The Human Rights Struggles of Disabled
Persons in Ghana’s Prayer Camps
An assessment of Ghana’s compliance with the Convention on the Rights of Persons with Disabilities
Abigail Akofa Atsutse abby_tam_ina@yahoo.co.uk Public International Law
Supervisor: Dr. Rosanne van Alebeek 13th July 2017
ABSTRACT
Africa is mostly thought of as the worst place in the world to be disabled. Whilst this can partly be attributed to resource constraints, certain negative cultural attitudes towards disabilities in Africa also undermine the rights of disabled persons. In Ghana, prayer camps are heavily patronised by families of persons with disabilities due to the traditional beliefs surrounding the cause of disabilities. Prayer camps are spiritual healing centres where persons with disabilities are sent for healing. The situation of disabled persons in Ghana’s prayer camps however, triggers questions concerning Ghana’s compliance with its obligations under the International Convention on the Rights of Persons with Disabilities(ICRPD). This thesis thus assesses whether the practices in prayer camps as well as Ghana’s current legal
framework are in accordance with the legal framework of the ICRPD.
Under the framework of analysing Ghana’s compliance with the ICRPD, regarding the rights of persons with disabilities in prayer camps, this thesis using the classical judicial method, firstly, inquires into the actual practices in Ghana’s prayer camps and then examines Ghana’s national policies and programs related to persons with disabilities and further assesses that in terms of the ICRPD obligations. Based on legal and non-legal sources such as conventions, general comments, states reports, concluding observations, journals, articles and news reports related to the actual practices in prayer camps as well as other relevant literature, Ghana’s compliance with its obligations under the ICRPD is thus assessed.
The outlining of Ghana’s obligations of respect, protect and fulfil under the ICRPD and the assessment of its compliance thereof showed that Ghana’s legal framework does not
adequately meet international standards such as the ICRPD and further does not provide a real and effective regulation of its prayer camps which offer services to persons with disabilities. The measures put in place by Ghana through the Persons with Disabilities Act, the Mental Health Act and the Commission on Human Rights and Administrative Justice are not adequately designed to ensure the promotion and protection of the rights of persons with disabilities resulting in a gap in the explicit legal protection of persons with disabilities in Ghana’s prayer camps. In view of this, even though the underlying factor of the negative cultural attitudes towards persons with disabilities has also negatively impacted Ghana’s efforts in putting a stop to the human rights violations in its prayer camps, cultural attitudes cannot be pointed out as a defence against non-compliance accusations. Ghana is not at all fulfilling the obligations that it can perform irrespective of cultural attitudes; there is no
government oversight of prayer camps, lack of protection and prosecution of perpetrators of human rights violations in prayer camps and lack of cooperation with the public in order to combat negative stereotypes about persons with disabilities.
Table of Content
ABSTRACT...1 CHAPTER 1 INTRODUCTION...4 1.1 Research question...5 1.2. Goal...6 1.3 Methodology...6CHAPTER 2 PRAYER CAMPS IN GHANA AND THE CULTURAL ATTITUDES TOWARDS PEOPLE WITH DISABILITIES...8
2.1 Societal attitudes towards people with disabilities in Ghana...8
2.2 Prayer camps...8
2.2.1 Treatment methods in prayer camps and the inhuman dimension of prayer camps...9
CHAPTER 3 GHANA’S COMPLIANCE WITH OBLIGATIONS UNDER THE ICRPD...11
3.1 BACKGROUND...11
3.2 Ghana’s obligations and compliance under the ICRPD...12
3.2.1 Obligation to respect...13
3.2.2 Obligation to protect...15
3.2.3 Obligation to fulfil...19
3.2.3.1 Legislative action to implement rights...21
3.2.3.2 Awareness raising...25
3.2.3.3 Budgetary legislation...27
3.2.3.4 Sanctions and effective remedy...30
3.2.3.5 Conclusion...31
CHAPTER 4 RECOMMENDATIONS: RECOGNISING THE INFLUENCE OF CULTURAL ATTITUDES AND THE ROUTE TO COMPLIANCE WITH THE ICRPD...33
4.1 How cultural attitudes retard the successful implementation of Ghana’s obligations...33
4.1.1 Recognising the influence of cultural attitudes at the state-level and the local level...33
4.2 Recommendations...34
CONCLUSION...36
CHAPTER 1 INTRODUCTION
Persons with disabilities (PWDs) in Ghana, like many other developing countries, still face human rights struggles due to resource constraints. However, in the Ghanaian community there are also certain cultural attitudes which undermine the position of the disabled and which consequently result in the unfortunate situation of PWDs not being accorded their due rights.1 It is traditionally believed in Ghana that “prayer camps” must be the first resort for the treatment of especially mental and physical disabilities since it is generally believed that these disabilities require a spiritual intervention rather than a medical one.2 These prayer camps have thus taken the place of the mental and physical health institutions and even admit children3 and babies4 as patients. The treatment methods in these prayer camps however raise many issues of human rights concern. Patients in prayer camps are chained, starved, beaten as well as accommodated in degrading and inhuman conditions.
This human rights situation triggers questions concerning Ghana’s obligations in ensuring the human rights of PWDs within its jurisdiction, especially due to the object and purpose of the International Convention on the Rights of Persons with Disabilities (ICRPD)5 to which 173 states are State parties including Ghana.6 The ICRPD, is a United Nations human rights treaty which came into force on 3rd May 2008 and which was ratified by Ghana on 31st July 2012.7 The ICRPD is mainly intended to protect the rights and dignity of PWDs whereby state parties are to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all PWDs as well as to promote the respect for their inherent
dignity.8 From the preamble of the ICRPD it can be deduced that PWDs must be recognized as full and equal members of the society who are also entitled to human rights9 but who nevertheless continue to face barriers in their participation as equal members of the society and violations of their human rights in all parts of the world.10 In view of this, the most obvious obligation incumbent upon State Parties is to ensure the full enjoyment of the human
1 J Edwards ‘Ghana's mental health patients confined to prayer camps’ (2014) 383 The Lancet 15-16. 2 Ibid, 15.
3 Ibid, 16.
4 Documentary; Prayer camps in Ghana - BBC -The World’s Worst Place to be Disabled (2015).
5 UN General Assembly, Convention on the Rights of Persons with Disabilities: resolution / adopted by the
General Assembly, 24 January 2007, A/RES/61/106.
6 United Nations Treaty Collection status of treaties chapter IV Human Rights section 15 <
https://treaties.un.org/PAGES/ViewDetails.aspx?src=TREATY&mtdsg_no=IV-15&chapter=4&clang=_en>. 7 Ibid.
8 Article 1 ICRPD. 9 ICRPD preamble (a). 10 Ibid preamble (k).
rights of PWDs. Considering the cultural attitudes towards disabilities in the Ghanaian community it therefore becomes more incumbent upon Ghana to raise awareness throughout the society in order to combat negative stereotypes, prejudices and harmful practices relating to PWDs.11
Prior to the ratification of the ICRPD, Ghana adapted laws and practices to enable the realization of the goals of the ICRPD.12 Ghana passed the Persons with Disability Act(PDA) in June 2006 which is to improve the lives of PWDs and to ensure them being part of the society at large.13 Furthermore, on 2nd March 2012 Ghana passed the Mental Health
Act(MHA) which addresses mental health issues and the protection of the human rights of people with mental disorders in Ghana.14 However, the human rights violations which still persist in Ghana’s prayer camps where most PWDs are found raise questions on the
effectiveness of the measures taken by Ghana in response to its obligations under the ICRPD. Such concerns have also been notably stressed by the UN treaty bodies in their concluding observations on reports on human rights violations in Ghana. The recent Human Rights Committee (HRC) concluding observations on the initial report of Ghana, for instance, expresses concern “at the existence of hundreds of unregistered private “prayer camps” to deal with illness, particularly mental illness, which operate with little oversight and no State regulation. It is concerned at reports regarding the use of torture and inhuman and
degrading treatment in such camps, including cases of shackling and forced fasting, on persons with mental disabilities, and treatment without free and informed consent.”15
1.1 Research question
In view of the above, this thesis will examine whether Ghana is in compliance with its obligations under the ICRPD regarding the rights of disabled persons in prayer camps. Regarding the fact that cultural attitudes and traditional practices seem to underlie many of the problems disabled persons in Ghana face, this thesis will especially inquire into the
11 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p 73.
12 LA Asante and A Sasu ‘The Persons with Disability Act, 2006 (Act 715) of the Republic of Ghana: The Law, Omissions and Recommendations’ (2015) 36 Journal of Law, Policy and Globalization 62-65.
13 Persons with Disability Act, 2006 (Act No. 715); An Act to provide for persons with disability, to establish a National Council on Persons with Disability and to provide for related matters.
14 Ghana: Act No. 846 of 2012, Mental Health Act (Ghana), 31 May 2012.
15 UN Human Rights Committee (HRC), CCPR Concluding Observations on the Initial Reports of Ghana, 9 August 2016, CCPR/C/GHA/CO/1 para 27.
obligations of the State in addressing these attitudes and practices, and into the actual practice in Ghana in that regard.
Sub-questions
1. What are the cultural attitudes towards people with disabilities in the Ghanaian community?
2. What are the prayer camps in Ghana meant for and what goes on in these camps? 3. What are Ghana’s obligations under the ICRPD and what are the measures taken by
Ghana through its laws or policies (especially policies on social change to combat negative stereotypes related to disabilities) regarding disabled persons in prayer camps and do these steps satisfy its obligations under the ICRPD?
4. What is the way forward for Ghana; how can Ghana improve its policies on cultural stereotypes?
1.2. Goal
The objective of this research is to highlight one of the major causes of Ghana’s inability to create the appropriate atmosphere which sustains the dignity of PWDs who are usually the vulnerable in society. While it is true that the lack of effective policies to counter human rights violations in prayer camps can partly be explained by the lack of (financial) resources and infrastructures, it is also worth noting that a major cause of the human rights violations which occur in Ghana’s prayer camps regarding PWDs is also due to the cultural attitudes towards PWDs. This research seeks to highlight Ghana’s obligations under the ICRPD and assess whether Ghana, with the awareness of the existence of the cultural attitudes towards PWDs, is on the right path in the successful implementation of its obligations under the ICRPD both at state-level and the local level or whether Ghana can point out to the negative cultural attitudes towards PWDs as a defence against non-compliance accusations.
1.3 Methodology
I will be applying a classical judicial method in carrying out this research. To be able to obtain an answer to the question whether Ghana is in compliance with its obligations under the ICRPD regarding the rights of PWDs in prayer camps I will first gather information on actual practices in prayer camps. I will thus make use of legal and non-legal sources such as states reports, concluding observations, journals, articles and news reports related to the actual practices in prayer camps. Concerning Ghana’s current legal framework regarding the rights
of disabled persons I will examine Ghana’s national policies and programs related to PWDs. Furthermore, concerning the assessment of whether the practices in prayer camps as well as Ghana’s current legal framework are in accordance with the legal framework of the ICRPD I will make an analysis of legal sources such as conventions, concluding observations, general comments and other relevant literature regarding the rights of PWDs.
The lack of a state report on the situation in Ghana and a concluding observation thereof by the Committee on the Rights of PWDs, at the moment, has limited the sources available on the situation of PWDs in Ghana. In view of this, I will thus inquire into the law and practices in Ghana’s prayer camps and assess that in terms of the ICRPD obligations.
CHAPTER 2 PRAYER CAMPS IN GHANA AND THE CULTURAL
ATTITUDES TOWARDS PEOPLE WITH DISABILITIES
2.1 Societal attitudes towards people with disabilities in Ghana
Africa is often considered as the worst place to be disabled due to the lack of understanding for disabilities and the unwillingness to accept the disabled as just any other person in the community. There is a general notion in Ghana that mental illness is caused by evil spirits or demons and not by a psychiatric condition.16 With this perception, families of those with disabilities often seek spiritual solutions rather than medical solutions.17 Consequently, families of PWDs are often intolerant of certain behaviours associated with disabilities resulting in PWDs often being abused in retaliation for the disgrace brought to the family.18 PWDs especially the mentally disabled are often physically and verbally abused by family members19 and in certain cases, some are killed by their families.20 This misunderstanding of PWDs has led to a culture where the stigmatization and maltreatment faced by disabled persons are not seen as abuses. The harsh treatment meted out to PWDs is perceived as necessary to protect the individual from the evil spirit that inhibits them.21 With the spiritual and superstitious connotations attached to disabilities in the Ghanaian community, PWDs are thought of as worthless and violent.22 They are not deemed worthy to be accorded the
fundamental human rights inherent in the mere fact of being human.
2.2 Prayer camps
The prayer camps in Ghana are centres for prayers and fasting where people with all sorts of problems visit for solutions.23 With the notion in Ghana that being disabled is a spiritual
16 S R Barriga “The in(human) dimension of Ghana’s prayer camps” (2014).
17 J Edwards ‘Ghana's mental health patients confined to prayer camps’ 2014 The Lancet vol. 383 no. 9911 p. 15.
18 United States Department of State, 2015 Country Reports on Human Rights Practices - Ghana, 13 April 2016 Section 6.
19 Human Rights Watch, “Like a Death Sentence": Abuses against Persons with Mental Disabilities in Ghana, 2 October 2012, ISBN: 1-56432-945-3 p 61.
20 E A Gyamfi African Disability Rights Yearbook 2013 p 228. See also; Documentary; Prayer camps in Ghana - BBC -The World’s Worst Place to be Disabled (2015).
21 J Edwards ‘Ghana's mental health patients confined to prayer camps’ 2014 The Lancet vol. 383 no. 9911 p. 15.
22 S R Barriga “The in(human) dimension of Ghana’s prayer camps” (2014).
23 Human Rights Watch, “Like a Death Sentence": Abuses against Persons with Mental Disabilities in Ghana, 2 October 2012, ISBN: 1-56432-945-3 p 8.
condition and not a medical one and with the tendency to first seek spiritual help in cases of disabilities, these prayer camps are heavily patronized by families of the disabled in Ghana. These prayer centres are referred to as “camps” because visitors who end up being admitted as patients mostly end up spending months in these prayer camps with the purpose of being healed.24 According to research, patients are sent to these camps due to ailments such as drug addiction, depression, schizophrenia and bipolar disorder among others.25 It is however important to note that the owners of these prayer camps are normally self-proclaimed prophets and spiritualists without any medical training with regard to the treatment of the ailments of patients found in these camps.26
2.2.1 Treatment methods in prayer camps and the inhuman dimension of prayer camps According to the owners of prayer camps, treatments for patients include Christian teachings such as bible reading, prayers and voluntary fasting27 whereby the use of shackling and chaining in these camps is denied.28 However reports have shown that the treatment methods in these camps actually harm more than heal: people with mental health conditions are treated inhumanly in these camps.29 A recent documentary film published by BBC, featured stories of victims of human rights abuses in Ghana’s prayer camps.30 Prayer camps patients were usually sent to these camps against their will and were tied to trees, shackled to chains and confined in order not to escape.31 For many disabled children and babies, the custom is to return them to the evil spirits that sent them.32 Spiritual and traditional healers helped in returning these children and babies by performing special rituals.33 The documentary film further featured the process of returning these disabled children and babies; children are sometimes killed by poisoning, starvation and in some cases fetish priests are paid to dispose of disabled children and babies by dumping them into a special river meant for such rituals.34
24 J Edwards ‘Ghana's mental health patients confined to prayer camps’ 2014 The Lancet vol. 383 no. 9911 p. 15.
25 Human Rights Watch, S R Barriga “The in(human) dimension of Ghana’s prayer camps” (2014).
26 Human Rights Watch, “Like a Death Sentence": Abuses against Persons with Mental Disabilities in Ghana, 2 October 2012, ISBN: 1-56432-945-3 p 8.
27 J Edwards ‘Ghana's mental health patients confined to prayer camps’ 2014 The Lancet vol. 383 no. 9911 p. 15.
28 General Assembly, Human Rights Council, Follow up report of the Special Rapporteur on torture and other
cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, (2015)
para.72. 29 Ibid.
30 Documentary film; Prayer camps in Ghana - BBC -The World’s Worst Place to be Disabled (2015). 31 Ibid.
32 Ibid. 33 Ibid. 34 Ibid.
It was further revealed by this documentary film that the kind of inhuman and degrading practices which occurred in these camps were seen as normal and necessary so that these inhuman practices are considered as part and parcel of the treatment methods in Ghana’s prayer camps. Rampant human rights abuses thus continue with impunity at prayer camps, including the non-consensual admission and treatment of children and adults, inhumane practices amounting to torture, such as shackling, prolonged chaining and restraint, and mandatory fasting.35
35 General Assembly, Human Rights Council, Follow up report of the Special Rapporteur on torture and other
cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, (2015)
CHAPTER 3 GHANA’S COMPLIANCE WITH OBLIGATIONS
UNDER THE ICRPD.
3.1 BACKGROUND
Prior to the coming into force of the ICRPD there were already other treaties on the international scene designed to address disability either generally or specifically.36 The
International Bill of Rights which comprises the Universal Declaration of Human Rights,37 the International Covenant on Economic, Social and Cultural Rights(ICESR)38 and the
International Covenant on Civil and Political Rights (ICCPR)39 were other human rights instruments which already existed and also addressed disability.40 The non-discrimination clause expressed in article 2 in the ICESR and the ICCPR, obliges States to guarantee human rights without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.41 “Other status” thus includes disability as grounds for protection from discrimination.42 The ICESR and ICCPR therefore do not refer to disability directly, the protection has to be inferred from “other status.”
Despite the existence of these human rights instruments, the ICRPD was nevertheless deemed necessary to be in force due to the general perception of PWDs as “passive recipients of assistance rather than rights holders.”43 The existing human rights system did not adequately ensure the promotion and protection of the rights of PWDs resulting in a gap in the explicit legal protection of PWDs.44
36 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 21.
37 UN General Assembly, Universal Declaration of Human Rights, 10 December 1948, 217 A (III). 38 UN General Assembly, International Covenant on Economic, Social and Cultural Rights, 16 December 1966, United Nations, Treaty Series, vol. 993, p. 3.
39 UN General Assembly, International Covenant on Civil and Political Rights, 16 December 1966, United Nations, Treaty Series, vol. 999, p. 171.
40 Article 2 of the ICESR and the ICCPR. 41 Ibid.
42 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 21.
43 Ibid, p. 22. 44 Ibid.
In view of the above, the ICRPD thus recognises the need to promote and protect the human rights of all PWDs.45 Due to the fact that PWDs are often denied their rights or are unaware of their rights, the ICRPD seeks to ensure that PWDs enjoy their rights without discrimination and on an equal basis with others.46 The obligations incumbent upon State parties according to the ICRPD is thus to promote and protect the rights of PWDs.47 This is also reflected in article 1 ICRPD which describes its purpose.
The Committee on the rights of persons with disabilities(Committee) is an established body under the ICRPD with authority to receive and review periodic reports from State parties.48 On the basis of these reports, the Committee works with the States parties concerned and makes concluding observations and recommendations to those States parties.49 In this regard, Ghana was thus supposed to submit its initial state report in 2014 according to article 35 ICRPD.50 However, there has been a delay which has resulted in the non-availability of a concluding observation on the situation in Ghana by the Committee.
The Optional Protocol to the ICRPD, gives the Committee the possibility to undertake two additional forms of monitoring; an individual communications procedure, through which the Committee receives communications (complaints) from an individual claiming that the State breached his or her rights under the ICRPD; and an inquiry procedure, through which the Committee investigates gross or systematic violations of the ICRPD and, with the agreement of the State party concerned, undertakes field missions to deepen the inquiry.51
3.2 Ghana’s obligations and compliance under the ICRPD.
The assessment of Ghana’s compliance with the ICRPD requires a mapping and an analysis of its obligations under the ICRPD.52
45 ICRPD preamble (j). 46 Article 4 ICRPD.
47 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 23.
48 Article 34-35 ICRPD. 49 Article 36 ICRPD.
50 E A Gyamfi African Disability Rights Yearbook 2013 p 223. 51 Article 1 and 6 Optional Protocol ICRPD.
52 Since there is no general comment by the Committee on the general nature of the legal obligations incumbent upon State Parties under the ICRPD, note will be taken of the ICCPR which also addresses disability indirectly as already mentioned. In this regard, reference will be made to the analysis of the general comment on the nature of the general legal obligations imposed on State parties to the ICCPR by UN Human Rights Committee; UN Human Rights Committee (HRC), General comment no. 31.
According to article 4 ICRPD, State parties have to “promote, protect and ensure the full and equal enjoyment of all human rights.” Due to the fact that this obligation, such as other international human rights treaty obligations, entails a very broad and comprehensive character the United Nations human rights treaty bodies in practice have adopted a tripartite typology stating that states must respect, protect and fulfil human rights.53 The Committee thus follows this typology and also makes reference to the obligations to respect, protect and fulfil in its general comments.54 With the obligation to respect, states must refrain from interfering with the enjoyment of rights.55 The obligation to protect obliges states to prevent violations by third parties.56 Further, the obligation to fulfil requires states to make legislative, administrative, budgetary, judicial and other action to realize rights.57
The following sub-paragraphs will analyse the effectiveness58 of measures taken by Ghana under the ICRPD regarding PWDs in prayer camps. The sub-paragraphs of the obligations to respect, protect and fulfil will address the efforts taken by Ghana through the PDA, MHA and the Commission on Human Rights and Administrative Justice (CHRAJ), where necessary, regarding PWDs in prayer camps. It is worth noting at this point that the obligations to respect, protect, and fulfil are closely interrelated and as such a clear-cut distinction is not always possible.59
3.2.1 Obligation to respect
The obligation to respect entails a negative obligation whereby states are expected to refrain from any act contrary to the ICRPD.60 According to article 4 1(b) ICRPD, states are obliged to take all appropriate measures, including legislation, to modify or abolish existing laws,
53 D Moeckli S Shah and S Sivakumaran (eds) International Human Rights Law (2nd edn Oxford University Press 2014) p 101. Furthermore, the international human rights system can also be based on the identification of two broad obligations; negative and positive obligations which precedes the tripartite typology; the negative obligation has to do with the obligation to refrain from taking any measures that result in a violation of a given right and with the positive obligation states are to take steps to promote rights.
54 UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No. 4 (2016), Article 2, para 38. See also: UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No. 3
(2016), Article 6, para. 24-27.
55 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 34.
56 Ibid. 57 Ibid.
58 The effectiveness of measures taken by states appear to be a relevant consideration for the Committee in assessing measures taken by national authorities; UN Committee on the Rights of Persons with Disabilities, Communication No. 1/2010, views adopted by the Committee at its ninth session para. 9.5-9.6.
59 D Moeckli S Shah and S Sivakumaran (eds) International Human Rights Law (2nd edn Oxford University Press 2014) p. 103.
60 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 34.
regulations, customs and practices that constitute discrimination against PWDs. This implies that states are obliged not to consciously or unconsciously violate rights either through states organs such as the parliament or through agents such as the police.61 Therefore to ensure that states respect the ICRPD, existing laws and policies need to be reviewed and those policies that ensure that the legal and policy framework of states supports the implementation of the ICRPD need to be adopted. These could be mental health laws and education laws among others and also secondary legislation such as policies regarding national disability and social inclusion strategies for instance.62
According to article 6 and 7 ICRPD there is a special obligation incumbent upon states concerning women. This is particularly due to their vulnerability to discrimination and abuse.63 Due to the multiple discrimination64 that women with disabilities face, article 6 ICRPD stresses the need for State parties to take measures to ensure the full and equal
enjoyment by women with disabilities of all human rights and fundamental freedoms. Women with disabilities are often discriminated against on the grounds of gender and or disability, and on other grounds as well.65 Under article 6 ICRPD states have the obligation to respect which requires them to refrain from interfering with the enjoyment of the rights of women with disabilities.66
With the obligation to respect, there are no indications of Ghanaian law discriminating against PWDs or states agents interfering with the rights of PWDs directly such as abusing them. However, with the persistence of the negative cultural attitudes and practices towards PWDs in Ghana which consequently leads to the human rights violations of such persons in prayer camps, it remains incumbent upon Ghana to take appropriate measures to abolish the negative customs and practices that constitute discrimination against PWDs.
3.2.2 Obligation to protect
61 D Moeckli S Shah and S Sivakumaran (eds) International Human Rights Law (2nd edn Oxford University
Where the legislation is a direct violation of the rights of PWDs. 62 This falls under the obligation to protect or fulfil.
63 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 33.
64 Ibid. 65 Ibid p. 26.
66 Multiple discrimination” refers to a situation in which a person experiences discrimination on two or more grounds, leading to discrimination that is compounded or aggravated; see UN Committee on the Elimination of Discrimination Against Women (CEDAW), General recommendation No. 25, on article 4(1) para. 12.
With the obligation to protect, State parties must protect individuals from human rights violations by third parties such as private enterprises and medical professionals among others.67 In this regard, states need to proactively ensure that all persons within their
jurisdiction do not become victims of human rights violations by third parties.68 This does not mean that states will be liable for every interference with individuals rights by private entities; states will be responsible for the failures which can be attributed to their shortcomings in protecting individuals from other individuals, for instance, because they adopted a law that allowed the violation or that they failed to do something that would have prevented the violation from happening, that is, the failure to exercise due diligence.69 This implies further that the exercising of due diligence is not an obligation of result, that is, ensuring that PWDs do not become victims, but rather an obligation on states to do everything that could
reasonably be required of them in preventing PWDs from becoming victims. The obligation to protect is thus seen as important in the disability context where this obligation is perceived to impose obligations on states to create an environment that is conducive for the enjoyment of the rights by PWDs.70
Regarding the specific obligations towards women, states must ensure that the rights of women with disabilities are not infringed upon by third parties71 such as prayer camps.
The obligation towards children as stated in article 7 ICRPD forms another specific obligation incumbent upon states. With this obligation, state parties are to “adopt and implement specific legislation to address the protection of children with disabilities against abandonment, neglect and mistreatment, including through the support of parents of children with disabilities.”72 Further, State parties are also to “abolish, in law and in practice, corporal punishment against children with disabilities in all spheres.”73
The obligation to protect entails the duty to enact laws for the protection of PWDs as well as the duty to implement these laws. The following sections will discuss these two distinguishing
67 UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No. 3 (2016), Article 6 para. 3.
68 UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No. 3 (2016), Article 6 para. 25.
69 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 34.
70 UN Human Rights Committee (HRC), General comment no. 31 para. 8 and 10. 71 Ibid para. 8.
72 D Moeckli S Shah and S Sivakumaran (eds) International Human Rights Law (2nd edn Oxford University Press 2014) p. 103.
73 UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No. 3 (2016), Article 6 para. 26.
duties while addressing the PDA, MHA and CHRAJ.
The protection of persons with disability through the law and the implementation thereof According to the PDA, the failure to respect the rights enshrined in the PDA results in a criminal offence with a corresponding fine of fifty penalty units74 or a term of imprisonment not exceeding three months or both.75 However, the question remains if this provision is indeed implemented. Although the PDA prohibits abuse, discrimination or disrespect to PWDs,76 Ghana’s prayer camps still remain one replete with abuse and disrespect of PWDs. This is partly due to the fact that family members of PWDs are themselves involved in these crimes so that it becomes practically impossible for them to expose the care takers of these prayer camps in order for them to face charges under the PDA.77 On the other hand, the non-availability of legislative instruments to aid the implementation of the PDA78 seems to have rendered the PDA ineffective resulting in a continuous abuse of human rights in prayer camps.
Under the MHA, the deliberate neglection of persons with mental disorder or the subjection of persons with mental disorders to discrimination under section 54 or the breach of any other rights of the person, will result in the commission of an offence with a liability to a summary conviction to a fine of not more than five hundred penalty units or to a term of imprisonment of not more than two years or to both the fine and imprisonment.79 Despite this provision and the existence of the provisions on the prohibition of torture, cruelty and any other inhuman treatment of PWDs under the MHA,80 the ministry of prayer camps to people with mental health problems remain particularly subject to abuse since patients are kept in these camps against their will and are often unable to advocate for themselves due to the nature of their illnesses.81 It is at this point worth noting that the scope of the MHA is not clear with regard
74 Committee on the Rights of Persons with Disability (CRPD) Concluding Observations on the Initial Report
of Ethiopia, (2016), para. 16.
75 Ibid.
76 “penalty unit” refers to such units established by the Fines (Penalty Units) Act 2000 (Act 572); the monetary value of a penalty unit stands at 12.00 Ghanaian Cedi(GHS); hence a fine of fifty penalty units is equivalent to GHS 600; Bank of Ghana guidelines for e-money issuers in Ghana<
https://www.bog.gov.gh/privatecontent/Banking/GUIDELINES%20FOR%20E-MONEY%20ISSUERS%20IN %20GHANA.pdf>.
77 Advocacy Toolkits Disability Rights in Ghana, A Simplified Version of Disability Rights in Ghana Commonwealth Human Rights Initiative Africa (2007), section 4.
78 Ibid, section 3.
79 Documentary film; Prayer camps in Ghana - BBC -The World’s Worst Place to be Disabled (2015). 80 E A Gyamfi African Disability Rights Yearbook 2013 p. 228.
to prayer camps so that it remains debatable if it applies to prayer camps or not. The MHA, applies to any place where a person with mental disorder is kept including public and private mental health facilities which must be licensed under the Health Institutions and Facilities Act 2011, (Act 829) and any other law.82 This can be said to allow for the legality, the regulation of such facilities as well as the protection of PWDs from abuse by such facilities. This means that the activities of unlicensed private mental health facilities will escape the regulation and monitoring of national authorities in Ghana resulting in the illegality of such facilities. Under the MHA “facility” refers to health care facility, that is, a mental health facility which has as primary function the provision of mental health care and “health practitioner” means a person with professional training in healthcare delivery such as a medical doctor, clinical
psychologist, nurse, social worker or other appropriately trained or qualified person with specific skills relevant for mental health care who is practising the skill.83 Furthermore, the provisions of the MHA as well as its regulations apply to a person received or admitted to a mental health facility84 which includes public and private mental health facilities. Since prayer camps are not recognised mental health care facilities which are not licenced and which also lack practitioners in health care delivery, the question remains whether persons with mental disabilities detained outside of psychiatric hospitals and found in prayer camps, can seek protection under the MHA. The uncertainty of the precise scope of the MHA is further reinforced by the fact that numerous prayer camps in Ghana continue to function and remain undisrupted by the MHA with respect to their regularisation and the inhuman treatment methods used in these camps. In this regard, the MHA cannot be considered to provide explicit legal protection for PWDs in prayer camps since such persons are considered as not falling under the scope of the MHA.85
As far as the obligation to protect is concerned, is the CHRAJ in Ghana also of relevance. CHRAJ is an independent body established in 1993 by Act 456 of the parliament of Ghana as enshrined in article 216 of the 1992 constitution of Ghana.86 Its function is to investigate complaints of violations of fundamental human rights and freedoms, injustice and corruption, abuse of power and unfair treatment of persons by public officers in the exercise of their duties, to investigate complaints concerning practices and actions by persons, private
82 Ibid, section 57.
83 J Edwards ‘Ghana's mental health patients confined to prayer camps’ 2014 The Lancet vol. 383 no. 9911 p. 15.
84 Ghana: Act No. 846 of 2012, Mental Health Act (Ghana), 31 May 2012 section 95. 85 Ibid, section 97.
enterprises and other institutions where these complaints assert violations of fundamental rights and freedoms under the Constitution and further with power to seek remedy in respect of such acts or omissions and to provide for other related purposes.87 In view of the functions of CHRAJ, its mandate is thus to promote, protect and enforce fundamental human rights and freedoms through providing mediation, advocacy and legal support.88 With legal support, the confidence of PWDs can be built so that such persons are able to claim their rights with less support in the future.89 With its advocacy role, it should be common for CHRAJ to take the initiative and investigate complaints on behalf of patients who suffer human rights abuse in Ghana’s prayer camps since such PWDs clearly need legal support in order to claim their human rights. PWDs have the right to recognition everywhere as persons before the law and states must take appropriate measures to provide access by PWDs to the support they may require in exercising their legal capacity.90 Despite the existence of CHRAJ, human rights violations in Ghana’s prayer camps remain a common occurrence. It has been noted that CHRAJ is unable to effectively fulfil its mandate due to woefully inadequate budgetary allocations that has led to it experiencing critical and systematic human, infrastructural, and logistical constraints.91 Further CHRAJ claims that it does not receive complaints of torture or other ill-treatment by the police because these practices do not occur; hence there are no reports of the involvement of CHRAJ in investigations concerning complaints of torture or other ill-treatment.92
In addition, regarding CHRAJ’s power to investigate complaints of violations of fundamental human rights and freedoms it should be expected that prayer camps owners and family members are prosecuted for the subjecting of PWDs to human rights violations. According to Act 456, the obstruction of CHRAJ in the exercising of its powers without lawful
justification, or the failure to comply with its lawful requests or the making of false statements whereby CHRAJ is misled by anyone, will lead to the commission of an offence with a liability to summary conviction and a fine not exceeding GHS500,000.00 and in default of payment to imprisonment for a term not exceeding six months or to both.93
87 S R Barriga “The in(human) dimension of Ghana’s prayer camps” (2014).
88 Ghana: Act No. 456 of 1993, Commission of Human Rights Act (Ghana), 6 July 1993 89 Ibid, section 7.
90 Ibid, section 7(a) – (h).
91 UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No.1 (2014), Article 12 para. 24.
92 Article 12 (1) – (3) ICRPD.
93 General Assembly, Human Rights Council, Follow up report of the Special Rapporteur on torture and other
cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, (2015)
Despite these powers mandated to CHRAJ, human rights violations in Ghana’s prayer camps remain undisrupted by CHRAJ. There have been no prosecutions by CHRAJ for the practice of chaining and other forms of inhuman and degrading treatments employed either by individual families or by healers yet.94 Based on the reports by human rights watch, the concluding observations of the human rights treaty bodies and journals highlighting the human rights violations in Ghana’s prayer camps it can be argued that CHRAJ should be aware of such violations so that it is expected to take action in addressing cases of violations of human rights in order to investigate, prosecute and provide an effective remedy in the event of a breach of a right of the ICRPD. In Ghana, it appears that families rather than the state are seen to be responsible for the welfare of their relatives in prayer camps.95
3.2.3 Obligation to fulfil
The obligation to fulfil requires that states take positive steps that will consequently result in the greater enjoyment of rights.96 Article 4(2) ICRPD contains a progressive realisation clause with regard to economic, social and cultural rights.97 The very notion of progressive
realisation implies the acknowledgement of certain onerous human rights obligations which if subject to immediate enforcement would impose disproportionate burdens on states.98 The progressive realisation norm thus entails a balancing of burdens and interests and takes account of financial, institutional and other constraints encountered by states in realising human rights.99 Further, under international human rights law, states have an obligation to devote the maximum of their available resources to the achieving of the full realisation of rights in a progressive manner.100 The sufficiency of government spending or investment and the efficiency of expenditure are elements to be considered under the duty to use the
maximum of available resources.101 These elements are further relevant in the determination
94 Ibid, para. 17.
95 Ghana: Act No. 456 of 1993, Commission of Human Rights Act [Ghana], 6 July 1993 section 24.
96 General Assembly, Human Rights Council, Follow up report of the Special Rapporteur on torture and other
cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, (2015),
para. 17. See also; UM Read E Adiibokah, and S Nyame ‘Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana Globalization and Health’ (2009) vol. 5 no.1 p 12.
97 Ibid.
98 D Moeckli S Shah and S Sivakumaran (eds) International Human Rights Law (2nd edn Oxford University
Press 2014) p. 103. 99 Article 4(2) ICRPD.
100 A Broderick, "The long and winding road to equality and inclusion for persons with disabilities: The United Nations convention on the rights of persons with disabilities." (2015) p. 181- 182.
of the reasonableness of state action.102 This is thus linked to the concept of reasonable accommodation.
According to article 2 ICRPD, reasonable accommodation means “necessary and appropriate modification and adjustments not imposing a disproportionate or undue burden” on states. To afford a person reasonable accommodation implies, for instance, making adaptations to the organization of a work environment, an educational establishment or a health care facility in order to remove the barriers that prevent PWDs from participating in an activity or receiving services on an equal basis with others.103 According to article 2 ICRPD, a failure to afford a person reasonable accommodation amounts to discrimination on the basis of disability.104 States are thus required to take all necessary steps to realise rights fully within available resources and the measures taken by states in that regard should be adjudged according to their reasonableness.105 The Committee assesses the reasonableness of measures according to many criteria.106 It has been stressed that any accommodation provided by an entity must be appropriate, that is, it must be effective107 in terms of resulting in the realisation of the ICRPD rights for PWDs.108
With regard to the vulnerable, the specific obligations of states involve the systematically mainstreaming of the interests and rights of women and girls with disabilities in all national action plans and in sectoral planning.109
Concerning children, states are to take all necessary measures according to article 7 ICRPD to ensure the full enjoyment by children with disabilities of all human rights and fundamental freedoms on an equal basis with other children. The term the “best interest of the child” stressed by the ICRPD in article 7(2) is borrowed from the Convention on the Rights of the
102 Ibid, 187. 103 Ibid, 187-188. 104 Ibid, 188.
105 UN Office of the High Commissioner for Human Rights (OHCHR), From Exclusion to Equality: Realizing
the rights of persons with disabilities, 2007, No. 14 – 2007, p. 60.
106 Article 2 ICRPD.
107 A Broderick, "The long and winding road to equality and inclusion for persons with disabilities: The United Nations convention on the rights of persons with disabilities." (2015), 213.
108 Ibid.
109 UN Committee on the Rights of Persons with Disabilities, Communication No. 1/2010, views adopted by the Committee at its ninth session para 9.5-9.6; requirement of effectiveness- in this individual communication brought before the Committee by Hungarian citizens the Committee observed that none of the measures taken by Hungary had resulted in ensuring accessibility in practice, meaning that the measures were not effective.
Child (CRC)110 and requires that this be a primary consideration in all actions concerning children with disabilities.111 The CRC is thus relevant for article 7 ICRPD.
The obligation to fulfil thus requires states to ensure access to the right in question in cases where people cannot realise the right by themselves.112 In order to meet the obligation to fulfil States parties must thus ensure the equal participation of PWDs in the society; this will involve the adoption of legislative, administrative, policy, programmatic and positive action measures, awareness-raising and educational measures to implement the rights of PWDs.113 The following sub-paragraphs will analyse these duties that arise under the obligation to fulfil under the following headings; legislative action, awareness raising, budgetary legislation, sanctions and effective remedy. The reasonableness of the measures taken by Ghana under its obligation to fulfil, through the PDA, MHA and the CHRAJ with regard to PWDs in prayer camps, will thus be addressed under the above mentioned headings
3.2.3.1 Legislative action to implement rights
This involves the taking of appropriate legislative action to realize rights.114 Under this obligation, state parties are to adopt appropriate laws that implement their international undertakings.115 This may involve the incorporation of the very rights protected by the Covenant into domestic law.116
With the establishing of a legal framework for the implementation of the ICRPD, Ghana has made some progress. In June 2006 Ghana passed the PDA (Act 715) which seeks to provide a legal framework for PWDs in Ghana.117 By passing the PDA Ghana seeks to fulfil a
constitutional obligation of enacting laws to protect and promote the rights of PWDs as well as to fulfil its international obligations.118 The purpose of the PDA is to provide for PWDs in
110 A Broderick, "The long and winding road to equality and inclusion for persons with disabilities: The United Nations convention on the rights of persons with disabilities." (2015), p. 175.
111 UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No. 3 (2016), Article 6 para. 27.
112 UN General Assembly, Convention on the Rights of the Child, 20 November 1989, United Nations, Treaty Series, vol. 1577, p. 3.
113 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 27.
114 A Broderick, "The long and winding road to equality and inclusion for persons with disabilities: The United Nations convention on the rights of persons with disabilities." (2015), para. 4.1 p. 81.
115 Ibid.
116 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 34.
117 Ibid.
order to ensure the full and equal participation of PWDs in the society, to establish a National Council on Persons with Disability and to provide for related matters.119 The PDA covers the right to family life and the right to participate in social, creative or recreational activities; the prohibition of differential treatment for residential purposes, the right to the same living conditions as persons without disabilities when PWDs are placed in special institutions; the prohibition of exploitation, abuse, discrimination or disrespect to PWDs, the right to
appropriate facilities when involved in court proceedings and access to public places.120 However, the PDA does not effectively and efficiently guarantee the rights of PWDs. This is partly due to the omission of the provisions on women, children and the right to life resulting in the PDA being incapable of meeting international standards such as the ICRPD. Traditional practices still encourage the killing of PWDs especially children with disabilities.121 In order to effectively and totally put an end to the killings of children with disabilities there needs to be an incorporation of the rights of children with disabilities and the right to life.122 On the other hand, it can be argued that the killings of children with disabilities is certainly not due to this omission since the act of killing PWDs is an offence which constitutes murder under section 46 of Ghana’s criminal code.123 Thus what remains certain is that even if the law included these provisions the traditional practices of killing PWDs, due to the beliefs surrounding the cause of disabilities, would still encourage the killings of PWDs.
Furthermore, under the PDA is an established body known as the National Council on Persons with Disability (NCPD).124 The function of the NCPD is, among others, to maintain a register of PWDs as well as institutions, organizations and associations which provide rehabilitation, services or support for PWDs and to play an advocacy role on disability issues at all levels.125 The governing body of the NCPD is the Board and its members who are appointed by the President of Ghana.126 However, the maintenance of a register by the NCPD appears only theoretical which has no effect in reality since unregistered prayer camps, which are private institutions which provide services to PWDs, still exist and operate without state regulation in Ghana. It can be argued here that the mere fact that these camps exist does not prove that
119 Advocacy Toolkits Disability Rights in Ghana, A Simplified Version of Disability Rights in Ghana Commonwealth Human Rights Initiative Africa (2007).
120 Ibid.
121 Ibid, section 2.
122 Advocacy Toolkits Disability Rights in Ghana A Simplified Version of Disability Rights in Ghana Commonwealth Human Rights Initiative Africa (2007), section 3.
123 Documentary; Prayer camps in Ghana - BBC -The World’s Worst Place to be Disabled (2015). 124 E A Gyamfi African Disability Rights Yearbook 2013 p. 228.
125 Ghana: Act No. 29 of 1960, Criminal Offences Act, section 46-47. 126 Persons with Disability Act, 2006 (Act 715) section 41 (1).
Ghana is not fulfilling its obligations. However, the fact that human rights reports over the past years till date constantly stress on the human rights abuse in the numerous unregistered prayer camps in Ghana and almost never on specific measures that have been put in place by Ghana for the regularisation of these camps with the aim of putting an end to the human rights abuses in these camps, proves that the NCPD still needs to do more with regard to prayer camps. In an interview with the secretary of the NCPD, as revealed by the BBC documentary film, the secretary stated that the government had done nothing to stop the inhuman and degrading treatment in prayer camps so far and that often PWDs are not considered, even when it comes to decisions that affect them.127 With the function of maintaining a register, it should be expected by the NCPD to make it a formality to request for the registration of prayer camps by their owners prior to the functioning of these camps. With the registration, these camps could be located, monitored and spontaneously inspected by the authorities that matter in Ghana. In so doing, Ghana would be exercising due diligence as well as fulfilling its obligations under article 15 (2) ICRPD since through the monitoring and inspections PWDs in prayer camps will be protected from being subjected to torture or cruel, inhuman or degrading treatment.
Another important legislative action was the adoption of the MHA by the parliament of Ghana in March 2012 which was further a significant advancement in the protection128 of the human rights of people with mental disabilities in Ghana.129 The MHA was thus passed to ensure that the legal and policy framework of Ghana supports the implementation of the ICRPD. The provisions of the MHA apply to a person with any degree of mental disorder including mental retardation but excludes personality disorders.130 The rights131 covered by the MHA are the prohibition of discrimination of PWDs, basic rights including, the right to education, vocational training, leisure, recreational activities, full employment and
participation in civil, economic, social, cultural and political activities whilst any specific limitations on these rights must be in accordance with an assessment of capacity and the humane and dignified treatment at any time with respect to personal dignity and privacy.132 The MHA further guarantees the right to the highest attainable standard of mental health care
127 Ibid, section 42 2(i). 128 Ibid, section 43.
129 Documentary; Prayer camps in Ghana - BBC -The World’s Worst Place to be Disabled (2015) <http://www.bbc.com/news/blogs-ouch-33523742>.
130 Even though the protection of the human rights of persons with disabilities is stressed here, this is also a measure which qualifies under the obligation to fulfil.
131 Ghana: Act No. 846 of 2012, Mental Health Act (Ghana), 31 May 2012 section 54-66. 132 Ibid.
by PWDs, and it stresses that a person with mental disorder is entitled to the same standard of care as a person with physical health problems and shall be treated on an equitable basis including quality of in-patient food, bedding, sanitation, buildings, levels and qualifications of staff, medical and related services and access to essential medicines.133 The prohibition of torture, cruelty, forced labour and any other inhuman treatment is further stressed in the MHA and intrusive and irreversible treatment is prohibited in emergency cases.134 Furthermore, is the prohibition on seclusion and restraint unless there is an imminent danger to the patient or others and tranquilisation is not appropriate or not readily available, the rights to information, employment, privacy and autonomy and the special rights regarding the vulnerable; females, children and the aged.135
The Mental Health Authority is an established body under the MHA.136 The object of the Authority is to propose mental health policies, implement health policies, promote mental health care and provide humane care including treatment and rehabilitation among others.137 The MHA has made some progress in the realization of a greater enjoyment of the ICRPD rights. The governing body of the Mental Health Authority is a Board (MHA Board)
consisting of a chairperson, chief executive and other representatives that matter.138 According to reports, the MHA Board has engaged with prayer camps to combat abusive practices and to promote accountability, and advocates for the establishment of an oversight board tasked exclusively with monitoring prayer camps and other privately-run treatment centres where persons are held involuntarily and ensuring that existing laws and proper safeguards are implemented.139 There has been some progress of taking an inventory of prayer camps and traditional healing centres throughout Ghana by the MHA Board.140 There have been cases of the deployment of psychiatric nurses to at least one prayer camp to help administer
medication as well as the organisation of trainings for prayer camp leaders on the human
133 These rights were already largely covered by the PDA with the exception of the special rights concerning children and women which is now covered by the MHA.
134 Ghana: Act No. 846 of 2012, Mental Health Act (Ghana), 31 May 2012 section 54-55. 135 Ibid, section 57. 136 Ibid, section 57. 137 Ibid, section 58 -66. 138 Ibid, section 1(1). 139 Ibid, section 2. 140 Ibid, section 4.
rights of PWDs such as was held in Sunyani, Brong Ahafo Region in 2014.141 Reports show some willingness on the part of prayer camp leaders to work with authorities.142
3.2.3.2 Awareness raising
Article 8 ICRPD states that awareness raising includes the raising of the levels of awareness about the ICRPD throughout society, including at the family level, regarding PWDs, and to foster respect for the rights and dignity of PWDs. This obligation further entails the promotion of awareness of the capabilities and contributions of PWDs which in turn will help reduce the negative attitudes towards PWDs.143
The Ghana Federation of the disabled (GFD), is a civil society organisation which brings together the key organisations of PWDs in Ghana.144 Its mission is “to advocate the rights of PWDs by influencing policies, programmes and activities at the national and local levels and strengthening the organisations of PWDs”145 and its programs involve projects in raising the awareness of PWDs.146 One of such projects is the Employment Project which aims at raising awareness particularly amongst policy makers, key stakeholders, as well as public and private employers, on the skills, capabilities and potentials of PWDs in Ghana.147 The project also seeks to look at ways in which both employers and PWDs can be supported to adjust to the workplace where PWDs will be employed through this initiative.148 However, such efforts by the GFD and other OPWDs149 seem inefficient since research conducted on the attitudes towards PWDs in Ghana shows that although disability policies exist on paper, the
implementation is very limited and awareness of the PDA is low amongst society and PWDs themselves.150 Most OPWDs face challenges in terms of lack of resources and capable staff members, limiting them in their work and ability to meet their objectives.151 There is not
141 General Assembly, Human Rights Council, Follow up report of the Special Rapporteur on torture and other
cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, (2015)
para. 75. 142 Ibid. 143 Ibid. 144 Ibid.
145 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 34.
146 GFD<http://www.gfdgh.org/about%20us.html>. Its current members are the Ghana Association of Persons with Albinism (GAPA), Ghana Blind Union(GBU), Ghana National Association of the Deaf (GNAD), Ghana Society of the Physically Disabled (GSPD), Inclusion Ghana(IG), Mental Health Society of Ghana (MEHSOG) and Sharecare Ghana < http://www.gfdgh.org/member%20organisation.html>.
147 Mission, vision and core values; < http://www.gfdgh.org/mission.html>. 148 Programmes; < http://www.gfdgh.org/programmes.html>.
149 Ibid. 150 Ibid.
enough cooperation between NGOs and OPWDs resulting in a situation in which they are hardly aware of each other’s activities.152 According to the research, 28% of respondents interviewed are aware of the existence of the PDA.153 Respondents with a disability are more aware of the PDA (39%) than respondents without a disability (27%).154 Awareness is highest among respondents with a high level of education and respondents with a disability who are a member of a disability organization.155 Further, those respondents who are aware of the existence of the PDA are mostly not aware of its contents.156 The most well-known contents of the PDA are the changes in infrastructure and equal treatment.157 In addition many PWDs are not aware of their own rights and therefore are not able to invoke them.158 Also, many PWDs have a low level of self-confidence which needs to be increased to enable them to participate in society.159 Furthermore, many organisations focus their awareness raising activities only on National and International Disability Days.160 Although it is a good opportunity, on such days, in drawing greater attention from the public, awareness-raising should be more often and widespread to reach as many people as possible.161
Awareness raising in order to combat stereotypes, prejudices and harmful practices relating to PWDs, thus seems to be an area that Ghana still needs to make more effective. Since cultural attitudes and traditional practices underlie many of the problems PWDs in Ghana face, Ghana must seriously take up this obligation in order to address these attitudes and practices. With a culture that considers the abuse of PWDs as normal and also with the perception that
disabilities are caused by evil spirits, Ghana needs to greatly intensify the sensitisation of family members and the society at large on the acceptance of PWDs in order for its laws and policies regarding PWDs to be effective. For instance, it has been recommended that state parties “in consultation with OPWDs, target the general public, PWDs, OPWDs, the media, employers, and health and education professionals to foster and promote the human rights model of disability and overcome entrenched gender and disability stereotypes by promoting a positive image of PWDs, their rights and their contributions to society.”162 Were there often
152 J Slikker, "Attitudes towards persons with disability in Ghana." VSO, Sharing skills, Changing Lives, Ghana
Volunteer May (2009), p. 31. 153 Ibid. 154 Ibid. 155 Ibid p. IX. 156 Ibid. 157 Ibid. 158 Ibid. 159 Ibid. 160 Ibid p. 58. 161 Ibid. 162 Ibid.
and widespread awareness raising to reach as many people as possible in Ghana, educating individuals in the community at large on the medical causes of disabilities and the capabilities of PWDs, individuals in the Ghanaian community will be sensitive to the needs of PWDs and consequently become more receptive towards PWDs which in turn will impact their care in prayer camps. With a positive attitude by families and care providers of prayer camps, prayer camps in Ghana will be void of human rights violations.
3.2.3.3 Budgetary legislation
Furthermore, states must also take appropriate budgetary legislation to realize rights.163 While some prohibitions on discrimination might not have financial implications, others will require funding to remove barriers to accessibility,164 for instance, making public spaces accessible for PWDs.165 Laws and policies which are not funded are unlikely to be fully implemented.166 Budgetary allocations will thus be essential in ensuring that states realise rights to the
maximum of available resources.167 According to article 4(2) ICRPD, maximum available resources entail both the states existing resources as well as those generated from international cooperation and assistance. The obligation to seek assistance through international
cooperation is particularly important for the progressive realisation of rights in developing countries that are party to the ICRPD168 such as Ghana.
Established by Ghana’s MHA is a Mental Health Fund to provide financial resources for the care and management of persons suffering from mental disorders.169 To achieve the objects of the Authority as already stated above, moneys generated from the fund shall be utilized for the training of persons with mental disorders, any matter connected with the rescue,
rehabilitation and reintegration of persons with mental disorders, the construction of facilities for persons with mental disorders and the training, capacity building and research.170 The sources of money for the fund shall range from voluntary contributions, moneys approved by
163 Ibid.
164 Committee on the Rights of Persons with Disability (CRPD) Concluding Observations on the Initial Report
of Gabon (2015) p. 20.
165 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 33-34.
166 UN Committee on the Rights of Persons with Disabilities (CRPD), General comment No. 2 (2014), Article 9 para 33.
167 Office of the High Commissioner for Human Rights United Nations 2014 The Convention on the Rights of Persons with Disabilities: Training guide No 19 p. 33-34.
168 Ibid, p. 33.
169 A Broderick, "The long and winding road to equality and inclusion for persons with disabilities: The United Nations convention on the rights of persons with disabilities." (2015) p. 188.
Parliament, grants from bilateral and multilateral sources to other sources approved by the Minister for Finance.171
However, there are concerns about the lack of funds for the Ministry of Health.172 Victims of human rights violations in prayer camps could be rescued by the government if indeed there were funds for the construction of facilities, the rehabilitation and integration as well as the training and the capacity building of rescued disabled persons. The fact that PWDs who are victims of human rights violations in prayer camps are not rescued despite numerous human rights reports on violations in these prayer camps proves Ghana’s inability to cater for such persons after rescuing due to lack of funds or the inapplicability of the MHA to persons with mental disabilities in prayer camps and thereby reinforcing the ineffectiveness of the MHA. In this regard, PWDs in Ghana’s prayer camps are mostly abandoned for long periods in prayer camps where they suffer human rights violations without any hope of rescue from the
government or family members.173
Furthermore, reports also show a deterioration in the services towards the increasing number of patients in the health care.174 Capacity and facilities for mental healthcare services remain vastly reduced, with only 14 reported practicing psychiatrists and 1,600 psychiatric nurses serving a population of nearly 26 million175 which is a an unbalanced situation and further below what would be expected of Ghana’s economic status.176 The country’s three psychiatric hospitals are all located in the coastal belt in the south of the country, and few options for care exist outside these facilities177 which is also below what would be expected of Ghana’s economic status. Even though there are collaborations with nurses training colleges, to facilitate the training of psychiatric nurses and community mental health workers, only 400 individuals have been trained so far.178
171 Ghana: Act No. 846 of 2012, Mental Health Act (Ghana), 31 May 2012 section 81. 172 Ibid.
173 Ibid, section 82.
174 General Assembly, Human Rights Council, Follow up report of the Special Rapporteur on torture and other
cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, (2015)
para. 49.
175 Human Rights Watch, “Like a Death Sentence": Abuses against Persons with Mental Disabilities in Ghana, 2 October 2012, ISBN: 1-56432-945-3 p.59.
176 General Assembly, Human Rights Council, Follow up report of the Special Rapporteur on torture and other
cruel, inhuman or degrading treatment or punishment on his follow-up visit to the Republic of Ghana, (2015)
para. 63. 177 Ibid.
178 M Roberts C Mogan and JB Asare ‘An overview of Ghana’s mental health system: results from an assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS) (2014) vol.8 no.1 p.1.
