Daily Life Challenges of Persons with Disabilities, Families and Staff

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Published on International Journal of Social, Politics & Humanities
Publication Date: June, 2020

Samuel Senyo Dogoe, Tabea Hampel, Luise Sauerbrey & Eunice Awoenam Dogoe
Contemporary Consultancy Organization (CCO)
Ho, Ghana

Journal Full Text PDF: Daily Life Challenges of Persons with Disabilities, Families and Staff (A Research Project in Ho, Ghana).

The purpose of this research project is to find out what challenges persons with disabilities, families and staff have to face in Ho, Ghana. Researchers were interested in finding out how meaningful persons with disabilities (PWDs) were included in various facets of lives. Significant diverse data were collected by researchers when they went into different communities and interviewed teachers, parents and people who work with persons with disabilities (PwDs) and also, those who are having different disabilities and special educational needs. Therefore, this article is organized as a literature review but it also include discussions about policies and personal observation. Furthermore this research will not only focus on the difficulties PwDs, families and staff are having in their daily life but the paper will also provide an insight into different aspects of an inclusive society for PwDs and its requirements. For instance, in Ghana Inclusive Education (I.E) policy explains the course of direction for the government for school education for every pupils or learners with Special Educational Needs (SEN) in the country, (IE, Policy of Ghana 2015). The inclusive education policy Ghana augments certain sections of 1992 constitution of the nation, Education Strategic Plan (ESP) and several international conventions on I.E which Ghana was a signatory to. Amongst some of them were United Nations Convention on the Rights of the Child (1990), World Declaration on Education for All, Jomtien (1990) and Standard Rules on the Equalization of Opportunities of Persons with Disabilities (1993). This work is organize into various thematic areas which give explanations each of the themes.

Keywords: IE: Inclusive Education, IEP: Individualized Education Program, PECs: Picture Exchange Communication System, PwDs: Persons with Disabilities, CP: Cerebral Palsy, ASD: Autism Spectrum Disorder, NGO: Non-Governmental Organization, GFD: Ghana Federation of Disabled. SEN Special Educational Needs.

1. Introduction
Coming as volunteers to another country to learn about different culture settings always brings up new perspectives and views on certain things. In Germany all schools have to practise Inclusive Education, however there are still many segregated schools for children with disabilities.
Even though, public places and transportation are accessible for almost all people in the form of ramps on in buses, floors and elevators in high-raised buildings. Although, discrimination and social exclusion still exist in some places throughout the country. As volunteers from Germany working with the NGO “Contemporary Consultancy Organization”, the researchers were able to learn more about the situation in Ghana and what kind of challenges PwDs have to face in their daily lives.
They also learned about different policies which contain Inclusive Education and social inclusion, for example the UN Convention on the Rights of Persons with Disabilities (UN 2006) or the Disability Act 715 (2006).
Interviews were also conducted by the researchers for them to have first-hand information on the situation in Ho-Ghana which gives researchers opportunity to talk with different people about their personal experiences and stories about disability in Ghana and in doing so they had a deeper insight on the chosen topic.

1.1 Personal challenges
People do to face different challenges in life which could be based on family issues, difficulties at work and personal challenges. If we talk about personal challenges it can be on the emotional, mental or physical level and the reasons for those challenges are as different as the individuals who have to face those challenges.
During the interviews persons with physical disabilities shared their stories where they had to face personal challenges because of their disability. Just like Francis Asong, who´s legs got paralysed by the age twenty one (21) and since then he has to use callipers and crutches to move around.

“In the beginning it was not easy, contracting a disability at the age of 21, a very youthful age. And it made me to really loose hope, thought life is nothing going to work for me. I had all the mental negative mind-set at that time. Especially when I see friends around and then classmates around, and it´s like wow. I really not going to make it in life.” (Francis Asong)

This excerpt of his interview shows us very well, what kind of mental and emotional challenges people have to face when a physical disability limits your freedom of moving around from on a daily basis. One the contrary, there is that fear that other people do not accept you any more,

“And of late I was so scared of going out and so I can say more like I actually don´t want people to know much about my disability…” (Francis Asong)

And on the other hand there is the big challenge of accepting yourself and your disability which can cause a lot of emotional and mental suffering as well. Some may adjust themselves to their disability very quick, for others it can be a long lasting process. Nevertheless, it is always important to factor the kind of physical disability somebody is having and how serious the limitation is in their daily lives. If the disability was caused by birth or if it happened in childhood or even in adulthood can also have a big impact on the way somebody deals with his or her disability. Persons who are having a physical disability since their birth have already learned from childhood to live with the disability and have never experienced living without it.
Even though the possibility of seeing themselves as “different” or “disabled” when they grow up is still there, the chance of integrating their disability into their personal life may be easier as compared to persons who are physical challenged in a certain state of life. Nonetheless, being physically challenged brings a lot of challenges in the daily lives of individuals and can cause different ways of struggling for each person.

2. Public understanding of disabilities and their causes
The understanding of disabilities and their causes can be different from culture to culture or even from person to person. Different factors can influence one’s perception towards disability which can be e.g. education, personal experiences or religious and spiritual beliefs.
Referring to the research, this topic also elicit the general understanding of disabilities and their causes among the people of Ho. At the end we will take a look at a model of disability, which brings up a certain view of disability as well.

2.1 Attitudes towards disabilities in Ghana
Religious and culture beliefs can have a big influence on people´s perception towards disability. In Ghana, most people have deep religious and spiritual beliefs and it often happens that people see disabilities as a curse or an evil spirit which was brought to the child or the parents. Some also believe that disability is a punishment for a “bad doing” of the mother during or before pregnancy or that it was even caused by something bad their forefathers did.
One mother of a PwD talked about a situations in public where people were talking about her and her child in a despised way. They accused her of not taking well care of herself when she was younger or even trying to abort her child during pregnancy so that might account to her child’s disability. According to another interview with a mother, some people believe that intellectual and physical disability can be an airborne disease. They think when they touch a child with a disability they might also get “infected”.
The mother explained this was one of the reasons why the school staff at a school in Ho did not accept her eight years old daughter into their community. Consequently she does not get any form of educational support and the mothers has to take care of her at home.
On the one hand these examples show us how people´s perception towards disability can influence the life of an individual and how important it is to explain the different causes of disabilities from a medical perspective as well.
One the other hand putting too much focus on the causes of disability and not thinking about methods and strategies of how to accept and support PwDs in an dignify way can also become a barrier when it comes to inclusion. Only looking for the reasons for disabilities as sins or “bad doings” can keep others from accepting the disability as something that can be supported and treated as well.

2.2 Mode of treatment of disabilities in Ghana
Because many Ghanaians believe in spiritual causes of disability, some think disabilities can be cured by prayers, herbalists or other spiritual practises.
There are numerous rituals which can be practised and the researchers do not see themselves in the position to talk about all of them since they do not have the necessary experience or knowledge about it. But during a few interviews they were told that some parents send their child to priests in in a shrine where they practise different rituals.
Another respondent with a physical disability explained that her parents took her to a lot of different churches and herbal centres for a spiritual cure but it did not work or made any positive change to her disability.
Nevertheless, some parents of children with physical disabilities do send their child to medical doctors and physiotherapist as well or visit the orthopaedic centre to get support in form of crutches and callipers. According to an interview with a mother, some people think her child is from the “sea” and if they perform certain rituals on the child, he or she will be send back to the sea and will become “free”, .
As explained by another interviewee, asserted that, another reason for such action is that the economic well-being of the whole family often becomes more predominant than the challenges of the child´s disability. In most cases the parents do not get enough support and cannot send their children to kindergarten or to school. As a result they have to take care of the child the whole day and are not having enough time to follow any economic activities. As a result parents might not be able to feed themselves and the rest of the family. Consequently they do not see any way out rather than giving up hope in their children. In this case it is important to not judge the parents too fast and deny them any love or responsibility.
It is clear that those cases could be prevented if the families would get more support in finances and education for their children and do not have to handle everything by themselves.

2.3 Social model of disability
The social model does not deny the problems and limitations of disabilities but locates those within the society instead of within the individual. As a result individual limitations are not the cause of the disability but the society which does not response in a suitable way by providing the necessary support and services for PwDs and including their needs into the social system.
Therefore the social model sees the barriers that prevent PwDs from a fully participation in society as a disabling factor (Slikker 2009).
Article 1 of the Convention on the Rights of Persons with Disabilities also defines:

Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

2.4 Knowledge and education about disabilities
Public awareness and education about different disabilities is an important aspect for an inclusive society. Through observation, the researchers realized that many people in Ghana do not have much knowledge about disabilities, their medical causes and how to support those disabilities. This lack of knowledge and understanding can cause stigmatization and social exclusion, especially when it comes to developmental and intellectual disabilities. Therefore those disabilities will be often understood as “madness”.
In Ghana, not many children get a full diagnosis of their disabilities. As a result their parents might not understand the behaviour of their children and become overwhelmed. Conflicts between child and parents could arise. If parents would have knowledge of the disability of their child since birth, understanding and support could be given to the child in an appropriate way. It is also necessary that teachers and staff are educated on disabilities and Inclusive Education (IE).
Disabilities are not always easy to identify- that is why it is important for teachers to be able to recognize certain signs and characteristics of the child´s disability as early as possible, so that he or she gets the right support in the classroom. Otherwise it could lead to wrong conclusions, bullying or exclusion by classmates or other school members.
It is also important that the PwDs understand their disabilities in the right way. Otherwise they might develop lack of self-esteem and they will not have the opportunity to find out their strengths and skills. After looking at these aspects, we can see how important it is to raise awareness and educate people about disabilities so that conflicts or exclusion could be managed and persons with disabilities feel understood and secured in their surroundings. Later on we will talk about some ways of how public awareness are created in Ghana.

2.5 Public attention
In most societies, having a disability means to be “different” or even “abnormal”.
Not looking or acting like the standard of people can cause a lot of unwanted public attention to an individual with disability. Everyone has his or her own definition and mental perception of what it means to be “normal” and this perception can vary by time, place, situation and culture.
That means if we see somebody who does not fit in this definition, we may get confused because we cannot relate this person to our definition of what it means to be normal. This classification in “normality” and “abnormality” can provoke discrimination, stigmatization or even social exclusion.

3. Staring as a type of discrimination
As already mentioned, this categorization of normality and abnormality can cause uncomfortable situations for person with disability in which they get unwanted public attention. This can be staring, rumours and even insults.
But not only individuals with disabilities are exposed to such situations. Also their families and friends have to suffer when it comes to staring for instance. They might want to protect their child or friend from those uncomfortable situations and might even stop going out with them so often.
According to some replies from interviews, some people in Ho hide their children inside the house because they are afraid of other people´s stigmatization.
Staring can also mean a loss of anonymity and privacy for most families. Being confronted with questions or others looking at you and your child or friend with glances of judgement or pity can become very challenging (Erika 2017).

“So I used to go out with him to public places but when you go, people will be looking at you because it looks weird, it is not normal. They do not see you, having such a child or they do not know the reason why you should carry such a child into their mist.” (Olivia Exorman, mother)

3.1 Ignoring persons with disabilities
Coming back to the phenomenon of staring at persons with disabilities, it is important to consider that some people might not be aware of their staring or they only recognize it after some time. Often people are also not aware of the effect it could have on the victim.
Especially when we talk about children, the reason for staring at others is often just because they are interested or they wonder about the behaviour of the person. They want to understand what is going on or why this person is looking or acting not in the way they expect.
In this case it is up to the parents to let their child observe the differences and maybe also explain in it to him or her, in case they know something about the certain disability, but also remind the child of the common humanity and teach him or her to feel empathy rather than sympathy or even embarrassment (Marlow 2018).
Telling children that it is not okay to pay attention to persons with disabilities can lead to the complete opposite behaviour of staring. Ignoring can be as discriminating as staring for PwDs. While staring at somebody turns the person into an object of curiosity, ignoring makes him or her to an object of fear or embarrassment. Both cases are a type of discrimination and let the individual not to feel the necessary respect human beings have to show each other in society.

After looking at these two aspects, what is the right behaviour towards persons with disabilities in public?
It is clear, that every human being wants to be seen as an individual with ordinary strengths and weaknesses but also as an equal part of society. And the same want individuals who are having intellectual or physical disabilities. We should pay attention to their specifics or differences but at the same time we should not forget to treat them as any other individual in society.

3.2 Social exclusion
After looking at the phenomenon of staring and other forms of public attention, there are many other ways of social exclusion, which can cause more challenges and difficulties for PwDs and their families. Social exclusion affects people’s personal wellbeing and participation in society in different ways e.g. the access to communities which support integration and connection with others or social and financial rewards that accompany employment and education (Appleton-Deyer and Field, 2014).
Even though inclusion of persons with disabilities and Inclusive Education are manifested in Ghana´s policies, the researchers realized through the interviews and personal experiences that social exclusion is still happening in most communities. In this topic we will focus on the Disability Act 715, 2006 and compare it with the results of the research and observations.

3.3 Accessibility at public places
When it comes to the access of public places the owner or occupier of a place shall provide appropriate facilities that make the place accessible to and available for use by a person with disability (Disability Act 715, 2006).

By observation the researchers realized that most public places in Ho were not provided with ramps or other devices which make a place accessible for persons with physical disabilities. Most of the buildings only featured stairs and the pathway towards the buildings were mostly rough and stony. One the one hand the named aspects could be seen as a form of social exclusion but on the other hand it is also necessary to consider the financial situation and the possibilities of a country to renew all public places.
Nevertheless, the access to any form of public amenities provided for PwDs should be an important factor when it comes to the planning. Accessibility does not only include persons with physical disabilities but also persons with developmental disabilities for instance Autism Spectrum Disorder (ASD).
Even though each person with Autism is individual and has his or her personal needs, difficulties and strengths, for most of them it is important to have orientation and structured instructions at a public places. This can be provided through signboards or an orientation map at the entrance of the buildings.
Often persons with ASD also learn through pictures which means they understand certain things better if they see them rather than only hear of them. In this case public places should be provided with PECS (Picture Exchange Communication System). These are simple drawings of how to use e.g. the bathroom or other devices.
Another facility which should be provided in public places like libraries could be a “sensory room”. This can be a simple and quite place where persons living with ASD can go if they feel overwhelmed by a situation and want to calm down. All these are different ways to make public places accessible for persons with physical, intellectual or developmental disabilities.

4. Transportation
A person who provides service to the public shall put in place the necessary facilities that make the service available and accessible to a person with disability (Disability Act 715, 2006).

In Ghana the public transportation mostly consists of simple taxis, tricycles, and minibuses. According to the Disability Act these services should be available and accessible to all persons with disabilities.
Of course, a person who´s legs are paralysed for instance finds it difficult to use a small vehicle like a tricycle but when we talk about taxis or buses, the necessary facilities should be provided to make them accessible for all.
A woman who has a physical disability explained in her interview that she always feels uncomfortable when she joins a bus because most of them are very tall and therefore she often needs support from a stranger. Another respondent finds it difficult to walk from her office to the roadside to pick a taxi so she always has to call the car to her house, which costs her extra money to pay.
A mother whose child has Cerebral Palsy (CP) said when she uses the public transportation, some people will move to the side and obviously do not want to touch her child. Being in company with a friend who is sitting in the wheelchair the researchers also realized that it takes them much more time to find a taxi since not all have enough space for her wheelchair but some may also think it could stop other customers to join the car as well.
All these examples are different forms of social exclusion and shows us that public transportation in Ho is not inclusive as it is describe in the Disability Act 715. Facilities to make public transportation inclusive can be ramps in tall buses, extra space for wheelchairs, signboards for persons with developmental disabilities and much more.

4.1 School communities
During the stay in Ghana, the researchers had the opportunity to visit different school communities in Ho and therefore they observed how these schools practise Inclusive Education. Through interviews with teachers and parents they also learned about difficulties and challenges persons with disability have to face when it comes to inclusion in schools.
The Disability Act states some important aspects about IE which will be discussed in the following sup topics.

4.2 Facilities and equipment in educational institutions
The Minister of Education shall by Legislative Instrument designate schools or institutions in each region which shall provide the necessary facilities and equipment that will enable persons with disability to fully benefit from the school or institution (Disability Act 715, 2006).

As already talked about accessibility at public places, school compounds should also be provided with facilities like ramps, flat grounds or signboards to make the place accessible for all students. Many schools in Ho are having steep stairs and sandy ground so that persons who are sitting in a wheelchair or using crutches could not move around by their own.
Another example for equipment that schools can provide are Braille text books for those who are having visual impairments. For students who learn through pictures or have to follow routines in certain situations, classrooms should be equipped with PECS. All these are just a few examples of how to make classrooms accessible for students with disabilities. Through visits in different school communities we can say that most of those facilities and equipment are missing in schools in Ho. One reason for this could be a lack of economic and financial resources.

Examples of PECS:

4.3 Free education and special schools
The Disability Act says that:
1) the Government shall provide free education for a person with disability, and
2) Establish special schools for persons with disability who by reason of their disability cannot be enrolled in formal schools. (Disability Act 715, 2006)
3) First and foremost it is important to note that still not all children have access to a school in Ghana. This could have different reasons but especially those who are having a disability often have difficulties to fully participate in a school community.
According to an interview with a mother, one school in Ho refused to take her son, who is having CP, into their community. Another school which is private was willing to take him but demanded higher school fees from the mother.

As already mentioned, another mother also experienced was teachers at a school refused to take care of her daughter who is also having CP. Therefore she did not get the right support and education and the mother had to take her out of school.
The Disability Act says that persons responsible for admission into a school shall not refuse admission on account of the disability unless the PwDs has been assessed by the Ministry responsible for Education in collaboration with the Ministries for Health and Social Welfare to be a person who clearly requires to be in a special school for persons with disability (Disability Act 715, 2006).
This extract explains very clearly, that first and foremost all schools should include all students regardless of their condition in their communities. Inclusive Education is a must for every school. Special schools should only be provided if the inclusion of a child with disability into a mainstream classroom was not successful and special support for this child is needed.
One the other hand, special schools could help students to get individual support and the opportunity to learn in their own speed but on the other hand however, when separated from the mainstream classrooms, it will also give raise to perceive “segregation”. One school in Ho is having a segregated place for children with physical and intellectual disabilities which is bounded by a fence. The students have the opportunity to play outside the fence but obviously this segregation reflects the idea that students with disabilities and those without disabilities have to learn separately and cannot stay together in one classroom which seems to defeat total inclusion policy Ghana.
The two examples of the mothers also show us that these schools in Ho probably did not try everything possible to include these children and did not follow their responsibilities to practise IE. One reason for this rejection could be a lack of equipment and specialist trained teachers, who will make the inclusion of PwDs possible.
Nevertheless, some of the schools the researchers went to; practise Inclusive Education in such way that they include children with developmental disabilities like Autism Spectrum Disorder or Down syndrome in the mainstream classrooms but according to most teachers, these learners are still having difficulties to do the same tasks as other students.
This is evident that Inclusive Education is not always easy and cannot be realized in a short period of time by only passing legislative instruments and policies. It is more of a process that each school has to go through. In the following topic we want to look at different methods and strategies for the practice of IE in schools.

4.4 Inclusive Education
Inclusive Education can be understood as a process of increasing the participation of all students in schools including those with disabilities and SEN. It is about restructuring the cultures, policies and practices in schools so that they respond to each student´s needs (Ankutse 2015).
IE also happens through accepting and adapting to the differences and diversity of a student. The access to education is a human right. Consequently it is the duty of every school or other educational institution to initiate this process of inclusion and to realize the full participation of every student with or without disability in the mainstream classroom. There are different aspects which are important when it comes to the practise of IE. In the following we want to look at a few of them.

4.5 The Curriculum
The Curriculum should be personalized to each child and should meet the individual needs and specific skills of the student. The Instruction should be child-centred (Ankutse, 2015).

5. Teachers
In every classroom in this study, regular education teacher takes the primary responsibility for all students. In addition there are special education teachers who are trained in the specific disabilities areas who go to various educational circuits in the municipalities to give professional expertise to teachers on how they could support individual learners with special educational needs and disabilities in recognition of learning diversity This is normally done according to country context and global best practise in IE.

5.1 Classrooms
The arrangement of equipment and tools in classrooms is another important aspect of Inclusive Education. As already mentioned, PECS can be provided for those learners who rather learn through the visual than through the auditory way and for students with visual impairments, Braille should be made available for them as well.
Classroom setting should also be adapted to suit the diversity of all learners with disabilities and special needs. Beside these aspects, there are many other opportunities of creating a classroom in a way that it meets all individual needs of students.

5.2 Developing IEPs
An IEP (Individualise Educational Programme) is a programme that school staff members develop together with the parents of a PwDs, special trained teachers and at times other specialists e.g. school psychologists. They come together in formal meetings and talk about the child´s individual needs and strengths and the type of educational program he or she needs. The decisions made at the meetings will be written down in a formal IEP paper which will be renewed at least every twelve months.This include the level of academic achievement of the child, agreements on special services, how and when they will take place or modifications the child might need when writing exams.

5.3 Resource rooms
A resource room is a quiet place on the school compound where students with disabilities go to calm down and be by themselves when they experienced overwhelming situations in the classroom for instance. For students with learning difficulties or intellectual disabilities this room can also be staffed by special education teachers who can give direct and specialized instruction, academic remediation or assistance with homework and assignments.
This room does not keep PwDs from attending the mainstream classroom but give them in addition the opportunity to focus on their special needs and to get individual support. How often a student is visiting the resource room and what kind of special service he or she is receiving is often written down in the IEP paper and should be discussed with the teachers and parents of the student.
All these methods are just examples of how Inclusive Education can take place in a school. In IE the system is not necessary of the view to change the learner but rather structured or adapted to meet the individual needs of all learners regardless of their conditions. It also recognises that, all students learn in different ways. Therefore, facilitators or teachers should be able to support their learning in a flexible way so that all students receive good, clear and accessible education (Ankutse, 2015).

5.4 NGOs working for inclusion in Ghana
Throughout Ghana there are various organizations which work in the field of inclusion of persons with disabilities and Inclusive Education.
During the stay in Ghana the researchers got to know a few of them and also did interviews with some persons who work for these NGOs. Therefore there was the opportunity to learn about their projects for an inclusive society and also to understand the importance of their work.
As already mentioned earlier on, the researchers realized that public awareness of disability and social exclusion is not much created in many parts of Ghana. Some people they spoke with had no knowledge about the differences of disabilities or how to include PwDs in society. Even some parents were not able to name the disability of their children are having or never received diagnosis.
So if we take account of this and also of the other aspects of social exclusion and misperception towards disabilities, we may see the importance of organizations which advocate and campaign for a change in society and try to raise awareness in different communities.
This could happen through presentations or programmes e.g. in churches or other communities, where they talk about the causes of disabilities and different ways of including PwDs into society. Some also organize self-help groups where parents having a child with disability can share their experiences, discuss and help each other. Some also work directly with families and meet them at home to give them support and advices. Another important area these NGOs are working in, are school communities.
They try to make schools more inclusive and help children with disabilities to get access to education as well. One NGO is building a school in Ho with the vision to be fully inclusive and to give all children with or without disability access to education. Some also support PwDs in providing them devices like callipers or crutches or help them to receive medical care.
One the one hand most NGOs said in the interviews that they do see changes in society through the work they are doing. They see changes in the school system and also in the public awareness and perception towards disabilities. One the other hand they also mentioned that there is still a lot to do when it comes to inclusion of persons with disabilities and so they all try their best to make Ghana´s society fully inclusive.

5.5 Changes in society
Changes in society never happen from one day to the other and are often a long lasting process. It always starts with a problem or a challenge a society is facing which could be political, economic or social issues. The less negative impacts an issue is having on society.
The less individuals are affected by it, the more time it often takes for a society to become aware of it and therefore to take action. Which does not mean the issue is less important or meaningful.
Especially when we talk about persons with disabilities, who are often a marginalised group in society, real changes in terms of acceptance and inclusion takes time.
Not many persons with disability are able to speak for themselves and stand up for their rights. This could be because of their disabilities but also because of the stigmatization and social exclusion they might have experienced. As a result they may developed a lack of self-esteem and a wrong self-perception, which can bring them to accept their situation and see their daily challenges as something normal.
During several interviews the researchers also got to realize that most PwDs are not even aware of their rights as a human being or e.g. the financial support they could get from the government.
Therefore it is often up to others to recognize these problems in society and to stand up for those who are not able to speak for themselves. Once there is a certain perception or attitude which is accepted in society, it is not easy to change it and often these changes can only be realized in small steps. But we should not forget that often many small steps can make a huge change in society.
During the interviews the researchers also talked about the changes in society the respondents wish to see in terms of inclusion and acceptance of persons with disabilities. One member of a NGO in Ho mentioned three important key words an inclusive society should comply with, which are: inclusion, representation and participation.
These three aspects describe the nature of an inclusive society very well and also gives us a guideline on which we can work on. Since inclusion was already discussed in this research, we will focus on representation and participation in the following topics.

5.6 Representation of PwDs
A good example for the representation of PwDs is Ivor Kobina Greenstreet.
He is a lawyer and publisher and also the 2016 Presidential candidate of the Convention People’s Party (CPP) of Ghana. As a result of a car accident sustained in 1997 he has to use the wheelchair.
The Ghana Disability Forum asserted that the election of Mr Ivor Greenstreet as the Flag bearer of CPP as an evidence that persons with disability could be trusted with leadership roles in various fields of enterprise (Aziz 2016).
As the first man in a wheelchair who contested the Presidential election in Ghana, he is huge inspiration for many people and shows us the importance of the representation of people with disabilities in the politics of Ghana. In 2014 the Ghana Federation of Disabled (GFD) also called for more representation of people with disabilities in the district assemblies.
The regions in Ghana are divided into districts, municipalities and metropolitan assemblies which discuss about policies and other needs of the citizens living in this district. According to GFD it is necessary that at least two PwDs are represented in each district assembly so that they have the opportunity to influence the decision making and bring in their needs and concerns as well.

6. Participation of PwDs
Taking closing look at the aspect of participation, persons with disabilities often do not have the opportunities to get involved into different social activities. According to the interviews, some parents of PwDs experienced stigmatization in church communities because they were carrying their child along. Therefore they left their child at home or did not go to church as often as they used to go.
The fact that many children with disabilities also do not have access to schools or other educational institutions is another proof of a lack of participation of PwDs in Ghana´s society. As a result of the missing education and training, people with disabilities have serious difficulties to find employment.
Therefore most PwDs have to depend on family members or friends for a living. Through observations in the capital of Ghana, Accra, some persons with physical disabilities engage in begging on the street.
They sit in a wheelchair or on a skateboard and move from car to car to ask for money. Even though this is an extreme example, it can be shocking to see in what condition some people have to live because of their disability. So we can see the necessity of a change in terms of access to jobs and employment for PwDs.
A non-profit organization in Ghana wants to ensure that PwDs are able to participate fully without any form of barrier in the work environment. They facilitate the employment of PwDs through training, coaching, awareness rising, advocacy and consultancy services for employers.
When we talk about accessibility to jobs for persons of disabilities, it is important to focus on both sides, the employers and the employees. For employers it is necessary to be aware about different disabilities and to understand how they can make their workplace inclusive.
Therefore the organization is doing a disability awareness training with the staff to look into misconceptions and to learn about practises for interviewing, communicating and working with persons with disabilities. They also try to make sure that the buildings of the workplaces are accessible.
For employees the organization is doing skill trainings which are short courses for PwDs to gain a career in e.g. Graphic Design or Computer Programming but also skills like bead making or the production of liquid soap to empower them to start their own business (cepdghana.org)
Advocacy work is also an important aspect to improve the situation of persons with disabilities in Ghana. This can happen through workshops, press conferences, newspaper publications or radio/television talks. It is necessary to inform the public about the challenges PwDs are facing in terms of employment and also to show different opportunities on how to make a workplace inclusive.

6.1 Rehabilitation of disabilities
The aim of Rehabilitation of persons with disabilities is to help them to regain their normal way of functional life.The process includes different aspects and is always in line with the individual needs of the person. Therefore rehabilitation can focus on treatment of pain, physical therapy, speech therapy and a lot more. It also helps the person to live independent and gain social skills.
Ghana has different rehabilitation centres for persons with disabilities which concentrate on different therapies. There is the “Honour-Barbara Centre” which provides speech and language therapy and the “Eight Foundation” which focus on the therapy for persons living with asthma. An influential Rehabilitation Centre in Accra had to close because of missing financial support. It was opened in 1962 by the Department of Social Welfare (today Department of Social Development) and its purpose was to train persons with disabilities in different skills in e.g. visual art, sewing or carpentry and also empower them to live on their own and get a job or start their own business.
According to an article the centre used to house 49 students and had 26 staff members, including security personnel and trade instructors. The government used to provide most of the finances, including the payment of utility bills and other facility user fees. Beside this the centre only received little support from social groups and NGOs.
Referring to the manager of the centre, the available finances were not enough to educate, feed and take care of the students. As a result they had to face challenges such as funds, lack of food staffs, detergents and accommodations (Mensah 2018).
Another source says that the Rehabilitation centre had not been renovated since its opening in 1962 and most of the time there were only one room for the females and one for the males. Consequently the centre had to close in 2019 because the necessary resources were not available and the centre could not meet the needs of the students anymore (Ezit 2019).

6.2 Methodology
The following explains the approaches and brief account about how this research project is been conducted. The work is organized as literature review approach, data collection approaches were employed, policy documents articles related to the topic were looked at and the researchers only focussed mostly on communities in Ho mostly as a case study. This work is also an integral part of a volunteering programme premise on cross cultural learning programme with the collaboration between Ghana and Germany.
This throws more insight on how the methodological process was carried through by researchers. Semi-structured interviews alongside questionnaires that were open ended were used. Open ended and participatory observations were also used. The observation took place in schools, public transport and other public places like churches or supermarkets.
Most interviews were recorded by camera and tape recorder and the questionnaires were concerted to persons with disabilities and their parents, teachers and workers of different NGOs which work in the field of inclusion. The answers of every interview were discussed and written down word-for-word.
The table below shows how many respondents were interviewed in each group:

6.3 Summary of key findings
Looking at the results of this work we can summarise the following key findings as follows;
The research shows that knowledge and awareness about different disabilities and their medical cause is not much delve into in Ghana. Very often the perception and attitude towards disability is influenced by spiritual and religious beliefs. Therefore disabilities are seen as a curse or a result of sin or a “bad-doing”. Some Ghanaians also practise different rituals to cure disabilities.
Furthermore persons with disabilities in Ghana have to face various challenges in their daily lives. This can be unwanted public attention like staring or excluding from social communities e.g. churches. Even though there are different policies which speak for inclusion of PwDs in Ghana´s society, discrimination and social exclusion still happens in different ways. Most public places and transportation are not provided with the necessary tools equipment to make them accessible for persons with physical or intellectual disabilities.
Many children with disabilities do not have access to a school or other educational institutions because the concept of Inclusive Education is not fully implemented in most schools. Adults with disabilities also find it difficult to find jobs. This can be as result of inadequate education and also, because most job placements are not inclusive enough.
Nevertheless there are several NGOs working and advocating for acceptance and inclusion of persons with disabilities. They sensitize on inclusive education in public, work together with families and raise awareness about inclusion in different communities. Support in form of Rehabilitation centres are also provided in Ghana. One influential centre in Accra had to close due to a lack of finances and resources.

6.4 Direction for future research
Since the data was only collected in Ho, it could be advisable to look into other parts of Ghana as well. The culture settings in Ghana vary from region to region. Therefore the circumstances in terms of inclusion of PwDs could be different in other parts of Ghana. Furthermore it might be interesting to look deeper into the Disability Act since this research only discussed the parts which talk about Inclusive Education.
At the end it might be also important to find out more about methods and strategies which can bring the concept of inclusion in one line with the culture of Ghana. Looking at the aspect of spiritual beliefs and how they can cause misconceptions towards disability, it would be interesting to find more ways of how to bring in the medical perspective as well.

6.5 Conclusion
The process of including persons with disabilities in Ghana´s society is still a right in Ghana. Misconceptions and a lack of massive education and awareness causes social exclusion and stigmatization in different ways. Spiritual and religious beliefs have a great influence on the behaviours towards PwDs. This leads to disability often being seen as something bad or something which is caused by a “sin”.
Many persons with disability still have to face a lot limitations in their daily lives and do not have the opportunity to realize their full potential. Nevertheless, the first steps have been taken. Laws which speak for the inclusion of PwDs have been passed and several NGOs raising awareness to educate the public about disabilities. These are all cornerstones on which an inclusive society can be built. Furthermore, schools and public buildings need to become more accessible, inclusive education must be implemented in every school and financial or other forms of support for PwDs and their families need be provided.
The process for a society to ensure inclusion of PwDs in all facets of life is a long lasting process and every country faces its own challenges and difficulties when going through this process. Nonetheless, it is the responsibility of every society to use all available resources and opportunities in order to implement inclusion as best as possible in all areas of social lives as permitted in the legislations mentioned above.

7. References
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