Disabled Land!

By Komla Adom and Aaron Appiah

Without sight. Limbless. Diminishing Hope. But Determined!

They call it way of life here in Karni, a remote village far off the Upper West Regional capital, it may seem idyllic, but to many, it's the end of the rocky road.

This is where the region's disabled, unfit and desperate drift to...obviously to live. A predominately farming community in the smallest District in the upper west Region, bordered to the South by the Lambuisse District itself, to the North by Ghana’s boundary with Burkina Faso, to the West by the Lawra District and to the East by the Sissala West District, Karni has an intriguing story - one that many describe as nothing short of inspirational.

Visually-impaired but active vegetable farmers

In a field of an open vegetable garden for the physically challenged, a man with visual impairment is spending another day watering his beds of vegetable seedlings.....He wears an oversized Baseball Tee, over a pair of faded pants, and a pair of Bruiser Caterpillar Boots aided by his white cane and makes his way steadily into the yard....

50-year old Peter who is visually-impaired does not survive on disability grants, which are not even available for those here. He is a farmer. It's dry season vegetable farming here at Karni, and dry season gardening has started here, with crops such as beans, onions, cabbage, carrots among others being cultivated.

He's been farming for nearly ten years in his condition. But tells me he's become so used to it that he travels to the farm and work all by himself. But how is he able to make his way and identify his vegetable beds to even begin to work on them..... He explained...

“I use my stick and walk my way slowly to this place. It is my garden, so I know it, I don't require much assistance to get here," Peter noted.

Asked how he is able to identify the weeds from the vegetable seedlings, he mentioned, “It’s something I've been doing for years. So I use my hand to feel the plants, once I touch and it's not a crop, I know....so I remove it...."Peter is not the only visually-impaired resident here who's putting himself to good use on the farm.

Meet Abdullah. He's in his late forties. Abdullah, a father of six became visually-impaired many years ago he doesn't even remember how. Most times, he requires assistance in order to make his way to the garden.

“Once I get here however, I'm able to manage my way because I've a mental picture of the location of my vegetable beds, aided by small pegs I've used as markings," Abdullah reveals amidst a spurt of giggles. Abdullah tells me he sometimes hires some children in the community to weed his portion of the garden when it's overgrown with weeds at a fee.

“I pick out the weeds sometimes when I can, but I mostly hire some young boys to weed the place after which I pay them with what I have," the red-and-black striped smock-wearing Abdullah noted.

Peter and Abdullah are only two of the over fifty visually-impaired persons, men and women, living here in Karni who till a piece of land they call the garden!

Physically-challenged and productive

45-year old Munira is clad is a faded textile knee-length dress, crawls across her vegetable bed, with a hoe in hand, softening the hardened earth, in preparation for replanting onion seedlings. She's been tricycle-ridden for nearly fifteen years. With her moving aid parked at the garden gate, she crawls on her backside into the garden and begins work everyday with no assistance.

Others - including the partially hunched Yasum, also appear busy...Planting bean seeds, sorting out onion seedlings for replanting and watering their seed beds....

While these persons grow vegetables, those who are also physically-challenged but are unable to engage in any form of strenuous farming activity in the gardens, engage in contract peanut shelling for a fee. In groups or cooperatives of between seven and ten individuals, they shell peanuts from the farms of their able-bodied neighbors for a fee. They also engage in de-husking maize crops after harvest to earn themselves some income.

Gardening blues; inhibiting factors

From about two hundred meters away from the gardens, sits a dam, which appears to be drying up by the day. It is intended to serve the irrigation needs of these persons but the water canals that link the gardens to the dam are in a state of disrepair.

Broken, choked canals is making water flow to the garden difficult, especially during dry seasons like this. These physically-challenged farmers have to trek to get water from the dam, to nourish their seedlings...

Assembly member for the Karni Central constituency, Mr. Kabiri Luanga tells us more about the irrigation challenges these persons face. “The canals have been broken for a long time, as a result these persons struggle to water their crops. An irrigation redevelopment plan proposed for the district, remains beautifully artworked and mapped onto a signpost," and that's how far it's gone.

On the far end of the garden, shoulder-level fencing around the farm have caved in, making room for rampaging animals who destroy the vegetable crops of these farmers, who appear helpless!

Lardy is an evangelist who's been engaging in charity work with some underprivileged communities at Jirapa, some miles away from Karni. She's been advocating for better conditions for persons living with disability in the region.

“One of the key challenges for us here is the issue of the fencing. You see the far end, animals break into the garden especially when the crops are almost reaching fruition stage," a sad Lardy lamented.

As if that's not enough, “the canals as you have noticed, are in bad shape. We are appealing for immediate aid for these people, reaching out to anyone touched by the plight of our people," she added.

"I'll take the opportunity to advise those who are on the streets begging, to take a cue from what pertains here. So at least persons living disability can be treated with some dignity," she concluded.

Organized roles

26-year old 5 ft 4 Joshua is a Dagaare teacher in the Karni community who developed his disability very early before the age of two. His mother gave up a search for healing after she sought help from different places to cure his elder brother's disability, to no avail.

Surviving being taunted throughout his schooling and being called CRIPPLE may have been a daunting reality to live with...but Joshua is living each day at a time.

He has a portion in the garden for the physically-challenged where he used to grow vegetables and other crops until he got his first teaching job out of the village. His teaching job does not offer him that much time to till his garden.

His 'able' mother has for the past three years been working on his farm together with his two sisters in his place. She tells me she's been helping out on his farm ever since her son got a job as a teacher.

"My son is tricycle-ridden and cannot come to his garden. It is the reason I am here with his two sisters to work here," the shy-looking woman noted. As she carefully picks out onion seedlings from the stalk for replanting, she tells me how she's had to do this for close to four years. "It's been tough for us. Especially as a woman, doing this by myself. My son is unable to come here because of his work. I have therefore taken it upon myself to do this," the mother of seven explained.

The idea of creating a garden for the physically-challenged and visually-impaired persons here we are told, was the brainchild of a white missionary named Sebastian over a decade ago when he visited the community.

Assembly member Kabiri tells me, "the missionary settled here over a decade ago, and having noticed the condition of some of the inhabitants here, decided to institutionalize the gardening system, an attempt to unite these persons and empower them to be able to work and feed themselves."

"The practice gave these persons at the time some sense of hope and belonging. Later, many more physically-challenged persons who hitherto were hiding, came out and were taking through rudiments of gardening," Mr. Kabiri added.

The system has since been carried forward with the expansion of the garden to incorporate those who come out late to register as physically challenged persons...

Period after period, new ways of farming and other agronomic practices have been provided to some of the farmers here.

Eight years ago, 28-year old Hamza lost his sight after he was hit by a football one afternoon. He tells me health officials assured him he was going to be fine after giving him an eye drop. But he has since never regained his sight.



It was an 'interesting game of football until I got hit by a flying ball. Just then I felt drowsy. Later when I visited the health center, I was informed it was not a serious injury and was given an eye drop," the pained young man recounts.

Married with an eight-year old son, Hamza is in his second year at the University of Education. But there is no void created in the garden. His wife manages his portion of the garden in his absence. According to him, he's been able to cater for the family with the small revenue generated from vegetable sale.

Stigmatization

His drive and passion to further his education has seen him gain admission at the University of education in Winneba. However, his condition is making education a pain, especially with the kind of treatment he receives from people.

“It’s a hard time in school for me, even on my way to campus and back to the village is an uphill struggle,” Hamza notes.

Sometimes when ‘I get to the bus terminals and the roadside especially hoping someone helps me cross over to the other side, they usually scold me, thinking I am about to beg them for alms, it gets really frustrating and embarrassing at times.'

Despite having some very helpful friends and close associates who aid him around campus, in the classroom is another challenge. Using the brail in the midst of other visually normal students is a pain, he laments.

“The lecturers will usually not waste time during lectures because of me. Whether I grasp the notes or not, they proceed to teach like they would normally do. I am always burdened having to go to my friends after lectures to catch up.” With each passing day, he finds strength from within to spur him on far away from his wife and only child, in Karni.

Like Hamza, Joshua the Dagaare teacher, wheelchair-ridden, has to deal with a few murmurs everywhere he finds himself – even in the classroom where he teaches.

But he takes them all in his stride – with an inner perception that everyone else is crippled in one way or another. For him, the cripple tag he’s been given means only one thing – that he is crippled physically, but not mentally.

“Well, I get people calling me cripple, they even refer to my mother the (cripple’s mother), but I say to you sitting right here, that you are also crippled in one aspect of life,” Joshua tells me, while feigning a wry smile.

After a couple of minutes, he asked me, ‘Do you speak and/or understand Dagaare?’

My response of course was in the negative – prompting a sharp response from him: “Ahuh, so you see, you are crippled in that area. You see?” Joshua exclaimed!

Eventhough other ‘fully-fit’ inhabitants here are generally receptive to their fellows who happen to have one physical cahllenge or the other, the traces of the stigma and isolation is latent.

But, assembly member Kabiri tells me the villagers are a helpul bunch – some make it a point to buy vegetables from their disabled counterparts as a means to assist them and encourage their hard work. But behind this, is a real reason. The vegetables sold by these physically-challenged inhabitants are roundly cheaper on the market – good reason!

NGO comes into contact with Karni

In the first quarter of 2016, an NGO, Macedonia Jerusalem mission, a charity arm of the Solution ground of Mount Moriah Church, discovered the Karni community and provided assistance to the scores of physically-challenged persons here by providing gardening equipment, watering cans, rakes, Wellington boots and clothes.

Through an outreach by the NGO that year, they encountered a group of students from the University for Development Studies, who themselves were en route the village for an outreach.The plight of the inhabitants touched the very core of the NGO’s passion – prompting a decision to mobilize funds and other materials to lend a hand of support to the group.

The NGO who look to adopt the community in order to mobilize resources from Accra to donate to them to complement their hard work, says it is constrained but will continue the project because it's a divine calling.

Pastor Peter Afolabi - executive director of the NGO noted his outfit’s vision is premised on three pillars, which it looks to ride on to better the lives of the less-privileged around the country.

“We serve as a voice for the voiceless, serve as a vessel through which resources could be channeled from society to those we deem less-privileged, and also promote entrepreneural development among these persons.”

“By that we look to establish vocational training programmes for some of these less-privileged persons, to equip them with some skills, they can leverage on, aside farming and menial jobs, to fend for themselves,” Mr. Afolabi elaborated.

During its first visit to Karni in the first quarter of the year 2016, it distributed used clothing, bicycles, farming equipment among others to the physiucally-challenged and visually-impaired community in the area.

Macedonai Jerusalem Mission decided to reach out once again to these deprived people here last Christmas by mobilizing used clothing, raincoats, gardening equipment from Accra.

Christmas came early

With these donations, 2016 Christmas came early for the physically-challenged community here in Karni. Never mind the long, bumpy trip up the Upper West Region. The activity in the regional capitral, the interesting means of intra-city transportation. The people, the language….

At a town hall organized by the group and carried through by the assembly member of the area, scores of residents and their children assembled – some assisted by their spouses and children. After the name-taking was done, each received used clothing and other equipment. The joy on the faces of these poor people was priceless. For those who could see, they simply tossed the clothes on their shoulder and trying them on. Before I knew it, a man who should be in his forties, sporting a cream – coloured oversized and a torn shirt, emerges from the town hall, crawling on his bottocks.

He crawls slowly until he gets to a motorbike and is lifted by his son onto the back of the bike and ridden away. He had made his way to the town hall, to benefit from the donations from the NGO.

In front of the town hall, about seven children argue over who got a nicer shirt or pair of pants. But there's a bigger need. Beyond the Christmas celebrations, lie an even bigger nightmare. These children have no uniforms, bags and other learning materials.

As he drools, struggling to string words together, Bayor murmurs...'I am fourteen years old. I'm in class four."

He probably is a student who requires special attention, but from where?

His right arm appears to have been affected too. The future remains uncertain as their parents continue to battle the experiences of disability with very little help from outside...

Healthcare challenges (Absence of eye center)

An area of urgent help the people of Karni require, is undoubtedly the establishment of an eye clinic and the improvement of general healthcare here. Madam Elizabeth is a medical assistant at the health facility in the community. She tells me the facility does not have an eye center to cater for the needs of the over fifty persons here who live with one form of eye defect or another, with some going completely blind, and others visually-impaired.

According to her, the National Health insurance Scheme does not cover eye treatment in the area, therefore these persons are referred to Jirapa anytime they require optician attention. Some watchers have blamed the absence of an eye clinic in the community for the worsening situation where many more people are getting visually-impaired with each passing month.

"We are very constrained here. The closest place we refer severe cases, including eye complications, is Jirapa, which in itself is some miles away," Madam Elizabeth mentioned.

"We get some of the visually-impaired persons coming here for treatment, but we do not have an eye clinic or center here. It's worrying, especially considering our situation here where we have all these people suffering from glaucoma, and other eye defects."

This position is rightly corroborated by assembly member Mr. Kabiri, who is of the view some of the visual impairment could have been avoided with prompt medical attention.

According to him, "during the period when the cattle were brought in for vaccination, the bites from the accompanying black flies, if treated, may just have saved many of these people."

"Our people are very traditional in their approach to many things, especially when it borders on health matters. Several years ago, when these persons began feeling some discomfort in their eyes, their first point of call was the bush, where they used all sorts of herbs, to treat themselves," Mr. Kabiri revealed.

Education

School's on vacation because it's Christmas holidays. Children are up and about.....some helping on their parent's gardens, others herding cattle ....but head teacher of Karni basic school, laments dropping education standards and low attendance due to poverty levels here.

Head teacher, Justin Dofobari explains that out of twenty seven (27) registered and presented students for the 2015/2016 Basic Education Certificate Examination (BECE), a pass per cent of 17 was recorded district-wide.

Mr. Dofobari admits, the results could have been much better. He attributes the poor performance to a number of factors which include lack of proper teacher-pupil monitoring and supervision.

"The school has a total population of about three hundred and sixty (360) from the kindergarten to the junior high school stage. I can tell you, some of the classes have over seventy pupils, making it difficult for teacher supervision," the head teacher noted.

As if that is not troubling enough, "many of the classrooms lack simple furniture - tables, chairs, cupboards and the like. Even course books are hard to come by."

He also mentioned that nearly all of the pupils especially those at the kindergarten and primary levels, sometimes report to school without uniforms and shoes.

"The district assembly last year brought some uniforms but we had to distribute them to selected students because they were inadequate. This means the majority of them did not benefit. We have some pupils reporting to school in tarted clothes and others barefooted," Mr. Dofubari added.

Social support & LEAP

The intriguing story about these people here in Karni is one which is laced with a lot of mystery. Government's livelihood empowerment against poverty program (LEAP), according to assembly member here is not covering all these persons living with disability.

There's been appeals from various quarters to open up the program to account for all the physically-challenged individuals and their families here, but that remains to be seen.

Concerns however, over the delay and sometimes non release of the disability common fund is also rife. We also gather accessing the disability fund by persons at the Lambuisse -Karni district assembly has been another challenge they have had to deal with....

As one of the most deprived communities in the Upper west region, getting support from outside has been pretty difficult. Some NGOs and corporates tend to focus on the communities in and around the regional capital, to the detriment of villages like Karni, which is a community, desperately in need!

Some opinion leaders believe some of the donations that are brought to the community, get diverted by folks at the district assembly - a claim the assembly denies.

The Lambuisse-Karni district assembly rather blames NGOs and other corporates for going into the community to give out items, without prior approval and consent of the assembly's Social Welfare department.

But some of these organized groups argue they want to get the items directly to the impoverished families here without third party intervention.

Cursed village?

Some call it a cursed village! Others call it a village of circumstance! For years, there have been efforts to uncover how one community of about six thousand people came to have nearly four hundred of them suffering one form of disability or another.

Karni could pass easily for a ghost town - with first-time visitors greeted with hardly anyone on the street. It took us several hours to arrive here from the Upper West Regional capital that Tuesday afternoon.



As we take the dusty road that leads to it, I notice the scant presence of human existence - barely a sight of anyone. The vegetation is completely dried out with large portions of farmlands burnt, leaving patches of black soot in the affected areas.

The afternoon sun is unforgiving, in an expanse many, many meters away are dots of mud huts, which we'll later find out are homes of the many many physically-challenged people living here. Karni stands bare and silence prevails all around, except for a group of pito-drinking young men and women under a street hut, who all turn to catch a glimpse of our vehicle, in the dust cloud.

As we'd later find out, some adjoining villages believe Karni is cursed!

But, assembly member of Karni Central - Mr. Kabiri Luanga gives some explanations to demystify the curse tag of the karni community. According to him, many decades ago when the community used to be the vaccination center for cattle in the upper west region, some cattle brought in to be vaccinated, came along with some disease-carrying black flies which are believed to have transferred various diseases to the people...



"Our village is not cursed, as far as I know. Many many years ago, this community used to serve as the central point where cattle from across the region were brought for vaccination. During those times, the livestocks that came in, came along with black flies which carried disease pathogens," Mr. Kabiri explained.

He added 'many of the villagers who came into direct contact with these flies, contracted diseases through bites - that's the beginning of our woes.'

"It did not end there, some of the vaccination for the six killer diseases in children was unavailable here, therefore many of the children at the time developed polio, measles and others, according to the records," he revealed.

"The poor health delivery system here meant that many of our people developed several complications from very simple ailments - which could have been treated." But there's also the group who returned to the village after settling several years in other areas and are beloved to have brought some of the diseases along with them.

Medical conditions gone bad?

According to medical experts, visual impairment is a major source of morbidity in the world, with close to three hundred million (300 million) people living with one form or another. About 80-90% of this number however, are people living in low-income-earning communities in developing countries.

Resident in Ophthalmology at the Korle-Bu Teaching Hospital, Doctor Vera Beyuo gives an indication of the severity of the matter and how many of us are exposed to some of these, inadvertently. "Eighty per cent of visual impairment conditions are treatable and preventable. The commonest defect however is cataract - which is associated with clouding of the lens and improper transfer of images," Doctor Beyuo noted.

"Aside that, there is glaucoma, which is caused also by a number of factors - diabetes, injuries, infections among others with immune conditions also causing the whitening of the cornea. It damages the eye’s optic nerve and can result in vision loss and blindness," she further explained.

According to Doctor Beyuo, many of these visually-impaired persons in Karni may have developed the condition but due to the absence of pain or other manifest symptoms, did not take action till it degenerated into blindness and visual impairment.

She further reveals 'infectious causes - trachoma, onchocerciasis, despite their reduced incidence across the country, still remains in some communities with Karni, a good case in point, per the account of the community leaders.'

"Uncorrected refractive errors also causes visual impairment and subsequently leads to blindness. In many instances however, it can be corrected with prescribed eye aids." The causes of increasing cases of visual-impairment and blindness among Karni residents are varied and very remote in some instances.

'One study estimates that measles causes up to 60,000 cases of blindness a year globally, with poor access to measles vaccination and malnutrition often correlating with higher rates of blindness in the most affected countries, including Africa.

It is believed that some of the conditions among residents here could have resulted from measles and other chronic diseases, which went unattended. To salvage what is left of the Karni community at this point, Doctor Beyuo prescribes regular medical outreaches.

" Despite Ghana having about hundred ophthalmologists catering for the needs of a population of over twenty six million ( out of which number the specialists are not evenly distributed throughout the regions), it is possible to carry out eye-screening outreaches to very deprived communities, such as Karni," Doctor Beyuo suggested.

This way, many of those whose condition are not 'hopeless' as yet, can get their condition properly managed, while others who are just reporting with early symptoms can be identified and given some special attention.

It is the case that many deprived communities in the cities' outbacks lack eye clinics and specialists to cater for their eye needs - a phenomenon many have attributed to the increasing cases of visual impairment and blindness in these parts.

On the issue of the black flies, 'apart from the use of drugs on bi-monthly basis, that kills the larvae, there should be intermittent spraying of the kraals, and other areas where cattle are usually kept to prevent the spread of the infection,' she advised.

While she believes all hope is not lost for some of the affected residents here, the earlier something drastic is done about the plight of the people, the better.

According to her once the screening is done and the specific causes of the eye defect and impairment are identified, 'some measures could be put in place to slow down the pace at which the disease progresses. Giving prescribed eye drops could also lower the pressure and preserve the little function of the eye that is left.'

Doctor Beyuo however warned that not all eye disease are infectious, therefore people should not stigmatize persons suffering some of these conditions.

"Blindness is not spiritual. Visual impairment is not a curse. Don't self-medicate. However, not every eye problem is a bacterial infection....therefore see a healthcare provider, get assessed and treated appropriately, "she cautioned.

‘Useless liabilities’ versus 'Survival of the fittest'

On the streets of Accra, hundreds of physically-challenged persons accost moving vehicles, halted by the traffic lights and beg for alms. Most do so in very untidy and unkempt clothes, in wheelchairs, skates, on crutches and some with their white cane, aided by another to navigate the streets, while the less-fortunate drag themselves on their buttocks, hands and knees.

From where I sit aboard the public transport, the view from outside is wide. Just as the vehicle screeched to a halt before the traffic lights at the intersection around airport junction on the Accra-Madina stretch, a visually-impaired old woman, being held and dragged along by a young man, possibly in his early twenties, approaches the next window and begins to sing.

While at it, she stretches her arms towards the occupant close to the window and recites why she should be helped because of her condition. The sight is just too common!



There have been concerns among a section of the public concerning these beggars, whom they describe as nuisance to movement in and around the capital, but when society fails these people, what possibly is the way out?

Efforts & Appeals

As of 2010, it was estimated that about 1.8 million Ghanaians — about 5 per cent of the total population — were in some fashion disabled, with problems of sight, hearing and speaking in the lead, according to the Africa renewal website.

In 2006 however, Ghana’s law-making body (parliament) passed the National Disability Act, intended to ensure that people living with disabilities enjoy the same rights as their able-bodied counterparts.

The act offers a legal framework to protect the rights of physically and mentally disabled persons in all areas of life, from education, training and employment to physical access and health care.

It also was intended to promote the creation of an environment that will advance the economic well-being of disabled people and enable them to function better.

But the lack of political will by some of the leaders since the passage of the act, leaves much to be desired.

A renewed sense of political will is urgently required, despite the existence of international conventions, the proclamation of an annual International Day of Persons with Disabilities (on 3 December) and other like programmes.

While we await that to be done, people with disabilities still face discrimination and receive little support across much of their families, homes, communities and country ..

Clothing. Farming implements. Crop seedlings. Gardening tools. School uniforms. Footwear. Classroom furniture. Teaching and Learning materials. Irrigation systems (disability-friendly systems). Medical outreach and eye-screening programs. Eye clinic.

These are but a few of the needs of people at Karni, where life is throwing the physically-challenged persons all sorts of lemons.

For them, hope remains thin. But for their contact with the Macedonia Jerusalem Mission last year, an already bad condition could have worsened. The NGO is however calling for donations from well-meaning Ghanaian citizens and groups to be able to bless the lives of the scores of hard working physically-challenged persons here.

And OH! No matter the type of people we are, in our individual spaces and general life spheres, there are useful lessons to be learned from persons living with disabilities. There’s no getting around it; having even the slightest form of disability is certainly a truly difficult ride in life, these people have to negotiate - but the life lessons without question makes it a near perfect bargain.