How do you deal with a psychotic who goes wandering in front of cars?

That is the question facing the parents of Abu, a 25 year old psychotic who started wandering in front of traffic completely oblivious to where he was. Along with 95% of Ghanaians they turned to a traditional healer who prescribed a treatment of herbs and restraint. The restraint involved Abu being confined to a dark room and having his leg attached to a tree trunk. When we met him on Thursday he had been there for over a month…


Restraining patients by chaining them up or attaching them to tree trunks is not unusual. In the case of Abu, his leg was inserted in a hole in the trunk, and then an iron nail inserted to prevent him removing his foot. He had to eat, sleep and spend the day in the room, with the constant weight of his foot underneath a tree trunk. The scene was almost medieval and one that I will not forget easily.


We heard about this case through Walter, a psychiatric nurse based in Wa where we were staying. Walter administered some tranquilizers which would last six weeks, and this would control Abu’s tendencies to go wandering. However in order to secure Abu’s release, the traditional healer would need to make a sacrifice of a chicken or fowl, so the next day his parents would pay some money for the animal and call the healer. Only then could he be released. In some circumstances where the family is too poor, Basic Needs have had to pay for the animal to be sacrificed in order to release a mentally ill person from their restraint.

We met an association of traditional healers then next day at their monthly meeting, and we raised the sensitive issue of chaining and restraining patients. Before the meeting we had met the chairman of the association at one of our training sessions for Basic Needs’ partners, and at the meeting the chairman stood up and talked to the other healers about the benefits of “white man medicine’s” tranquilisers which can stabilise patients without the need for restraints, before they go on to administer herbal remedies. This was the catalyst for a number of other healers to stand up and talk about their experiences combining the “new medicines” with the “traditional” approaches, and this avoided having to chain people up for months on end. Some healers, however, stated they never used the “new” medicines – implying that they did indeed use some pretty rudimentary and backward approaches.

It has become clear from our conversations with many people that there is a real gulf of distrust between the traditional healers and the modern medical community, yet the traditional healers are at the front line of care for most of the population. Later on Friday we had a very productive session with Peter, head of Basic Needs in Northern Ghana, on how to take the organisation forward, and this was one of the topics we discussed.

We have now left Northern Ghana and travelled south to Kumasi, the second largest city in Ghana and the principal city of the Ashanti Region:


This was SUCH a tedious drive, much of it on dirt roads, taking almost the whole day. The Ashanti Region is virgin territory for Basic Needs – no self-help groups for the mentally ill, no psychiatric outreach clinics, none of the support they provide to transport psychiatric doctors up from Accra – and therefore an area with much to do.

Before we left Wa in the North, there were more (inevitable) hordes of kids who were so excited to see us. Here is Robbie trying to teach some of them yoga (he does his yoga every day) – some of them clearly couldn’t balance too well and were toppling all over the place:

And I love the expression of the kid on the left in this picture – he was absolutely hyper when we came across him and his excitement rubbed off on all the other kids, who wanted to see their own picture on the camera screen!


Finally this weekend there has been a major incident involving a baboon. The police are using the more common local term of a “babincident”. Here is a picture of the offender and some of his criminal gang just before the babincident:



It just ran out from nowhere and grabbed Robbie’s bag which contained his camera, pictures of his family and some flags from New Zealand that he was about to give to some kids at the local village. The baboon then ran up a tree and started going through the bag, dropping things out onto the ground. When Robbie and others tried to get the bag back, the baboon then charged at him but luckily backed off.

We reported the crime to the local police and they ran a check on their national database and came up with a hit. Here’s the photo from when the baboon was last in police custody:



I am therefore making a public appeal – if anyone sees a baboon’s tree decked out with New Zealand flags and pictures of Robbie’s family, it is highly likely to be our suspect. He may even be wearing my underwear that he stole a few weeks ago – see my earlier entry in the blog. Please approach with care – he may be dangerous…