(A GNA feature by James Amoh Junior) Attitudinal Change: Key to the Attainment of the MDG on Sanitation

Bolgatanga, Oct. 8, GNA - Not long ago, President John Dramani Mahama as part of efforts to tackle the nation's sanitation problem, launched a campaign on sustained healthy sanitation practice in Ghana.

In this regard, the Ministry of Local Government and Rural Development (MLGRD) came up with a short-term strategy to deal with the sanitation menace and behaviour change among Ghanaians.

The three-month nationwide programme dubbed, 'The National Sanitation Programme', would be driven by an all-inclusive National Sanitation Task Force to be chaired by the Minister of Local Government and Rural Development. The responsibility of the task force is to, among other things, educate Ghanaians on sound sanitary practices and ultimately help in the collection of waste.

Logistics including 80 refuse trucks, 5,000 shovels, 20,000 refuse bins, 500 communal brooms, 500 Wellington boots and 5,000 rakes, have been provided for the programme.

In ensuring a cleaner environment, however, there's need for shared and collective responsibility in dealing radically with sanitation issues. So far, however, efforts at ensuring that sanitation in the country is improved to meet the targets of the Millennium Development Goal (MDG) on water and sanitation is commendable.

In September 2000, 147 Heads of state and governments as well as 189 nations including Ghana committed themselves to the attainment of the Millennium Development Goals. The MDGs stand for renewed commitment to overcome persistent poverty and address the most enduring failures of human development. Halving, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation is one of the targets set for achieving these MDGs.

Billions of people in the world currently lack access to adequate sanitation and are forced to dispose of their excreta in unsanitary ways. Those who suffer from the lack of this most basic human need, also tend to be victims of poverty, ill health and an overall poor quality of life.

A document issued at a forum by the Water and Sanitation Sector Monitoring Platform indicates that the country is on track at meeting the MDG, at 78 per cent, for the proportion of its population that uses improved quality of water by 2015 and could exceed the target by six per cent.

Nonetheless, it said achieving the target for improved sanitation appeared to be difficult and required an average of six per cent coverage per annum between 2006 and 2015 for Ghana to reach that particular MDG at 54 per cent.

The observation exposes the reality that, despite the best efforts of the government at improving sanitation in the country, a majority of the country's population still lack adequate sanitation.

Again, figures from the Environmental Health and Sanitation Directorate (EHSD) of the MLGRD revealed that poor sanitation cost the country 290 million dollars each year, representing 1.6 per cent of national Gross Domestic Product (GDP).

Whist open defecation costs Ghana 79 million dollars per year, 215 million dollars is lost each year due to premature death from unwholesome water, sanitation and hygiene. The country loses 19 million dollars each year in access time for defecation, whiles each person spends 2.5 days every year finding an obscure place to hide and defecate leading to economic loss.

Additionally, about 54 million dollars is spent each year on healthcare treating diarrhoea and other sanitation-related diseases. Approximately 13,900 Ghanaian adults and 5,100 children under five years die each year from diarrhoea, nearly 90 per cent of which is directly attributed to sanitation and water problems.

Indeed, if attitudes and behaviours are not changed with the current sanitation coverage of 14 per cent and current negative practices of open defecation, it would be difficult to meet the MDG on sanitation.

Without a sound national policy, there would be no focus for the planning of sanitation programmes. Policy inadequacies are the root cause of the failure in expanding sanitation coverage. There may, however, be some policies on sanitation but there have been difficulties in terms of their sustained implementation.

Information on sanitation in the country remains unsatisfactory and international non-governmental and sanitation related organizations have expressed worry about the sanitation situation in the country.

The Country Director of the United Nations Children's Fund (UNICEF), Dr Iyobo Olusanmi, expressed similar sentiments in an interaction with the Upper East Regional Minister, Mr Mark Woyongo during a visit to the Region.

She expressed dissatisfaction on national figures that ranked the Upper East Region highest in open defecation and second lowest on improved sanitation. She therefore called on district assemblies in the region to be more proactive in ensuring that all hands were on deck to encourage individuals to make sanitation their priority.

The Regional Minister in a swift response to the UNICEF Country Director's plea during the Annual Regional Health Sector Performance Review meeting, instructed district assemblies in the region to urgently consider the construction of public places of convenience at strategic locations to help reduce or eliminate open defecation in the region.

The directive was to ensure that building plans which did not make provision for toilet facilities were not approved, considering that positive health behavioural change practices by individuals was the best to accelerate the achievement of the MDGs.

Despite efforts of the Regional Minister in declaring a “zero-tolerance for litering” in the region and dealing with sanitation issues on a sustained basis, the once hygienic and cleanest region has given way to filth and there seems to be little improvement. A lot more needs to be done. This would be better achieved with the involvement of all stakeholders and community leaders in dealing with the canker.

“Sanitation and Open defecation in the region is still unbridled, despite intensive educational campaigns over the time”, Vice Chairman of the Coalition of NGOs in the Upper East Region, Mr Alogskomah Asekeya Noble said in an interview.

He attributed the incidence of increased open defecation to landlords in the region who have refused to provide toilet facilities in compound houses, adding that the district assemblies had also failed to ensure the effective implementation of sanitation bye-laws.

According to him, if some of these measures are not put in place, the region might not be able to contain the situation if there is an outbreak of cholera as has been experienced over time.

“Three out of 10 compound houses in the region have no places of convenience and this is a serious situation that must be addressed by Assemblies”, he said, adding that the health budget of the country could be reduced drastically if sanitation laws were strictly adhered to thereby reducing the prevalence of cholera and other diseases.

The question that then arises is: "Where do the tenants in these “compound houses defecate when they have to swiftly answer to nature's call?" Your presumptions perhaps are as good as mine.

President Mahama was as well quoted to have said at the launch of the National Sanitation campaign that Ghana was likely to miss the MDG target for improved sanitation by 2015 if pragmatic measures were not put in place to deal with the sanitation menace.

The President's observation is apt as sanitation remains a critical intervention needed to improve the living conditions among the poor and reduce or prevent diarrhoea, cholera and other serious conditions, especially among children.

While stating the way forward in tackling the sanitation menace in the Region and the country as a whole, there's the need to acknowledge the efforts of Zoomlion Ghana Limited and various environmental health and sanitation agencies.

With barely three years to reach 2015, however, the elimination of open defecation in the Upper East Region and the entire country for that matter, would require effective sensitization among individuals for rapid and positive attitudinal change. This also necessitates the popularisation of the use of latrines and improved toilet facilities.

There should be increased investment support to the Community Water and Sanitation Agency to ensure efficiency in the improvement of sanitation while government should further increase budgetary allocation to water and sanitation.

Development partners in the region and the country should institute environmental clubs and strengthen existing ones in schools to instill in children, environmental cleanliness to do away with poor sanitation at all levels. In furtherance to that, an award scheme should be instituted for schools that consistently observe environmental and sanitation regulations.

In the Upper East for instance, a Regional Inter Agency Coordinating Council (RICC) has been the established to provide efficient policy direction, plans and review progress of water, sanitation and hygiene. This could be replicated nationwide for the same purpose.

With the country achieving only 14 per cent of sanitation coverage out of the 54 per cent envisaged for 2015, there is urgent need for attitudinal and behavioural change with all key stakeholders getting involved in nibbing in the bud the sanitation canker bedeviling the entire country. An intensified and sustained campaign for ttitudinal and behavioural change is paramount in the search for a solution to Ghana's sanitation predicament.

GNA