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More rhetoric or less action? Digging into urban health vulnerabilities: insights from urbanizing Accra

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Abstract

Urbanization is a product of development and in recent years, most cities have been experiencing unprecedented growth with improvements in their infrastructure. The obvious benefits of the process tend to paradoxically overshadow its insidious symptoms, as unregulated growth tend to create huge unmet needs such as lack of access to good-quality services, increasing poverty and deteriorating environment. The origin of this dichotomy is rooted in the governance practices where city authorities pay greater attention to issues of managing the ‘global commons’ than the critical ‘brown issues’, such as improving water supply and sanitation that affect the urban poor. Using multiple research techniques, this study highlights how such neglected necessities consign sections of the population to one of the deadly infectious diseases Ghana has ever known—cholera. The paper calls for an all-inclusive and explicitly pro-poor community-led orientation as one of the effective strategy for achieving equity in the urban settings and possibly, helps win the ‘war’ on poor sanitation.

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Notes

  1. Reclassification can be due to increased population or the redefinition of an urban area. Several countries face this dilemma following population growth or political pressures.

  2. Everyday risks emanate from environmental inadequacies in poor cities and in especially their poor, un-serviced and disadvantaged neighbourhoods. It is often argued that these inadequacies are perhaps the most important avoidable environmental cause of ill-health.

  3. http://www.worldbank.org/urban/upgrading/ghana.html.

  4. http://www.ghanadistricts.com/reg-info.asp/RegionID=1.

  5. See, for example, Speech by Dr. Patrick Manson at St. George's Hospital, London, 1 Oct. 1897, Encl. in C.O. Memorandum by Read, 2 Dec. 1897; Colonial Office Confidential Print, Miscellaneous 119, No. 1, p. 7. Colonial Office Prints are available at the Colonial Office Library and at the Public Record Office, London.

  6. Sources that by nature of their construction or through active intervention are protected from outside contamination, particularly faecal matter. These include piped water in a dwelling, plot or yard, and other improved sources.

  7. The practice whereby some people defecate into plastic bags and dump the bag somewhere out of sight. Such persons view plastic bags as handy, portable and disposable private toilets and the practice is pernicious as the plastic bags present the faeces from decomposing.

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  1. University of Ghana, Accra, Greater Accra, Ghana

    Martin Oteng-Ababio

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  1. Martin Oteng-Ababio
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Correspondence to Martin Oteng-Ababio.

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Oteng-Ababio, M. More rhetoric or less action? Digging into urban health vulnerabilities: insights from urbanizing Accra. GeoJournal 79, 357–371 (2014). https://doi.org/10.1007/s10708-013-9498-6

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