The Coronavirus Pandemic: A Perspective from Ghana

Psychologists in Ghana are addressing coronavirus-related fears and anxieties.

Posted Apr 15, 2020

Guest contributor Dora Awuah shares her experience as a psychologist working in Ghana

Every Ghanaian went about their daily routines smoothly until Thursday, March 13 when the first two cases of COVID-19 in Ghana were confirmed. Many hoped that there would be no increase in the number of cases since the confirmed cases were imported from Turkey and Norway. However, the numbers kept increasing. The fear and panic which had gripped many heightened when the President of the Republic of Ghana, His Excellency Nana Akuffo-Addo, announced a ban on social gatherings and closure of all educational institutions for four weeks commencing on Sunday, March 15, when the total number of cases rose to six (6). With this announcement, all religious gatherings, funerals, marriage ceremonies, conferences, etc. could not be held or had to be put on hold. At the time of writing this post, 566 people have been identified as suffering from COVID-19 with 8 deaths.

Recommendations to minimize the spread of the virus included observation of hygiene practices such as hand washing, the use of hand sanitizers, social distancing, and many more. The country was locked down on Monday, March 30 which heightened existing fears. Although these measures have been helpful in mitigating the spread of the coronavirus, the disruptions in community and individual activities have implications for mental health, both locally and globally.

 Ghana Flag/Pixabay
Fig 1: Flag of Ghana
Source: Ghana Flag/Pixabay

Ghana has a population of over 21 million people, of whom 660,000 are assessed by the World Health Organisation as experiencing severe mental health disorders with 168,000 evidencing moderate to mild mental health conditions. The majority of mental health treatment is provided through specialized psychiatric hospitals, close to Accra, leaving a large majority without specialized care.

In addressing the pandemic, the population is confronted by many challenges. First, the social distancing policy has brought a halt almost to all social engagements such as church services, marriage ceremonies, funerals, and all other forms of social gathering. This has deprived many of the sense of connectedness to their loved ones and has denied religious groups of the opportunity to enjoy fellowship within familiar settings. Although some arrangements are in place for online prayer meetings, the majority of people cannot access such services due to poor internet connectivity or a lack of internet and computers. Particularly in rural areas, the majority of people do not have access to computers.  Also, the usual handshake, body contact, facial expressions, and other engagements that are inevitable during face-to-face meetings cannot be experienced through online programs.

Focusing further, social distancing has affected the social life of children and adolescents who derive their sense of wellness by relating with peers. In most cases, some kids stay home without adult supervision. Besides boredom, children are exposed to social media, internet, and in extreme cases the potential of sexual abuse by adults. A study of abuse in Ghana reported that 28 percent of women were subject to domestic violence in 2015, that is, prior to the current stressors. Social isolation coupled with an imposed shift away from usual routines constitute major sources of stress to both the adult and young population.

Secondly, the COVID-19 pandemic has led to some Ghanaians losing their jobs and source of livelihood with potential impacts on mental health. Most businesses are experiencing huge financial losses and are therefore not able to pay their staff. For instance, the hospitality industry, most especially hotels, have already commenced staff downsizing since the patronage of their services has seen a significant decline due to travel restrictions across the world. Major markets in Accra are quiet as shoppers and business operators have to adhere to the government’s directives on social distancing. About 80% of Ghanaians work in the informal sector. If the current situation persists, individuals in the informal sector will experience particular difficulty supporting their families economically. On the other hand, persons in the formal sector with economic power irrespective of social distancing will need to deal with the psychological impact of the adverse economic effects on the country.

Finally, the fear of contracting the COVID-19 poses a significant psychological burden for citizens exposed to ongoing events internationally including reports of over 2,000 deaths on a single day and predictions of deaths in the U.S. approaching 100,000 people. Many are desperate to stay abreast with the latest news on the global pandemic which requires staying awake sometimes deep into the night. Adopting habits including compulsory handwashing and the use of sanitizers has become synonymous with staying virus-free. The inability to observe these hygienic practices is likely to cause fear and panic reactions. Although these practices are appropriate at this time, they may also predispose people to experience increased stress associated with mental well-being such as phobias and obsessions which may well extend beyond the period of the pandemic. At the same time, anxiety may encourage many to flee from major cities to villages.   

Ghana’s mental health sector is understaffed and seemingly unprepared to address the looming challenges. Notwithstanding, some community interventions may assist in curbing the impact of COVID-19 on mental health in Ghana. For instance, setting up crisis intervention centers in affected regions to address emotional distress through telephone or social media platforms is relevant. The Ghana Psychology Association in collaboration with psychologists can manage hotlines to provide psychosocial support which is much needed in these times. Besides that, psychologists should be recruited into frontline medical teams in the various treatment centers established across the country to provide psychosocial support to both infected persons and their relatives. It’s also important to conduct a community survey to identify both the prevalence of COVID-19 and of mental health problems and predisposing factors in the population to formulate treatment measures. Finally, the public should be sensitized on effective coping strategies to minimize the risk of developing mental health challenges both during and after the pandemic. Similarly, individuals and their families who may be affected by the levels of uncertainty and anxiety may be provided with opportunities to engage in counselling. These educational programs can be aired on FM channels and TV networks and also published in newspapers.  

In addition, individuals have a major role to play in maintaining mental health by connecting with others through telephone conversations or social media. Individuals experiencing the lockdown should be active by engaging in listening to inspiring music, reading, drawing, writing, or physical exercise. It is also important to maintain a sense of calm, to stay positive, and to seek help from an appropriately qualified person or trusted other when there is need. Parents may spend more time with children and respond to their questions and address their fears. A balanced diet with fruits rich in vitamin C and staying hydrated may also contribute to strengthening one’s immune system.

Interestingly, the collectivist African culture may affect the course of the pandemic in Africa, and  especially in Ghana. Individuals infected by the virus continue to enjoy social support through telephone conversations and social media friendship even in the absence of face-to-face interaction.

Image supplied by Dora Awuah
Fig 2. Dora Awuah
Source: Image supplied by Dora Awuah

COVID-19 has the potential to expose large populations not only to the direct impacts of the virus, but to diverse mental health problems. The threat of contracting the infection, as well as social isolation and economic challenges, has implications for mental health service providers in Ghana. Appropriate community and individual interventions, however, can help ameliorate these challenges.

Dora Awuah participated in a recent Australia Awards-Africa Short Course on Mental Health, and heads the Dora Awuah Foundation, an NGO committed to promoting community mental health in Ghana.