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Psychiatric patients, some in shackles, are seen at the home of Afa Dauda, a traditional healer, in Nyankpala. Though Dauda is gentle with his patients and clearly cares about their wellbeing, he uses shackles to restrain those who pose a danger to themselves or others - a common practice in northern Ghana in particular. In some cases, healers assert that such restraints are a necessary part of the treatment and warn that they cannot be removed, except by the healer, without spiritual ramifications.