Developing Land and Infrastructure for Health Promotion. Following my first article on the problems of town planning in Accra, a number of people responded to the content, and made suggestions regarding the underlying causes of the current problems, and the way forward. These responses provide the bases for me to argue for collaboration between central and decentralised planning bodies, and for our Government and planning departments to visualise the situation in relation to coming decades, as they may impact on health and total quality of life.
The current definition of good health by the World Health Organisation suggests that good health is not the mere absence of disease. For a country like Ghana that spends the bulk of her resources to treat illness and diseases, we need to plan both land use and infrastructure towards health promotion in our capital city, urban centres and settled areas. I want to use the case of Accra to illustrate why we need to do this and how other areas may look at the strategy for adoption. Many settled areas in Accra and Ghana defy the some common-sense rules like building in marshy areas, near our water sources, and the reserves ear-marked for parks, sports-grounds, clinics and schools. As noted in my Article on 'Why Town Planning in Accra is Flawed…' the settlements in the Weija dam area is a case in point, which have implications for access, health and quality of life.
In the case of Accra, it is apparent now that, with a rapid increase in the Ghanaian population and tendency towards living in urban areas, Accra will stretch as far as Nsawam and Winneba by the end of this decade. This projection also means that the capital city will merge with Suhum, Dodowa and possibly Apam-Junction by the year 2050. The other thing, essential to observe about Accra is the import and use of all the old cars from Europe, which are like moving chimneys on our narrow streets. There is a lot of documentation in the Ghana Media about the rate of air-pollution in Accra from such a combination of factors, which are bound to get worse.
The implications of such projections suggest that inevitably, there will be more problems about access, limitations to good health and quality of life. This thus requires that our planning services broaden their purview to allow for forward vision about restructuring essential services and infrastructure required for such a vast urban area; one that will cumulatively arrest the deterioration of health of the population.
We can envision that without such a broader and forward approach, the health of people in the Accra will deteriorate, mainly from these structural deficiencies. In remembering that good health is not merely the absence of disease, there is need for land use to change in line with the notion of health promotion.
The current practice in our urban planning departments appears to give little attention to revising the ratio of built-up to the non-built up areas in land demarcations. Should these current practice continue, I envision that by the year 2050 the disproportion between the built-up and non-built-up areas in Accra, will result in Accra becoming one of the biggest ghettos in the world; one that will surpass the ghettos of Rio de Janerio.
This situation I contend, applies to all the urban areas of Ghana. In my recent article published on the Ghanaweb Sports section (26th May 2005) entitled 'Tamale New Stadium: A Look Beyond the Walls', I called on the Northern Regional Administration, Ministry of Sports, and Tamale Municipal Assembly to set up a comprehensive development plan linking the building of the new stadium, to the development of the Tamale Forest Reserve. Tamale is lucky to have such a unique reserve in the centre of town, close to which the new modern stadium for the African cup 2008 is to be built. It becomes evident that the reserve is a resource that needs to be developed as party of a renewed eco-sustainability vision, and for the short and long-term benefit of the 2008 event, and the Tamale population respectively.
The issue about linkage in Tamale applies to Accra, and in order to avoid the creation of a big 'ghetto capital city', many people responding to my first article had different short and long-term ideas. However, I thought of three (3 ) issues that all have bearing on ensuring positive health outcomes of the population. The suggestions, which I present below can, have some positive impact on the quality of life of the population, because they are likely to resolve problems around water supply/quality, air quality, recreation and physical health.
I suggest the following actions be undertaken now in Accra:
1. Government should acquire or at least protect the water resources, and systematise the sewerage systems. In particular Government needs to acquire and protect the land and catchment areas of the Weija dam and rivulets from settlement to provide drinking water into the next century.
2. Reserve up to 5 % of the land areas in the city of Accra for parks, gardens, sports and recreation arenas, to compensate for the absence of these facilities in old settled areas of Accra. The World Health Organisation and other health bodies have emphasised the benefit of parks/ open-lands for recreation and sports to our health, and total well-being. Surprisingly, in the whole of Accra, there is only one known natural reserve -The Achimota Forest. God knows how long it will take this reserve to grow into a real forest, but the natural piece of green enhances the air quality around Accra. Many young people are forced to play soccer on side streets in Accra, and in the newly developed areas there is not enough space for walk-ways/bike paths. The net effects of all these problems will be borne by the future generation.
Many more of such open areas are required in the city and it is possible to demarcate a targeted percentage of land now and develop them later into parks, sports venues and reserves. Otherwise, we will be creating (perhaps) the biggest 'ghetto capital city' in the 21st Century. I am aware that the department of planning (in theory) has a set percentage, which is considerably inadequate for such purposes. Thus, this target percentage may need to increase to levels commensurate with our growing population and changing lifestyles, and to require all land users to rigorously adhere to laid-down procedures.
3. Alternative roads are also needed out of the city, and it is reasonable and practicable now to create multiple carriage roads along the Dodowa corridor and the Awoshie area. The Dodowa multiple carriage roads could eventually link up with Akwapim and also branch off to link with the roads in the Somanya area. The Awoshie area multiple carriage roads could head in a North-Westly direction, with branch off heading towards the coastline to link-up with the Cape Coast road beyond Winneba-Junction. The other branch road that will head north should link up with the Kumasi road around the Suhum junction or beyond. These measure are needed ahead of any developments that will make such an idea impracticable.
4. Decentralise official business in Accra by creating a Northern Sector Business District in the Northern suburbs after Madina. These sector offices should include all the relevant Government ministries including Foreign Affairs, Education, Health, Employment and Social Welfare etc. It is further suggested the Northern Business District be located between Medina and Dodowa, and should have intra-net linkages with the southern sector offices in the current ministries area. At the present many travellers from Akwapim, Legon/Medina and Tema have to travel 10 miles from Medina area into the city for official business in the Ministries area. By empowering the offices in the Northern Business District to deal with these issues through caseload allocation, people will not go to Accra central to do business, and all buses from Akwapim will simply off-load around Medina area. This development also provides opportunity for the population to consider moving settlements away from the congested coastline areas that are prone to flooding. With the current projections in favour of general sea-level rise due to Global warming, Government can decongest these areas including unauthorised settlements like 'Sodom and Gomorrah' in advance of other eventualities.
5. A law is also needed that gives Government the power to demolish properties constructed in marshy areas even after 50 or 100 years. At the present in Accra, whole communities are suffering the lack of desired and/or adequate services. In some cases streets cannot be constructed to standards because of illegal encroachment and developments, as well as settlement in marshy areas. This type of law will allow subsequent generations to have access to built-up pieces of land that impact on the wellbeing of the entire community at no cost to the public.
Ghana has the potential to undertake the best for her population and I hope these suggestions will be given thought by all of us, because they may contribute to improving access, and quality of life in the capital city in the coming decades. Thanks to all those who contributed to the discussion! God
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