Disability Rights in Ghana

On Friday, I was asked to pull together a briefing paper for the US Embassy on the socioeconomic rights of disabled people in Ghana. This was a challenge. I only had about 3 hours to carry out all the necessary research and write the paper, and power was out and the internet was down for most of that time. Still, I managed to put something together before the deadline was up. Some of what I learned was really very interesting indeed.

Unsurprisingly, in Ghana persons suffering from both physical and mental disabilities constitute an impoverished marginalised group, characterised by lack of access to public health, education, and other social services that would ideally promote, support and protect the socioeconomic rights and realities of disabled people.

The legal framework protecting the rights of disabled people in Ghana has been poorly implemented, and rights provided for in law are frustrated in practice owing to lack of services, funds and facilities. Although District Assemblies (local government) are obliged to ring-fence 2 per cent of their funds for disability related issues, the Ghana Federation of the Disabled (GFD) has reported that in reality this rarely happens. Services for disabled people are therefore chronically underfunded.

A further problem is that disabled people and their families are simply unaware of legislation and government policies designed to assist them. For example, according to an administrative directive, persons with disabilities employed in the public sector are entitled to a disability allowance of 48 cedis every three months. This can be used for any purpose but might go towards home adaptations or mobility aids which are not covered by the National Health Insurance Scheme. The institutions where the persons with disabilities are employed are responsible for paying the allowance. This is the case only if the budgets are not exhausted, which means that in reality very few receive the allowance. Few persons with disabilities are aware of their rights as employees so few claim the allowance.

In 2006 Parliament passed the Persons with Disability Act (PDA). This is a commendable piece of legislation which includes provisions to promote and protect disabled persons rights in the fields of education, employment, transportation, access to public spaces, and medical care. The Act also provides guidelines for the public and private sectors on how they should respond to the needs of persons with disabilities, and creates the National Council on Disability, responsible for coordinating disability related activities in Ghana.

However, the Act has some significant shortcomings. For example:

• The Act mainly addresses matters relating to physical access to services with no mention of core rights relevant to persons with mental disabilities. For example, the community-based rehabilitation programmes provided for by the PDA is mainly restricted to the needs of the physically disabled without acknowledgement of the provision for community rehabilitation needs of people with mental disability.
•  The National Council on Persons with Disability is under-staffed and under-resourced.
• Vital legislative instruments have not yet been enacted. For example, no legislative instrument has yet been enacted regarding the Act’s provisions on free education for disabled people. It is therefore unclear at what level individuals will be able to access free education and what education will be covered. The legislative instrument regarding the Act’s provisions on tax rebates for employers of disabled people has also not yet been enacted, and thus the percentage tax rebate remains unconfirmed.
• Disabled people and the general public are unaware of the provisions of the Act, thus significantly hindering the realisation and enforcement of the Act’s provisions.

In 2012, Parliament successfully passed the Mental Health Act (MHA). The Act brings with it a raised prospect of the delivery of a better quality mental healthcare and also the protection of human rights of people with mental disorders in Ghana. It introduces a number of initiatives, such as the establishment of a Mental Health Authority and Visiting Committees to inspect hospitals and investigate patient complaints; and the recognition and protection of the human rights of persons with mental disabilities. Although this is an enormous step forward for Ghana, the MHA  also has some shortcomings. For example:

• it falls short of international best practice and the provisions of the UN Convention on the Rights of Persons with Disabilities as it allows for arbitrary detention of people with disabilities as well as removal of legal capacity, rather than supported decision-making; and
• although it applies to hospitals and clinics, prayer camps -  where very many mentally disabled persons are accommodated owing to prevailing beliefs that mental illness arises from evil spirits - fall outside the scope of the Act.

Learning about traditional healing and prayer camps was the most interesting thing I learned about during the course of my research. Both Human Rights Watch and HRAC have documented terrible abuses and harmful practices carrying on in traditional healing and prayer camps. These include patients being chained to trees outside in the heat/rain; patients being forced to remain there for months or years against their will; low standards of hygiene and sanitation; overcrowding; denial of medication, food and water; and mental and physical abuse. For more information about this see http://www.hrw.org/news/2014/03/10/ghana-monitor-mental-health-facilities

Yesterday, I was told that my briefing paper seems to have had an impact at the Embassy, and HRAC has, as a result, been asked to put together a proposal for funding from the Embassy for a programme of work surrounding disability rights. This was great news. The only catch was that it had to be submitted within 48 hours! I quickly sat down to work and put together a project proposal, with clearly stipulated objectives and activities.

As far as I can see, despite the much improved legal framework now in existence in Ghana, the rights contained in the above mentioned legislation will be rendered illusory without a public education initiative to educate both service providers and disabled people themselves about their legally enforceable rights.  Moreover, the availability of a legal forum where people can go to seek enforcement or redress to the breach of their rights, trained health/education/and justice professionals and administrators, and advocates to assist people in their representations, are necessary conditions for the successful implementation of both the PDA and the MHA.

My project therefore proposed the following objectives:

1. To educate disabled persons and their families on their rights under the law (including those with multiple needs, such as parents with disabled children or disabled LGBT persons).
2. To help disabled persons and their families seek redress for abuses of their rights.
3. To educate service providers, including health professionals, teachers, the police, and the prison service on promoting and protecting the rights of disabled people in Ghana.
4. To educate employers on their obligations under the PDA and how to make the workplace more accessible.
5. To provide training and written guidance to the judiciary on disability rights and best practice in access to justice for disabled people; and
6. to advocate for the promotion and protection of disabled persons’ rights with relevant government departments, and specifically to advocate for the enactment of necessary implementing legislation.  

My proposal included the following activities:

Educating disabled people and their families on their rights under the law

I proposed developing an outreach programme targeting separately persons with physical and mental disabilities. The programme should address:

• Challenging disability related stigma and specifically countering the idea that disability is a result of spirits or demons.
• Educating people on the key provisions of the PDA and the MHA, telling people in simple, accessible language what rights and benefits they and their loved ones are entitled to, how to request reasonable adjustments at work, and how to seek redress for abuses. Seminars should run, where necessary, with the assistance of counsellors, and in sign-language. Written guidance should also be made available in multiple formats, including oversize font and “easy read”. Seminars will also address the particular concerns of people with multiple needs, such as disabled women and parents with disabled children. Outreach sessions should be coordinated using HRAC’s existing networks, collaboration with service providers and other civil society organisations, professional associations, mosques and churches.
• Signposting people to reputable sources of help, including counsellors, psychiatrists, hospitals, employment offices, professional associations, and HRAC’s network of pro bono advocates.

Help disabled persons and their families seek redress for abuses of their rights

I proposed that HRAC train a specialist group of its existing network of pro bono lawyers on the content of the PDA and the MHA, as well as relevant international human rights law, so that they are able to provide representation to those in need. This should include providing training to advocates who themselves suffer from a form of disability.

HRAC could also training to HRAC’s mediators and paralegals at its Human Rights Clinic so that they are better able to support disabled people in resolving disputes without recourse to the courts. HRAC could also train its mediators and paralegals so that they are able to identify test cases or other cases that would benefit from a hearing in court.

Finally, I proposed providing training in disability law and disability rights to traditional community leaders, so that they are able to assist in resolving disputes in their own community, and also help combat the endemic stigma surrounding disability in Ghana.

In addition to the above, I proposed publishing comprehensive written guidance on relevant international law, the PDA and the MHA aimed at advocates taking disability cases, made freely available on our website, as well as designing training on disability and health law for students studying law throughout Ghana and take that training to the Universities. Training could be accompanied by a disability law handbook for university libraries and clinics, in order to ensure the sustainability of HRAC's work. HRAC is currently collaborating with universities so that law students can gain experience in the office at HRAC and develop hands-on experience in disability rights.

Educating service providers, including health professionals, teachers, the police, and the prison service on promoting and protecting the rights of disabled people in Ghana

I proposed that HRAC, in collaboration with the Ghana Bar Association and the Ghana Law School, provide training on the PDA, the MHA and international best practice in promoting, protecting and advancing disability rights. This will include training on human rights centered service provision, accessible buildings, how to make reasonable adjustments to accommodate disabled people, and placing the inherent dignity and autonomy of the person at the heart of public service. Simple, accessible publications will accompany training.

Training sessions should be tailored according to sector and could cover:

• Schools and education (specifically aimed at Parent-Teacher associations in special schools)
• Human rights centered approaches to health care provision (specifically aimed at health care providers, and especially in Ghana’s three psychiatric hospitals);
• Policing and prisons.

 Educating employers on their obligations under the PDA and how to make the workplace more accessible

Again, in collaboration with the Ghana Bar Association and the Ghana Law School, I proposed that HRAC provide training to employers on their obligations under the PDA and the sanctions they could face for failing in those obligations. HRAC will also draw attention to the benefits of employing disabled people and how to make reasonable adjustments to the workplace environment to accommodate disabled employees. Training sessions should be accompanied by written guidance, and made freely available on HRAC’s website.

Provide written guidance to the judiciary on disability rights and best practice in access to justice for disabled people

I also proposed that HRAC design manuals for members of the judiciary on the UN Convention on the Rights of Disabled People as well as the content of the PDA and the MHA. This will ensure that judges are well versed in the relevant legal and human rights framework so that they are able to effectively adjudicate cases, including in those instances where the applicant does not have the assistance of counsel.

HRAC could also provide seminars for those working in the court system best practice in enhancing access to justice for disabled people without legal counsel. For example:

• Ensuring hearings are accessible for the physically disabled by ensuring accessible courtrooms and/or alternative venue availability (including hospital-based hearings).
• Ensuring hearings are accessible for those with mental disabilities or learning difficulties by providing for the availability of medical professionals, counselors, or responsible adults who can provide support and translate legalese into simple, accessible language.

Advocating for the promotion and protection of disabled persons’ rights with relevant government departments

I also proposed that HRAC continue to lobby relevant government departments to ensure that the National Council for Disability and the Mental Health Tribunals receive adequate funding to fulfill their functions meaningfully. HRAC should also continue to lobby relevant government departments to ensure the full implementation of all the provisions of the PDA and MHA, and for the publication of appropriate statutory guidance.

My proposal is now with the accounts department who are costing my proposals before submitting it to the Embassy. Watch this space…