Mat<strong>the</strong>w Biniyam KursahTRITA LWR Master Thesisenvironments, characterised by near-<strong>the</strong>-door-faeces, far-from-door-clean-<strong>water</strong>,uncontrolled sewage, presence <strong>of</strong> dugout pits, frequent interruption <strong>of</strong>pipe <strong>water</strong>, poor waste disposal, poverty, illiteracy <strong>and</strong> ignorance. Thehigh use <strong>of</strong> woodfuel for cooking (also charcoal processing), <strong>and</strong> tosome extent <strong>the</strong> widespread <strong>of</strong> bushfires <strong>and</strong> <strong>the</strong> Harmattan,accompanied by dust, may explain <strong>the</strong> widespread <strong>of</strong> respiratory diseasesin <strong>the</strong> district, irrespective <strong>of</strong> geography. Due to <strong>the</strong> fewer number <strong>of</strong>vehicles that ply <strong>the</strong> roads in <strong>the</strong> district <strong>and</strong> <strong>the</strong> nature <strong>of</strong> potholes on<strong>the</strong> road (reduces speed), <strong>the</strong> emission <strong>of</strong> smoke <strong>and</strong> dust are generallyminimal, <strong>and</strong> <strong>the</strong>refore may have limited effects on <strong>the</strong> health (RTI) <strong>of</strong><strong>the</strong> people. It is not surprising that <strong>the</strong> study did not find any significantrelationship between RTI <strong>and</strong> distance to roads in <strong>the</strong> district. Theintervention measures to reduce health burdens (malaria <strong>and</strong> o<strong>the</strong>rdiseases) in <strong>the</strong> district must not target only settlements alongconventional <strong>water</strong>courses (rivers, streams etc) but <strong>the</strong> entire district as awhole, with focus on eliminating potholes <strong>and</strong> stagnant <strong>water</strong>. This studyhighlights that issues <strong>of</strong> environment, specifically <strong>water</strong> <strong>and</strong> diseasesmust be treated multi-sectorial manner, including departments <strong>of</strong>;finance, health, sanitation, agriculture, animal husb<strong>and</strong>ry <strong>and</strong> <strong>water</strong>; <strong>and</strong>above all, a strong political will, since <strong>water</strong> is a right to life, <strong>and</strong> goodhealth a right to existence. The study finally concludes that <strong>the</strong> policy for<strong>the</strong> district must accept that <strong>water</strong> has no substitute <strong>and</strong> could be <strong>the</strong> oilcrisis <strong>of</strong> 21 st century, <strong>and</strong> its inadequacy in quality could be devastating on<strong>the</strong> health <strong>of</strong> <strong>the</strong> people. It must also be understood that <strong>the</strong> districtcannot solve <strong>the</strong> 21 st century <strong>water</strong> challenge with 20 th centurybureaucracy <strong>and</strong> laws.RecommendationsBased on <strong>the</strong> study, <strong>the</strong> following recommendations are made to helpinfluence <strong>and</strong> redirect health, <strong>water</strong> <strong>and</strong> social policies for <strong>the</strong> benefit <strong>of</strong><strong>the</strong> citizenry in Saboba district, <strong>and</strong> Ghana as a whole.Health <strong>of</strong>ficialsThis study recommends that health <strong>of</strong>ficials, <strong>and</strong> also district assembly<strong>and</strong> <strong>the</strong> NGOs, to reprioritise <strong>the</strong>ir health campaigns to create moreawareness on <strong>the</strong> most common diseases in <strong>the</strong> district such as Malaria,Typhoid, RTI <strong>and</strong> diarrhoea, ra<strong>the</strong>r than tolling <strong>the</strong> international-diseasecampaign-trends. While it is important to campaign against HIV/AIDS<strong>and</strong> Guinea worms, doing so by neglecting Malaria, Typhoid <strong>and</strong> RTI isinappropriate, hence <strong>the</strong>re is <strong>the</strong> need for <strong>the</strong> campaigns to also embrace<strong>the</strong>se diseases. It is surprising to see that people in Saboba district ratedGuinea worms as <strong>the</strong> third most common disease, when in fact <strong>the</strong>disease is almost completely eradicated in <strong>the</strong> district. Health <strong>of</strong>ficialsshould keep Spatio-temporal data <strong>of</strong> patient’s attendance for monitoring<strong>and</strong> assessment <strong>of</strong> disease patterns, trends <strong>and</strong> occurrence.It is recommended that intervention measures towards creation <strong>of</strong>awareness to minimise <strong>water</strong> related diseases must not focus on onlycommunities along <strong>the</strong> conventional <strong>water</strong>courses (rivers, streams etc)but must take <strong>the</strong> whole district in its entity into consideration, since <strong>the</strong>study discovered no significant correlation between <strong>the</strong>se <strong>water</strong> courses<strong>and</strong> <strong>water</strong> related diseases in <strong>the</strong> district. Health <strong>of</strong>ficials should make it apriority to explain to patient clearly <strong>the</strong> disease <strong>the</strong>y are diagnosed <strong>of</strong>, itscausal agent <strong>and</strong> how it can be prevented. Though, <strong>the</strong> high number <strong>of</strong>patients waiting for treatment is usually <strong>the</strong> deterrent factor, thisexplanation to patients will in <strong>the</strong> long-run reduce <strong>the</strong> disease burden<strong>and</strong> <strong>the</strong> stress on <strong>the</strong> health centres. It is also recommended to health<strong>of</strong>ficials, district assembly <strong>and</strong> <strong>the</strong> NGOs to shift from <strong>the</strong> curative58
Water <strong>sources</strong>, <strong>infrastructure</strong>, <strong>space</strong> <strong>and</strong> <strong>the</strong> <strong>dynamics</strong> <strong>of</strong> environmental diseases in Saboba District: Using GIStreatment <strong>of</strong> diseases (such as <strong>the</strong> current artesunate-amodiaquinecampaigns) to preventive measures such as closing <strong>of</strong> all pits or potholesaround houses <strong>and</strong> <strong>the</strong> use <strong>of</strong> mosquito nets.District AssemblyIt is recommended to <strong>the</strong> district assembly to incorporate extralegalmanagement <strong>of</strong> <strong>water</strong> re<strong>sources</strong> by including <strong>the</strong> traditional setup such asUmoadanbor, Utindan <strong>and</strong> chiefs into <strong>the</strong> formal management system as away <strong>of</strong> gaining grassroots support for <strong>water</strong> management. The assemblyis encouraged to provide funding <strong>and</strong> logistics to <strong>the</strong> Saboba CommunityWater Development Board to provide treated <strong>and</strong> uninterrupted pipe<strong>water</strong> supply to <strong>the</strong> communities. It is surprising to note that <strong>the</strong> <strong>water</strong>company has not bought chlorine since 2003.This study also recommends to <strong>the</strong> district assembly to provide morere<strong>sources</strong> to <strong>the</strong> District Environmental Health Office so that it canundertake some health campaigns <strong>and</strong> monitor <strong>water</strong> <strong>and</strong> sanitationconditions in <strong>the</strong> district. The district assembly should repair all damaged<strong>and</strong> non-functioning boreholes (examples are Moadani, SABTECH <strong>and</strong>Hilltop boreholes) for <strong>the</strong> communities <strong>and</strong> encourage <strong>the</strong> public to takeresponsibility <strong>of</strong> maintenance in <strong>the</strong> future. The assembly also need totake a serious attention to ascertain why some boreholes’ <strong>water</strong>(Bordagbalm, Moadani etc) smells <strong>and</strong> devise remedies to avoid drillingin such geological areas, as it makes no sense providing borehole <strong>water</strong>when <strong>the</strong> communities do not use it. A good number <strong>of</strong> boreholes arepartially inaccessible to users during rainy seasons when <strong>water</strong> floods <strong>the</strong>intervening streams, valleys <strong>and</strong> lowlying areas. It is recommended thatefforts be put in place to consider all-year-round accessibility when drillingnew boreholes for communities in <strong>the</strong> district. A bye-law is also neededto encourage people to close or cover up any s<strong>and</strong>-winning pit(s) dug forbuilding purposes. Alternatively, common areas should be earmarked fors<strong>and</strong> winning purposes while careful steps are taken to disinfect it tomake it difficult for mosquitoes to breed. There is also <strong>the</strong> need toprovide waste bins for <strong>the</strong> district. The ongoing efforts <strong>of</strong> ZoomlionGhana Ltd is in <strong>the</strong> right direction <strong>and</strong> commendable. However, moreneed to be done if <strong>the</strong>re is to be any environmental health gains.Government MinistriesThe various government ministries are also urged to collaborate inreducing environmental <strong>and</strong> specifically <strong>water</strong> related diseases through amulti-sector <strong>and</strong> integrative management plans with o<strong>the</strong>r departmentsincluding sanitation, environment, finance, <strong>and</strong> health as suggested byWorld Bank (2002). The involvement <strong>of</strong> local communities will be a plusfor <strong>the</strong> success <strong>of</strong> such plans. To help reduce age inflation or reduction<strong>and</strong> remove fraud, <strong>the</strong> ongoing National Identification Card System mustbe fastened. Also, <strong>the</strong> District Electoral Commission should release <strong>the</strong>district’s register for <strong>the</strong> NHIS to use to verify ages <strong>of</strong> people.Local CommunitiesThe local communities are encouraged to grow a plant, which is locallybut sarcastically named unadon-born, which literally means, mosquito love orpartner (Appendix IV a) around <strong>the</strong>ir houses. The plant is largely <strong>and</strong>unquestionably known to repel mosquitoes. Also, <strong>the</strong> use <strong>of</strong> mosquitonets is one <strong>of</strong> <strong>the</strong> best options available. The people should also beencouraged to contribute money to maintain or drill boreholes for<strong>the</strong>mselves, since <strong>the</strong> days when governments needed to provideeverything for its people (socialism) are over. The general public is urgedto end <strong>the</strong> burning <strong>of</strong> plant matter in <strong>the</strong>ir rooms. Alternatively <strong>the</strong>59
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