Towards an open defecation-free nation: Contrasts from Bakpe and Kpale-Xorse

(A GNA feature by A.B. Kafui Kanyi)
Ho, March 6, GNA - Dysentery, worm infestation, typhoid and cholera are common diseases in Bakpe, a farming community near Akrofu in the Ho-West District of the Volta Region.

Children are often rushed from the community to nearby health centres for medical attention, some losing their lives along the line.

Many more people, old and young, rely on herbal preparations and destiny for healing from the diseases, with opinion leaders blaming the situation on an invasion of the community by houseflies.

Indeed, Bakpe is the hometown of houseflies. They are everywhere and one has to be extra alert, especially if you are holding ready-to-eat food.

You are also likely to swallow a couple of houseflies should you keep your mouth opened for seconds.

Community-Led Total Sanitation (CLTS) is an approach to achieve sustained behaviour change in mainly rural people by a process of "triggering," leading to spontaneous and long-term abandonment of open defecation practices.

Bakpe is a candidate for CLTS. It has a very poor hygiene and open defecation is the norm. One is welcomed into the community by small pools of bathwater from bathhouses dotted around the community.

Shrubs are found around bathhouses and behind houses.

Bakpe Number One, with a population of over 400 people has only one poorly constructed communal latrine located a few metres away from the community.

That latrine serves both males and females and can only be used by two persons of same sex at a time, for which reason a good number of people in the community admitted they defecate in the open.

Emmanuel Dorla, Chief of the Community in an interaction with journalists and a team from the Environmental Health and Sanitation Department of the Local Government and Rural Development said children defecate in the open but their parents 'clear them'.

Available statistics in 2015 indicate that about 19 per cent of Ghanaians, representing nearly five million people, defecate in the open every day with the practice exerting significant financial pressure on the nation running into about 79 million dollars annually.

People in Bakpe are part of that percentage with their domestic animals - goats, dogs and fowls competing with humans in free range Open Defecation (OD).

The World Health Organization says, 'using proper toilets and hand washing - preferably with soap - prevents the transfer of bacteria, viruses and parasites found in human excreta which otherwise contaminate water resources, soil and food.

'This contamination is a major cause of diarrhoea, the second biggest killer of children in developing countries, and leads to other major diseases such as cholera, schistosomiasis, and trachoma.'

Schoolchildren in the community are served free meals (school feeding) in an open kitchen very close to a bathhouse, with flies traversing between the kitchen and the bath area.

The Ghana News Agency (GNA) spotted a few pupils stepping into bathwater meandering through the kitchen as they jostled in a windy queue to be served free meals.

A girl was also spotted cleaning her 'backside' with leaves in a bush after using the school toilet, with the excuse of no anal cleansing material in the toilet built by Pencils of Promise, an NGO.

After talking to the GNA reluctantly, the Class Two pupil hopped out of the bush and rushed to join her friends who were playing under a mango tree.

Kpale-xorse, a homogenous Church community whose residents are all members of the Christ Apostolic Faith, is a sharp contrast to Bakpe.

Kpale-xorse is known for the belief in faith healing as against the use of orthodox medicine and other scientific ways of healthy living.

In the year 2000, the community came into local and international media for preventing medical teams from immunizing their children against polio, arguing that no medicine can cure humans except the power of God.

Interestingly, the people welcomed CLTS of the Ghana Government and UNICEF Water Sanitation and Hygiene (WASH) in 2012, which they said was in line with Deuteronomy 23:12-14.

After officers of the Environmental Health Office in Ho triggered the community on CLTS, natural leaders took up the campaign to eradicate open defecation totally in the community and encourage every household to own toilets and hand-washing facilities.

Within three months, over 60 per cent of the households owned toilets and hand-washing facilities, leading to the declaration of the community as among the first five Open Defecation Free (ODF) communities in the Volta Region in 2012.

Currently, over 80 per cent of households own toilets and locally made hand-washing facilities with houses yet to have toilets sharing with their neighbours, Madam Janet Abiwu, Natural Leader in the Community told journalists and a team of officers from the Environmental Health Department and UNICEF during a tour of the community.

The GNA observed that the town is very clean. Houses, lanes and alley-ways and other public places, well swept with no sign of rubbish anywhere.

Pastor Henry Johnson, an Assistant Pastor in the Church said the Church was built on biblical principles which prescribed cleanliness as an attribute of God so it capitalized on the CLTS campaign to enforce such provisions in the Bible.

He said the Church disabused the minds of the people that household toilets are for the rich and encourage them to own the facility as demanded by God.

The community has no drinking spots as the people do not take alcoholic beverages. The GNA was also told the community never had issues of teenage pregnancy because adolescents are strictly entreated to abstain from sex until they are married and polygamy and concubines prohibited.

Madam Abiwu said in the last three years, people in the community were able to save enough money from not visiting the hospital, which they mobilized to construct a Junior High School for the community.

The GNA learnt that because of the Church's principles on cleanliness since 1931, the life expectancy of people in the community is around 90 years, and that the youngest person who died in the community was 58 years.

Mr Emmanuel Addai, Communication Consultant, Environmental Health and Sanitation Department, Ministry of Local Government and Rural Development says access to water and improved sanitation has a direct influence on life expectancy.

Indications are that CLTS is changing open defecation behaviours in thousands of rural communities.

As at the end of 2014, none of the 769 rural communities in the Volta Region where CLTS had been introduced had reported a cholera case since the outbreak in June that year, which affected 680 people in the Region - an indication that the Region could achieve its target of open defecation-free by December 2016 but of course having to work on Bakpe and a few other OD communities.

It is recommended that ODF communities, which are now racing to be declared sanitized communities must mentor OD communities.

There should be a network of natural leaders - a platform for sharing ideas and experiences to fast-track CLTS campaign aimed at 'killing' the habit of endemic open defecation in the Volta, Northern, Upper East, Upper West and Central regions by 2020.

It is worth noting that the world has become a global village and one can find him/herself in any community anytime, hence the need for cooperation and collaboration in addressing the challenge.

Metropolitan, Municipal and District Assemblies must also demonstrate commitment to the course and support the efforts of the locals in constructing household toilets and access to water.

Financial institutions could also come in with soft loans to help the locals overcome financial challenges in achieving their targets of being ODF.

That way, the country would be inching towards achieving Sustainable Development Goal Six - access to clean water and sanitation, ahead of 2030.

GNA

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