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19.11.2008 Feature Article

Sanitation: a primary step to human development

Who says people are not prepared to change? Who says no matter the social amenities provided for people, they will not make good use of them? Who says the Ghanaian society, as well as the African continent, will never develop till the people have a change of mindset?

The nature of an environment is always believed to be the nature of the people. In the Ghanaian society many people often complain of not the having enough social amenities to keep society and themselves hygienic. Imagine a community called Kakasunanka, near Kpone in the Greater Accra Region, with a population of about 3000. The increase in the migration of people to the community is making the population of the community grow rapidly. However, it does not have the needed social amenities to support the growth.

The community with a population as such, has only one public toilet, which people find difficult to use due to the stench at the place, which compels them to take a bath immediately after use, with others complaining of nausea due to its extremity.

In preventing these adverse effects, the alternative people choose, is defecating into polythene bags and dumping it in bins. Others prefer to go to a nearby bush to defecate, which in the long run produces an extremely bad odour in the environment. Apart from the behaviour of people this community, other communities, which find themselves near river banks and seashores, tend to use these places for defecation.

This in a way implies that if communities are provided with a good number of Kumasi Ventilated Improved Pits (KVIPs), surely, they would have no reason for this uncouth behaviour.

People must come to the realisation that improving sanitation fosters social development or human progress in several ways. People and the community will automatically develop when the proper amenities are made available, hence preventing them from being infected by diseases. As much as sanitation is important, health, as well as education, is essential for the development of people, and the community as a whole.

Sanitation and defecation

According to the Ghana Statistical Service multiple indicator cluster survey report for 2006, open defecation was prevalent in all the ten regions of Ghana, but most widespread in Upper East with 82% without any form of latrine, followed by Upper West 79% and the Northern Region with 72%. Official's statistics of the Ghana Health Service indicates that about 80% of out-patient-department (OPD) cases are sanitation and water-related. The Environment Health and Sanitation Directorate, of Ministry of Local Government, Rural Development and Environment (MLGRDE), says that Ghana is able to manage only 30% of solid waste generated daily. The 70% deficit accounts for the incremental heaps are found in almost every corner of our cities like Accra, Kumasi, Tamale, etc., everyday.

According to the Integrated Social Development Centre (ISODEC) sanitation needs champions willing to break the taboos surrounding open defecation, and speak plainly about the high economic, social and environmental and costs associated with the lack of sanitary toilets.

Toilets are a prerequisite for clean, healthy households and community living environments, particularly in dense settlements. They are also vital to safeguarding environmental quality more broadly, especially the quality of water resources.

Each person produces about 150 grams of faeces per a day, so open defecation around the world results in huge tonnages of human excreta deposited in and around communities. Living in a squalid environment harms the physical and psychological health, and is stigmatising and deepens human poverty. In the developing world, roughly 90% of sewerage is discharged, untreated, into rivers, polluting waters and killing fish and plant life. In Southeast Asia alone, 13 million tonnes of faeces are released into inland water sources each year, and in Indonesia and Vietnam, it creates environmental costs of over US$200 million annually, primarily from the loss of productive land. Sanitation and health

Sanitation is vital for health. A community with a bad sense of sanitation has a high possibility of its people being always sick. According to ISODEC, diarrhoea, caused by poor sanitation, kills 5,000 infants and children. Access to hygienic toilets can reduce child diarrhoeal death by more than 30%, and hand washing can reduce them by more than 40%. Intestinal worms, which are transmitted when people ingest faecal matter or step in it barefooted, divert around one-third of the food a child consumes. Water is an essential component for human beings and all forms of life on earth; water has always been part of the global commons by default, hence the inalienable rights of individuals to the accessibility of water.

This right means guaranteeing a minimum quantity of water that is “sufficient for life and health” for everyone. Most times, when water is contaminated, especially through defecation, it results in the outbreak of diseases. Lack of access to clean water exposes people to water-borne diseases such as guinea worm, cholera and diarrhoea. In 2007 and after 50 years of independence, Ghana became the second most guinea worm infested country in the world. Privatisation has led to an improvement in the existing facilities, but has led to unreliable water supply and tariff increases, which have priced out, in the process, a large section of the population from accessing water.

Health and the society

In as much as sanitation is vital for health, ISODEC's research indicates that a major challenge in the health sector, is the difficulty in reaching the poor and communities, which are very hard to reach, particularly those in the rural areas and deprived communities still lacking access to quality health services? The new Ghana health policy indicates that currently 65% of the population use traditional and alternative medical care, although this component of health service is not adequately regulated or fully integrated into the existing health service delivery system. The disparity in service input is largely driven by the exceedingly unequal distribution of doctors across the regions. In 2003, the doctor to population ratio was 1:5,368 in the Greater Accra Region, whereas the Northern Region was 1:71,267. It is therefore not surprising that rural dwellers have a worse health status than the rich and urban dwellers.

Tremendous gains made in the health sector, from the immediate post independence era in Ghana, has led to improvements in life expectancy over the years. The prevention of a range of communicable diseases such as measles, poliomyelitis and diphtheria, has also led to improved child survival and development. Expanded health services, based on the principles of primary healthcare, as well as progress in education and socio-economic development, have also contributed to these gains. Furthermore, public resources to the health sector have increased substantially in recent years. Between 2000 and 2005 budget allocations to the Ministry of Health from the consolidated fund grew by 179%, increasing from 7.54% of total domestic financed discretionary expenditure to 12.43%.

However, despite this progress, and despite the improvements in the level of funds to the health sector, access to quality health service continues to elude many people in Ghana, especially the poor and rural dwellers.

For instance, there has been no significant change in Ghana's under-five and infant mortality rates between 1993 and 2006. Life expectancy has also stagnated between 57.42 years in 2000 and 56 years in 2005. Ghana's Human Development Index (HDI) is also worsening. After improving from 0.444 in 1975 to 0.563 in 2001, the HDI dropped to 0.520 in 2005.

Conclusion

People need orientation through education and awareness, if the people' economy is improved through the provision of good infrastructure, and social amenities things around them will automatically change. If people are educated, it would give them the knowledge on how infrastructure and social amenities are used, when they get access to them. Education is a basic human right. It is also a pre-condition for sustained growth and poverty reduction.

According to ISODEC, most of international conventions and other national and sector reports, like the Ghana Poverty Reduction Strategy (GPRS) concentrate on access, quality and equity at the basic level.

The 1992 Constitution of Ghana guarantees free and compulsory basic education to every child of school going age. The Millennium Development Goals (MDGs) puts emphasis on universal primary completion by 2015. This implies that the primary admission ratio must reach 100% by 2006/2007, in order for all of them to complete primary by 2012 and JHS by 2015. The number of primary schools has increased from1 6,903 in 2006/07 to 17,315 in 2007/08, due to how important education is.

It is the obligation of Ghanaians to encourage themselves, as well as others, to seek academic education.

The Chronicle
The Chronicle, © 2008

The author has 68 publications published on Modern Ghana. Column Page: TheChronicle

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