Linking Sanitation and safer meat processing to Community Health and Development in Northern Ghana.
Environmental Health, Water, Sanitation and Hygiene (WASH) issues are one area that compromises the health and well being of majority of people in Ghana, especially the underserved poverty stricken population of northern Ghana.
In Northern Ghana, an estimated 80 percent of residents defecate in the open, access to water in this part of the country remains a major challenge, whilst unhygienic handling and processing of meat for local consumption have remained a major headache for decades. These factors have all contributed in impacting negatively, the wellbeing of the people.
The Government agencies overseeing this sector is the Ministry of Local Government and Rural Development, (Main agency) The Ministry of Environment Science and Technology and The Ministry of Water Resources Works and Housing (Support agencies), working through the Environmental Health Officers who are low manpower capacity staff. And as reported at their annual national congress in Bolgatanga, The National President of the Environmental Health Officers Student’s Association complained that resource allocation to Environmental Health Training Schools is woefully inadequate hence, the poor quality of Staff and the products they churn out.
In response to the recommendations made in most of the field reports received from Community Based Education and Service (COBES) students of the UDS (www.uds.edu.gh) TTFPP), it was clear that sanitation related diseases stands highest among the ten top diseases causing morbidity and mortality in the health facilities in Northern Ghana, because of the high incidence of open defecation, inadequate access to portable water and unhygienic meat handling.
My organization, the University for Department Studies, collaborated with an NGO, Community life Improvement Program (CLIP) to develop training modules, using the modules in the community Tools box of Kansas University to upgrade Environmental Health Officers and UDS Students with skills, knowledge and competency in behavior change and advocacy through curriculum development for Certificate, Diploma, undergraduate and Post Graduate courses in Community Health and Development and Environmental Health Water, Sanitation and Hygiene. These students conducted a field survey for 4 weeks and created change in the Under Served Communities.
Through the four week field attachment survey, each student attached him/her self to a household where they observed among other indicators their health seeking behavior, the pattern of diseases in adults, children and women (the vulnerable group) the source of drinking water and how they treat it for domestic consumption, their waste disposal methods and how and where they attend to “natures call”. The students in collaboration with the community leadership organized durbars for an appraisal of their stay and encounter with the community to announce some of the unhealthful practices in the community.
Website: http://www.uds.edu.gh/
ECOSAN toilet showing fly trap.
Pilot ECOSAN toilet.
Assessment: Following an analysis of the students field reports, I conducted a community health assessment using a diagnostic checklist. This confirmed the reports that the students generated, as can be seen from the video clip 1 and the accompanying audio recording.
Planning: There was first a community entry to identify key informants and the leadership of the community, a date for community durbar was fixed and a ‘town crier’ (community announcer) informed community members that the chief and his elders will sit in state to receive a report from us on the findings of the students stay in the community for 8 weeks. See excepts of community durbar in video two. Information about the state of sanitation in the community was reported to the gathering and a challenge thrown to the chief and elders to assess their own sanitation situation and take a collective decision to reverse it as in the Community Led Total Sanitation (CLTS) concept.
Taking Action: The UDS successfully piloted a pro-poor sanitation technology called ECOSAN in the communities. The university is now collaborating with some microfinance institutions to provide credit facilities to community members to upscale the ECOSAN project. This we believe will help eliminate open defecation.
Evaluation: We interviewed a cross section of community members on the use of the piloted latrines and most of expressed satisfaction about the ECOSAN toilets. Some community members have also teamed up to build communal toilets.
The sensitization of the butchers on proper meat processing has also gone down well with the general meat consuming public; this is reflected in the development of preference for some butchers who are seen to be more hygienic in the processing meat. This has intend created competition among the butchers for better service.
Sustaining the work: The department of community health of the UDS has mounted a BSC course in environmental health, water and sanitation to enable more environmental health officers to build their capacities for behavior change promotion. The department is also collaborating with CLIP to provide credit facilities for households to build their own latrines. Additionally, the by-product of the ECOSAN latrines is used as manure for backyard vegetable farming and household economic trees cultivation. This has also improved the nutritional status of community members and improved their livelihoods as some households sell some of the produce from their backyard gardens.
It is too early in the intervention to assess the medium to long term impact of the intervention; however, the short term assessment has revealed a considerable change in behavior and attitudes towards hygiene. Meanwhile it is envisaged that, in the long term, the beneficiaries of the training programme will acquire skills, competence and knowledge to influence policy reforms and implementation in the area of WASH not only in Northern but the country at large.
