1. Inherited burden of disease: agricultural dams and the persistence of bloody urine (Schistosomiasis hematobium) in the Upper East Region of Ghana, 1959–1997
- Author
-
John M. Hunter
- Subjects
Health (social science) ,Adolescent ,Endemic Diseases ,Rite of passage ,location.country ,Population ,Upper Volta ,Developing country ,Schistosomiasis ,Ghana ,Schistosomiasis haematobia ,location ,Cost of Illness ,History and Philosophy of Science ,Water Supply ,Prevalence ,medicine ,Animals ,Humans ,Child ,Socioeconomics ,education ,Hematuria ,Schistosoma haematobium ,education.field_of_study ,biology ,business.industry ,Water ,Agriculture ,biology.organism_classification ,medicine.disease ,Geography ,Rural area ,business - Abstract
A major agricultural development project was commissioned to celebrate Ghana's independence in 1957. In the Upper Region along the border with Upper Volta now named Burkina Faso, a total of 185 clay-core dams were constructed in 15 years to enhance village water supplies during the 6-month dry season. In a concentrated area of N.E. Ghana (now the Upper East Region) no fewer than 104 dams were erected in only 3 years. The beneficial impacts of the dams are indisputable, and life today would be unthinkable without them, despite severe problems of neglect of maintenance. Equally undeniable has been a negative disease impact whereby the regional rate of schistosomiasis tripled in 1 or 2 years from 17% to 51% prevalence. Thus, an agriculturally induced hyperendemicity of "red water" or "bloody urine" disease was established. To test the longevity of community disease impact, a survey of hematuria (bloody urine) was conducted in the same areas in 1997. It showed a 40-year ecological entrenchment of elevated levels of schistosomiasis, that is, seemingly permanent alteration of regional disease ecology. The consequences of planning negligence have left a generational impact in that hematuria has become a "rite of passage" for young boys and girls. Unprepared and overburdened rural health care systems are ill-equipped in the face of competing demands to respond to the presence of schistosomiasis. Yet excellent medication is available to break the transmission cycle provided that there is a sufficiency of political will, accompanied by effective, inter-sectoral campaign coordination.
- Published
- 2003
- Full Text
- View/download PDF