Shelia Stigall at the House of St. Francis

My name is Shelia Stigall and I recently had the pleasure of working in Ashaiman, Ghana at the House of St. Francis.  I was there from June 28^th through August 16^th as part of my education in the field of social work.  I had the opportunity to connect with many people, addicts and “normies” alike, who are working to make recovery happen in Ghana. It was a life enhancing experience and I am very grateful for the time I spent with these amazing people.  I am especially grateful to Dan and Agnes for making this opportunity a reality.

Following is an entry from my blog about my experience working in Alcohol and Drug Treatment over the course of an 8 week stay in Ghana.

Recovery is Definitely in Its Infancy Here

This will be my longest and, perhaps, least entertaining of all posts on this blog but this, after all, is why I am here in Ghana.  A lot has been happening and this is a subject that I am passionate about; though I realize it may hold little interest to others.  So, read or don’t read; it is my blog!!!  As always, the comments that follow are my opinions and interpretations of what I have been told or have personally observed and may bear little or no resemblance to actual fact.

I am a student of social work at Portland State University.  The chance to enhance my education by doing an international field placement with a social services agency in Ghana was put on my path.  I am so grateful that I did not turn down this opportunity.  It has been a rewarding experience in so many ways.  I have learned that I actually have useful knowledge, skills, and abilities in the field of Addiction and Recovery.  I had mentally taken work in this field “off the table” as a career path.  I have found, through the work I am doing in Ghana, that not only do I enjoy working with clients in early recovery, I seem to have a knack for the work, and I feel that I am doing something important.  Although the field of Alcohol and Drug Treatment is not quite back on the table it is no longer shoved to the back of the pantry!!

Recovery is definitely in its infancy here.  Religiosity is apparent in nearly every aspect of Ghanaian life, including the ideas, beliefs, and attitudes about addiction and recovery.  One man told a story of his family’s belief that “juju” (magic or witchcraft) had been worked on the family in the form of his “disgraceful” use of alcohol.  The belief was that a demon had been placed in his belly with a thirst for alcohol that could not be quenched as a form of punishment for some perceived sin or wrongdoing.  The man was subject, on more than one occasion, to community members trying to “beat” the demon out of him.  Another talked of being forced to participate in week long “prayer services” in the hopes that he would be “saved” from his own sinful ways.  

I don’t pretend to understand addiction, although I do have some knowledge on the subject, nor do I wish to be perceived as sitting in judgment of beliefs that conflict with my own.  Joseph Campbell once said, “Remember, one man’s superstition is another man’s religion.”  I try to be open-minded when it comes to other belief systems.  I do believe, however, that addiction is “a primary, chronic, progressive, and fatal disease,” which, with help, can be managed.  Much as with the disease of diabetes, people can manage the disease of addiction and live long, productive, and useful lives.  In the United States this idea is gaining wide acceptance and, fortunately, the idea is catching on in Ghana, too.

House of St. Francis

For the past month I have been working 40 plus hours per week at the House of St. Francis (HSF), a residential treatment center for men in Ashaiman, Ghana -- one of only a handful of treatment centers in the country.  The house currently has about 15 clients with room for up to 44.  There are six staff members including two full-time resident cooks (Matthew and Rueben) who prepare 21 meals per week, a resident house manager (George), two resident peer counselors (John and Mark), and a program supervisor (Byron) who lives off site.  To the best of my knowledge these dedicated and devoted men are volunteers who receive room and board and/or a small stipend for their service.  

 

Dan

Dan O. is the chair of a Non-Government Organization (NGO) called the Hopeful Way Foundation and is the man who made my work at HSF possible.  The NGO was established to encourage and support recovery in Ghana and helps fund HSF.  It gets pretty complicated and my summary here simplifies matters to an extreme.  The Catholic Archdiocese for Ashaiman actually owns the facility and is set to take over its daily operations in two years.  The Catholic Church gave Hopeful Way Foundation three years to get the program “up and running”.   The first year anniversary of HSF is August 1^st.  

 Dan has tirelessly sought funding and support from various sources to keep HSF going.  He divides his time between the United States and Ghana.  There is expectation among Hopeful Way board members, HSF staff, and their supporters that, at the end of the three years, the house will be registered as an NGO whose board of directors will set policies for facility to be run by volunteers and recovery professionals.  Helping to promote and support recovery in Ghana has been a labor of love for Dan and many, many others over the last several years.

 When I was preparing to come to Ghana I was under the impression that I would be working with women who have substance abuse issues.  Indeed, HSF launched a women’s outpatient treatment facility on 16 July, 2013.  I was there for the “big” day.  No one showed up.  The women’s center has been open for a couple of weeks now and we are still waiting for our first client.  I did not have a clue the extent of stigma placed on alcohol and drug use and abuse in this country.  It’s bad for men but it is even worse for the women.  Even the male clients I work with are, in general, very negative about women using, let alone abusing, drugs and alcohol.  In this culture, heavy into denial, “women just do not drink, smoke, or use drugs.”  Professionals say that there is a “conspiracy of silence” about the prevalence of substance abuse among women and the problem is firmly behind closed doors.  It will take a very courageous woman to step out of the doors of her isolation and through the doors of the treatment facility.  Once she does, I believe others will follow in quick succession. 

Water Carriers

 

So, what have I been doing? – A great deal of education about the disease of addiction.  There are three woman who are “in charge” of the facility. 

Sister Brigid

The Church has assigned a nun, Sister Brigid, to oversee the program on their behalf.  She is firm in her belief that overcoming the “weakness” of addiction is a matter of learning “self-discipline”.  There are also two

Stella

Clinical Psychologists, Jennifer and Stella, who are involved in the project.  They are fully aware of the “disease concept” of addiction but are genuinely puzzled as to why a person, after becoming aware of and educated about the disease, could ever choose to use again (relapse).  I daresay that neither of these beliefs is all that different than the belief of many people in the United States.  I also need to add that these three women are all dedicated to helping people with the disease of addiction and are willing to learn.  Although not addicts themselves they see the devastation caused by the disease to the addict, their families, and society. They genuinely want to help make a difference.

 I have been sharing my experience in this area and answering the rapid fire questions that each of these three women have about the disease.  Often my answer is “I don’t know” and I have been doing a lot of research to try and find answers.  Other times I think I offer valuable insight into the biology and psychology of the disease and offer the idea that addicts are not “hopeless” and, given the chance at recovery, will become useful and productive members of society.  

 Stella, Jennifer and I have also been doing some brainstorming to try to identify barriers to reaching women addicts and identifying ways to overcome these barriers.  We have been talking to doctors in clinics, religious leaders in churches, social service agencies, youth groups,

Reaching Out to Youth Groups

and women’s groups.  We are planning to speak at churches (hopefully I will be able to participate in this before I leave Ghana) and are in the process of getting permission from various church leaders to have some time devoted during the weekly services.  There is also the idea of going into the market area (which is so not like the market experience in the United States!!)

To Market, To Market.......

and distributing informational flyers.  Literacy, although fairly high in general, is often lower among women.  We are discussing the use of a “pictorial flyer” that will be more readily understandable to a greater number of women. 

Because I have several hours work each week and the women’s program is, regrettably, taking so little of my time, I am also working with the male clients and staff at HSF. Mr. Amigashi from the Korle-Bu Teaching Hospital’s Addictive Disease Unit (ADU) refers men to HSF.  There is one client from Cote d’ Ivorie (Ivory Coast) who speaks only French.  I have access to a translator program and have used it to translate much of the material used at the treatment center from English into French so that this client can have a better understanding of what is being taught at HSF. 

 The current curriculum used at HSF is called Recovery Dynamics; a 12-Step based recovery program.  Although it is very good it does not contain a Relapse Prevention segment.  I have been doing a lot of research in this area and have put together a 4-hour training session on recognizing stages and signs of relapse and understanding how to turn a potential relapse around.  I have facilitated an education and discussion training session based on my research and existing knowledge of the subject. I will be delivering this training one more time before I leave Ghana and staff members at HSF are working with me to further develop this training material and turn it into a regular part of client education.  

 I have also been given the opportunity to do some one-on-one “counseling” with the men at HSF.  What this actually amounts to is my listening to them talk about their experience and nodding my head empathetically. Since there is so little “long-term” recovery in Ghana I have also been given the chance to do some 12-Step work with individual men.  Although AA is alive and kicking in Ghana, meetings are not always easy to get to and sponsorship is not always easy to find.  I have some knowledge in this area and have been helping to guide a couple of men at HSF through Steps One, Two, and Three.

The Principles

One last area where my skills are being put to use is in the development of Position Descriptions for the jobs that the dedicated staff members at HSF are currently doing on a voluntary basis.  There is hope that, someday soon, there will be funding available to make these paid staff positions.  When that happens there is a need to be ready to justify funding for each, hopefully, well-defined position.  I am glad to be able to contribute my talents in this endeavor.  

I have also had the opportunity to spend some time with Sylvester Adu from the Narcotics Control  Board of Ghana (NACOB).  NACOB’s main goal is to ensure a drug-free society through simultaneous supply and demand reduction measures. This is being done through enforcement and control, education and prevention, and treatment, rehabilitation and social re-integration.   Mr. Adu is really an incredible man.   He is the Head of Social Rehabilitation and Precursor Chemicals Unit of NACOB and is really dedicated to social education on the disease of addiction.  He has spent time in the United States visiting various treatment centers and received training in Recovery Dynamics in Little Rock, Arkansas.  He spends time teaching at HSF and is dedicated to NACOB’s efforts to reduce demand for illegal drugs in Ghana.  Much of the time he spends on social education and working with clients at HSF goes above and beyond his duties as a NACOB employee.      

Dr. Al Mooney

I have also had the opportunity to meet Dr. Al Mooney, who is co-author of “The Recovery Book” and chair of the Willingway Foundation. For the last half century this Georgia born foundation has been committed to reducing the suffering of individuals and families who have been impacted by alcoholism and other drug addictions.  Dr. Mooney has also been involved in starting an NGO called Recovery Africa, which is still in its initial stages of formation and growth.  

 From July 17 – 25, 2013 Dr. Mooney was in Ghana to help spread the message of addiction treatment and recovery and to conduct training sessions for interested Ghanaians.  I was fortunate enough to be in Ghana at the same time as Dr. Mooney and was able to benefit from his extensive knowledge in the field of recovery.   

 One of his training sessions was billed as a “Peer Counselor Training Course”.   This was anything but “peer” training.  Most of the attendants were not addicts which meant, to me, that they were not “peers”.  I was getting a little incensed that the training was not “going my way”. Then I started paying attention to what was really happening.  I realized that there are pockets of recovery all over Ghana.  Most of these are run by caring individuals who fight for funding and resources.  They are dedicated to the ideas of education, treatment, and recovery, that addiction is a disease that can be managed, and that addicts in recovery can benefit society and are “worth the effort”.  

 I started to realize that Dr. Mooney’s training was the first time that these isolated pockets of individuals and groups working in recovery had the opportunity to get together as “peers” in the field of treatment and recovery.  They exchanged ideas and contact information.  People who felt they were alone in their efforts were shown that there are many throughout Ghana dedicated to the same principles of recovery – though they may go about it in different ways.  I began to realize that I may have been witness to a giant step for recovery in Ghana; the beginning of a collaborative process between different social service agencies working towards the same goal.  I felt grateful to be witness to something of this potential magnitude. 

 Change is a process not an event.  Recovery is definitely in its infancy here.   I would love to be able to transport into the future to see what recovery, for women and men, looks like in Ghana in five or ten years.