The world has travelled very far from the stone age through bronze and iron age to what we term today as a technological age. The movement from a simple less-civilized living to a more sophisticated technology-driven way of life has brought in its wake significant development at both the individual, household, community and national levels. The state of our buildings have changed. Our roads and the vehicles that ply them have changed. The way we communicated with one another has changed. There is a general sense of social progress in the wake of continuous innovations.

It is however regrettable to note that in the midst of the perceived multi-dimensional change and progress in our social setting, one area of our living has not change that much: the way we perceive and actually deal with sanitation.

1. Houses without toilets:
It is difficult to comprehend why in a 21st Century Ghanaian society, anyone would put up a building and forget or deliberately overlook the need to make provision for a place of convenience. In so long as we supply our bodies with food and water, nature would call as a matter of logical consequence. Dispelling waste matter from the body is a key biological characteristic possessed by all living things. Humans therefore need a well prepared place to respond to nature's call in a convenient and hygienic manner. Landlords who build without toilets are therefore inconsiderate, especially when such houses are offered for rent. Under normal circumstances one would expect prospective tenants to reject an abode without toilet facilities. Unfortunately we live in a country with a huge housing deficit which renders prospective tenants very vulnerable with limited choices available. Metropolitan, Municipal and District Assemblies should live up to their own bye-laws and rigorously enforce building standards to overcome this challenge to national development. The national body charged with the responsibility to oversee rent and its related activities must also be proactive and undertake inspection of homes for clearance and accreditation as places fit to be offered for rent. It is worth pursuing even if this may call for legislation. We must get to a time when recalcitrant landlords must be charged before the law for inconsiderate behaviour and lack of compliance with national building code.

2. Litter everywhere in our cities
All our major cities and towns are filled with litter all around. Litter is found on streets, in markets, in gutters, in all open spaces and so forth. Beaches are not spared this canker. Holiday makers at a beach in Accra on the 2012 Republic Holiday were seen swimming in the sea filled with garbage. It was a despicable spectacle. So serious is the litter menace that President John Evans Atta Mills when campaigning in 2008 promised to rid Accra of filth within the first 100 days in office. Three and a half years into the President's rule, Ghana is more filthier than ever before. While we can conclude that President Mills has failed to redeem his promise to rid Accra of filth, it is reasonable to note that even if he ensure that Accra was cleaned each day, but the littering continued unabated, he would surely not succeed. The problem therefore goes beyond merely getting the filth away. It has to do with our mindset. As a society we are all guilty for the indiscriminate littering of our cities and towns. Men are guilty, women are guilty. Children are guilty, adults are guilty. Illiterates are guilty, the educated are guilty. Non-worshippers of God are guilty, worshippers of God are guilty. In today's society when countries are raking in money from tourism and enhancing the total national earnings, a filthy environment is surely a disincentive.

3. No Toilets and urinals along major highways.
One area where our social planners and policy maker in local government have given little attention to is what the Americans call 'rest-rooms'. I mean toilets and urinals along major highways. Travelers must do well to contain any uneasiness they may feel while in transit or content themselves with free range in the bush! From Accra to Bolgatanga, the only rest-places are LindaDor at Bunso, the respective yards of the various transport companies in Kumasi, and the Rest-stop at Kintampo Waterfalls. Have you come across a passenger bus that has stopped in the course of a journey with both men and women urinating together? In this era when most women wear trousers, it is not a good sight to bear. Local Government authorities must endeavour to provide toilets and urinals along highways to create jobs and to serve as a source of revenue. It would at the same time serve commuters and make travelling convenient.

4. Spiting and throwing of phlegm in public
There is nothing so nauseating and irritating than to be in a spitting party. People spit and throw phlegm everywhere. From moving vehicle they spit. On the street they spit. In the market they spit. In fact anywhere is a spiting place. To the extent that in one hospital in Accra, it is boldly displayed at vantage points: DO NOT SPIT HERE'. Indiscriminate spiting is definitely a public health menace that should be stopped. Maybe we need to get donor funds to provide education on the dangers of open spiting and throwing of phlegm just as we did with hand washing.

Obviously, EnvironMENTAL consciousness and sanitation awareness are so limited among a section of the people that by our individual and collective acts, we have destroyed our wet-lands, reduced the attractiveness of our beaches, created flooding as a result of chocked gutters etc. The cost of the insanity with sanitation is obviously high to Ghana and it is about time we enforced the law, changed our attitude and became each other's keeper.

The writer is a Health/Public Administrator and a Youth Development Advisor