A/HRC/25/60/Add.1 71. The lack of recent-generation psychoactive drugs leads to the inadequate treatment of patients. The Special Rapporteur is gravely concerned about the application of electroshock therapy as practised at the psychiatric hospital in Accra, which is administered with the use of restraints, without adequate anaesthesia and not as a last resort. The hospital documents the consent of the patient, but the Special Rapporteur doubts that, in practice, such consent is free and informed, as international standards require. Prayer camps 72. Prayer camps are privately owned religious institutions that play a large role in Ghanaian society. It is estimated that 70 per cent of the population turn first to a prayer camp to receive spiritual healing in order to deal with any type of illness, in particular mental illness, as it is believed to be caused by evil spirits or demons. There are hundreds of private prayer camps, of which a majority are Christian-based and located in the south of the country, while there are some Muslim camps in the north. The camps are run by prophets, many of them self-proclaimed. 73. These prayer camps are essentially alternative residential facilities for those with mental disabilities, but they currently operate with little oversight and no State regulation. The Ghana Pentecostal and Charismatic Council, an umbrella body for 122 churches and evangelical associations in the country, has an ad hoc committee of elders but their oversight of the prayer camps is limited and practices in the camps are often inconsistent with the guidelines of the Council, which prohibit chaining or fasting of any “sick” person and require the camps to send persons with mental disabilities to hospitals. 8 74. The Director of the Ankaful psychiatric hospital has taken the initiative of reaching out to the traditional healers to try to coordinate traditional and medical/psychiatric approaches, in order to provide holistic solutions. The Special Rapporteur observed extremely disturbing practices in the two prayer camps he visited. He documented cases of shackling and fasting forced on persons with mental disabilities or in some cases with neurological problems, including children. In Edfuma prayer camp men, women and children were shackled to the walls or floors of their cells. The building holding adult males contained 16 concrete cells laid out like cattle stalls. There was a separate building for women and juveniles where 10 persons were chained to the floor, including a 14 yearold girl and a 7 year-old boy, who exhibited symptoms not of a mental illness but of a neurological disease that required specialized treatment and medication. 75. In Jesus Divine Temple (Nyakumasai) prayer camp, individuals were chained to trees. Some were under wooden shelters or large plastic bags but others were completely exposed to the elements. The main reason for the shackling of patients in the prayer camps, according to the leaders, was the risk of escape or the aggressive behaviour of some patients. However, that reason does not fall within the scope of the exceptions for temporary measures recognized in international standards. In addition, most of the individuals that the Special Rapporteur examined in the two camps were shackled 24 hours a day for prolonged periods - months and in some cases years. The Special Rapporteur saw a man confirmed to be the same individual who had been shackled when visited two years earlier by an NGO and he was still shackled.9 76. The traditional leaders told the Special Rapporteur that those individuals were not permitted to leave until the leaders received a message from God that they had been “healed.” Some remained even after being discharged, because their families had abandoned them and they could not return to their home communities. It does not appear 8 9 14 Ibid, p. 36. Letter from Human Rights Watch to the Special Rapporteur, 18 December 2012.