Dementia is not witchcraft

Growing up, I lived with my grandparents in a small village called Akyem Awenare in the Atiwa West District of the  Eastern Region, and every aged person who was mentally unstable was labelled as a witch or a wizard. 

The myths and superstitions about witchcraft were so much engrained in the history and setup of the village. Sometimes, the aged would be abandoned by family members because of these misconceptions.

Interestingly, we all tend to forget that we will become old and frail one day. 

Beliefs

Religious beliefs, especially in rural Ghana, also exacerbate the perception of age-related mental health disorders like dementia.  

In rural Ghana, religion significantly influences the perception and understanding of dementia, shaping both the social stigma and even caregiving practices associated with the condition.

Dementia is often interpreted through a spiritual lens, where symptoms such as memory loss and behavioural changes are sometimes attributed to spiritual curses, witchcraft or divine punishment rather than recognised as a medical issue.

This belief system leads to delays in seeking medical help, as families may initially consult spiritual healers or traditional practitioners.

Usually, because of the religiosity in Ghana, when pastors, fetish priests and other men with supernatural powers reveal or proclaim that indeed, someone is suffering from witchcraft, everyone believes it.

Lack of education

In my small village,  and most places in rural Ghana, people do not know about dementia and have no idea if someone is suffering from it because there is a high level of illiteracy in the village and woefully access to health information.

Due to poor public education and awareness, access to health information is lacking in most remote areas in Ghana, and it continues to pose a threat to life.

One unfortunate and horrific incident happened in 2010 when a 72-year-old woman was burned to death for being a witch.

To give a clearer picture of the severity of how people with age-related mental health disorders are treated in Ghana, let’s not forget there are witchcraft camps in the northern part of Ghana where people are camped to isolate them from society.

This is a serious challenge to the health system of Ghana and needs urgent attention with good policies in place, especially as the ageing population continues to grow.

My Grandmother’s Dementia

My grandmother, affectionately called Maame, was a true matriarch who served in many leadership capacities and worked hard for the well-being of her family.

She was a farmer who doubled as a trader during harvest. Even in her 70s, she was still strong enough to perform normal duties.

In her later years, she continued to work, and despite being nonagenarian, she was strong and healthy until one day, she fell sick and started talking nonsense and being hysterical, in 2016.

She was taken to the hospital and fortunately for the family, one grandson was a medical doctor at the time and had friends at that particular hospital. Initially, the doctor ran tests for high fever, but they turned out negative.

Eventually, he ordered other tests for perhaps the diagnosis of exclusion and it was concluded that grandmother could be suffering from dementia since there is no test definitively that detects dementia, especially in the early stage.

It dawned on the entire family, mainly, that we did not see it coming and were unprepared for the change. 

No help

Developing countries like Ghana, unlike other developed countries, have woefully inadequate specialists, good social safety nets and appropriate facilities to cater to age-related mental health disorders.

We were all worried about what the village people would say about her. What would be the perception? Would they believe the explanation we gave them? We had to find a better way to explain to them what dementia is and how it is not witchcraft. 

Recommendations

There must be increased public awareness and education on dementia through culturally centred education and materials, including pamphlets, radio programmes and local language videos.

To address misconceptions and reduce stigma, it is crucial to implement public education campaigns that dementia is a medical condition, not witchcraft or spiritual punishment. These campaigns should involve collaborations with community leaders, traditional healers and other public figures.

Secondly, more geriatricians and healthcare providers should be trained in rural areas.

Healthcare professionals in rural Ghana often lack the training to detect and manage dementia effectively, leading to delays in treatment, management and care.

There is a need for specialised training for primary healthcare workers. We also need to train more ageing specialists in Ghana.

Thirdly, integrate Dementia Care into Religious and Community Structures.

Given the strong influence of religion in Ghana, churches, mosques and other religious institutions can serve as platforms to provide accurate information about dementia by partnering with religious leaders to disseminate information and create awareness.

Also, we need to improve the social safety net by creating policies for older adults to ensure access to quality medical care and social support.

Finally, we need to provide support for family caregivers who often bear the brunt of caregiving, especially in rural Ghana, where formal support systems are scarce. Therefore, counselling and financial assistance programmes should be established.

• Writer’s email: Dmagyei@memphis.edu

The Writer is a PhD Student in Health Communication at the University of Memphis, Tennessee, USA