Public latrines,not extensions of homes - Prof. Akosa

Former Director- General of the Ghana Health Service, Prof Agyeman Badu Akosa has emphasised that public latrines are not extensions of homes and that landlords who rent out homes to tenants without toilet facilities should be sanctioned by the Accra Metropolitan Assembly (AMA).

He was in a conversation with the Greater Accra Regional Director of the Ghana Health Service (GHS), Dr Linda Van Otoo and the Public Health Director of Accra Metropolitan Assembly (AMA), Dr Simpson Boateng. They spoke on Akosa's Take last Sunday on Multi TV

Prof. Akosa, who is also the Executive Director of Healthy Ghana, a health-based NGO wondered how the country could break the cycle of the annual cholera ritual.

Dr Boateng recounted that four years ago when the capital was hard hit by the epidemic, the worse affected area was Abossey Okai and a survey conducted in the area revealed that about ninety percent of the households there did not have toilets.

He stressed that these homes originally had toilets in them but surprisingly they have been converted into living rooms and offices for extra income. “It is not as if Government is allowing that but it's the individuals themselves. Most of these people did these out of ignorance, not knowing what the absence of toilet in their homes can cause”, he added, saying that, before houses are built in Accra, drawings are submitted to the AMA for approval.

Dr Otoo regretted that Greater Accra Region led this year's epidemic with about 12,124 cases and 93 deaths recorded so far. She said every district in Accra, except Ada-West recorded cases.

“There have been a few cases from other regions and records show that, the victims travelled down to Accra to transact business and went back with diarrhoea which turned out to be cholera.”

The Regional Health Director revealed that areas which were hardest hit, had some form of public toilets which are privately owned, with sewage water running through gutters where water pipes have been laid. Some of these pipes have holes in them, making it easy for the pipes to carry bacteria into taps.  

She also pointed out that certain areas in the metropolis relied on tankers for domestic water supply, and some of these tankers are contracted to provide water for other purposes such as building which is fetched from anywhere. In some of the districts where people reported to hospitals with cholera, “it was realised that they relied on the services of these water tankers and it is possible that the water they drunk contained the faecal matter.”

The Metro Health Director said some areas in Accra were not planned for human settlements; therefore those places were not taken into account when water infrastructure was being laid.

He mentioned that one of the early cases of cholera was traced to a suburb called Neeboye town, where the source was traced to a well on which people depended for domestic water consumption. He again admitted that cholera is a major challenge in areas where there is water shortage.

Dr Otoo advocates that persons eating from public places should avoid washing their hands in bowls of water provided them, and advised consumers to rather pour water unto their hands from a jug or running water and refuse these bowls when they are provided.

In the same vein, Prof Akosa was concerned about the practice where there are no proper health checks, authorisation, certification and proper identification of food vendors who operate under hygienic conditions.

According to statistics available to the AMA, there are over 35,000 food vendors in the city, and an inadequate number of Environmental Health Officers which currently stands at about 120. This is a huge deficit to the required number of 2,000 according to WHO standards, considering the population of Accra.

He emphasised that it is not the policy of the AMA to allow people to vend food when they have not been certified medically fit to do so.

He stated that AMA is consistently arresting and prosecuting people through its sanitation court for sanitation offenses.

 The Health Service is particularly worried about children who are yet to return to school after the holiday season and the food and water they might consume in insanitary conditions. She urged parents and care givers at home to teach children how to wash their hands regularly with soap, especially after visiting the toilet and said the key to breaking the annual cholera cycle is the practice of personal and environmental hygiene.

She mentioned that the Ghana Health Service will embark on public education campaigns in almost every first and second cycle school in the regions