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Letter from Ghana — From the May 2017 issue

A Prayer’s Chance

The scandal of mental health in West Africa

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When Kwame Nkrumah, Ghana’s founding prime minister, assumed office in 1957, he had ambitious plans for his country. A number of his grandiose designs for an “industrialized socialist society” came to fruition, but most did not. Among the discarded projects was the Pan-African Mental Health Village, a cutting-edge experiment in a kind of therapeutic collectivism. Outfitted with a cinema, a supermarket, and a surgical theater, the village was conceived as a tranquil place where the mentally ill and their families, free from societal strains and prejudices, could live and work alongside leading clinicians. But Nkrumah was overthrown in 1966, and construction was halted. At the time of his death, six years later, the quarter-finished Mental Health Village was already falling into decrepitude.

For the succeeding generation of mental health advocates, these crumbling, deserted buildings represented all the shortcomings of Ghana’s psychiatric system. J. B. Asare, the country’s former chief psychiatrist, described the discarded project to me as just one of a “series of unrealized dreams.” Any prospect of improvement was thwarted by an ensemble of political and economic woes. In the Seventies and Eighties, while Europe and North America were being flooded with new drug therapies and shuttering their psychiatric hospitals in the name of community mental health, Ghana suffered three military coups and several financial crises. Medical professionals left the country in droves. Under austerity constraints imposed by the World Bank and other foreign creditors, Ghana’s government had neither the will nor the capacity to invest in a public psychiatric system.

Twenty-five-year-old Odeneho Samson, restrained by the leg at Nazareth, being prayed over to remove the spirits believed to be causing his mental illness

Twenty-five-year-old Odeneho Samson, restrained by the leg at Nazareth, being prayed over to remove the spirits believed to be causing his mental illness

By the time Samuel and Philomena fell sick, the country’s circumstances, as in much of West Africa, were manifestly grim. A mere 2 percent of Ghanaians with serious mental health needs had access to treatment of any sort; the relative few who were hospitalized were routinely subjected to involuntary injections, electroconvulsive therapy without anesthesia, and overcrowded, unsupervised wards. Not for nothing were Ghana’s government-run asylums popularly perceived as places where you went to die.

In the 1990s, as the new Pentecostal churches sought to fill the vacuum left by the state’s retreat from providing social services, the prayer camps began proliferating. Drawn by reports of sensational miracles, supplicants flocked to the mountains and forests in the south, where most of the camps were located. Some grew into enormous settlements as big as towns; others were ramshackle operations with little more than a signboard and a plot of land. (Healing therapies were also offered by traditional shrines and, in the north, a handful of mosques.) The pastors and healers, prophets and prophetesses running the camps typically lived on site, where they were sustained by tithes, offerings, and consultation fees (and sometimes by farming and business initiatives). Several had close ties to major Pentecostal churches and denominations. Others refused to accede to any authority, or “anointing,” but their own. Those visiting the camps were equally diverse, in terms of both the predicaments that brought them there — disease, financial problems, difficulty getting pregnant — and their class and social backgrounds. At the larger, more established camps it was common for the poorest of the poor to find themselves praying and fasting alongside Ghana’s political and business elite.

Soon numbering in the hundreds, these secluded healing centers evolved to be as heterogeneous as the Pentecostal movement itself. But they shared a few basic convictions. First, that God had promised his people not just life but life “abundant,” as it says in the Book of John. And second, that sickness and misfortune were the result of one’s true reality having been blocked or thwarted — by the Enemy and his agents, by human foes, by one’s own transgressions. Whatever the circumstances, the camps were there to identify such threats and help eliminate them.

When Martin arrived at Nazareth Prayer Centre with his mother and siblings, he was shocked by the dingy, primitive appearance of the place, and also by its size: an unending series of run-down buildings, constructed in the traditional mud-and-thatch style, separated by a maze of muddy pathways. The family fell into a routine organized around twice-daily prayer services, revival meetings, extended healing and deliverance sessions, weekly Bible study, and consultations with Prophet Tawiah, the camp’s founder. Martin went to school as Agnes looked after her two young daughters, Veronica and Dorcas, and ensured that Samuel and Philomena stayed safe. (Her eldest son was attending secondary school and had remained behind with Anthony.) Several months passed. By the end of their first year at the camp, their resources had dwindled, and Agnes was struggling to feed the six of them. Martin dropped out of school and began working on a local cassava farm. Anthony was becoming less and less a presence in their lives, and his support, financial and otherwise, grew scarce. “Now and then he came around on the weekend,” Martin said. “If he had money in his pocket — thirty cedis, forty cedis — maybe he would give it to my mom.” Beyond that, they were on their own.

Philomena seemed to benefit from the camp’s structured, communal environment, but Samuel’s symptoms steadily intensified. One afternoon, Agnes was preparing a large cauldron of soup on an open fire, and Samuel ran over and shoved it violently. As Agnes and a neighbor scrambled to contain the flames, Samuel hurled stones at them. Agnes screamed for help. The pastor who arrived demanded a severe but not unusual measure: that Samuel be shackled to a tree outside the family’s room. The pastor explained that, lacking more sophisticated methods of restraint (injections, locked isolation rooms, padded leg or arm cuffs), this was the only sure way to protect both Samuel and the other residents as they waited for God to heal him. It was not a form of discipline, Martin told me. It was an act of desperation. What if Samuel ran off into the forest? Or killed somebody, or himself?

The sight of his younger brother chained was almost too much for Martin to bear. Whenever Prophet Tawiah came to pray for him, Samuel writhed and struggled, begging to be released. Sometimes they did free him, but inevitably he would be chained again. Many nights, especially during thunderstorms, Agnes left her bedroom to lie beside Samuel on his mattress under the tree. Martin could hear her singing to him, trying to calm him, intoning the same psalms she used to pray over him in his bed back home.

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is a 2017 Luce/ACLS Fellow in Religion, Journalism and International Affairs at Emory University.

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