Most Africans are largely unaware of autism, despite its prevalence. In surveys conducted in Kenya, Nigeria, Tanzania and Ethiopia, healthcare workers and families frequently attribute its features to a curse brought on by a taboo such as cheating on a spouse or being possessed by an evil spirit.
ASD (Autism Spectrum Disorder) refers to a range of conditions characterized by some degree of impaired social behaviour, communication and language, and a narrow range of interests and activities that are both unique to the individual and carried out repetitively.
ASDs begin in childhood and tend to persist into adolescence and adulthood. In most cases the conditions are apparent during the first 5 years of life. Individuals with ASD often present other co-occurring conditions, including epilepsy, depression, anxiety and attention deficit hyperactivity disorder (ADHD). The level of intellectual functioning in individuals with ASDs is extremely variable, extending from profound impairment to superior levels.
Individuals with ASDs are not by-products of society. They are important in the society as anybody else. When a society does not have a collective understanding of a group of people, they are often subject to neglect and abuse of many forms. The society I have lived for many years will even go to the extent of inventing derogatory names to classify people born with such a condition.
The brain drain of countries in Sub-Sahara Africa is not all about our doctors, engineers and scientists seeking greener pastures across the Atlantic. The brain drain of Autism is not carried away in ships or airplanes to Europe or the Americas. It is carried away by ignorance and the attitude of society. This kind of brain drain occurs when there are too many politicians in a region of the world who do not appreciate their priority of enacting and amending laws for the vulnerable groups in society.
I will take a cue from the American Creed on the declaration of independence. Thomas Jefferson was the principal author of the Declaration of Independence. The Declaration states, “We hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness….”
All men are created equal not because they are genetically, intellectually or emotionally identical. All men are created equal because they all have in them something to give to the society with equitable opportunities. This required opportunity is what is missing for individuals with ASD in many societies.
There is a long list of people who have achieved so much in their areas of endeavors who had an ASD. Albert Einstein was thought to have autism because he experienced delayed language development and a significant slowness in his early education.
It is estimated that worldwide, 1 in 160 children has an ASD. This estimate represents an average figure, and reported prevalence varies substantially across studies. Some well-controlled studies have, however, reported figures that are substantially higher. The prevalence of ASD in many low- and middle-income countries is so far unknown. Based on epidemiological studies conducted over the past 50 years, the prevalence of ASD appears to be increasing globally.
Available scientific evidence suggests that there are probably many factors that make a child more likely to have an ASD, including environmental and genetic factors. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or Fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder.
Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder. Available epidemiological data are conclusive that there is no evidence of a causal association between measles, mumps and rubella vaccine, and ASD. There is also no evidence to suggest that any other childhood vaccine may increase the risk of ASD.
Intervention during early childhood is important to promote the optimal development and well-being of people with an ASD. Monitoring of child development as part of routine maternal and child health care is recommended. It is important that, once identified, children with an ASD and their families are offered relevant information, services, referrals, and practical support according to their individual needs. A cure for ASD is not available. Evidence-based psychosocial interventions, however, such as behavioural treatment and skills training programmes for parents and other caregivers, can reduce difficulties in communication and social behaviour, with a positive impact on the person’s well-being and quality of life.
We cannot continue to let children with an ASD to sit in the same classroom with others receiving the same style of education which is disadvantageous to them. Many have been called stupid by societies which were not intelligent enough to adopt or create innovative ways of teaching these individuals and giving them equitable opportunities.
The health-care needs of people with ASDs are complex and require a range of integrated services, including health promotion, care, rehabilitation services, and collaboration with other sectors such as the education, employment and social sectors. Interventions for people with ASD and other developmental disorders need to be accompanied by broader actions for making their physical, social, and attitudinal environments more accessible, inclusive and supportive.
Dr. Osei Boaitey
Institute of Qualitative Methodology
University of Alberta, Canada
World Health Organisation (WHO)