Dementia: Working Together for a Global Solution 29th International Conference of Alzheimer´s Disease International

“I AM NOT A WITCH” Stigmatisation of People with Dementia in Ghana

Susanne Spittel, M.Sc. Alice Salomon University of Applied Sciences Berlin

Alzheimer´s Ghana

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Ghana

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Stigmatisation How can stigma be defined?

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Erving Goffman (1963)

“tig a is a attribute, behaviour, or reputation which is socially

discrediting in a particular way: it causes an individual to be

mentally classified by others in an undesirable, rejected

stereotype rather tha i a accepted, or al o e. [Goffman 1963]

WPA; WHO (2002)

Stigma results from a process whereby certain individuals and

groups are unjustifiably rendered shameful, excluded and

discriminated agai st. [WPA, WHO 2002]

"Our mother was

never a witch

and had never

suffered any

mental disorder

throughout her life,

apart from

exhibiting

signs of

forgetfulness

and other

symptoms of old

age. [Smith 2010]

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Stigmatisation What else is associated with it?

[I]

Methodology Results

Quantitative Data (March 2012)

nursing students

□ response rate 97.7 % (n=171)

□ sex 59.6 % women

40.4 % men

□ mean age 22.93 (n=166)

Qualitative Data (March 2012)

6 expert interviews

□ 5 conducted in Ghana Researcher (PhD - Population Studies)

Ministry of Employment and Social Welfare

HelpAge Ghana

Medical Director (Psychiatric Hospital)

Lecturer for mental health

□ 1 conducted in Germany

German historian

Literature Review (2014)

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Stigmatisation Results – Literature

□ Accusation of witchcraft

old woman [Aboderin 2006]

accusation after death of husband [ActionAid 2012]

missing support from relatives [Aboderin 2006]

□ Life in witch-camps

7 camps in northern Ghana [Badoe 2012]

remote locations [ActionAid 2012]

over 3,000 women are accused [Badoe 2012]

tiny thatched mud huts, limited access

to food, electricity or even water [ARDAG 2012]

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[II] J. Hahn

[II] J. Hahn

People neglect them due to problem associated with aging and relate it

with wit h raft. [in answer to: Do you think old people need more attention in

Ghana?]

People associate signs and symptoms of dementia to witchcraft. [in answer to: Do you think Dementia disease need more

attention in Ghana?]

98%

1% 1%

Yes

No

n/a

Figure 1. Need for more attention for older

people (n=170)

95%

1% 4%

Figure 2. Need for more attention for

dementia disease (n=170)

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Stigmatisation Results – Quantitative Data

□ Lacking awareness about the process of aging

We should take out of our minds, that

when somebody gets old then the person is

finished. I mean, is useless – you cannot do

a ythi g with that perso . [Interviewee - MOESW 2012]

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Stigmatisation Results – Qualitative Data

[III] R. Schmidt

[…] anything mentally

abnormal in code is

madness. That is the

general definition. [Interviewee - HelpAge Ghana 2012]

□ Missing knowledge

about dementia

[IV] B. Holtzhausen

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[III] R. Schmidt

Be ause people don´t know the disease and associates it to witchcraft. [in answer to: Do you think Dementia disease need more

attention in Ghana?]

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Be ause old age is ostly ot u derstood y people. [in answer to: Do you think old people need more

attention in Ghana?]

Stigmatisation Results – Quantitative Data

□ Dementia is content of

nursing education

93%

4% 3%

Yes

No

n/a

Figure 3. Is or was dementia or Alzheimer´s

Disease a topic in your education? (n=171)

Be ause ost of the Gha aia communities or population has no knowledge in this condition and hence see´s it to be normal not knowing that it is a disease and

eed to e are for. [in answer to: Do you think Dementia disease need more

attention in Ghana?]

□ Grandparents

average age 80,74 ( 12,85)

Min: 45, Max: 130

with dementia 18% (n=78)

average age (PwD) 84,04 (n=72)

Demographical Aspects Results – Quantitative & Qualitative Data

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Now more older people living alone, because other family members migrated […]. [Interviewee - HelpAge Ghana 2012]

□ Urbanisation

70,2 % (n=120)

35,2 % (n=56)

job-related

privat

Figure 4. Contact with PwD

□ Extended family system

breaking apart

People want their privacy; they do not want to go the standard family way. They want to go the

u lear fa ily way. [Interviewee - Research 2012]

Conclusion Trial of Ageing

(1) Inadequate

ageing policy

(2) Lack of

knowledge

(3) Accusation of

witchcraft

(4) Exclusion from

society

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[VI] ARDAG

[IV] B. Holtzhausen

[V]

Growing population of

old people

□ Research projects and reliable data

about ageing and dementia

□ Awareness and better education about

the ageing process and dementia

□ Specialists for people with dementia

□ Nursing and medical care as well as

insurance structures for the elderlies

So it´s like, as of now, they are provided with

ge eral health are like a y other age group. [Interviewee - MOESW 2012]

Conclusion Future Perspective

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[VII]

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[The Witches of Gambaga 2010]

Conclusion Future Perspective

OUR VISION IS TO CREATE A SOCIETY

WHICH IS DEMENTIA FRIENDLY AND DEMENTIA LITERATE

WHERE A PERSON WITH DEMENTIA CAN LIVE

WITH DIGNITY AND HONOUR,

WHICH HE/SHE DESERVES.

Alzheimer's & Related

Disorders Association of Ghana Care and Support for Dementia

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THANK YOU FOR YOUR ATTENTION !

Questions?

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[VIII]

Aboderin, I. (2006): Intergenerational Support and Old Age in Africa. New

Brunswick/London: Transaction Publishers.

ActionAid (2012): Condemned without trial: women and witchcraft in Ghana. London:

ActionAid

ARDAG – Alzheimer´s and Related Disorders Association Ghana (2012): They Are NOT

Witches. http://alzheimersgh.org/care-for-them/#more-' [site accessed on 29.10.2012]

Badoe, Y. (2012): Representing Witches in contemporary Ghana. Challenges and reflections

on making the `Witches of Gambaga´. In: Feminist Africa, 16: 82-97

Goffman, E. (1963): Stigma: Notes on the Management of Spoiled Identity. Englewood

Cliffs, New Jersey: Prentice-Hall

Smith, D. (2010): Gha aia wo a ur ed to death for ei g a 'wit h‘, o li e . . : http://www.theguardian.com/world/2010/nov/29/ghanaian-woman-burned-death-witch

WHO; WPA (2002): Reducing stigma and discrimination against older people with mental

disorders. Geneva: WHO, WPA

Literature

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□ Alzheimer´s Disease International (2012): Overcoming the stigma of dementia. World

Alzheimer Report 2012, London: ADI

□ Alzheimer´s Disease International (2011): World Alzheimer Report 2011. The benefits

of elderly diagnosis and intervention. London: Alzheimer´s Disease International

□ Kalaria, R. N. et al. (2008): Alzheimer´s disease and vascular dementia in developing

countries: prevalence, management, and risk factors. In: Lancet Neurol., 7(9): 812-826

□ Kowal, P. et al. (2010): Ageing and adult health status in eight lower-income countries:

the INDEPTH WHO-SAGE collaboration. In: Global Health Action, 3(2)

□ Ogwumike, F. O.; Aboderin, I. (2005): Exploring the Links between Old Age and Poverty

in Anglophone West Africa: Evidence from Nigeria and Ghana. In: British Society of

Gerontology. Generations Review, 15(2): 7-15

Additional Literature

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[I] 72 year old grandmother burned alive as a witch; by Kramer, Hugh (2010) http://www.examiner.com/article/72-year-old-grandmother-burned-alive-as-a-witch [site accessed on 24.04.2014]

[II] Ghana witch camps; by Jane Hahn Photography (2006-2014) http://www.janehahn.com/#/ghana/witch-camps/Ghana_WitchCamps_01 [site accessed on 24.04.2014]

[III] A Kenyan senior citizen leans on his cane in a Nairobi street; by Roberto Schmidt http://www.theguardian.com/global-development/2012/apr/04/poorer-countries-health-needs-ageing-population [site accessed on 22.04.2014]

[IV] Africa – Reflecting on dementia care around the world; by Berrie Holtzhausen (2013) http://www.wellsphere.com/caregiving-article/africa-8211-reflecting-on-dementia-care-around-the-

world/1973865 [site accessed on 22.04.2014]

[V] Children in Nigeria protest against witchcraft accusations in 2009; by AFP/Getty Images (2009) http://www.takepart.com/article/2010/08/10/albino-killings-child-witchcraft-accusations-fueled-occult-

beliefs-africa [site accessed on 25.04.2014]

[VI] Don’t Worsen Their Trauma; by Alzheimer´s Ghana (2012)

[VII] Clean Watts Make Africa´s Future Look Brighter; by Rosie Spinks (2011)

http://sierraclub.typepad.com/greenlife/2011/01/four-watts-providing-a-big-change.html [site accessed on 25.04.2014]

[VIII] Ageing Indians Sidelined, by Kalpanaa Misra (2012)

http://kalpanawrites.blogspot.de/2012/11/ageing-indians-sidelined.html [site accessed on 25.04.2014]

Links of Pictures

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