It is 2pm and the sun is hot, as usual, and Kwame Danso (not real name) is seated at the back of a trotro heading to Circle, Accra. Kwame is with two friends and having a good conversation whiles the trotro stops and pick passengers at virtually every bustop.

With the sun burning, it didn’t take long for Kwame to beckon a hawker who sold ice cold water and bought three, one for him and two for his friends. They down the water and within the twinkle of an eye, the empty sachets were lying by the roadside, instead of keeping them in the car where they would have been properly disposed off.

That sight is not a one off. This is the sorry story of the everyday life of Ghanaians. Throwing of rubbish from windows of moving cars is just one arm of the problem of trying to keep the cities, towns and villages clean.

Apart from throwing rubbish through windows, Ghana is faced with the issue of open defecation at the beaches, drains, dump sites and bushes. Our drainages, instead of freely flowing with water are chocked with rubbish due to the daily rituals of throwing debris into our drainage systems.

The United Nations Children’s Fund (UNICEF) recently noted that three out of five Ghanaians practice open defecation, adding that Ghana could take 500 years to eliminate the practice due to the slow pace at which strategies, laws and interventions are being implemented.

The Chief Officer at the Water, Sanitation and Hygiene, WASH, Unit of UNICEF Ghana, David Duncan, notes that in the last 25 years, Ghana made one percent progress at eliminating the practice.

According to him, though the current pace is nothing to write home about, he was hopeful Ghana could achieve an Open Defecation Free society within the four-year national target if actions are expedited on all fronts.

Ghana had also been ranked second after Sudan in Africa for open defecation, with five million Ghanaians not having access to any toilet facility. The country has also been performing poorly with sanitation coverage of only 15percent, making the practice of open defecation a key sanitation challenge because people do not have access to key basic facilities.

With a sanitation coverage of 15percent, the nation is ranked after South Sudan, which has a 7percent coverage, Niger, 11percent, Chad, Madagascar and Togo, 12percent each and Sierra Leone which has a 13percent access to household toilets, the measurement used for the ranking.

Poor sanitation, according to Kweku Quansah, a programmes officer at the Environmental Health and Sanitation Directorate (EHSD) of the Ministry of Sanitation and Water Resources, costs Ghana US$290million every year.

The cost incurred is as a result of poor sanitation delivery arising from time spent on accessing water and sanitation facilities, deaths due to poor sanitation, exposure to preventable diseases, among others.

“If we have 2,000 pan latrines in Accra alone, then we are not safe as a country,” he recently said, adding that open defecation alone cost Ghana US$79million per annum and, therefore, stressed the need for the issue of open defecation to be taken seriously in Ghana.

Mr. Quansah indicated that households used other means for defecation, including using plastic bags, a situation that exposed children to preventable diseases.

“Children play where people defecate. Child safety, especially for the girl child, is compromised, while children are exposed to snakes and other animals. The strategy to stop open defecation is cheap, but the benefits are so many,” he stated.

He stated that in 2014, preventable diseases, including diarrhoea, killed over 4,500 children in Ghana, while cholera killed 247. He attributed the bad hygienic attitude among Ghanaians to the poor sanitation situation in the country.

What can be done by me, you and the government?

To a large extent, the challenges to sanitation in Ghana and many other developing nations are linked to the inability to create proper disposal points for solid waste, lack of enforcement of sanitation laws, population growth, poor financing of sanitation policies, rural-urban migration, poor sanitation infrastructure, lack of sanitation technologies among others.

It is important to note that because these factors are intertwined and not mutually exclusive of each other, there is the need to approach interventions to sanitation by using a systems approach. The experience of the user of sanitation facilities must be considered and connected to the collection of wastewater, solid waste and excreta to their transportation, treatment and result in their recycling and reuse.

In addition, there are also disparities between rural and urban areas with regard to the factors that limit access to sanitation, the extent of their influence and the nature of the interventions. These should be taken into proper cognizance when formulating sanitation policies or interventions.

The government, three years ago, declared that every first Saturday of each month must be marked as a National Sanitation Day following the unforgettable cholera outbreak that claimed over 150 lives in Ghana that year, Ghana is still lagging behind it terms of attaining its target.

To tackle the issue of inadequate sanitation infrastructure, government must collaborate with the private sector as well as Non-Governmental Organizations to provide widespread sanitation infrastructure such as public toilets, sewage systems, septic tanks and container Based Sanitation equipment.

It is not enough for government to always lash out at the public for doing open defecation and throwing faecal matter into drains. People know that it is not good to defecate in public because they value their privacy and safety, people are shameful enough not to throw faeces into gutters in polythene bags, and they know that government can’t do everything for them and they don’t expect it to.

But government must not expect in its wildest expectations that its citizens will walk two kilometres daily to defecate even though they know the implications of open defecation.

Moreover, government itself should not be seen to be sleeping on its own laws regarding sanitation responsibilities. Very too often, the government is loudest to lament about commercial residences not having toilet facilities especially in the cities whiles forgetting that it has the backing of the people of Ghana to enforce the laws to ensure order and responsibility.

As much as open defecation is condemnable, it is not only foolish but criminal for people to build houses without toilets for the sole purpose of renting them out. In this case, tenants are culprits as much as landlords. In the face of local government units concentrating on financial benefits they receive from businesses whiles compromising the law, it is important for central government to take much interest in the enforcement of sanitation laws by local government units.

Another important way to reduce the menace of sanitation and promote access is to address the issue of rural-urban migration.

According to Professor George Owusu of the Centre for Migration Studies of the University of Ghana, over 80percent of national investment has been concentrated in Accra alone since 2008. What this means is that, the resultant infrastructure, services and a whole lot of other investments from this concentration will form the congruent of factors pulling migrants from the edge to the centre. For Professor George Owusu, it must be expected that more of the slums in the capital will be seen in the coming years if the current trends continue.

Concentrating resources in Accra means that other regions are deprived of essential services and infrastructure. This results in people moving to Accra in search of services and opportunities that they have been deprived of in their region.

Consequently, this concentration means existing sanitation facilities become limited against the increased demand caused by a larger population. Also, shanty houses spring up causing an upward surge in the number of slums in the country thereby worsening the problems of sanitation as squatters must also have their way.

What is therefore expected of government is to spread investment of resources equitably across the country to create opportunities in other places outside the capital city.

To this end, the growth poles (Northern Development Authority, Middle-Belt Development Authority and Coastal Development Authority) that the current government promised to establish must be given serious attention and consideration. Government must prioritize the needs of the various growth poles over corruption and mismanagement to revenge the failure of the Savana Development Authority.

It is without any shred of doubt that if rural-urban migration is curtailed, the sanitation problem which is predominantly deplorable in the urban areas will be minimized.

Another pair of factors that cannot be overlooked when it comes to providing sanitation is population growth and poor financing for sanitation interventions. The rate of population growth has continued to exceed the rate at which sanitation facilities are provided in Ghana.

A WaterAid financial report indicates that 7million more people in Ghana lack access to sanitation than in 1990. This logically means that with so much increase in population over the period, not much has been added in terms of sanitation facilities or services.

These are all indications of the poor funding for sanitation facilities. It therefore behoves of government to do more to provide sanitation by allocating more money to finance a greater number of sanitation facilities than previously.

Most importantly, any sanitation intervention must end in making the waste disposed usable. In view of this, government must commit to making room for new technologies to treat and recycle waste. In this regard, the solid waste collected and deposited at designated dumpsites, the faecal matter in our toilets as well as the wastewater collected should all be treated and reproduced for use in various ways.

We need systems that will yield long-lasting production capacity and survive changes in government. Ghana’s premier technology institution, the Kwame Nkrumah University of Science and Technology alongside the newly converted technical universities, other technical institutions as well as the private sector should be given the chance to tackle this challenge.

Government should work with these institutions to introduce courses and develop curricula to train and produce students on a yearly basis with the capacity to treat wastewater, recycle solid waste and excreta for use in further production and energy generation. Government should also have the will to part with a few millions of Cedis to invest in providing the human resources as well as the materials and equipment necessary for the training of students in the various schools for that matter. This should be the new page in the country’s industrial transformation drive.

Finally, as much as government can do and must do, the public need to be thoroughly educated in words and deeds about the benefits of sanitation. There is a lack of information to the public about how diseases spread because of germs and poor sanitation. Most people are not aware that Accra’s trash problem is a growing cause of many of its diseases.

In 2008 over US$700million dollars was spent on treating malaria in Ghana. That figure has not slowed down. Malaria is the number one health problem all over Ghana, especially in Accra.

Malaria accounted for 53percent of Accra’s illnesses last year. According to the National Malaria Control Programme, “During 2009, a person in Ghana died from malaria about every three hours. This means about 3,000 people died of malaria in Ghana that year alone, most of them children.

Cholera is another big problem in Ghana. As of November 2011, cholera has claimed 101 lives. There have been 10,002 cases reported in Ghana. The cholera outbreak has been directly linked to a lack of proper refuse dumping sites and improper disposal of waste.

The biggest problem facing Ghana is that of mindset. We need to adjust our mindset to the changing times. It is no longer okay to throw trash on the ground and in their gutters. People must educate themselves on the dangers of inadequate sanitation and begin using garbage containers. Authorities from the Accra Metropolitan Assembly (AMA) must implement proper sanitation planning.

Sanitation is a human right. The right to water and sanitation are an important part of the right of every citizen to an adequate standard of living as recognized by a resolution of the United Nations Human Rights Council. It should therefore be the quest of every citizen to enjoy the full complement of human rights by contributing actively to promote sanitation.

As we call on government to take a lead role in promoting sanitation, we all as Ghanaian citizens must push our efforts therefore a little bit farther, and embolden our commitment much more broader, to secure for this and future generations a nation that is safe, sound and free from the fear of disease.

We can do this as individuals in our homes, we can lead our households to rid ourselves of filth, we can play an active role in promoting sanitation in our communities, and we can advocate for all stakeholders to play their roles in sanitizing our environment and making it safer. We do these in our realization that this is our responsibility and contribution as true and active citizens to create a society in which all are strong and sound to pursue their own measure of happiness.