How do teens living with disabilities in Ghana view their future? We asked them to show us

About 8% of Ghana's population is disabled. A high percentage are adolescents, which could be linked to the country's dominant population of young people (15 to 35 years).

The perspectives of adolescents with disabilities in Ghana are often overlooked, as most of the time, society views the cause of the disability as related to parental sins against the gods, being a descendant of river gods, and bewitchment or curses by family members. Consequently, the adolescents experience pejorative labelling, ableism and social exclusion, resulting in depression, low self-esteem, a lack of confidence and suicidal thoughts.

I was part of an interdisciplinary research team with diverse expertise on stigma, nursing, public health and social work. We engaged adolescents in Ghana with disabilities in a recent study that focused on their lived experiences. This research involved working with 54 adolescents aged 10-19 years with hearing, visual and physical disabilities. We explored their lived experiences using photos that participants captured. Participants used a range of visual images to represent their challenges.

We also found that adolescents with disabilities often face hostile experiences that contribute to negative self-perceptions. These include feelings of hopelessness about their future. This calls for urgent attention to addressing the needs of this vulnerable population.

Finding the challenges

We provided participants with a range of visual images to represent their challenges. These included images symbolising darkness, a stick lying on the floor, a coconut tree, heaps of sand, and stacks of wood logs. These images from the participants were used in the study as they captured the perspectives and the meaning of their experiences with disability.

Of the 54 adolescents we interviewed, 22 were hearing impaired, 23 were visually impaired and 9 struggled with physical disability. Of these, 34 were females and 20 were males. The majority of the participants had been born with their disabilities. Only four participants with visual impairments had been disabled later in life. The visually impaired participants informed the researchers to take pictures of images that the participants preferred to depict their experience of disability. The researchers informed the participants of the content and the features of the images captured in the photos.

We then used photo voice data analysis. This is a process where participants' stories related to the photos were interpreted into meaningful clusters of ideas known as themes. Three overarching themes emerged from the data:

• adversity

• resilience

• social support.

Adversity

Some of the adolescents characterised the adversity experience of disabilities as difficult, burdensome, and full of rejection. Participants presented images symbolising darkness, a stick lying on bare floor, a coconut tree, heaps of sand, and stacks of wood logs as challenges they face.

The photographs of wood logs and darkness were used to explain participants' lived experiences. According to the adolescents with disabilities, the images of wood logs and darkness meant that life was a burden. Those who used darkness compared their lived experiences to an unforeseen, blurred future because they were physically challenged, lacking strength, and appeared unfit for any productive job.

A 19-year-old adolescent with physical impairment compared her life journey to a stick lying on the ground, indicating “everyone can walk on her life”.

According to her, a stick on the ground could be easily picked up, used, and then dumped at any time. She said several men had showed interest in her but abandoned her after a sexual encounter. She had a child with a partner who did not provide paternal support, and she found it difficult to get any employment, which made her vulnerable to similar exploitative advances.

A visually impaired participant related her experience with a coconut tree.

I could see with my eyes before this sickness happened to me. When I was having sight, people saw me as someone who would be a great person in the future, but now that I am blind, they believe that it is the end of my life. Some still consider me beautiful in my current state because I have not given birth yet. However, I know if I allow myself to become pregnant, I will become a wretched thing after giving birth, which can be related to the coconut tree: once the fruit has been harvested and the leaves have been removed, it will lose its attraction.

A 17-year-old who was visually challenged used a heap of sand at the side of the road to explain his predicament.

According to him, life was a burden because it required him to bear more weight, and occasionally he thought about ending his life.

A female physically challenged adolescent compared her life to a footpath that anyone could walk on. She indicated that the disability had devalued her personality and she'd lost her identity. She felt bullied by her peers, and excluded, which had affected her academic and sporting life and mental health.

Resilience and social support

Some adolescents were hopeful and resilient about their life experiences. They used a photograph of a chapel representing a place where their experiences, struggles and identity were most visible and meaningful.

One of the participants indicated that the church was a place where he felt accepted beyond his disability.

The photo of a group of people meeting and holding hands together signified a space to share their experiences and their sense of safety as well as expressing feelings such as anger, frustration and hope. According to the participants, such meetings fostered a sense of community and offered practical coping strategies for navigating school activities and life in general.

What needs to happen

The findings show that there's a need for culturally appropriate interventions to support and empower adolescents with disabilities in Ghana.

An example is the Obuntu Bulamu peer-to-peer support intervention in Uganda. The concept underlying the this intervention is fostering behaviour that reflects a shared set of values promoting well-being, togetherness and unity. The intervention, which was co-created by a team of children, parents, teachers, disability rehabilitation workers and academics in Uganda, consists of training sessions, peer support meetings, and activities for children, parents and teachers around the themes of peer support, disability and belonging.

Finally, the findings also provide a basis for programmes and policies to incorporate their voices into decision-making that affects their well-being.

Mary Asirifi receives funding from the Social Sciences and Humanities Research Council of Canada, Insight Development Grant. She is affiliated with the Black Community Health and Innovation group at MacEwan University.

By Mary Asirifi, Assistant Professor, Department of Nursing Foundations, MacEwan University

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