Environmental Degradation's Effect on Infectious Diseases in Ghana

: Conflict of Public Health Policy v. Mining Interest

Cholera has claimed some lives recently at Akim Nkwantanang, near Kade in Ghana’s Eastern Region (See: “Two Die in Cholera Outbreak”, Ghanaweb.com; January 16, 2002). This preliminary news report indicated further, “about 40 others are on admission at the Kade Health Center and the St. Dominic’s Hospital at Akwatia following a cholera outbreak.” Cholera killed a lot of people at Akwatia, last year.

At the center of this story is the fact that most causes for the incidence of cholera are man-made and preventable. Therefore, the issue for discussion, here, focuses on why preventable environmental conditions that tend to take the lives of citizens have been allowed to persist by responsible people for a long period of time. In the case of Ghana, it is defensible to say that reckless and insensitive public policies in the mining industry operations have contributed, nefariously, towards persistent incidences of infectious diseases.

Akwatia and Kade share some common characteristics besides proximity: they are both located in the diamond belt along the Birim River; majority of the people in these townships are poor; people in these townships do not have access to fresh drinking water; and both towns do not meet anybody’s sanitation standards. This scenario is not a product of one’s imagination. “Mr. Emmanuel Owusu Tenkorang, Assemblyman, told the GNA [Ghana News Agency] that health personnel, members of the Ghana Red Cross Society and staff of the District Assembly had launched a campaign to educate the people on the need to ensure environmental cleanliness to bring the epidemic, which broke-out about five days ago, under control,” according to the report cited above.

What the referenced news report did not mention is the interconnection between diamond mining operations, pollution of the Birim River and the incidence of cholera and other infectious diseases afflicting the people of Akwatia and Kade as well as most people living in Ghana’s diamond belt.

For the purpose of information, scientific research from Kwame Nkrumah University of Science and Technology has found that Birim River’s water level is dwindling, according to a reliable source. It is well known that water basins get their protection from forest overgrowth. The fact that Birim River’s water volume is thinning is an indication that both the forest’s undergrowth and overgrowth are degraded, most probably from indiscriminate diamond prospecting along its banks.

That the banks of the Birim River are dotted with timber process sawmills could not be sheer coincidence with respect to the dwindling of water in the basin. In addition, the diamond mining company based at Akwatia since 1947 has been dumping excessive silt leftover from its processing plants into the Birim River. It should not take any great imagination to understand that excessive silt deposit into the Birim River contributes to the thinning of the water volume.

To anybody’s thinking, the problems mentioned above call for public policy solutions; and this is where the government of the day comes in. In spite of the need for public policy action to solve the problem of environmental degradation along the banks of Birim River, Ghana’s Minister of Mines recently advised the Board of the ailing Ghana Consolidated Diamond Company to extend its operations downstream towards Akim Oda. One wonders whose interest the Honorable Minister Kwadwo Adjei-Darko is protecting, the voters in the community or profits of the mining company?

For an unexplained reason, it appears the directives of the Minister of Mines are in conflict with the concerns raised recently by Ghana’s Vice President Alhaji Aliu Mahama regarding degradation of the forest cover for water basins in Ghana. In a recent speech, the vice president is reported to have charged District Assemblies “to deal drastically with environmental offenders …” (See: “VP Launches Environmental Protection Program”, Ghanaweb.com, Jan. 12, 2002). In this context, why shouldn’t Kwaebibirem District Assembly and the other District Assemblies along the banks of Birim River “deal drastically” with mining operators and prospectors that degrade the ecology of the areas under their jurisdiction?

Cholera belongs to the group of deadly illnesses classified as “diarrhoeal disease” among other infectious diseases. Diarrhoeal diseases cause their victims to lose body fluids and matter rapidly and excessively, often resulting in death quickly if left untreated immediately. Besides diarrhoeal diseases, the World Health Organization, WHO, identifies pneumonia, AIDS, TB, malaria and measles as the leading infectious diseases afflicting the world today.

In layman’s terms, the diseases identified above are described as “infectious” precisely because once they come into existence they are communicated or transmitted from the sources or agents to their human victims. Humans who have the misfortune of hosting the infectious agent of the diseases pass them on directly or indirectly to others leading to a multiplying effect or epidemic. “Direct transmission is the immediate transfer through touching, kissing, biting, or sexual intercourse or by droplets spread during sneezing, coughing, spitting, singing, or talking,” according to AVISO, an information bulletin on global environmental change and human security (“Infectious Diseases and Global Change: Threats to Human Health and Security,” Issue No. 8, June 2001).

Other direct transmission of infectious disease agents includes exposure of open tissue to affected soil, decaying vegetable matter, animal bites and transfer from a pregnant mother to the fetus. “Contaminated objects such as soiled bedding or dressings, or poorly cleaned utensils, as well as water, food, milk, blood and serum …” are indirect vehicles for the transmission of agents of infectious diseases, according to the AVISO bulletin.

To reinforce the view stated earlier that there is interconnectedness between social environmental conditions and the incidence of infectious diseases, the AVISO bulletin stated: “The potential for micro-organisms to cause disease outbreaks is dependent on exposure of humans to environmental risks, the overall health of the individual, and the ability of the pathogen to affect humans.” The bulletin emphasized, “There is an intrinsic relationship between pathogen, host, and environment (physical, biological, social, cultural, and economical).”

Polluted water features prominently as vehicle for the causes and transmission of infectious diseases and that is where the concrete situation of Akwatia, Kade and the outlying villages come into focus relative to the contradiction between diamond mining operations in the area and public health policy of Ghana (or the lack of it.)

Since 1947, diamond mining operations based at Akwatia have resulted in the dumping of waste water into the Birim River which historically has been the source of drinking water for citizens living along its banks. The Birim River since 1947 has lost its value and essence for the people at Akwatia and downstream. It is a joke among some circles familiar with the unhealthy quality of Birim River downstream from Akwatia that even frogs cannot survive in the water.

What public policy has failed to do, since 1947, is to introduce quantifiable, verifiable and enforceable rules and regulations enjoining diamond mining operators from depriving voters and all citizens along the banks of Birim River of fresh drinking water.

Indiscriminate diamond prospecting with impunity has tended to leave abandoned pits filled with water thereby creating preferred breeding grounds for malaria carrying mosquitoes.

In spite of several years of corporate diamond mining located at Akwatia there is no indication of affluence in the area. Rather, the evidence is that people along Birim River downstream from Akwatia are dirt poor without the capacity to provide for themselves basic social infrastructures relevant for the provision of adequate public sanitation.

Kwaebibirem District Director of the National Commission for Civic Education, Mr. Kwame Nkrumah told people in the Kade area, “a German non-governmental organization plans to help communities in the District by providing the people with potable water and sanitary facilities,” according to a GNA story of July 17, 1999. This must be seen as good news for the people of Kwaebibirem District. The question, however, remains as to why it must take a foreign NGO to provide potable water and sanitary facilities for a community in Ghana that produces diamonds?

Reliance on foreign assistance for the provision of potable water and sanitary facilities in a local community is consistent with Ghana’s seemingly entrenched culture of dependency. Yet, many are those Ghanaians who despise the idea of placing Ghana in the category of Highly Indebted Poor Country, HIPC, by the government. ‘Are Ghanaians for real?’

According to the news report on the outbreak of cholera at Kade, there is only one toilet serving more than 5,000 inhabitants in the afflicted locality where homes do not have indoor plumbing. The Assemblyman for the community is reportedly, appealing to the Kwaebibirem District Assembly for assistance to construct an additional public toilet. At the dawn of the 21st Century, one would have thought that developing societies would be making choices that enhance the quality of life for their citizens, including indoor plumbing, for example. No, not Ghana at this time!

In the “State of the Nation 2001” address to parliament recently President John Agyekum Kufuor paid attention to the unsanitary conditions of Ghana in general. One can only hope, for the mean time, that the president’s vision would be translated into action. However, given the pronouncements and directives of Ghana’s Minister of Mines, it appears the likelihood of translating the president’s mission into reality would take a long time to materialize.

On the same day that Ghana’s Vice President charged District Assemblies to “deal drastically” with those whose activities degrade the forest that protect water basin, the minister of mines admonished Ghanaian farmers for cultivating on land designated for mining activities, “even when they have been cautioned.” (See: “Minister of Mines Advises Media”, Ghanaweb.com, Jan. 25, 2002). Again, the question that needs to be asked is whose interest does Mr. Kwadwo Adjei-Darko represent? To ask more bluntly, does the minister of mines expect the farmers whose lands have been hijacked, for the profit interest of mining companies, to chew sand for food?

For a more human-centered policy, Kwadwo Adjei-Darko should caution mining companies to desist from encroaching on farm lands, otherwise the farmers ought to be provided with alternative means of subsistence or a form of compensation comparable to what they derive from their farming activities. Does this sound right?

Adjei-Darko needs to be reminded, “Disease outbreaks [such as cholera] caused by pathogens within water are exposed to humans via the mouth through contaminated food or drink, unsanitized water, or from food grown in poor soil.” (See: AVISO, Issue No. 8, June 2001 page 3).

Food grown in poor soil, such as soil degraded by mining activities, yields low quality nutrition that weaken the immune system of humans thereby paving the way for the onslaught of opportunistic, infectious diseases such as AIDS, malaria, TB, cholera, pneumonia and measles. This is Nature Study “101”.

To illustrate and reinforce further the point about the linkage between degraded soil, production of poor quality food and the incidence of infectious diseases, sources familiar with the situation have indicated that the Akim Oda government hospital, the biggest serving the South Birim District of Ghana and beyond, is brimming and overflowing with cases of malaria, TB and AIDS diseases. What is worse is that provision of health services in Ghana, on the whole, has been life-threatening, in and of itself; more significantly it is skewed in favor of urban populations and against the rural poor. Does anybody care?

What is disturbing, with regard to the damaging effect of Akwatia-based diamond mining operations is that there does not seem to be lack of knowledge of the situation. For a reason yet to be identified, it seems reasonable people associated with both public and private institutions have remained paralyzed without the capacity to advocate or effect change of the environmental conditions relative to the case of Akwatia in particular and the other mining communities of Ghana. Is it any wonder that Ghana and other developing countries in Africa experience the massive shifting of population from rural to urban areas, given that rural folks are denied basic public infrastructures and health amenities?

President of Ghana Institution of Surveyors, GIS, in 1999 speaking of the impact of diamond mining operations on the vegetation at Akwatia, reportedly said, “the extent of damage to the vegetation would take about five years to restore and would involve a lot of money.” Mr. Jean Dotse, the GIS president, led members of the Institution when they “undertook a day’s tour of the operations area of the Ghana Consolidated Diamonds (GCD) to assess the extent of damage to the vegetation by mining activities. (See: “GCD to Restore Degraded Vegetation,” GNA, June 11, 1999.) According to this news report, “The visit, which formed part of GIS’ annual continuing professional development program, took the group to the main mining zone of GCD as well as the Akwatia township where there are pockets of small scale mining activities going on.”

So, what did the GIS group discover at Akwatia? Answer: “The group was disappointed about the extent of damage to the large tract of land that has been rendered barren and needs to be restored,” the news report indicated.

In an interview with a small-scale diamond prospector in Akwatia, the GIS group was told that the youth of Akwatia had no choice but to engage in so-called illegal digging of the land because their main preoccupation as farmers has been destroyed as a result of GCD’s activities. Speaking for the youth of Akwatia, the interviewee said, “We are also not happy about the way we are destroying our own land with the mining activities, but we have no choice as there are no jobs for us.” He noted that farming as an option has been closed to the youth of Akwatia, an agricultural population, because of “the devastating activities of GCD…”

According to the news report the interviewee at Akwatia told the GIS inspection group, “the GCD, with a mining concession of about 351.94 square kilometers had already destroyed the landmass of the township and that one cannot embark on a viable farming venture.”

In defense of its corporate behavior, GCD bosses told the GIS inspection group that the 80-year old company “some years ago … embarked on afforestation program which included large oil palm and orchid plantations.” GCD officials told the GIS investigators that the reasons why these auspicious plantations failed are: activities of small-scale illegal diamond mining prospectors and litigation by landowners.

If activities of small-scale diamond prospectors, using shovels and hand pickaxes, could destroy oil palm and orchid plantations, one can only imagine a worse case scenario resulting from large-scale machine operations of GCD. The point here is that before GCD had the audacity to complain about small-scale diamond prospectors it ought to have evaluated the impact of its own activities on the vegetation in the large area it operates.

Introducing oil palm and orchid plantations as means of reafforestation of devastated vegetation raises the question of whose interest the program was expected to serve. Are orchid and oil palm plantations what the people of Akwatia want or deserve? Should the oil palm and orchid plantations had done well how were the landowners of Akwatia going to benefit?

Reasonable people would assume that a diamond mining company that destroys the vegetation of an area must be in a position to restore it to its original form. In lieu of failure to restore the vegetation, it should be within the realm of reasonableness for the mining company to accommodate and compensate all the people whose farmlands have been seized through the power of the state. It is defensible to state that failure or refusal by GCD to accommodate, compensate and restore farmlands to their original state deprives the people of Akwatia the means for producing and reproducing the conditions for their existence on a daily basis.

In fairness, depriving whole rural communities, anywhere in the world, the means to produce their conditions of existence is tantamount to denying them their human as well as civil rights. It should not be surprising to find that somewhere in the voluminous constitution of Ghana there is a provision that it is illegal to deny any people their civil as well as human rights. Why such a constitutional provision ought not to be respected or enforced in the area of mining in Ghana calls for a serious national debate.

Despite the havoc wrought by diamond mining operations upon the people of Akwatia and those living downstream along the banks of Birim River since 1922, it appears the worse is yet to come.

GNA report of June 11, 1999 on the visit of the Ghana Institution of Surveyors inspection group stated, “GCD which is now faced with a myriad of operational problems, including obsolete machinery and overstaffing, is on divestiture. “This however, has not stopped the company from exploiting the Birim forest belt for more diamonds.” What does this mean? Read what follows.

To break the hearts of many environmentally-conscious people, GCD’s Chief Geologist in 1999, told the GIS inspection group, “We are now working towards the Rivers Birim and Pra confluence, a project life in excess of ten years with an annual production of 500,000 carats. “We are doing all our best to restore the past glory of GCD and make it more efficient….”. A cursory look at the map of Ghana shows that what the GCD’s Chief Geologist called efficiency actually means total degradation of the forest area covering the Central and Eastern Regions of Ghana.

Since GCD “started operation in the area in 1922, more than 100 million carats of diamond have been mined from the bowels of the Akwatia vegetation,” stated the news report about GIS group inspection of the Akwatia situation. As the news report indicated, “GCD, once the mining gem of West Africa has suffered a decline in production from a peak of 2.4 million carats in 1974 to less than 251,000 carats in 1998.”

Besides the infectious diseases mentioned above, government has known for the last three years, “that Ghana is the third most guinea worm endemic country in the world.” (See: “Ministry Helping to Stem Resurgence of Guinea Worm Disease”, GNA, Feb. 22, 2000). Responding to parliamentary question, Dr. Moses Adibo, then-Deputy Minister of Health, reportedly said, “the surest means of breaking the transmission cycle of the disease is by providing the people with potable water.” The news report indicated further, “Asked why the upsurge in the disease, Dr. Adibo explained that many people, especially those in rural communities, contract the diseases through drinking guinea worm-infested water if their known water sources dry up during the dry season.”

Dr. Adibo told Ghana’s parliament about the necessity for the health ministry to conduct “intensified public education on the need to protect water sources to help stem the resurgence of the guinea worm disease …”. The operating word here is “Water”!

Indeed, Dr. Adibo’s responses and statements to parliament in 2000, went to the core of addressing the need to protect Ghana’s water basins. What he failed to recognize is the role played by mining operators in the degradation of the conditions necessary for protecting the sources of water. The point is that potable water for the population can materialize if (and only if) water sources are available and protected.

Changes in climatic conditions from dry to wet year round, are acts of nature that cannot be defied. What humans have been capable of doing, since antiquity, is to apply commonsense in managing to adapt to the conditions of nature at given geographical locations. People located in desert areas devise means to have water for their needs. In the specific case of Ghana, what needs to be done is to apply some commonsense in the protection and management of water sources.

One other misfortune in Ghana, currently, is that areas designated as forest reserves have been penetrated by timber concessions, all in the interest of making a buck. The danger lying ahead for Ghana in the area of deprivation of clean fresh water is frightening and the solution could be daunting. Happily, it seems there are some reasonable Ghanaians in positions of authority who are paying attention to the problem of forest degradation; one of them is the sitting Vice President, Alhaji Mahama.

In a report cited above, V. Pres. Mahama said, “the felling of timber without effective afforestation measures pose a grave danger to the survival of forests.” He is reported also to have said, “degradation of our forest resources through inappropriate concession management practices has put our forests and national economy at risk.” The function at which the vice president made his remarks was attended also by other public officials who expressed concern about the massive destruction of Ghana’s natural ecology and vegetation with grave consequences for water availability and the economy as a whole.

According to the news report Brong Ahafo’s Regional Minister Mr. Ernest Debrah, “noted that the volume of water in the Tano River and its tributaries had drastically reduced over the past few years because of the depletion of the vegetation along the river.” The Tano River is the main source of water for five Districts in the Brong Ahafo Region and others in the Western Region. One economic impact of the reduction of volume of water in the Tano River is that senior officials of the government of Ghana were in the United States last year looking for funding for a $50 million water project to serve the people who depend on the river.

Professors Dominic Fobih and Kasim Kasanga, Minister of Science and Environment and Minister of Lands and Forestry respectively, who were with the vice president, offered suggestions to solve the identified ecological problems associated with the dwindling of water volume of the Tano River. Prof. Fibih urged tree planting along the banks of the river and called for “the formation of environmental protection volunteer corps to arrest offenders.” The Minister of Science and Environment told his listeners, “a Desertification Fund would be established with the support of international partners to assist communities … who depend solely on the environment for their sustenance to seek alternative livelihoods.”

According to the Minister of Lands and Forestry, Ghana’s forest cover has reduced to two million hectares from 18 million over the years. He “cautioned Forestry and Land Commission officials to desist from condoning with those who destroy the environment,” the news report indicated.

In the one-page news report cited above, three different public authorities in Ghana with tangential responsibility for protecting the ecology were identified: ministries of Science and Environment, Lands and Forestry; as well as Forestry and Land Commission. Other known government departments and agencies whose work have something to do with the ecology include ministries of Works and Housing, Health as well as Mines and there is the Environmental Protection Agency, EPA.

Given the multiplicity of public authorities and agencies with oversight responsibility that affect the quality of life in the area of provision of fresh clean water for Ghanaians, it should be no wonder if nobody in particular could be held culprit when things go awry. It is fair to assume that the confluence of all decisions and policies by government departments, agencies, commissions and other public bodies is located in the office of the president. Thus when there is inaction with respect to protecting Ghana’s water basins it must be fair to demand responsibility and accountability from the chief executive who runs Ghana.