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 28th
through August 16th 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.
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 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 1st.
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.
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.
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
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.
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.
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.
