The prevalence of poverty in Africa in concert with extreme levels of illiteracy and ignorance creates the unfortunate status quo of autism not being sufficiently understood and catered to or even tolerated, making life extremely difficult for persons living with autism and their caregivers.
POVERTY, AND THE VALUE OF A CHILD IN AFRICA
In Africa, where poverty abounds, the joy at the birth of a child sometimes stems from other reasons aside from the obvious ones. There are often certain expectations placed on the child – hopes of a better future are anchored on them, where they are expected to eventually lift the family out of poverty. For instance, usually, in most parts of Africa, a substantial dowry from the marriage of a female is eagerly anticipated by her parents throughout her single life, while the boy represents income-earning potential. Particularly giving the worsened national economies of recent times, the potential financial support a child would offer factors very heavily into the realities of these families.
WHAT IT THEN MEANS TO HAVE AN AUTISTIC CHILD
Children with autism do not commonly go on to live successfully autonomous lives. They typically would require care all their lives. For a poor household, what this means is that the autistic child will possibly never, as is traditionally expected, bring in any money to their parents; instead, these children represent a reason for the endless expenditure of their meagre resources. (On the average, medical expenses for children and adolescent with autism is 4 to 6 times greater than those without autism). For this reason, the mindset of these parents towards their autistic children is easily overt rejection throughout.
AUTISM – A MEDICAL PROBLEM, OR A MYSTICAL ONE?
Superstition is a part of the African worldview, particularly where there is poverty. Situations that are not well-understood or recognized would commonly be interpreted on a superstitious basis. For instance, many mental health conditions are not addressed through medical means in African societies but are fearfully vilified instead. A lot of African children with autism are dismissed as being demon-possessed and so are not diagnosed early. They also are not likely to eventually receive proper treatment for their conditions. What happens rather, is that the remedial measures they receive are intended to expel ‘evil’, and these are often extremely detrimental to themselves. For example, there are cases where the autistic child is locked away and sometimes chained, even beaten.
STIGMA
With poverty there is usually ignorance, and with ignorance, there is usually stigma. An added burden to caregivers of persons living with autism within low-income households is the stigma commonly attached to the condition. No one wants to be labelled the parent of the ‘strange’ or ‘mad’ child and suffer the social rejection that will ensue. A usual consequence of this is that these families would rather hide away their autistic children from view rather than seek medical help for them.
THE KNOWLEDGE AND RESOURCE DEARTH IN AFRICA
Even when poor households show the appropriate health-seeking behavior regarding their autistic children, treatment resources are very limited, and mostly far too exorbitant where they exist. From a national-planning perspective, there is very little in place for the diagnosis, treatment and management of autism and similar developmental disorders. There is also a heavy lack of research knowledge, and research efforts around autism in Africa. Even regarding health in general, most developing African countries still fall far shy of the mark. For instance, the Abuja declaration on health budget policy pegs the minimum allocation for healthcare in Nigeria at 15% of her annual budget, but the country does not spend anywhere near this on healthcare. It is only a few non-profits and private individuals who so far do the bulk of the work on autism research, therapy, and advocacy in Africa.
Autism Spectrum Disorder (ASD) is a nuanced situation for many persons living with it as well as their caregivers, for reason of the poverty dimension to it. Widespread, extreme poverty in Africa, and the attendant ignorance and stigma shroud the condition sometimes, so that it is not properly recognized and addressed, and force a deleterious response (such as concealing the autistic child), rather than encourage proper health-seeking behavior. What is more, the lack of household funds, knowledge resources and treatment facilities for autism all combine to compound the challenges of autism within poverty in Africa.