violations of their children's rights in the contexts �Implementation and regular monitoring of the of employment and education needs attention. Disability Law.
�Education and awareness raising of parents will �Education of the public and parents of PWID on hopefully contribute in acceptance of their the Disability Law and disability issues in general. children's disability and will be a start to think of
�Special consideration should be made for PWID the future of these children .to also access the District Assemblies Common
�Promotion of life-skills education and counselling Fund.to help parents and caretakers of children with
�Legal protection for PWID is a powerful way of intellectual disability cope with stigma. redressing, and thereby mitigating, the unequal
�Advocacy is needed for social change in response power relations, the social inequality and the to intellectual disability-related stigmatization, exclusion that lie at the heart of ID-related discrimination and exclusion. The role of parents stigmatization and discrimination. Such and families of PWID and of religious and political protection should be promoted, together with leaders in such a process cannot be appropriate reporting and enforcement underestimated. mechanisms.
RECOMMENDATIONS: Opening New Doors to PWID and their Families
31
8
8.3 Media Intervention 8.4 The Community is key
�Raise awareness so that families and PWID can �Education in communities about some identified access interventions (e.g. care and support causes and prevention of intellectual disability, services) as they become available, or hold capabilities of PWIDs, the need to send children authorities accountable if such services are not with intellectual disabilities to school and the available. contents of the Disability Act.
�Public information campaigns have an important �Positive portrayal of PWID at grassroot level role to play in helping people understand the through role models. Demonstrate the unfairness and unjustness of stigmatization and contribution PWID can make to society and the discrimination of PWID. They can also change development of the nation, for example by individual and social attitudes. showing role models of PWID who have made a
meaningful contribution to society.�Lobbying for positive portrayal of PWID and
change of terminology in the media.: The media �Involvement of religious leaders in educating the needs to involve PWID in programmes public about intellectual disability issues.
�Media campaigns: television and radio shows in �Support PWID in training and educationlocal, understandable language about PWIDs
�Positive portrayal of intellectual disability at grass issues.root level through campaigns and advocacy
�Sensitization of government institutions, businesses, corporations, schools, and hospitals about intellectual disability issues.
�Media Campaigns to encourage parents to send their children with ID to special or regular school: parents and families have to be made aware of educational capacities of their children.
32
Recommendations: Opening New Doors To PWID And Their Families
This report has highlighted a number of areas in which more research would be beneficial. Research is urgently needed to identify the most effective ways of tackling stigma, discrimination and exclusion across a range of contexts:
�Health Care System
�Education
�Social Life
�Employment
�The legal framework relating to PWID can also be explored.
FURTHER RESEARCH
33
9
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Jørgensen, P. (2009). Initiatives supported by Danish Ingstad, B. (31 March). Fact Sheet on Poverty and organisations regarding persons with disabilities in Disability. Inclusion International, www.inclusion-Ghana. Accra.international.org/site uploadsA1223821811255866183.pdf
Lewis, A. & Norwich, B. (2005). Special Teaching for GES (2005), Special Educational Needs Policy Special Children?: Pedagogies for Inclusion. FrameworkMaidenhead, Open University Press.
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nd.pdf
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35
References
Interviewer: Date of Interview:
Child/Relation's Name:
Region: Residence: £ Village £ Town
Language: £ English £ Twi £ Ga £ Ewe £ Hausa £ Other:
Sex: £ Male £ Female
Religion: £ Christian £ Muslim £ Other
PART A
a) What is your age?
£< 16 years
£16-30 years
£31-45 years
£46-60 years
£61 years and above
b) What is your marital status?£Single/Never been married£Married £Separated/Divorced£Widowed
c) What is the highest level of education you have attained?
£None
£Primary School graduate
£Junior High School graduate
£Senior High School graduate
£Teacher Training College
£University or Polytechnic
£Higher than university
d) What is your current employment situation?
£Student
£Unemployed
£Employed
£Own business
£Retired
Interview Guide
Parents / Caretakers of PWIDAnnex 1
36
PART B
1. Have you heard of the term intellectual disability / mentally handicapped?
£Yes
£No
£Don't know
2. How would you describe Persons with intellectual disability / mentally handicapped? ..........................................................................................................................................................
3. What types of intellectual disability do you know?
£Down Syndrome
£Autism
£Others, specify: ............................................
4. What do you think is / are the cause /causes of intellectual disability?
£Medical reasons / diseases
£Accident
£Spiritual cause / juju
£Medical error
£Others, specify: .............................................
5. Do you think people with such disabilities are responsible themselves for their disability? Why
£Yes, ....................................................................................................................................................
£No, .....................................................................................................................................................
£Don't know
6. Do you think intellectual disability can be cured? How or why ?
£Yes, by...............................................................................................................................................£No, because.......................................................................................................................................
7. What is the relationship between you and the person with intellectual disability?£Child £Spouse/partner £Sibling£Member of immediate family £Friend £Neighbour £Colleague/work contact £Employer
8. How old was your child / relation when you first suspected the impairment?£Younger than 2 years£2-4 years£5-7 years£8-10 years£Older than 10 years
37
Interview Guide-Parents / Caretakers of PWID
9. What were the first signs that something was unusual about your child?£Hearing£Physical £Behaviour,.............................................£Other,....................................................
10. Who did you first consult?£Doctor£Spiritual leader£Priest£Family Member£Community Leader£Other,..................................................
11. Have you sought for treatment?£No, because............................................£Yes, ........................................................
12. Which of the impairments is your child / relation diagnosed of?£Down Syndrome£Autism£Others, specify: ......................................
13. How often do you have close contact (one on one) with your child / relation?£Daily£Weekly£At least once a month£Once every three months£Less often than once every three months
14. Does your child do small house hold tasks (sweeping, washing dishes, etc)?£No, because............................................£Yes, ........................................................
15. If there's a family festivity taking place (eg funeral), does your child attend?£No, because............................................£Yes, ........................................................
16. If the family is preparing a family festivity, does the child have a role in the preparation like other children in the family?
£No, because............................................£Yes, ........................................................
17. If a mother of the child, did you notice any change in your relationship with the father of the child?£Yes, significant£Yes, slightly£Don't know£Not at allPlease explain:....................................................................................................................................
38
Interview Guide-Parents / Caretakers of PWID
18. Did you notice any change in your relationship with other family members?£Yes, significant£Yes, slightly£Don't know£Not at allPlease explain:....................................................................................................................................
19. Did you notice any change in your relationship with the neighbours and community?£Yes, significant£Yes, slightly£Don't know£Not at allPlease explain:...........................................................................................................................................
20. How do you personally feel about persons with intellectual disability?
£Fear
£Pity
£Uncomfortable
£Sadness
£Compassion
£Avoid or ignore them
£Laugh at them / insult them
£Other, specify: ......................................................................
21. Has this changed since your child was born/since you met the 'relation'?
£Yes, ....................................................................................................................................................
£No, .....................................................................................................................................................
22. In general, to what extent do you feel that your child / relation is included in society. Would you say they are?
£Fully included
£Somewhat included
£Not at all included
£Depends on level of mildness of the intellectual disability
23. What do you think is the reason why your child / relation is not fully included in society?
.....................................................................................................................................................................
24. How difficult do you believe it is for your child / relation to:
a. Get employment?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
b.Get good education?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
c. Get good health care?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
39
Interview Guide-Parents / Caretakers of PWID
d. Have a social life?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
e. Be financially independent from others?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
f. Get married?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
g. Participate in decision-making in the family and community?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
h. Be an active member of a church?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
25. Do you think persons with intellectual disability are discriminated against and to what extent?
£Yes, often
£Yes, sometimes
£No, not at all
£Don't know
26. In your opinion, what is / are the cause(s) of the discrimination?
£Fear
£Ignorance
£Stigma / stereotyping
£Other, ................................................................
27. Is there something that you think can be done to stop the discrimination towards your child / relation?
£Yes, .......................................
£No, ........................................
£Don't know
28. How do you think children with an intellectual disability should be educated?
£In regular schools
£In special schools
£No education needed
Why:....................................................................................................................................................
29. How comfortable would you feel if persons with intellectual disabilities were your next door neighbour:
£Very Uncomfortable £Slightly uncomfortable £Comfortable £Don't know
30. What do you think can be done for persons with intellectual disabilities to improve their inclusion in society by:
a. Government
£Improve education for PWID
£Implementation of Law
£Educate people on ID
£Educate teachers
£Other,.....
£Nothing
40
Interview Guide-Parents / Caretakers of PWID
41
Interview Guide-Parents / Caretakers of PWID
b. Parents /family of persons with intellectual disability
£
£Show pride of child/Stop hiding children
£Advocate/Talk
£Push government
£Support children
£Other
£Nothing
c. Media
£Educate
£Seek right resources
£Discuss/publish information
£Advocate
£Other
£Nothing
d. Persons with intellectual disability themselves
£Accept disability
£Socialise
£Speak for yourself/Advocate
£Other
£Nothing
e. NGOs
£Fill gaps of government
£Other
£Nothing
31. Are you aware of any legislation or law for people with disabilities?
£Yes (go to Q32-33)£No
32. What legislation or law can you name?.......................................................................................................................................................................33. Can you shortly describe the contents of any of this legislation or law?
.......................................................................................................................................................................
.......................................................................................................................................................................
.......................................................................................................................................................................
34. What do you think are the capacity/training/support needs of organisations or parents groups working to promote the rights and needs of persons with intellectual disability
.......................................................................................................................................................................
.......................................................................................................................................................................
.......................................................................................................................................................................
.......................................................................................................................................................................
Stand up for their rights
42
PART C
To what extent do you agree or disagree with the following statements?
1 = Agree, 2 = Neither agree nor disagree, 3 = Disagree
I.
My child/relation is treated fairly in Ghana
1
2 3
II.
My child/relation should live in special institutions
1
2 3
III.
My child/relation should stay at home
1
2 3
IV.
My child/relation should be able to have children
1
2 3
V.
My child/relation is well integrated into society
1
2 3
VI.
My
child/relation should participate like everyone else in social activities
1
2 3
VII.
My child/relation is discriminated in Ghana
1
2 3
VIII.
My child/relation should be kept away from other children in school
1
2 3
IX.
My child/relation should be able to get married
1
2 3
X.
My child/relation should study in regular schools
1
2 3
XI.
I /The family is blameable for my child’s disability
1
2 3
XII.
It is okay with me if a person with an intellectual
disability was my next door neighbour
1
2 3
XIII.
My child/relation should be kept apart from the rest of the society
1
2 3
XIV.
People should avoid person with intellectual disability because
they can transmit the disability to other people
1
2 3
XV.
My child/relation should have the right to vote in political elections
when he/she turns 18
1
2 3
XVI. My child/relation is less likely to be hired for a job than those with other form of disabilities or without disabilities, even if they are equally qualified
1 2 3
Interview Guide-Parents / Caretakers of PWID
43
Interview Guide
Independent Leaders / SpecialistsAnnex 2
1. Have you heard of the term intellectual disability / mentally handicapped?
£Yes
£No
£Don't know
2. How would you describe Persons with intellectual disability / mentally handicapped?
..........................................................................................................................................................
3. What types of intellectual disability do you know?
£Down Syndrome
£Autism
£Others, specify: ............................................
4. What do you think is / are the cause /causes of intellectual disability?
£Medical reasons/diseases
£Accident
£Spiritual cause /juju
£Medical error
£Others, specify: .............................................
5. Do you think people with such disability are responsible themselves for their disability? Why?
£Yes, ....................................................................................................................................................
£No, .....................................................................................................................................................
£Don't know
6. Do you think intellectual disability can be cured? How or why ?
£Yes, by...............................................................................................................................................
£No, because.......................................................................................................................................
7. How do you personally feel about persons with intellectual disability?
£Fear
£Pity
£Uncomfortable
£Sadness
£Compassion
Interviewer: Date of Interview: Interviewees Name: Telephone: Region: Town:Job/Function:
44
Interview Guide-Independent Leaders / Specialists
£Avoid or ignore them
£Laugh at them / insult them
£Other, specify ...................
8. How do you personally feel about family members of persons with intellectual disability?
..........................................................................................................................................
9. In general, to what extent do you feel that persons with intellectual disability areincluded in society, in comparison with people without other disabilities? Would you say they are:
£Fully included
£Somewhat included
£Not at all included
10. What do you think is the reason why persons with intellectual disability are notfully included in society?
........................................................................................................................................................
11. How difficult do you believe it is for a person with an intellectual disability to:
a.Get employment?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
b.Get good education?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
c.Get good health care?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
d. Have a social life?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
e.Be financially independent from others?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
f. Get married?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
g. Participate in decision-making in the community?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
h. Be an active member of a church?
£Very difficult £Difficult £Somewhat difficult £Not difficult £Don't know
12. Do you think persons with intellectual disability are discriminated against and to what extent?
£Yes, often
£Yes, sometimes
£No, not at all
£Don't know
45
Interview Guide-Independent Leaders / Specialists
13. In your opinion, what is / are the cause(s) of the discrimination?
£Fear
£Ignorance
£Stigma / stereotyping
£Other, ................................................................
14. Is there something that can be done to stop the discrimination towards persons with intellectual disability?
£Yes, .....................................................................................................................................
£No
£Don't know
15. How do you think PWID should be educated?
£No education needed
£In regular schools
£In special schools
16. How comfortable would you feel if persons with intellectual disabilities were living in your house / next door neighbour:
£ Very Uncomfortable £ Slightly uncomfortable £ Comfortable £ Don't know
17. What do you think can be done for persons with intellectual disability to improve their inclusion in society by:
a. Government
££££££
£££££££
Improve education for PWIDImplementation of LawEducate people on IDEducate teachersOther,..........................Nothing
b. Parents /family of persons with intellectual disabilityStand up for their rightsShow pride of child/Stop hiding childrenAdvocate/TalkPush governmentSupport childrenOtherNothing
46
Interview Guide-Independent Leaders / Specialists
c. MediaEducateSeek right resourcesDiscuss/publish informationAdvocate OtherNothing
d. Persons with intellectual disability themselvesAccept disabilitySocialiseSpeak for yourself/AdvocateOtherNothing
e. NGOsFill gaps of governmentOtherNothing
££££££
£££££
£££
18. What do you think are the capacity/training/support needs of organisations or parents groups working to promote the rights and needs of persons with intellectual disability
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
.
47
PART B
To what extent do you agree or disagree with the following statements?
1 = Agree, 2 = Neither agree nor disagree, 3 = Disagree
I. Persons with intellectual disability are treated fairly in Ghana 1 2 3
II. Persons with intellectual disability should live in special institutions 1 2 3
III. Persons with intellectual disability should stay at home 1 2 3
IV.
Persons
with intellectual
disability should be able to have children
1
2
3
V.
Persons
with intellectual
disability are well integrated into society
1
2
3
VI.
Persons
with intellectual
disability should participate like everyone
else in social activities 1
2
3
VII.
Persons
with intellectual
disability are blameable for their disability
1
2
3
VIII.
Persons
with intellectual
disability are discriminated in Ghana
1
2
3
IX.
Chichildren in school
ldren with intellectual disability should be kept away from other
1
2
3
X.
A person with an intellectual disability should be able to get married
1
2
3
XI.
Children with intellectual disability should study in regular schools
1
2
3
XII.
I am
happy to be associated with persons
with intellectual
disability
1
2
3
XIII.
It is okay with me if a person with an intellectual
disability was my next door neighbour
1
2
3
XIV.
Persons with
intellectual disability should be kept apart from the rest
of the society
1
2
3
XV.
People should avoid persons
with intellectual
disability because they can transmit the disability to other people
1
2
3
XVI.
Persons with intellectual disability should have the right to vote in
political elections
1
2
3
XVII.
Persons with intellectual disability are less likely to be hired for a job
than those with other form of disabilities
or without disabilities, even if they are equally qualified
1
2
3
Interview - Guide Independent Leaders / Specialists
48
Annex 3
RESPONDENT FUNCTION
Mawuli Tetteh Consultant, Special Needs Education
Mohammed Bukari National Inclusive Education Coordinator, GES
Mawusi Adiku
Educational Director, Autism Awareness, Care & Training
Alexander Tetteh
Executive Director, Centre for Employment of PWDs
Charles Appiagyei
Executive Director, Ghana Society for the Physically Disabled
Lawrence Lamina
Executive Director, Echoeing Hills
Philip Okai Darlas
Social Worker, Echoing Hills
Sheikh Ahmed Adjei Adjetey
Deputy Regional Imam, Ghana Muslim Mission
Suleiman Nettey
Secretary, Council of Ghana Muslim Mission
Grace Preko
Head, National Assessment and Resource Centre
Dr. Albert Paintsil
Head, Plastic Surgery, Korle-Bu Teaching Hospital
Duut Bonchel Abdulai
Acting Executive Secretary,
National Council on PWDs
Rita Kyeremaa
Executive Director, Ghana Federation of the Disabled
Nii Tetteh Adjabeng I
Chief, Adabraka Atukpai
Nii Okwei Kinka Dowuona VI
Chief, Osu
Dr. Ebenezer Badoe
Intellectual Disability Specialist, Korle-Bu Teaching Hospital
Rev. Sister Catherine Gah
Assessor, National Assessment & Resource Centre
Nana Akua Owusu
Speech & Language Therapist
Doreen Araba Obu
Special Educator,
Madina Cluster 1 EID Unit, Accra
Mercy Asiedu
Special Educator,
Madina Cluster 1 EID Unit, Accra
Godfred Nudey
Secretary, Traditional Council of Klefe
George Gura
District Director, Ghana Education Service, Ho
Japhet Buamah
Municipal Special Education Officer, Ho
Elizabeth Adu
Special Educator, Anglican Basic School EID Unit, Ho
Mawusi Awuni
Special Educator, Anglican Basic School EID Unit, Ho
John Duaye
Special Educator, Anglican Basic School EID Unit, Ho
Esinam Arku
Special Educator, Anglican Basic School EID Unit, Ho
Kudior Shine
Teacher, Helekpe EP Primary School
Emily Chekpa
National Service Person, Helekpe EP Primary School
Vincent Bansah
Head Teacher, Helekpe
EP Primary School
Frank Bissi
Ghana Federation of the Disabled, Ho
Togbe Kwafai
Paramount Chief, Ho Traditional Area.
Emelia Akorfa
Programme Head, Community Care, Ho
Very Rev. Mgsr. Thomas
Anamoo
Diocesan Administrator, Catholic Church, Bolga
Joycelyn Akorfa
Assembly Woman, Ho
Bradford Tay
Business man, Ho
David Aziagu
Community Mobilizer, Ho
Very Rev. Fr. Moses Akebule
Cathedral Administrator, Catholic Church, Bolga
Felix Frederick Amega-Etego
Executive Director, Centre for Child Development, Bolga
Edward Alira
Head Teacher, Balobia L/A Primary EID Unit, Navrongo
Hilda Asora
Social Worker, Bolgatanga
Paulina Agomsitiba
Social Worker, Bolgatanga
Grace Billah
Social Worker, Bolgatanga
Mary Zoesioni
Social Worker, Bolgatanga
List of Respondents-Independent
Leaders / Specialists
49
Kofi Anokye Owusu - Darko Head, Consumer Banking Operations, Merchant Bank
Ebenezer Kye-Mensah Capacity Building Specialist, CHF International
Raymond Ategbi Okrofu Country Coordinator, Co2balance Ltd.
RESPONDENT FUNCTION
Sabogu Ubald Education Coordinator, VSO, Bolga
Achimpua Roger
Teacher, Bolga
David Azupago
Director, Meta Foundation
Mercy Pwakra
Municipal Social Welfare Officer, Bolgatanga
Stephany Asido
Special Educator, Balobia L/A Primary EID Unit, Navrongo
Timothy Allou
Special Education Coordinator, GES, Bolga
Paul Rewom
Special Educator, St. Charles Primary EID Unit, Bolgatanga
Mary Magdalene
Ayoma
Head Teacher, St. Charles Primary EID Unit, Bolgatanga
Mark Nabiah Deputy Director-Finance, GES, Bolgatanga
Akagre Johakim Deputy Director, Ghana Education Service, Bolgatanga
Francisca Ateere Deputy Director-Finance, GES, Bolgatanga
Agnes Attagabe
Director, Ghana Education Service, Bolgatanga
Ben Yindol
Deputy Director-Human Resources, GES, Bolgatanga
Godwin Gyasi
Deputy Director, Mission of Hope for Society Foundation
Amoah-Buanin
Headmaster, St. Pauls’ Primary School, Kintampo
Pastor James Anane-Domeh
Pastor, Seventh Day Adventist Church, Techiman
Nana Obiri Yeboah Kokorko
Chief, Bamim, Techiman
Alfred
Special Educator, School for the Deaf, Bechem
Armstrong
Special Educator, School for the Deaf, Bechem
Linus Baaba
Special Education Needs Coordinator, Sunyani
Christiana Akum Yeri
Headmaster, St. Pauls R/C Basic EID Unit, Techiman
Rafae K. Lantah
Administrator, Hanukkah Children’s Home, Techiman
Henrietta Nyarko
Special Teacher, St. Pauls R/C Basic EID Unit, Techiman
Martha Tiwaa
Teacher, St. Pauls R/C Basic EID Unit, Techiman
Prosper Y. Dombul
Teacher, St. Pauls R/C Basic EID Unit, Techiman
Thomas Patrick Otaah
Deputy Director, SPED, Accra
David Tettey
Officer, SPED, Accra
List of Respondents-Independent Leaders / Specialists
50
Data
On B
asi
c S
chool
Enro
lment
For
Pers
ons
Wit
h
Inte
llectu
al
Dis
abil
ity
No.
SC
HO
OL
S
YE
AR
E
ST
AB
LIS
HE
D
En
rolm
ent a
s at
31st
July
201
1
MA
LE
FEM
AL
E
TO
TA
L
NO
. OF
TE
AC
HE
R(S
)
Sp
ecia
l Sch
ools
for
Inte
llec
tual
Dis
abil
ity
1D
zorw
ulu
Sp
ecia
l Sch
ool,
Acc
ra
1970
87
63
150
25
2
Gar
den
Cit
y Sp
ecia
l Sch
ool,
Ku
mas
i
1977
132
54
186
32
3
Tw
in C
ity
Spec
ial S
choo
l, Se
kond
i
1977
79
57
136
11
4
Cas
tle
Roa
d S
pec
ial S
choo
l, A
ccra
19
80
38
15
53
5
5Sc
hool
for
the
Dea
f E
ID U
nit,
Kof
orid
ua
19
85
15
7
22
6
6T
hree
Kin
gs S
pec
ial S
choo
l, B
atto
r
1995
68
53
12
1
9
7Sh
alom
Sp
ecia
l Sch
ool,
Nko
ranz
a
1997
91
56
14
7
15
8C
omm
uni
ty In
clu
sive
Sp
ecia
l Sch
ool,
Kp
and
u
1999
24
16
40
7
9Sc
hool
for
the
Dea
f (E
MH
Uni
t), W
a
2000
24
29
63
5
10Y
um
ba S
pec
ial S
choo
l, T
amal
e
2004
45
49
94
12
11C
omm
uni
ty S
pec
ial V
ocat
iona
l Sch
ool,
Ded
uak
o-K
um
asi
20
05
27
13
40
5
12G
bi K
led
zo S
pec
ial S
choo
l, H
ohoe
20
05
71
41
112
11
13C
atho
lic S
pec
ial V
ocat
iona
l Sch
ool,
Fija
i-T
akor
adi
20
10
18
7
25
4
Pri
vate
S
choo
ls
for
Inte
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tual
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abil
ity
1N
ew
Hor
izon
Sp
ecia
l Sch
ool,
A
ccra
19
72
92
43
135
2A
uti
sm A
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s C
are
and
Tra
inin
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19
98
29
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34
20
Ann
ex 4
51
No.
SC
HO
OLS
Y
EAR
ES
TA
BLI
SHED
En
rolm
ent a
s at
31st
Ju
ly 2
011
M
ALE
FE
MA
LE
T
OT
AL
N
O. O
F T
EAC
HER
(S)
Uni
t Sch
ools
for
Int
elle
ctua
l Dis
abil
ity
1
R
ev. F
r. Jo
hn B
asic
Sch
ool E
ID U
nit,
Win
neba
20
03
23
21 44
4
2
Mad
ina
Clu
ster
1 E
ID U
nit,
Acc
ra
2004
8
7
15
2
3
GC
D B
asic
Sch
ool E
ID U
nit,
Akw
atia
2005
9
11 20
2
4
St. C
harl
es P
rim
ary
EID
Uni
t, B
olga
tang
a
2005
14
15
29
3
5
Kas
seh
DC
Pri
mar
y EI
D U
nit,
Ada
2006
0
2
2
1
6
Arc
hang
el R
/C B
asic
EID
Uni
t, W
alew
ale-
Sugu
ru
2006
14
4
18
2
7
Pres
by B
asic
Sch
ool E
ID U
nit,
Ago
na S
wed
ru
2006
8
8
16
1
8
Yilo
Sta
te B
asic
Sch
ool E
ID U
nit,
Som
anya
2006
7
6
13
2
9
Nan
a A
kuam
oah
“A”
Basi
c EI
D U
nit,
Nka
wka
w
2006
19
16
35
3
10
St. J
osep
h Ba
sic
Scho
ol E
ID U
nit,
Obu
asi
2006
7
2
9
3
11
Met
hodi
st B
asic
Sch
ool E
ID U
nit,
Goa
so
2006
6
8
14
1
12
Met
hodi
st B
asic
EID
Uni
t, A
boom
-Cap
e C
oast
2006
32
17
49
3
13
Balo
bia
Inte
grat
ed P
rim
ary
Scho
ol, N
avro
ngo
2006
16
14
30
3
14
Met
hodi
st B
asic
EID
Uni
t,
Adu
krom
2007
9
8
17
2
15
Met
hodi
st B
asic
Sch
ool E
ID U
nit,
Eff
idua
se
2007
27
18
45
3
16
Nya
maa
Bas
ic S
choo
l EID
Uni
t, Su
nyan
i
2007
15
12
27
4
17
Dan
som
an 5
EID
Uni
t, A
ccra
2007
16
10
26
5
18
Ang
lican
Bas
ic S
choo
l EID
Uni
t, H
o
2007
15
5
20
4
19
Chi
cago
Bas
ic S
choo
l EID
Uni
t, K
eta
2007
18
5
23
4
20
Rom
an C
atho
lic P
rim
ary
EID
Uni
t, N
adow
li
2007
4
2
6
1
21
Rev
. Hoo
per
Basi
c Sc
hool
EID
Uni
t, T
arkw
a
2007
12
10
22
2
22
SDA
Bas
ic S
choo
l EID
Uni
t, D
akpe
ma-
Tam
ale
2008
6
7
13
2
23
OPA
SS B
asic
Sch
ool E
ID U
nit,
Kuk
uran
tum
i
2008
4
7
11
3
24
St. P
auls
R/C
Bas
ic E
ID
Uni
t, T
echi
man
2008
14
4
18
3
Special School List
52
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
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INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANAINCLUSION
GHANA INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA INCLUSION
GHANA
INCLUSION GHANA
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