Aid agencies are scrambling to treat thousands of cholera patients in Sierra Leone's capital, Freetown, where the number of infections is mounting by more than per day. Most patients are from the city's urban slums, where open defecation is rife, toilets are rare, sewage is improperly disposed of and awareness of cholera is low.
Water and sanitation specialists say unless these problems are addressed, cholera will continue to flourish both in Sierra Leone and throughout west Africa.
LGCP Ghana: Sanitation service delivery at the local level
As in Freetown, a high proportion Literature Review On Poor Sanitation In Ghana the cholera cases in Conakry, the Guinean capital, and Accra, Ghana's capital, are concentrated in urban slums, where there are few clean toilets and most people openly defecate, often dangerously close to open wells that are the source of water for most residents.
Governments tend to clean up the cholera mess once it is in full swing rather than working on prevention, said an independent water, sanitation and hygiene Wash specialist, adding: Donors, too, prefer to fund reactively, hence "Unicef's sword and shield [response-prevention] strategy is more sword than shield," said Patrick Laurent, west Africa Wash co-ordinator at the organisation. When aid agencies approached the African Development Bank last year for cholera prevention support in the Central African Republic, the response was: Those living near the sea defecate on the beach.
The Ghanaian government banned open defecation and bucket latrines inand arrests all perpetrators, said Boateng. Unlike in neighbouring Guinea and Sierra Leone, where the governments are weak and rely on aid click to drive the response, the Ghanaian authorities are leading the cholera action but have "underplayed it" for political purposes, said Laurent.
The recent death of President John Atta Mills and the approaching parliamentary elections have drawn the attention of most government officials for weeks. Arrests may be a temporary deterrent, but people will continue to defecate in the open as long as they have no alternative, say aid agency staff.
The key is to get communities across west Africa to want to use and maintain clean toilets. In Sierra Leone, Unicef is pushing community-driven total sanitation, in which communities move away from open defecation once they understand its consequences, and go on to build and maintain clean toilets themselves. In this model, Unilever, which manufactures cleaning products, has worked with Unicef and local partners in Gambia, and with Water and Sanitation for the Urban Poora non-profit group, in Ghana to form the Clean Team.
A project in Kumasi, in south-central Ghanatargeted families, most of Literature Review On Poor Sanitation In Ghana were sharing dirty latrines. Each was given a free chemical toilet with a sealed waste container that was exchanged two to three times per week. The waste is processed in the city's septic tank system, but the municipality hopes to use it to produce biofuel. So far the scheme has improved hygiene, lowered household costs and reduced the use of plastic bags for defecation, said Clean Team manager Asantewa Gyamfi.
The plan is to expand it to 1, families. Transferring such an intensive approach to an urban slum setting in Freetown is a challenge, said Unicef's Sierra Leone communications specialist, Gaurav Garg.
An urban Wash consortium — made up of Oxfam, Action Against Hunger, Save the Children, Goal and Concern — charged with helping the government improve sanitation in Freetown's slums, has decided that improving and rebuilding public toilets is the only option, but keeping them clean is the real challenge, said Marc Faux, the group co-ordinator.
Community committees have been set up to run the toilets. Each is given four roles: Health officials say until each of these jobs here done well, use will continue to be low.
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Most of the waste from public latrines has been dumped in nearby rubbish tips or into the sea. The NGO consortium is experimenting with a low-technology device that pumps waste into containers that can be taken to trucks. Another method being tested is a device used to separate urine from faecal matter, which can then be turned into compost.
These and other innovations are an important start to addressing the myriad challenges in unsanitary, densely populated, coastal cities such as Freetown, Conakry and Accra.
But they will only make a dent in cholera prevention. The issue must be addressed "not on a project-by-project basis, but holistically, involving education, health systems, water and sanitation infrastructure — the lot", said Mariamme Dem, west Africa head of WaterAid. That looks a long way off. For now, NGOs are hastily setting up treatment centres to care for the cholera victims who come their way — as they have done every few years since the s.
In Niger, the situation is different in terms of topography and humanitarian context. The rest are in refugee camps in Ouallam, in south-western Tillaberi. see more
Cholera has broken out against a backdrop of high rates of malnutrition and food insecurity, and large numbers of refugees who fled the takeover of northern Mali. The rains and insecurity make it difficult to access some cholera-hit villages, said Unicef's Laurent.
BRIDGING WATER AND SANITATION INFRASTRUCTURE GAP IN GHANA water and sanitation services, combined with poor reviews literature review while section. West Africa desperate for cleaner toilets to save slums from for the Urban Poor, a non-profit group, in Ghana to form the and poor sanitation. children. More investment is required in hygiene and sanitation. • CAN POOR PEOPLE AFFORD TO BUILD SAFE LATRINES? • Yes. University of Ghana, Literature Review. These waste handling methods are a likely contributory factor for poor sanitation in the area.
The government has a low capacity to respond to cholera but is willing to collaborate with the many relief and aid agencies working to alleviate the emergency there, said Laurent. Sierra Leone's worst major cholera outbreak for 15 years has affected an estimated 32, people, claiming more than lives. Give them an alternative Arrests may be a temporary deterrent, but people will continue to defecate in the open as long as they have no alternative, say aid agency staff.
Keeping toilets clean Transferring such an intensive approach to an urban slum setting in Freetown is a challenge, said Unicef's Sierra Leone communications specialist, Gaurav Garg. Cholera in Niger In Niger, the situation is different in terms of topography and humanitarian context. Sierra Leone's cholera outbreak — in pictures. Will data linking open defecation to undernutrition force change? Studies suggest there is a strong link between open defecation and undernutrition click at this page India.
Is sanitation being taken seriously? Guinea and Sierra Leone find respite from cholera outbreak. Reduction in number of new cases suggests situation improving in both countries, say aid groups. Africa's broken promises on improved sanitation exact deadly toll. Cholera sweeps across Sierra Leone and Guinea following severe rainfall.
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