KWAME Nkrumah's economic policies have attracted much scholarly attention.Footnote 1 The literature generally agrees that Nkrumah's Convention People's Party (CPP) shifted gears after 1961 to embrace a ‘big push’ towards state-led industrialization, after focusing on welfare and social services during the 1950s.Footnote 2 No-one has noticed, however, that Nkrumah's abandonment of welfarism coincided with a major rehabilitation program for disabled Ghanaians. The project began in late 1960, when Nkrumah invited John WilsonFootnote 3 to survey the state of disability in Ghana and make policy recommendations for registration, rehabilitation, and training. Based on Wilson's estimate that 100,000 Ghanaians were disabled, Nkrumah launched a mass registration program in 1962 followed by the development of Rehabilitation Units across the country.
How do we account for the emergence of this apparently welfarist initiative during Nkrumah's shift to economic growth and industrialization? The explanation lies in the goal of the project, which sought to integrate disabled Ghanaians into the workforce as productive wage laborers. Nkrumah's program drew heavily on the British project of ‘social orthopaedics’ developed during the World Wars for disabled soldiers.Footnote 4 The British model, like Nkrumah's, sought to transform disabled British soldiers into wage workers. It was ‘social’ in that it defined social citizenship by participation in the labor market; to be a full citizen, that is, one had to be a productive worker. For the British state, expanding the workforce to include the disabled was especially important during wartime because military recruitment triggered domestic labor shortages.Footnote 5 Although Ghana had a labor surplus in the 1960s, Nkrumah faced a shortage of skilled workers, and in this sense he faced a situation similar to that of postwar Britain. Nkrumah's rehabilitation project therefore was more about economic growth than welfare. As we shall discover, this economic bias, although positive in several important respects, also raised serious questions about the nature of social citizenship and the rights of Ghana's disabled citizens to state-sponsored welfare.
BACKGROUND: COMMUNITY DEVELOPMENT AND REHABILITATION IN GHANA, 1943–57
Nkrumah's rehabilitation program was linked to British social orthopaedics through a colonial program in the Gold Coast (colonial Ghana) during the 1940s. Between 1943 and 1947, the colonial government developed a Rehabilitation Unit at the 37th General Military Hospital in Accra. The project grew directly out of Britain's rehabilitation program, which the secretary of state for the colonies believed should apply to colonial as well as British soldiers. The Gold Coast initiative attempted to translate the British model to West Africa, rehabilitating disabled African soldiers and reintegrating them into the urban workforce. After an encouraging start, however, the Unit closed in 1947 and the government devolved most services for the disabled to voluntary agencies.Footnote 6
The withdrawal of government-sponsored rehabilitation services coincided with the emergence of the colonial doctrine of community development. Focused on rural areas, the doctrine focused on protecting African communities from the disintegrative effects of individualism perceived to flow from the development of wage labor.Footnote 7 This doctrine was rooted in the earlier program of indirect rule, under which the colonial state codified the power of chiefs as trustees over their communities.Footnote 8 Community development sought to modernize this system by absorbing the educated elite into village politics, but the goal of preserving African communities against the rapid emergence of capitalist relations remained intact.Footnote 9 With its vision of transforming the disabled into wage laborers, the social orthopaedics model of the 1940s therefore stood outside the colonial doctrine of community development. In contrast, Nkrumah was a modernizer who did not strongly support the preservation of traditional social structures.Footnote 10 When he ‘discovered’ disability shortly after Ghana's independence,Footnote 11 Nkrumah therefore did not hesitate to put economic rehabilitation back on the agenda. In so doing, the CPP Government redefined community development to include disability initiatives, in the interests of expanding Ghana's supply of skilled labor.
NKRUMAH AND DEVELOPMENT, 1951–61
Nkrumah won an election in 1951 that granted the CPP control over the colony's internal affairs but stopped short of full independence. Two subsequent elections in 1954 and 1956 paved the way for the Gold Coast to emerge as the independent nation of Ghana in 1957.Footnote 12 During this period, the CPP inherited a ten-year development plan created by colonial governor Sir Charles Arden-Clarke, telescoped it into five years and implemented its provisions between 1951 and 1956. The ‘First Development Plan’ allocated most of the budget to infrastructure and social services (36 per cent each), with only 9 per cent allocated to ‘productive activity’.Footnote 13 In 1957, Ghana obtained full independence from Britain under a CPP majority government. After a two-year consolidation period, Nkrumah launched the Second Development Plan in 1959. The emphasis on infrastructure and social services carried over from 1951, with 80 per cent of the Second Plan allocated to non-productive activities.Footnote 14 As Killick observes, this approach prioritized social overhead capital (SOC), which included health and education as well as infrastructure, under the belief that this would induce the growth of directly productive activities (DPA).Footnote 15 The funds earmarked for DPA in the 1950s targeted agricultural development rather than industrialization, based on the recommendations of the economic advisor W. Arthur Lewis.Footnote 16 Introducing the Second Development Plan in 1959, Nkrumah expressed much hope for national development. ‘Fellow countrymen and women’, he said, ‘let us build not only for ourselves but for future generations, a brighter Ghana which will be an inspiration and shining example to all of Africa.’Footnote 17
This optimism would not last for long. Although the 1951 and 1959 Plans produced respectable growth rates of 5 per cent per year, the returns failed to cover their budgets. As a result, spending under the Second Development Plan produced a deficit of £53 million, or 12 per cent of the national product, by 1961.Footnote 18 Poor economic performance and the growing deficit fed into opposition against Nkrumah and the CPP. Facing a persistent battle to maintain a unitary state against federalist opponents, growing opposition prompted Nkrumah to eliminate political dissenters and concentrate the power of the CPP. In 1958, he implemented the Preventive Detention Act, which empowered the Government to arrest and detain political opponents without trial.Footnote 19 The CPP also co-opted and absorbed labor unions and producers' associations. The 1958 Industrial Relations Act created 24 official unions and subordinated them to the Trade Union Congress (TUC), which in turn was subordinated to the Party. As part of the deal the CPP also banned strikes. An amendment in 1959 solidified CPP control by prohibiting any unions outside the TUC.Footnote 20 Along with the unions, the CPP absorbed the Farmers' Council and numerous mass organizations, including women's and youth groups, and producer cooperatives. ‘Eventually’, writes Rimmer, ‘membership of such organizations became simply membership in the CPP.’ By 1960, parliament became the sole instrument of the CPP and the party reorganized local government boundaries to take over regional and village politics.Footnote 21 In 1962, Nkrumah declared formally that village-level organizations, including those led by chiefs, would be absorbed into the Party.Footnote 22 By this time, Ghana had become a corporatist, de facto one-party state.
It was under this political structure that Nkrumah abandoned the Second Development Plan in 1961 and began constructing a new Seven-Year Plan as a basis for aggressive economic growth. The new plan rejected Lewis's emphasis on agricultural development in favor of rapid industrialization based on Ghana's supply of cheap labor. Influenced by development economics, Nkrumah decided that Ghana needed a big push towards industrialization.Footnote 23 Rapid industrialization was necessary, so the argument went, in order to break with the poverty-inducing colonial past of economic growth through the export of primary products. Although social services and infrastructure remained important, the Seven-Year Plan reduced their share of the budget from 90 to 63 per cent, while increasing productive expenditures from 10 to 37 per cent. Social services declined at a lower rate than infrastructure (42 to 32 per cent, compared to 46 to 26 per cent) and the dollar amount increased due to the increase in the budget as a whole.Footnote 24 However, as we shall discover, the apparently welfarist spending on disability programs under the Seven-Year Plan in fact was meant to increase national productivity by reintegrating disabled Ghanaians into the workforce.Footnote 25 As such, the policy reflected the increased focus on DPA in the Seven-Year Plan.
Nkrumah's rhetoric during this period remained socialist, and the trigger for the Seven-Year Plan might have been Nkrumah's 1961 visit to eastern Europe where he witnessed rapid industrialization under Soviet socialist planning.Footnote 26 By this time, the Second Development Plan was failing and Nkrumah worried about the slow pace of Ghana's development. According to Awooner, the trip convinced Nkrumah of the need for scientific socialism as a counterpoint to the ‘confusions of laissez-faire capitalism which had already exploited the continent for 400 years and made very little contribution to it in 20th-century socio-economic terms.’Footnote 27 Nkrumah's writing supports this idea, at least at the level of rhetoric. For instance, he claimed that disillusionment with the West, especially over the Congo crisis, pushed him towards socialism. He also announced that the Program for Work and Happiness, created in 1962 as a basis for the Seven-Year Plan, sought to build ‘a socialist state devoted to the welfare of the masses.’Footnote 28 In addition, Nkrumah occasionally referred directly to Marx. For instance, in 1961 he declared that the CPP sought to build ‘a socialist pattern of society in which the free development of each is the condition for the free development of all.’Footnote 29 Looking back from exile in 1973, he wrote that ‘we aimed in Ghana to create a socialist society in which each would give according to his ability and receive according to his needs.’Footnote 30
Did Nkrumah possess a genuine commitment to socialism as a tool of mass welfare? Perhaps in the long run, but in the short-term his vision privileged economic accumulation through a mixed economy. This vision reflected the dominant Western model of development economics as much as the Soviet system. The development economists rejected the primacy of agriculture, arguing instead that governments could industrialize quickly by raising capital through forced domestic savings and foreign loans. The state would direct capital inflows into centrally-controlled import substitution industrialization (ISI). In March 1963, the World Bank sponsored a conference of leading development economists, including A. O. Hirschman, Nicholas Kaldor and Dudley Seers, who convened in Ghana to discuss the draft Seven-Year Plan.Footnote 31 The experts endorsed the idea of a big push, but the Plan's architect J. H. Mensah drew criticism for overestimating the country's potential for raising large amounts of capital extremely quickly.Footnote 32 One of Nkrumah's critics, T. Peter Omari, says that the optimism over capital formation and rapid industrialization reflected the fact that Nkrumah was ‘always in a hurry.’Footnote 33 Indeed, as early as 1957, Nkrumah wrote that ‘what other countries have taken three hundred years or more to achieve, a once dependent territory must try to accomplish this in a generation if it is to survive. Unless, as it were, “jet-propelled” it will lag behind and thus risk everything for which it had fought.’Footnote 34 As Nugent remarks, this meant that Nkrumah's supposedly socialist program did not emphasize ‘universalist aspirations towards human equality’, but rather ‘the fastest means of catching up with the developed world.’Footnote 35 By 1961 this vision had taken on a keen sense of urgency.
The important point here is that the CPP strove to achieve socialism through the ‘evolutionary path’ of increased economic productivity rather than the socialist transformation of the economy or property relations.Footnote 36 John Tettegah, the TUC's General Secretary, admitted as much in 1962. ‘We will bring about our economic independence’, wrote Tettegah, ‘by the transformation of our entire national economy by raising the productivity of every worker at his place of work and in our entire national economy.’ J. H. Mensah, Chair of the National Economic Planning Commission, echoed this idea with a more explicit rejection of Marxist doctrine. Because the means of production were severely underdeveloped in Ghana, the focus of socialism should not be ‘the rearrangement of the ownership of the means of production. The central concern must be with the building up of the nation's productive assets.’Footnote 37 Nkrumah himself had expressed a similar idea in 1959, declaring that ‘it is only from the surpluses of increased productivity that a higher standard of life for the whole nation can be achieved.’Footnote 38 Drawing from this vision, the Seven-Year Plan envisioned the development of state-owned enterprises (SOEs) in some sectors, existing alongside joint public/private ventures as well as fully private companies.Footnote 39 Eventually, the state sector would eliminate the private sector through efficiency and productivity rather than revolutionary struggle.Footnote 40
The Seven-Year Plan was developed by a team of young radicals, including Tawia Adamfio, who were promoted by Nkrumah after he sacked a number of moderate CPP leaders in the early 1960s. In 1962, Adamfio anticipated the Plan by announcing the Programme for Work and Happiness, which signaled a budgetary shift towards productive activities. Nkrumah officially launched the Plan in 1964, the same year that Ghana officially became a one-party state.Footnote 41 To achieve the big push, he needed to absorb 1,100,000 new workers into the economy by 1970.Footnote 42 Labor would be put to work simultaneously to develop industry and modernize agriculture. The CPP's control of the TUC would keep wages low, and Nkrumah's one-party state would be free to increase forced savings through tax deductions at source. Low wages and forced savings would propel a self-reinforcing process of ISI, and Ghana would emerge as an economic power on par with the West and a leading nation in the Pan-Africanist movement.Footnote 43
In order to deliver on his vision, Nkrumah needed to persuade the population to participate in national development. To this end, he couched his message in terms of the obligations and responsibilities of citizenship, including the need for individual sacrifice ‘in the interest of the nation.’Footnote 44 Nkrumah's speeches routinely emphasized loyalty, sometimes taking on military hues as in his 1959 broadcast introducing the Second Development Plan:
If this campaign is to succeed it will require an all-out effort from every man and woman living throughout the length and breadth of the land. You, the farmers, the fishermen, the masons, the lawyers, the doctors, the laborers, the business men, the engineers, the architects, the traders, the teachers, the students, the whole people of Ghana, whatever your occupation or status, have a vitally important part to play in making this campaign a resounding success. You are the troops who will make the assault and sustain it through the next five years and who will in the end break through and to a wider and fuller life for our nation … I call upon each one of you, Chiefs and people, fellow men and women of Ghana, to make you maximum contribution to this concerted assault on national poverty, disease and ignorance. Tomorrow the battle will be joined. We move into the attack. If every soldier in this fight does his duty well and truly, victory is assured.Footnote 45
Nkrumah reiterated the military metaphor in a dawn broadcast in 1961, referring to ‘the unknown warriors – dedicated men and women who serve the party loyally and selflessly without hoping for reward.’Footnote 46 The message was clear. Nkrumah was the General demanding dedication, obedience and sacrifice from his foot soldiers until victory – national economic development – was assured. These ideas infused Nkrumah's speeches between 1959 and 1964. Speaking at the opening of Parliament in 1960, he promised that the CPP would help Ghanaians to live ‘fuller’ and ‘richer’ lives, but he also emphasized ‘usefulness’, by which he meant ‘loyalty, hard work, and the conscientious application of his talents to the nation.’Footnote 47 At the Winneba Ideological School in 1962, Nkrumah emphasized discipline, stating that ‘the whole nation from the President downwards will form one regiment of disciplined citizens. In this way, we shall move forward with great confidence, stepping ahead every more firmly with a keen sense of purpose and direction.’Footnote 48
Not surprisingly, Nkrumah reiterated these views in his statements about the Programme for Work and Happiness and the Seven-Year Plan. For instance, in a broadcast in May 1962, Nkrumah declared that ‘I am convinced beyond all doubt that Ghana and Ghanaians will travel full steam ahead, conscious of their great responsibilities and fully aware that the materialization of this bright picture of the future is entirely dependent on their active and energetic industry.’Footnote 49 Two years later, in a speech launching the Seven-Year Plan, Nkrumah emphasized that Ghana's ‘socialist’ future had to be ‘built by the people … worked for, even sacrificed for.’ Development depended on the ‘maximum contribution to the national economy’ from ‘each citizen … according to his ability and training.’Footnote 50 Citizens who complied, declared CPP insider Kofi Baako, and accumulated wealth through hard and honest labor, would have their property protected from ‘lazy, unscrupulous undisciplined but able bodied citizens.’Footnote 51 By implication, those who did not comply would not be allowed to share in the fruits of economic development.
DISABILITY AND REHABILITATION UNDER THE CPP, 1961–6
Baako's 1961 allusion to ‘able bodied’ Ghanaians is interesting because that year marked the beginning of a comprehensive program to rehabilitate disabled Ghanaians and integrate them into the workforce. Nkrumah ‘discovered’ disability in Ghana when the government took over the management of destitutes and beggars from municipal authorities through the Control of Beggars and Destitutes Ordinance of 1957. As CPP officials rounded up citizens under the Ordinance, they discovered that most of the ‘offenders’ were in fact disabled.Footnote 52 In fact, the Department of Social Welfare and Community Development had been aware of this reality since the early 1950s. In 1954 the Department sponsored an official enquiry, which came on the heels of three smaller investigations between 1951 and 1953 prompted by public concerns over increased begging in the larger towns. In 1951, District Commissioners reported 202 beggars and destitutes in nine towns.Footnote 53 These findings were considered significant enough to prompt a Working Party on destitution in 1952, which reported 353 cases in those nine towns plus Kumasi. In September, 1953, the Department of Social Welfare and Community Development undertook a more detailed survey of the six largest towns and found 515 beggars and destitute persons in those towns alone. This was followed by a larger survey in July and August, 1954, which covered 11 towns and found 596 cases of begging and destitution.Footnote 54
The 1954 investigation formed the basis of the official Report on the Enquiry into Begging and Destitution in the Gold Coast, published in 1955. The Report confirmed that disability was a major issue, with only 100 non-disabled individuals among the 596 reported beggars and destitute citizens. The remaining 496 had some form of disability, including blindness, leprosy and physical debility. However, this number was relatively small and the report's author, senior welfare officer M. L. Clarkson, recommended nothing beyond forced removals through Bye-Laws. Although he mentioned employment training for the blind and physically disabled, Clarkson stated that this would require special instruction and ‘organized industries’ (sheltered workshops), which the small numbers did not warrant.Footnote 55 Clarkson's conclusions no doubt prompted the development of the Ordinance of 1957, but there was nothing in the report to indicate a sense of urgency over rehabilitation. In fact, the reports of the Department of Social Welfare and Community Development before 1960 hardly mention disabled Ghanaians at all.
Why, then, did Nkrumah instruct his Cabinet on 10 October 1959 ‘that action be taken urgently to promote a comprehensive Government-sponsored program of education and rehabilitation designed to restore economic and social independence to as many of the disabled as possible in the shortest possible time’?Footnote 56 As noted above, it is possible that he only discovered the problem after the central government implemented the Control of Beggars and Destitutes Ordinance of 1957. But there appears to have been a personal connection as well. Nkrumah had a good relationship with Sir Charles Arden-Clarke, the governor of the Gold Coast between 1949 and 1957, who became chair of the Royal Commonwealth Society for the Blind (RCSB) in 1959.Footnote 57 It seems likely that Arden-Clarke introduced Nkrumah to Sir John Wilson, a founding figure and director of the RCSB. This connection appears plausible because six days after Nkrumah's statement to the Cabinet, the Government recruited Wilson to carry out a survey of disability in Ghana ‘and to prepare a comprehensive programme for their care and rehabilitation.’Footnote 58 In August 1960, the CPP created the Advisory Committee on the Rehabilitation of the Handicapped and the Destitute under the Chairmanship of W. A. C. Essibrah to coordinate the program, which included representatives from government ministries and voluntary organizations.Footnote 59
Reporting on 6 December 1960, the Wilson Committee estimated that there were at least 100,000 disabled people in Ghana, of whom 10,000 were children.Footnote 60 The magnitude of this number must have surprised the Department of Social Welfare and Community Development, but it was based on better evidence than the Report on Begging and Destitution. Where the 1954 report simply relied on street counts, Wilson compiled data from a four-year survey of blindness in West Africa carried out by the RCSB, as well as hospital records analyzed by the Wilson Committee itself.Footnote 61 The resulting estimate was a very significant number in a country of seven million people.Footnote 62 Wilson's report went on to issue a number of declarations and recommendations that set the tone for the CPP's disability program between 1961 and 1966. Most importantly, Wilson's team stated emphatically that all disabled Ghanaians should have the opportunity to participate alongside non-disabled citizens in ‘the normal occupations of town and country.’Footnote 63 To this end, adults with disabilities should be rehabilitated in vocational training centers, where they would learn the skills necessary to reintegrate into the urban labor force or their village economies. Children would receive special education according to their particular disabilities. With its emphasis on restoration to normality, Wilson's report argued that, where possible, training and education should not be segregated. While this would be difficult in urban areas such as Accra, schools for children could easily be integrated, while the Rural Rehabilitation Units would achieve integration through attachment to Rural Training Centers for non-disabled trainees.Footnote 64 Specific recommendations included an Industrial Rehabilitation Unit (IRU) in Accra and eight Rural Rehabilitation Units (RRUs), beginning with Kwaso in the Ashanti region, Ho in the Volta region and Tamale in the Northern region. Wilson also argued that control of the units and all aspects of disability policy should be vested in the central government, with the voluntary sector's role redefined as supplementary. Finally, before the program started, disabled citizens should be encouraged to register with the Department of Social Welfare and Community Development.Footnote 65
In short, Wilson's report recommended a centralized, state-driven disability program designed to integrate disabled Ghanaians into the national economy. If the disabled could be rendered economically productive by participating in the labor market, the government would save on welfare costs and the economy would benefit. In his letter to Nkrumah introducing the report, Wilson clearly set out his vision of normalizing Ghana's disabled citizens economically in urban and rural areas:
The old idea that the disabled are capable only of subsidized, sheltered handicrafts is out of place in the towns of modern Ghana; we propose that they should be assisted to find employment, on their merits as workmen, in the offices and factories. In the villages, where the main problem exists, disabled people could be trained as farmers and craftsmen.Footnote 66
The final report expressed its economic recommendations in national terms, insisting that rehabilitation had to be considered a step beyond humanitarianism:
A modern system of rehabilitation can be justified not simply as a humanitarian gesture, but also as a means of affording the disabled an opportunity for making their contribution to the national economy. To allow the disabled to remain uneducated and unemployed involves a double loss, firstly because they have to be maintained, and secondly because the country loses their potential output.Footnote 67
In other words, rather than relying on state welfare, Ghana's disabled citizens could contribute to national development. For Wilson, himself blinded at age 12, this approach to disability policy represented a deeply held belief in equality of opportunity.Footnote 68 As we shall discover, the CPP appropriated Wilson's vision and set it within the broader and less humanitarian vision of development economics.
The CPP accepted Wilson's recommendations and began to develop its disability program in 1961. As a first step the government created a Rehabilitation Section within the Department of Social Welfare and Community Development. Nkrumah followed this by declaring the third week of June 1961, ‘Handicapped Citizens’ Week', during which all disabled citizens were encouraged to register with the Rehabilitation Section.Footnote 69 Before the announcement, newly appointed rehabilitation officers received a one-week briefing course. From there they met with various bodies to promote the registration campaign, including churches, youth organizations, benevolent societies, schools, village development committees, and local councils. To raise awareness, the CPP launched a full-blown propaganda campaign via radio, cinema and newspapers. The Handicapped Citizens' Week kicked off the registration process, during which the government encouraged chiefs and family members to gather disabled individuals and bring them to the Registration Centers.Footnote 70 D. K. Okyere, senior assistant mass education officer for Brong-Ahafo, provided an insider's glimpse of the process. With the help of families and chiefs, Okyere's team devoted the last ten days of June exclusively to the registration effort. ‘All and sundry’ showed up at the Registration Centers, including the elderly, men and women with minor ailments such as headaches, and the unemployed. Okyere referred to the unemployed as ‘toughs’ and recounted the following story:
Even at times some “toughs” would hang around and throw at you pertinent questions. They went to the extent of asking to be registered, arguing that they were unemployed and were being smothered by poverty. But we took all these in good spirit and directed them to the labor exchange.Footnote 71
More generally, many individuals appeared suspicious of the government's motives and believed that the goal was to round up ‘destitutes’ and beggars, and lock children away forever. Also, the government held the registration drive during the farming season, which meant that many villages were deserted, at least in northern Ghana.Footnote 72 These experiences illustrate the challenges of registration, including the basic task of identifying the disabled. As we shall discover, the definition was not straightforward and the CPP later would expand the purview of rehabilitation to include sufferers of chronic diseases and certain categories of the unemployed.
At the end of the first week, 4,833 disabled individuals had registered, not a terrible result but one which prompted the Rehabilitation Section to revamp the process in early 1962. Each region was divided into six campaign areas and the registration teams concentrated on one area at a time. Using this strategy, the campaign registered 12,577 disabled individuals during 1962, but progress slowed down thereafter to produce a final total of only 13,608. Given the challenges of the campaign, however, this must be considered a relatively large number. More importantly, it was well in excess of the capacity of the proposed system, which envisioned restoring ‘at least 1,500 people to productive life’ by the end of 1964.Footnote 73
While the registration campaign unfolded, the Rehabilitation Section developed a comprehensive rehabilitation program based on the advice of a Technical Advisor, E. G. Johnson, recruited in July 1961, from Britain's Ministry of Labor. In late September, Johnson recommended proceeding with the IRU in Accra and RRUs in Kwaso, Ho, and Tamale. The CPP accepted the recommendations and kept Johnson on as an advisor until early 1963.Footnote 74 Of the two types of rehabilitation, industrial was the most straightforward since it aimed to integrate urban Ghanaians, experienced in city life, into the workforce. The Accra IRU opened in February, 1963, with the mandate of providing strengthening and basic training to wage laborers disabled through work accidents or disease. The unit did not provide occupational training, but instead taught the basic skills needed as a foundation for job training onsite. The Rehabilitation Section estimated that the IRU would train between 240 and 280 people per year.Footnote 75 Case conferences would assess individual needs based on specific disabilities. The biggest groups were polio victims and amputees, although the IRU also admitted deaf and blind individuals, and many trainees suffered from paralysis of some kind. Once admitted, assessed and trained, the IRU employed the rehabilitees in workshops in carpentry, metalworking, and farm gardening. The placements were meant to assess the rehabilitees' capacity for specific occupations. The carpentry workshop took private orders and it made chair and stool frames for other disabled persons (outside the IRU) to finish and sell. From the metalworking workshop, individuals identified as gifted were apprenticed to the Labor Department as lathe turners. Farm gardening was meant to give them a skill they could use upon graduation to reduce their cost of living.Footnote 76
Rural rehabilitation was more complex than industrial, particularly because the government considered disabled peasants less modern than their urban counterparts, and partly because they had been less fully integrated into labor markets. The Rehabilitation Section envisioned producing ‘all-rounders’ through a ‘programme of activity … designed to promote the development of the whole man. On return the rehabilitee should be worthy of acceptance socially, and regarded as a confident, self-supporting villager of independent views.’Footnote 77 Graduates would be capable of supporting themselves independently and providing for their families, but also literate and well-versed in citizenship and African and world affairs. ‘The objective’, wrote Rehabilitation Director J. S. Adoo, in 1964, ‘is to turn out well informed, independent, self-supporting craftsmen and farmers.’ RRU trainees would receive instruction for six months in a wide variety of skills, including farming, poultry raising, house construction, tailoring, sandal-making and ‘one or more rural crafts.’ In addition, the RRUs devoted evening sessions to literacy training (including vernacular languages), discussions of African and world affairs and citizenship classes.Footnote 78 These classes, however, were not just about citizenship for citizenship's sake. Rather, they were ‘designed to … introduce them to work-discipline, and create work-mindedness in them.’Footnote 79 This would encourage the graduates to make ‘the fullest possible use of their residual capacities’ for the benefit of themselves and their communities. In this manner, the RRUs sought to internalize a strong work ethic in the peasant trainees, in the process making them believe that their social worth was tied to economic productivity and self-help. This did not, however, mean complete individual independence or freedom. In fact, citizenship topics included ‘the responsibility of the individual to the community’, and ‘ways in which the community could be helped.’Footnote 80 In other words, disabled peasants were to be rehabilitated as responsible citizens, self-supporting and economically productive but aware of their obligations to their communities.
Based on the Wilson Report, the Government established eight RRUs across the country, each capable of training fifty people every six months for a total of 800 per year. The Units were housed at existing Rural Training Centers already set up by the Department of Social Welfare and Community Development.Footnote 81 The technical advisor took up residence at the first RRU (Kwaso) in early January 1962, and disabled trainees began to arrive in early February. In August, 14 blind trainees from the Vocational Training Center for the Blind, which had been converted into the Accra IRU, were transferred to Kwaso bringing the total number of trainees to thirty. With the Unit up and running, the Government officially opened the Kwaso RRU in December 1962. Meanwhile, preparations were underway for a second unit at Ho, which also received 14 blind trainees from Accra, bringing the total to 34. The government officially opened the Ho RRU on 13 January 1963. The following April, a third RRU was opened officially in Tamale. Similar to the other RRUs, the Tamale unit received nine blind trainees from Accra, in addition to 27 from local areas. Finally, in the same month the government took over the Bolgatanga Sheltered Workshop and Vocational Training Center for the Blind and opened it as an RRU with 24 trainees as of the end of 1963.Footnote 82
Significantly, all of the trainees up to the end of 1963 were men.Footnote 83 Conscious of this problem, in 1964 the community development journal Advance referred to gender as a pressing issue, especially considering the socialist doctrine of the CPP. ‘[Women], like men’, stated a report in July 1964, ‘have a right to receive from a socialist society every assistance in improving their spiritual, social and economic welfare.’ To this end, women needed to be rehabilitated in trades offering adequate markets, including poultry farming, vegetable gardening, handicrafts, sewing, and soap-making. Provisions for women were to be made ‘as soon as possible’ by building accommodation for 18 women at each of the four RRUs. This program would build on a Home Training Scheme for Blind Women that was already underway, led by Grace Ingham, an Overseas Executive with the RCSB. On the surface, Ingham's scheme limited blind women's training to unpaid domestic labor, helping them ‘to once more become good housewives, mothers, and valued members of the community within which they live.’ However, this was not the full story, for Ingham also believed very strongly in training blind women for productive work, giving them an equal chance with their non-disabled counterparts. Her model and mentor was John Wilson, who had persevered to achieve much success in the workforce. Motivated by Wilson, Ingham encouraged Welfare Assistants to spend enough time with disabled Ghanaian women to understand their abilities and desires. Any woman who was motivated and showed promise for higher education would be sent to a Rehabilitation Unit. Propelled by Ingham's example, women found their way into the rehabilitation program between 1964 and 1966.Footnote 84
Along with disabled women, the Rehabilitation Section extended the program to able-bodied ‘destitutes’. Community development experts floated this idea as early as 1962 during a seminar on social work in West Africa held in Accra.Footnote 85 In the same year the Department of Social Welfare and Community Development explicitly placed the destitute in the same category as physically disabled persons.Footnote 86 In 1964, the Rehabilitation Section issued a plan for rehabilitating ‘able-bodied beggars and destitute people.’ The specific recommendation was to create a Rehabilitation Unit for the destitute, ‘preferably away from the big towns’, where they would be medically examined and ‘sorted into medical grades e.g. “fit for heavy full time work, fit for medium work.”’ Short training courses would be given and then the rehabilitees would be provided with government work ‘to tune them up’ and ‘accustom them to the rigors of a day's work.’ When they were ready, graduates would be ‘rigged out in a working suit’ and placed in industry or assisted with self-employment.Footnote 87 The records do not indicate how many ‘destitute citizens’ the Government integrated into the rehabilitation program. For our purposes, however, the principle of equating destitution with disability was significant in itself (more of which below).
During 1963, a relatively large number of rehabilitees found productive employment. In Accra, 56 out of 75 graduates found jobs, mostly in manufacturing but also in retail and the hotel industry. During the same year, a similar number of RRU graduates obtained wage employment in the smaller towns.Footnote 88 However, in light of Wilson's projections these numbers did not satisfy the Rehabilitation Section. To improve job placements, the Advisory Committee classified certain jobs as Designated Occupations, which gave preference to disabled persons when vacancies arose.Footnote 89 The archival records do not indicate whether this move enhanced employment opportunities for the rehabilitees. In fact, the RRUs reported in 1964 that many graduates failed to find work and ended up back home, dependent on their families as they had been before. Rehabilitation Section Director J. S. Adoo blamed this on a lack of capital and marketing support, and he recommended that the Government provide tools and marketing assistance. Voluntary Societies could help with the latter. He also suggested the development of sheltered workshops to combine the production of the graduates into bigger units.Footnote 90
There is little evidence that the Government made good on Adoo's requests, but in 1966 the Community Development journal Advance did highlight ‘successes’ in rehabilitation, showing that the program had worked for at least some rehabilitees. The journal published a list of 25 successful rehabilitation graduates, including men and women, from the IRU and RRUs. The rehabilitees found productive employment in a number of occupations, including craft production, teaching, industry, and trade. Most notably, ten became teachers at the middle school level, five worked as independent entrepreneurs, and four found work as seamstresses and tailors.Footnote 91 These stories indicate that Nkrumah's initiative achieved some notable successes, placing the graduates in relatively skilled occupations. However, this still leaves unanswered the question of the relationship between disability policy and Nkrumah's vision of national development.
DISABILITY, REHABILITATION AND THE NKRUMAHIST DEVELOPMENT VISION
In 1963, the director of the Rehabilitation Service claimed that the program had produced ‘a happy marriage between community development and rehabilitation.’Footnote 92 This statement reflected a shift in the meaning of community development. As noted above, since the late colonial period the term referred to protecting African communities from the disintegrative effects of ‘Westernization’ and individualism.Footnote 93 This doctrine subordinated economic goals, specifically the development of African wage labor, to the social goal of community preservation. By the 1960s the meaning had shifted, at least with respect to rehabilitation, because of the CPP's urgent need for economic growth. The tendency therefore was to subordinate social to economic goals. Hence, in 1963 the director reported that, although rehabilitation sought to develop ‘the total personality of each rehabilitee’, ultimately the program would be judged ‘by the extent to which it is able to find employment for its trainees.’Footnote 94 In the same year, the director of the Social Welfare and Community Development Department wrote that rehabilitation would allow disabled Ghanaians to become ‘producers rather than consumers.’Footnote 95 In this manner, by transforming disabled Ghanaians into productive workers, rehabilitation would make them ‘useful’ as well as ‘independent’ and ‘happy’ members of their communities.Footnote 96 This was an urgent matter connected to nothing less than ‘the Progress of the Nation.’Footnote 97 As we have seen, Nkrumah's national development program required a massive mobilization of new workers, towards which the country's 100,000 disabled citizens represented a potentially valuable contribution. ‘With the present emphasis on total utilization of man-power to meet the needs of our developing countries’, wrote rehabilitation service director J. S. Adoo in 1963, ‘the productive potentialities of the handicapped must be developed to enable this large segment of our population to find its place in the national economy.’Footnote 98 More specifically, rehabilitation could help to increase Ghana's skilled workforce, which was in short supply at this time.Footnote 99
In order to monitor and secure this project, the CPP absorbed disability organizations into the corporatist structure of the Nkrumahist state. During the 1950s the CPP left disability work largely to voluntary organizations, but by 1961 the Government had absorbed the voluntary sector. This meant that, although voluntary organizations were consulted on rehabilitation, the government took over the program's practical aspects and reduced the voluntary agencies to advocacy, experimentation and supplementary services.Footnote 100 Even then, CPP officials kept a watchful eye on their activities. ‘There is such a close liaison between the Department and these Voluntary Organizations’, stated the 1962 Annual Report of the Department of Social Welfare and Community Development, ‘that in certain cases department staff actively assist in the secretarial work of the societies. The Rehabilitation activities of these societies are closely watched both by the department and the National Advisory Committee for Rehabilitation in order to direct their resources properly towards making the most effective contribution to the national rehabilitation service.’Footnote 101
A prominent example of the corporatist take-over was the Gold Coast/Ghana Society for the Blind, which had been founded in 1951 as a branch of the British Empire Society for the Blind. The Society became autonomous at independence in 1957, responsible for a Vocational Training Center for the Blind in Accra (opened in 1954) and two sheltered workshops for rehabilitees. In the early 1960s, the Rehabilitation Section of the Department of Social Welfare and Community Development appropriated ‘the whole of the practical aspects of the Society’, reducing its role to public education, transport, pilot schemes and resettlement.Footnote 102 As part of the take-over, the CPP closed the Vocational Training Center in August 1962, and used the facilities for the Accra IRU.Footnote 103 In the same month, the minister for social welfare and community development created the Ghana Society for the Deaf as a lobby group for deaf Ghanaians, but under the control of the CPP.Footnote 104 As these examples demonstrate, the CPP's corporatist reach included the agencies working with disabled Ghanaians. Nkrumah, in short, absorbed disability programs into Ghana's de facto one-party state. In this manner, the CPP treated the disabled like all citizens, as potential inputs into the industrialization drive, who would fulfill their responsibilities towards national development under the watchful eye of the Nkrumahist state.
CONCLUSION
Nkrumah's rehabilitation program represented both a break and continuity with the late colonial period. He broke with colonialism by redefining community development to include rehabilitation, and he extended the rehabilitation programme to rural areas. But the program also drew directly on the colonial experience of the late 1940s, which in turn was rooted in the British model of social orthopaedics. This meant that Ghanaian rehabilitation in the 1960s shared the economic focus of the postwar British project. In retraining disabled individuals as wage workers, social orthopaedics tied citizenship to participation in the labor market. The journal Advance expressed this position very clearly in 1966, stating that ‘the aim of a rehabilitation system is to restore the disabled as nearly as possible to the economic and social position which they would have occupied but for their disability.’ This was justified by arguing that the disabled would benefit fully from ‘their status as a citizen’ only if they became productive workers.Footnote 105
Linking citizenship to work has been criticized severely in the literature on disability programs in Europe during the 1940s and 1950s. In a case study of Stoke Mandeville's Spinal Unit, for example, Anderson argues that rehabilitation was driven by political calculations as much as genuine concern over the lives of disabled ex-soldiers. Specifically, the British government supported rehabilitation because reintegration into the workforce would transform disabled citizens into taxpayers and reduce welfare costs. Anderson also notes that, although Stoke Mandeville achieved positive results, rehabilitation in general simply failed to integrate disabled soldiers into the regular workforce. Furthermore, most ‘rehabilitated’ persons found themselves confined to low-paying, low-skilled occupations.Footnote 106 Borsay echoes this argument, writing that ‘the bankruptcy of employment legislation after the war was made manifest in ongoing discrimination, low wages and unemployment.’Footnote 107 Bunzel makes a similar argument for East Germany. Even under state-socialism, the ‘ethos of productivism’ embedded in wartime rehabilitation subjected disabled persons to poorly paid or forced labor as well as social segregation. This reality undermined the ‘integration and self-actualization of people with disabilities.’Footnote 108
It is unclear whether this was true for Ghana in the 1960s. First, the rehabilitees who found work did relatively well, working in skilled occupations rather than ‘poorly paid or forced labor.’ Second, drawing from John Wilson's vision, the CPP's program opposed segregation and attempted to integrate disabled Ghanaians with the general population in schools and rehabilitation units. The training programs also integrated members of different disabled communities with each other. Third, it is debatable whether Nkrumah's rehabilitation program fed into ‘ongoing discrimination.’ Many disabled Ghanaians did not seem to have been treated well in their home communities,Footnote 109 and the successful rehabilitees might very well have improved their social standing through skilled occupations.
That being said, the Ghanaian program can be criticized from several angles, albeit different from those described by the critics of European rehabilitation. First, the program left little agency for the disabled themselves or for the voluntary organizations working on their behalf. Nkrumah's state kept as tight a rein on the disability program as on any other CPP-led initiative. Second, rehabilitation's focus on ‘normalizing’ disabled citizens had potentially negative implications for their treatment after graduation. Since the model assumed that rehabilitation leveled the playing field in the labor market, graduates who failed to find work had no-one but themselves to blame if they fell into destitution. For non-disabled ‘destitutes’, the Government asserted the right to arrest rehabilitees if they fell back into destitution. ‘After a course of rehabilitation of this sort’, wrote J. S. Adoo in 1964, ‘a relapse into begging could more appropriately be treated as an offence, and the person prosecuted for failing to maintain himself by lawful means.’Footnote 110 By including destitutes in the rehabilitation program, the CPP equated destitution and disability; one might say that ‘disabled’ meant ‘unemployable’. Presumably, therefore, the Government could have jailed disabled rehabilitees if they ended up begging on the streets. If they did not find productive employment, in other words, they could be considered ‘undeserving poor’, having joined the ranks of the ‘lazy’ and ‘unscrupulous’ citizens held in such contempt by Nkrumah and the CPP. On this point, rehabilitation officers regularly warned against the disabled becoming ‘idle consumers’ or falling into ‘delinquency or social maladjustment’.Footnote 111 These warnings betrayed the Janus-faced nature of rehabilitation under Nkrumah; it provided employment for some, but it unfolded within a regime that did not countenance refusal to participate in national development. Either way, Nkrumah's rehabilitation program was more about transforming Ghana's disabled population into ‘responsible’, productive citizens than looking after their welfare as an end in itself.
In the end, however, the positive legacy of the CPP's disability program arguably outweighed its negative aspects. First, Nkrumah's disability policies were unique and ahead of their time.Footnote 112 Second, despite the problems of corporatism discussed above, the CPP's centralization of the voluntary organizations helped to maintain Ghana's disability programs after 1966. In 1983, for instance, a comparative study of Ghana and Nigeria concluded that Ghana was providing more and better rehabilitation services than Nigeria.Footnote 113 Thirty years later, the Accra rehabilitation center in Accra survives as a going concern.Footnote 114 Third, the state-sponsored organizations of the 1960s laid the foundation for the emergence of a strong disability movement in the 1990s, which played a major role in the passage of the Persons with Disability Act of 2006.Footnote 115 While not unproblematic, the Act asserts the human rights of Ghana's disabled citizens to equal access to transportation, education, healthcare and employment.Footnote 116 This important step towards disability rights is perhaps the greatest legacy of Nkrumah's pioneering work of the 1960s.
