Presentation at the West African Household Water Tretment and Safe Storage workshop in Accra- Ghana- La Palm Beach Hotel, Accra-Ghana 6-8 May, 2013

1. Emergency Response and CholeraEmergency Response and Cholera
in Ghanain Ghana
West Africa Regional Workshop on HWTSWest Africa Regional Workshop on HWTS
La Palm Beach Hotel, Accra-GhanaLa Palm Beach Hotel, Accra-Ghana 6-8 May, 20136-8 May, 2013
Presentation by:Presentation by:
Enoch OfosuEnoch Ofosu
WASH in Emergencies Coordinator,WASH in Emergencies Coordinator,
GhanaGhana
blessedenoch@gmail.comblessedenoch@gmail.com

2. Developing CountriesDeveloping Countries -- Causes ofCauses of
DeathDeath
CommunicableCommunicable
DiseaseDisease
Major Cause ofMajor Cause of
Death inDeath in
DisasterDisaster
Directly RelatedDirectly Related
to Poor Waterto Poor Water
and Sanitationand Sanitation
Source: WHO 2010
CauseCause DeathsDeaths
HIV / AIDSHIV / AIDS 2,678,0002,678,000
Respiratory InfectionsRespiratory Infections 2,643,0002,643,000
Heart DiseaseHeart Disease 2,484,0002,484,000
Diarrhoeal DiseaseDiarrhoeal Disease 1,793,0001,793,000
Cerebrovascular DiseaseCerebrovascular Disease 1,381,0001,381,000
Childhood DiseasesChildhood Diseases 1,217,0001,217,000
MalariaMalaria 1,103,0001,103,000
TuberculosisTuberculosis 1,021,0001,021,000
Pulmonary DiseasePulmonary Disease 748,000748,000
MeaslesMeasles 674,000674,000

3. WHO Cholera 2012 Report
Sno Country Cases Deaths CFR
1 Somalia 77636 742 3.17
2 Cameroon 22433 783 3.49
3 Democratic Republic of Congo 21700 584 2.69
4 Chad 17267 458 2.65
5 Ghana 10628 105 0.99
6 Niger 2324 60 0.58
7 Mali 2220 95 4.28
8 Angola 1810 110 6.08
9 Mozambique 1279 5 0.39
10 Cote d'vore 1261 24 1.9
11 Zimbabwe 1220 2 0.16
12 Liberia 1146 0 0
13 Burundi 1072 1 0.09
14 Other Countries 26682 1214
Total 188678 4183 2.22
This is 2011 data

4. Ghana Cholera Report 2012
Total cases for 2012= 9548, Deaths=100, CFR=1%

5. Main Causes of
cholera

6. Risk factors
Insufficient/Unsafe water supply (quality
and quantity).
Unsafe Excreta Disposal
Poor hygiene practises (including hand

7. 7

8. FRAMEWORK FOR EFFECTIVE
MANAGEMENT OF OUTBREAKS
Preparedness
Response
Efficient surveillance
system
Prevention

9. Preparedness
Pre-positioning of oral dehydration
salts and other medical supplies;
Pre-positioning of water treatment supplies;
Training of personnel;
Preparation of national and sub – national
plans of action.
FRAMEWORK FOR EFFECTIVE
MANAGEMENT OF OUTBREAKS (Contd.)

10. NADMO (Coordination)
Health (Database Management);
WASH;
Education;
Social sector;
Communication;
OVERALL COORDINATION (Declared
Emergency)

11. Intervention EffectIntervention Effect
 ↑↑ Water QualityWater Quality
 ↑↑ Water QuantityWater Quantity
 Hand WashingHand Washing
 Latrines – SafeLatrines – Safe
Excreta DisposalExcreta Disposal
 All MeasuresAll Measures
EXCRETA
WATER FLIES HANDS
MOUTH
FOOD
BARRIER
BARRIERBARRIER
BASIS OF WASH OVERALL WASHBASIS OF WASH OVERALL WASH
INTERVENTIONSINTERVENTIONS

12. Surface water
Water source Risk of faecal
contamination
Rivers High to very high
Lake High to very high
Rainfall Low to high
Transmission potential through potableTransmission potential through potable
waterwater

13. Groundwater
Water source Risk of faecal
contamination
Protected spring Nil or very low
Closed dug well Low
Open dug Well Medium to high
Borehole Nil or very low

14. Improved access to
safe water sources;
Knowledge in how to make
water safe for consumption;
Health education that encourages
improved food safety and
personal hygiene.
FOCUS OF WATER SAFETY INTERVENTIONS

15. Baseline data collection;
Frank reporting;
Analysis of data to guide interventions
accordingly to lead to timely prevention
and preparedness activities.
APPROACH

16. THE ROLE OF HWTS
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EXCRETA
WATER FLIES HANDS
MOUTH
FOOD
BARRIER
BARRIERBARRIER

17. HWTS MEASURES USED
• Household water purification tablets (e.g.
Aquatabs)
• Household level filtration (e.g. Ceramic
Filters)
• Disinfection of Household Wells
• Behaviour Change Communication /
promotional activities on HWTS
• Boiling – mainly as result of promotional
activities
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18. OUTCOMES AND LESSONS
LEARNT
• Effective redress of cholera situation the situation in ER
and BAR (unsafe water)
• Anecdotal evidence to reduction in other diarrhea
related disease
• Increased awareness and knowledge in water hygiene
(general hygiene)
• Effective entry point for HWTS programme
interventions ( as well as CLTS and HWWS)
• Enhanced capacity of implementers in promotion of
HWTS and use of methods/ technologies
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19. THANK YOU
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