Sanitation over the years, has become a serious challenge in most developing countries and Ghana, our homeland country has not been an exception. In Accra and other parts of the country, one can not stand the stench. Filth is everywhere, from our homes to public places, gutters to water bodies, the streets to transport stations and even market places. The country is sinking in filth.

At the market places, people buy goods and services that would satisfy their needs and wants. However, we do buy diseases each and everyday without being aware of that. A visit to the Kaneshie Market will give an imagery scene of how people unknowingly trade diseases.

The Kaneshie market is one of the busiest markets in the country's capital city, Accra. It is a double-storey building market which was built in the 1970s. It is equally said to be the second largest market in the country. Besides trading in the building, selling and buying in the open is brisk.
Filth is little by little swallowing up the Kaneshie market. The entrance view of the market has heap of rubbish openly displaced. The market women and traders who sell in the open of the Kaneshie market, do so under very unhygienic conditions as they display their wares ranging from wears to food stuffs, around the mountain of rubbish in the market .

At worst food vendors who sell ready-to-eat foods such as cooked rice, kenkey, fried yam and fish, fruits which are not properly covered and drinks also have their tables near the refuse. Most of the fast foods in the market are are also prepared in unhygienic manner.

The poor sanitation and waste management at the Kaneshie market have paved way for other disease vectors, as the piled food waste and rubbish not only provide good breeding sites for flies like houseflies but also mice and rats which contaminate food stores.

Personal hygiene of the market women and men at the Kaneshie market is also a problem and contributes to disease transmission and external body parasite such as flea. Some of the market women's kids defecate around the refuse and after cleaning their butt, their hands are straight into the foods they sell which we buy. Even some of the market women also do not visit the ladies to ease themselves with the fear of losing buyers and hence urinate into a container or a polythene bag just near the food stuffs they sell and do not wash their hands with soap and water after, then sell with that same contaminated hands.

These acts give in the opportunity for food-borne viruses such as Hepatitis A, Norovirus and viral gastroenteritis to be transferred onto foods causing food borne diseases in humans, as the contaminated hands are used to handle and serve buyers the fruits, the fish, the vegetables and other foodstuffs which when not washed thoroughly or cooked well , the individuals that consume such foods get food borne diseases.

The refuse also breeds mosquitoes in the market place and help the fast spread pathogens such as parasites, bacteria and viruses that cause contamination of foods and beverages.

Apart from the health related issues concerning this alarming issue, the traders at the Kaneshie market have been complaining bitterly about low patronage of their goods as buyers get swayed off by the filth and strong foul smell it produces and this affect their sales.

The country over the years has witnessed numerous cases of food poisoning.
According to Yeleliere, E. Et al.,(Cogent Food and Agriculture), a review of microbial food contamination and food hygiene in the capital cities like Accra which was published in 2017, over 625,000 food poisoning incidences are recorded annually in the country with over 297,104 people being hospitalized annually and death rate due to food related illnesses was up to about 90,692 annually according to the Ministry of Food and Agriculture, MoFA/ World Bank, (2007) and Food & Drugs Authority, (2008) respectively.
In a report given by the Ministry of Food and Agriculture and World Bank in 2007, one out of every forty (40) persons in Ghana suffers from food-borne illness annually.

In the same report, one out of every 40 persons in Ghana suffers from food borne illness annually with over 420,000 year round reported cases. Out of this number, 65,000 persons die resulting in economic loss of about US $ 6,900,000.00. Also the cost incurred by the government of Ghana on curbing food borne diseases annually is estimated to be 69 million US $ (MoFA/World Bank, 2007).

The government spents huge sums of money on food borne diseases in this country. However, the question is, has the government over the years strive very hard to solve the sanitation crisis of this country?

With the passing years, all the successive governments have witnessed this problem of sanitation the country is facing but so far, none has been able to devise a sustainable solution to it. Even with the introduction of Zoomlion, a waste management company since 2006 and its different contracts such as the Sanitation Improvement Package (SIP), YEA Youth in Sanitation, Ministry of Local Government Fumigation, Nationwide Mosquito Control Program (NAMCOP), Sanitation Guards and Final Waste Disposal Site Contracts with the assemblies in Ghana, the country stills wallows in filth.

Under the immediate past government, the Ex. President John Dramani Mahama instituted the National Sanitation Day to be observed by Ghanaians to do cleaning in the country, but the initiative is now dead and buried.
The current government under President Nana Addo Dankwa Akufo-Addo as having a very keen interest in curing the sanitation headache of the country, created a new ministry, thus, Ministry of Sanitation, Water and Resources to purposefully and efficiently tackle the problem of sanitation in this country but our sanitation problem does not seem to have improved.

In other countries like Rwanda, where the President is bent on solving the sanitation and waste management problems in his country, Paul Kagame walks the talk of keeping the title his country has got as the "Singapore of Africa" as some call it and knows how the sanitation problem in the country cost them much money and affect the health of his people which in a long run prevent development, he puts down his presidential position and joins his people to clean the country in every last Saturday of the month. With the first gentleman my of the land clearing choked gutters, how dare you sit in your house and sip tea or open your shop to sell?

In fulfilling his promise to Ghanaians that, at the year of his tenure in office, Ghana will become the cleanest city in Africa, the President Nana Addo Dankwa Akufo-Addo also launched a National Sanitation Campaign which has equally failed just like the Town Council Sanitation Officers known as " Tankase Officers" in the late 1950s, Sanitation Program in the early 2000s and National Sanitation Day of 2012, woefully failed or should we say his has not yet failed since the proposed tenure of office he mentioned in his promise is not due?

With all the tonnes of cedis the country is wasting on sanitation, we still have market places as refuse dump sites, the streets full or refuse, beaches full of plastic waste, human and animal faecal, gutters and other water bodies pregnant with rubbish. Everywhere in the country, especially in our cities is filthy and suffocating. All numerous policies and contracts being done by the government have not proven to be futile. Yet we keep spending on sanitation in the country.

The turning of the Kaneshie market into a refuse dump site has been countlessly been reported by numerous media houses but as usual, the place would be clean for some few days and then after, back to the disturbing sight of garbage. This is as a result of the late emptying of refuse containers at the market place and hence get overflows with rubbish leading to the heap junk at the Kaneshie market. This can as well cause an outbreak of diseases which will greatly affect the country especially during the rainy season.

But as the approach proposed by R.W. Firth(1964) in ensuring change in a society says, using a repetitive method to make a social change, this worrying issue at the Kaneshie market will be reported over and over and over again until a permanent solution is found to cure this canker.

The Accra Metropolitan Assembly (AMA), Ministry of Sanitation, Water and Resources, Food and Drugs Authority , Environmental Protection Agency (EPA), Zoomlion and all the appropriate authorities are being called upon to ensure the hygienic condition of the Kaneshie market. The refuse bins should be relocated to a different site or the authority in charge should ensure the regular emptying of the bins in the market.

Behavioral wise, the citizens of the country are basically the cause of the poor sanitation. However, it is the duty of the country to see to the well-being of the people in the country, which includes making policies to regulate the behaviors of the citizens to the betterment of the country as a whole.

The following are suggestions to consider in curbing the sanitation crisis in the country.

•People flooded in our prisons for minor crime like fighting, assault, stealing of goat and others could be by court order sentence them to be cleaning our gutters and street for some number of years depending on the gravity of the offense. This will reduce the financial burden on the government for contracts with waste management companies in cleaning our environment.

•Also, contract agreements should include clauses where failure of the waste management companies in emptying the rubbish containers on time would attract an instant fine by the Metropolitan Assembly in charge of the area in particular. Knowing that if the refuse is not taken on time, the Assembly would apply charges even more than their daily charge on them would encourage the effective and efficient work of the waste management companies.

•Irresponsible citizens who create mess in filtering in the environment should face the music of paying a fine and serving a sentence of at least a six (6) months duration of cleaning the places which they were found guilty filtering. This will serve a deterrent to others.

•The government should also ensure that the mentally challenged persons are taken off the streets of especially the cities to the psychiatric hospitals. As they live on the streets, they accumulate refuse at every place they settle contributing to the sanitation problem.

•The agencies like Environmental Protection Agency (EPA) should embark on massive public education, teaching the people domestic waste management techniques, recycling methods and emotionally appealing them to desist from littering the environment by letting them know the very bad consequences the filth they create in the environment cause to themselves, on the environment and the country as a whole.

The government ought to make bold, effective and efficient policies about sanitation and actively supervise the implementation of those polices.
If anywhere should be filthy, market places should be at least be spared, as we get food stuffs from these places and we become what we eat. If we eat healthy food, we become healthy and if we eat contaminated food, we falls sick and if care is not taken we die.

Until then, as one goes to our market places like of Kaneshie market, Kantamanto market, Abobloshie market, Okinshie market and hear trader calling on buyers to purchase their goods, one thing that should come in mind is "diseases on sale".