Cultural Issues on Disability

One of the student’s assignments for this trip was to interview at least one non-disabled community leader in the Accra region about their perception of disabilities and disability culture in Ghana. We (of course) also talked to a lot of people with disabilities, but we wanted to get a sense from the broader community how those with disabilities were viewed. Accra is capital city of Ghana. The community leaders we interviewed were generally educated, middle class individuals. Much of what they said was not new in terms of the traditional beliefs regarding disabilities in Ghana and other developing countries in Africa. In the past, and in many areas of Ghana still today, if a child is born with a disability it is believed to be a result of evil spirits, a failure of the family to keep taboos, or some type of witchcraft. In some cases infanticide is committed, other times the child is kept hidden for years. The child may also be left at an orphanage or sent to beg on the streets (which is where you find a lot of Ghana's disabled population). Published in the International Journal of Rehabilitation Research in 1983, Sylvia Walker indicated that college-enrolled students in Ghana were less likely than their non-educated peers to blame the individual or their parents for the disability, though they were less favorable about actually interacting with a disabled person. Based on the people we talked to on this trip, level of education does seem to play a role in the understanding of disabilities and the potential of those who are disabled. There is even some acknowledgement that disabilities are not all physical; we frequently heard mention of the disabled being “those not right in the head” or even once those “suffering from the heartbreak”. The new Ghanaian disability law promises education and access for those with disabilities though there is a lot of skepticism on the part of both the disabled and non-disabled alike how effective this law will be, particularly in the more rural regions of the country. I like this article on ModernGhana.com

One of my personal goals for this trip was to identify future projects, ways to partner with the people in Ghana to aid in their efforts to make the promises made in the disability law a reality. One major initiative that needs to happen is good-old education. Now the way to do this is not to go storming into the country and saying “your beliefs are wrong, let me show you what us wise westerns know”; NO, that is not a good idea. But I do think that by traveling to different villages (particularly in rural areas)and talking to the local health care workers or birthing attendants, would provide opportunities to help people understand not only what causes disabilities (e.g. like bum polio shots and bad water), but more importantly increase their awareness that children born with disabilities can still grow to be contributing, functional members of their families and communities. If these things are acknowledged, then you can begin to start talking to them about appropriate treatment and therapy. During this trip I was shocked when we met a 9 year old girl who clearly had Down ’s syndrome (or a very similar chromosomal disorder) and the family told us that what they really needed was to get to the doctor to get more medication to help cure her. This was a family with limited means and who clearly wanted to help their daughter (who had been kicked out of school because she bit her teacher and the teacher thought her disorder was contagious), but needed basic education and guidance about the nature of her condition.

Our group brainstormed with one Ghanaian family about how disability education could be done through videos or skits put on in the local villages. This approach apparently has worked in the past and is currently being used (along with signs and billboards) to educate people about HIV/AIDS. This is just one of the many ideas for future projects VCU students could get involved in, potentially in partnership with our friends in the School of Social Work and the School of Nursing…

One Bad Day

So last night I found out that I did not get into the grant program that I had been hoping to get into. I thought I was in. I thought I was perfect for this program. I have been turning it over and over in my mind what I could have done differently, why I can't seem to catch a break when all I have done is work my butt off for the past four years in this job. I have been sad. I have been angry. I have had a very "woe is me" day. Then I took a break tonight to look at my pictures from the Ghana trip and I thought...

I have a home




I eat three meals a day




I have three college degrees and a good job




My son and I have health care




In general I wake up each day with a purpose and do things that I feel good about. I like what I do and if I ever stopped liking what I do I have choices and opportunities open to me. Through my work I have gotten to meet new people and do new and exciting things.




So now...after reflecting...I do not feel so sorry for myself. I do not feel so sad, or angry, or disappointed. I feel thankful for what I have and the opportunities that have been available to me.

There is a link on my blog to the Mocha Club Organization; their saying is "I need Africa more than Africa needs me". At times like this I know this saying to be true. If it weren't for Africa I would not be able to frame things the way I do now. It has taken me 3 trips to understand this, but now I am beginning to see.

MacGyver Kits

Previously mentioned on this Blog were the "MacGyver Kits" (apologies for any legal or copyright infringements) we took with us on our journey. These kits were projects developed as part of our second year students coursework in the OT program at VCU. As their project leader, I requested 2 kits that were portable and contained items that we would need to modify or build adaptive equipment in Ghana using the natural materials readily available in country. The students, using the Disabled Village Children book as a guide, came up with a variety of items that packed fairly easily into one large duffel bag and 1 book bag.

Some of the contents of the kit included: Velcro, superglue, duct tape, piping insulation, PVC pipes, dowel rods, paint sticks, puffy paint, straws, balloons, mole skin, foam pads, scissors, knife, saw with protective cover, foldable shovel, hammer, screw driver with interchangeable heads, more duct tape, sewing kit, rope with differing widths, D-rings, pens/markers, rubber bands, nails/screws, laminating sheets...and more. Here is a picture of the kit materials laid out for packing pre-trip:



The kit definitely came in handy and we actually did an inservice for the teachers and staff New Horizons School on how to adapt school, self-care, and play materials for the children they serve. I will let the students share some of their own creations but I am most proud of the sock-aid made out of a used water bottle that I helped to make.




Not knowing what to expect (or what we would be asked to do) going into this trip, both myself and the students had to be flexible and quick thinking to meet the needs of the individuals we saw. This was a great hands-on learning experience for the students and a very good wake-up for me since it has been a while since I have done some of these things (you know, ivory tower and all...). The MacGyver Kits definitely came in handy and I would bring many of the materials on our next trip. What is unfortunate is that some of these materials are not easily found in Ghana (e.g. laminating sheets, Velcro, puffy paint for raised lines)so the sustainability is limited. What would be better, and could be accomplished with more time on future trips is trying to get a better understanding of what materials are available and how to use these materials to get the job done.

Along this train of thought, we met a physiotherapist volunteering at the New Horizons school who was working with Appropriate Paper Based Technologies. This is essentially using a form of paper mache which they were using to make standing frames and positioning devices for children with cerebral palsy. This was very cool and something that can be done anywhere in the world for a very limited cost. You can see one of the seating devices below (the theraband is from our kit). Very cool!

Return to Western Culture

Well, I have successfully managed to teach for three consecutive days without falling over or having the remnants of my malaria medications cause me to see purple elephants sitting in the class instead of students; That I feel is an accomplishment considering how jarring my return to western culture has been. I have not had much time for reflection on our experiences in Ghana, at least not the solid hours of time with which I would like to have. I have finally managed to get my diurnal rhythm back on track and am no longer waking up at obnoxiously early hours of the morning, that is a blessing.

My eating habits were so out of sorts while in country that it almost seems odd to return to the standard 3 meals a-day routine that we have here in the states. I have to say that I am missing some of the Ghanian foods that I have grown to love (jollof, fufu with palm nut soup, and fried plantains to name a few) not to mention the fact that I did not have to cook any of these things while I was away. I realize that my son has probably been missing these foods since he came to the US as well, and while I have prepared a few Ghanaian dishes over the past two years, maybe I need to make more of an effort to incorporate Ghanaian dishes into our weekly meal plan. One of our new OT students is Ghanaian (born in US) and said that you can microwave fufu using the instant powder; that sounds much more feasible to me than pounding the cassava myself! I also found this great site which provides recipes for lots of my favorite Ghanaian dishes. For people who read this blog and will be staying in the Accra region there are several restaurants in the city of Adabraca that I would recommend: The White Bell, the restaurant at the Niagara hotel (Lebanese), Paloma, and the restaurant at the Hotel President.

Here is a pic from my first trip to Ghana of fried plantains and bean sauce...yum!!!

Starting with Service

If I have been of service, if I have glimpsed more of the nature and essence of ultimate good, if I am inspired to reach wider horizons of thought and action, if I am at peace with myself, it has been a successful day.

-Alex Noble

Previous VCU groups that have worked in Ghana have spent the majority of their trip doing service projects with Sovereign Global Missions; primarily working on clearning the grounds and literally building the child development center in the village of Adoteimen. I thought from the beginning that service should be part of our trip, but I wanted also to make sure that this experience was more of a course/learning experience than purely a service trip. So we decided to spend the first two days in Ghana painting the school/child development center at the SGM complex. Under the guidance of professional painters from the town, we were able to get 1-2 coats on both the inside and outside surfaces of the school. Now, I have to say that what sticks in my mind most about the experience was how HOT it was and how I don't think I have ever been quite that dirty in my life! But, I also think that working with the painters and becoming a part of the history of the development of this center was one of the most personally rewarding experiences of the trip. I also think that this initial work helped our group to bond and work together as a team in an area unrelated to OT. I hope that future groups of students can continue to be a part of the development of this center and I will be sure to include service work into future trips. Here are some pics of the center and our painting team:


The Center (Before)



Our Team


One of our Professional Leaders


The Occasional Interference







Hard at Work


The Center (after)