Is there anything the West can do?
The pontificate of Francis will bring increased focus to the continents of Asia, Africa, and South America. This will provide an opportunity for those living in the materialistic and consumer-driven cultures of the West to learn simpler values of community, sacrifice, and sharing – and in so doing, they will enrich their own lives. Western mental health professionals have experience in treating child abuse, and although the types of abuse in countries such as the United States differs from that found on Africa, the sharing and application of these principles can help these wounded children.
As a corollary to this, Westerners need to learn the unique features of African culture and how these are intertwined with child abuse. A greater range of interventions and treatments – focusing on the African cultures, will need to be developed. This will take time in a framework measured by decades, not years.
I interviewed the Rev. Francis Perry Azah, Ph.D., who is a doctoral level pastoral counselor. He is also a priest from Ghana and has been serving in a New York parish for seven years. While some of Father Perry’s descriptions are disturbing, they are an honest portrayal of treatment of children at its worst. Within these situations one will discover the poorest of the poor. Combining pastoral as well as psychological principles from East and West will offer a meaningful striving to, in the words of the psalmist, “make them stronger in the broken places.”
As Africa opens up to the rest of the world, do you anticipate shock or concern when the extent of child abuse is revealed?
Due to advancement in technology the world has become a global village, and whatever happens in one part of the world can be seen in other parts of the globe. These happenings can have a positive or a negative repercussion on such people. As Africa is open to rest of the world, many people are becoming aware of the pernicious acts perpetrated against the most vulnerable children in our society. In this 21st century Africa, I do not anticipate a shock when the evils of child abuse are revealed.
This is because there are many laws and pronouncements in many African countries that tried to protect the rights of these children. Many if not all African countries are signatory to the United Nations’ and other world bodies’ regulations and laws that prohibit acts of violence against children all over the world. According to the Constitution of Ghana (1992), “every child has the right to the same measure of special care, assistance, and maintenance as is necessary for its development from its natural parents, except where those parents have effectively surrendered their rights and responsibilities in respect of the child in accordance with the law. Also, children and young persons shall receive special protection against exposure to physical abuse and moral hazards. A child shall not be subjected to torture or other cruel inhuman or degrading treatment or punishment” (p. 28, Sections 1a, 1b, and 1e).
Despite all these constitutional and other provisions, a day scarcely passes without one hearing or reading from the African (or in particular, Ghanaian) media about various degrees of physical abuse or maltreatment being meted out to children by parents or other caregivers. Countless numbers of atrocities against children have eaten into the moral fiber of society in both rich and poor nations. Therefore, it is incumbent on us as parents, caregivers, counselors, psychologists, and psychiatrists to propagate the message of the evils of child abuse in our society. African governments and other stakeholders ought to be proactive in the fight against child abuse and must not just be paying lip service to the laws and pronouncements that are there to protect the rights of our children. Abuse robs children of the childhood they deserve – that is their right and leaves broken families, dashed aspirations, and misery in its wake.
In your book, what are the particular forms of child abuse studied?
There are many forms of child abuse in our society, but one cannot adequately discuss all these forms in a particular book. In my book, Wholeness of the Abused Children and Post-Traumatic Stress Disorder: A Psycho-Pastoral Perspective, I paid attention to physical abuse and neglect; child trafficking; female genital mutilation; trokosi – slaves of the gods; child sexual abuse; gbortoworwor – the nubility or initiation rites of the Ewe girl; and how all these forms of abuse can lead to post-traumatic stress disorder in the children. Children who go through these forms of abuse carry with them a baggage that is too heavy for their small shoulders, thereby robbing them of their future success.
According to the religious custom of trokosi, when a relative commits a crime ranging in severity from petty theft to murder, the family must offer a virgin daughter – typically from eight to fifteen years of age – to the local shrine, where she will become a trokosi, or “slave of the gods.” The pagan priest then exerts full ownership rights over the girl, beating her when she tries to escape, controlling her interaction with others, demanding labor and sex from her, and denying her education, food, and basic health services. In spite of such conditions, most families willingly give a virgin daughter to a shrine. They do so in exchange for the gods’ forgiveness, delivering their child to the priest for sexual and economic exploitation.
Many Ghanaian children are trafficked from their home villages to work along the shores of Lake Volta, living under tough conditions and working long hours every day. The depletion of fish stocks is one of the key reasons why children are needed as workers in the fishing industry. Children represent cheap labor, and their small, nimble fingers are useful in releasing the fish from the small nets. Another task that trafficked children frequently perform is diving to disentangle the fishnets from the numerous tree stumps in the lake. Diving is a dangerous job that can have dire consequences for the children, from catching water-based diseases such as bilharzias, gastrointestinal disease, ear infections, and guinea worm to death from drowning.
Female genital mutilation (FGM) is one of the major negative cultural practices that affect the dignity and violates the fundamental human rights of women. It must be emphasized that the practice does not only affect the dignity and pride of women but it also has a serious health implications on them. FGM is a practice that involves the complete or partial removal or alteration of the genitals for non-medical reasons.
Gbortoworwor is the puberty rite performed on Ewe girls. This rite leads the girl into womanhood and offers the neophyte the opportunity and permission to actively take part in the communal activities of her community. It is performed only after a girl’s first menstruation, between the ages of 13 and 16. A criterion for the celebration is that the neophyte must not have engaged in pre-initiation sexual contact. Detection of sexual intercourse prior to the celebration is punishable by a shameful purification rite. If a girl engages in sexual intercourse before the inception of her first period, she is accused of ‘blood-shedding’ – an act that is deemed an offense to the community. Sexual abuse is linked with homicide because the forceful breaking of the girl’s hymen could cause her to bleed – a willful shedding of blood that the Ewe believe drive the super powers in their fury to inflict calamities on the living. Early childhood sexual and physical abuse rips at the core of an individual’s developing sense of self. It violates fundamental assumptions about the integrity and control of the body.
What can African counselors learn from Western concepts such as post-traumatic stress disorder, depression, etc.? Do you see a need for these treatments to be brought to Africa?
Human beings are the same and also unique; despite the various dimensions of our culture, a particular therapeutic process that works well in a given society can equally work in another society. As an African counselor, I know that the Western concepts of post-traumatic stress disorder, depression, etc. are not peculiar to other cultures. The knowledge of these concepts and their treatments would broaden the horizon of the African counselor. I am equally aware that there are specific limitations for indigenous psychologies that arise from the pervasive acceptance of Western diagnostic tools as a primary source of diagnostic criteria for psychopathology. Even though I will depend on DSM IV-TR or DSM V for recommendations for the treatment of diseases, I will blend it with the rich cultural dimension of Africa since there may be some limitations for its proper use in my culture.
It is possible – and imperative – that indigenous psychologies find meaningful points of integration with western psychologies, and may include the systematic operationalization of mental illness within rigorous diagnostic criteria. However, integration towards a global psychology or other overarching cross-cultural framework of psychological phenomena transcendent of specific cultural ontologies may require the inclusion of models and procedures that exist apart from traditional western-scientific understandings.
What dimension does pastoral counseling add to psychological treatment?
Pastoral counseling is an important discipline for human growth and development in which psychologically trained people provide therapy as well as a representation of a religious tradition, using the insights and principles of religion, theology, and modern behavioral sciences in working with individuals, couples, families, groups, and in situations toward the achievement of wholeness and health. The major dimension that pastoral counseling add to psychological treatment is the conviction that mental and emotional illness are best treated by both the wisdom of religious teaching and the knowledge and skills of human behavioral sciences.
Do you think Francis’ pontificate will more greatly extend the resources of the Church to the problems of child abuse in Africa?
Pope Francis has brought a new dimension to the papacy. In the assumption of his pontificate, the new Pontiff has sent a signal to the whole world to be an agent of the new evangelization. All Christians are called to imitate Christ and transform their lives according to the Gospel in order to reach out the most vulnerable in our society. The Church is to be the voice of the voiceless in our world. Pope Francis has demonstrated this in his episcopate while in Argentina, and for the short period of his pontificate he equally showed it when he washed the feet of prisoners in Rome and by choosing to reside in more humble lodgings. I believe this gesture is an urgent sign to all Church leaders to look into the problem of child abuse in all communities. The Church must champion the course of vulnerable children, who are in effect the future leaders of our Church and society at large. Our faith in Christ must urge us to extend our resources to these children. Like Christ, we need to embrace, nurture, and protect these children from any aggressor or abuser.
In your own diocese, does the Church sponsor agencies to provide mental health or services for abused children?
The Diocese of Ho in the Volta Region of Ghana has hospitals that provide mental health and services for abused children. The most unfortunate situation is that these centers are not well resourced, and some even lack the trained personnel to carry out the psychological treatment that is needed for the abused children. It is therefore the responsibility of the diocese to invest more resources in services for at-risk children, adolescents, young adults, and their families, and for adults with psychiatric disabilities in community settings, community-based group homes and residential services, and supported independent living environments. There must be programs in the areas of prevention, early intervention, and diagnostic assessment, as well as treatment and rehabilitation. I will assist my diocese with my expertise to provide community-based, public residential, clinical, and educational facility, serving children and adults with severe emotional disabilities. Brief assessment units provides psychiatric evaluation, medication management, environment behavioral treatment, psychological treatment, and educational intervention.