The sanitary condition of most cities in Ghana, especially the capital city has not been a pleasant story to narrate for some time now. Undoubtedly, this has prompted many stake holders in the country, which includes the President of Ghana to suggest actions to help curb this malaise. In response to the call of the president, the Greater Accra and Ashanti Regions are among those that have set aside every first Saturday in a month, to conduct the clean-up exercise.
Meanwhile, although this directive is aimed at providing a clean environment, leading to the control of some diseases such as cholera, if the clean-ups are not well arranged, and not done properly, this promising aim can be compromised, and eventually be defeated. This article is therefore aimed at discussing some diseases that the monthly clean-ups in Metropolitan, Municipal and District Assemblies (MMDAs) can contribute in both their control and spread in Ghana.
Poor environmental condition has been a concern for most people in Ghana. Among these include the President (GhanaWeb, 2014; Ghana Times, 2014), Local Authorities (peacefmonline, 2015) and some celebrities (citifmonline, 2014). In a noteworthy call by the president, he directed all Metropolitan, Municipal and District Chief Executives (MMDCEs) to set aside a day in every month, for general cleaning exercise in their jurisdictions. This he said will help to instill the virtues of cleanliness in the people. On the clean-up day, stalls and shops are to be closed, to enable the involvement of everybody, to rid the country of filth. The President gave the directive, in the wake of the wide-spread cases of cholera outbreak which claimed many lives in the country (Ghana Times, 2014). In a similar call, a Divisional Chief of James Town, in Accra, appealed to the people to collaborate with the Accra Metropolitan Assembly (AMA) and other Metropolitan, Municipal and District Assemblies (MMDAs) to maintain environmental cleanliness. He added that, the fight to live without filth is not solely the duty of Metropolitan, Municipal and District Assemblies but requires concerted efforts and commitment by all (peacefmonline, 2015). In view of this, the Greater Accra and Ashanti Regions are among the regions in Ghana that has set aside every first Saturday in a month, to conduct the clean-up exercise, and so far, this has seen lots of participation. For instance, in the Ashanti Region, the Police Command deployed officers to join in the clean-up days every month (myjoyonline, 2014). The president has also joined the clean-up in the greater Accra (GhanaWeb, 2014 ; Ghana Times, 2014) and Ashanti region (citifmonline, 2014b).
As stated earlier, the main aim of the Monthly clean-ups in MMDAs is to provide a clean environment leading to the control of some diseases. Disease can be described as a combination of signs and symptoms, phenomena associated with a disorder of function or structure or illness associated with specific causes (Campbell et al., 1979). In developing countries majority of disease are as a result of unsanitary practices within these environments. Poor sanitation has been implicated to be associated with infectious diseases including cholera, typhoid, malaria, cryptosporidiosis, Campylobacter infection, some helminthic infection, among others (WHO, 2000 ; Carr and Strauss, 2001).
Contribution in cholera, typhoid and malaria infection
Cholera and Typhoid are bacterial disease that is most often spread by eating contaminated food or drinking contaminated water. The results of an experimental study showed that cholera microbes survived on the external surface of flies for 5 to 7 days, and in the insect organism in the course of their whole life. (Kotenok and Chicherin, 1977). Typhoid bacteria have also been recovered from house flies caught in the neibourhood of cases of typhoid fever (Hewitt, 2012). The monthly clean-up will therefore help control cholera and typhoid infections to some extent, since it will help get rid of conditions favorable for the breed of houseflies. Ironically, in some communities, the refuse collected from gutters are left near the gutters, sometimes for days before collected by the authorities. During this time, flies that get into contact with the exposed refuse will end up carrying some pathogenic organisms including vibro cholera and Salmonella typhae; the causative agents of cholera and typhoid infection respectively. When such contaminated flies subsequently get into contact with uncovered food, anyone who eats such food is at risk of these infections. More than 28,900 cholera cases were reported in Ghana in 2014. For the month of January 2015 only, 366 cases and 1 death from cholera were reported (CDC, 2015). In the Editorial commentary on cholera and Ebola virus disease in Ghana, Ofori-Adjei and Koram (2014) stated in the Ghana Medical Journal that, attempts at controlling cholera were not successful because the needed long term approaches, which included proper disposal of solid waste were not implemented. Also sanitary reforms have been inactive, ineffective and local authorities have failed in applying necessary bye-laws on sanitation, environmental health and waste disposal (Ofori-Adjei and Koram, 2014).
A similar story can be told for malaria infection. Malaria is caused by parasitic plasmodium species that are carried by the female of an anopheles mosquito and introduced into the bloodstream of humans by an infected mosquito. The vector for the malaria parasites thrives well in stagnant water. Most of the refuse collected from the gutters during the clean-ups include tins and cans. They are sometimes filled with water from the gutter. When the refuse is left uncollected, the mosquitos use the tins and cans as breeding environment, leading to the spread of malaria. In such cases a case, the clean-up exercise has contributed in both controlling and spreading of the malaria infection. Eventually, the main aim of the clean-up can be defeated.
The Monthly clean-up exercise in MMDAs is a very good initiative towards reducing filth and getting rid of infections. All the same, proper measures need to be put in place so that the aim is not defeated. One of such measure is prompt collection of waste collected from gutters during the cleanup process. Also, provision of dust bins will help keep the collected refuse out of the reach of flies and mosquitoes; even if the refuse will be left near the gutter for some time before collection. This will make the Monthly clean-ups in MMDAs success story and will go a long way to help prevent the spread of cholera, typhoid and malaria in Ghana.
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