River Blindness Ruins Communities in Upper East, Ghana
The villages of Farfar, Sisie, Zabu and Kuka in the Garu-Tampane district, the poorest countryside in Ghana’s Upper East region, are home to the country’s largest number of sufferers of the onchocerciasis disease, also known as “river blindness”. The disease causes blindness and various skin conditions, and is transmitted to humans by black flies that live close to rivers – hence, the name.
Onchocerciasis broke out in the area in the late 1980s and early 1990s when black flies invaded these communities and left many villagers permanently blind. Today, the number of people who suffer from visual impairments in the area is estimated to be more than 3,000, according to documents obtained from the Presbyterian Hospital at Garu, the district capital.
Abandoned and currently living without support, sufferers of the painful onchocerciasis disease are struggling to maintain their livelihoods. Amina is a 43-year-old resident in Farfar community. She has been blind for 20 years. She says: “My current situation in life is so tormenting. I am weak, I am blind, things are getting impossible at this stage and living is just regrettable.”
Most of the visually impaired people are left at home to fend for themselves while the young go about their daily business. They are excluded from all aspects of public life, marginalised and neglected, which makes their lives difficult.
“Some of us who do not have young children to support us at home, so we have to fast daily until the whole family is back home in the evening,” Amina said as she stretched her left hand for her walking stick.
Documents obtained from the hospital reveal 6,500 recorded cases of eye conditions in the first six months of this year alone, spanning from January to June.
The Garu-Tampane district is about 25 km away from Bolgatanga, the Upper East region’s capital. It has a population of 116,215, according to the 2000 Population and Houses Census, spread around 200 communities. The area is predominantly agricultural, although fishing is another livelihood – on a rather small scale. Migrants from other parts of the country, especially the south, and the neighbouring countries of Togo and Burkina Faso also make the area their new home. The predominant tribes in the district are Kusasi, Busangas, Mosis, Bimobas and Mamprusi’s. On average, there are seven people per household. Women are generally less active in decision-making and income-generating activities.
Yet it’s the women, children and the elderly who are the main sufferers of river blindness. The Bonkafarigu/Farfar electoral area has a population of about 1,900, according to the 2010 Population and Houses Census. Every second person in the area suffers from various eye conditions. The chief of Farfar community also rules his people without his sight and he walks with the aid of sticks.
In the 1980s, the government frequently sprayed the area with chemicals against the infectious black flies. However, the presence of these insects in the area still poses a huge threat to local communities.
Joseph Duutt Yennukua, assembly member for the Bonkafarigu/Farfar Electoral Area, is not surprised this land still has the highest rate of eye infections in the country. In an exclusive interview after a community durbar in Farfar on 12 July this year, he said that despite the previous fumigation of the black flies, they still remain a real danger to local people. For example, in September and October farmers have to fully cover their bodies; as spots on the skin turns black when bitten.
Yennukua said that, despite several reportsmade to the authorities about the presence of the black flies, nothing was done about it. He appealed to government, NGOs, international development agencies and individuals to support the communities in fighting the black fly endemic.
After undertaking the spraying exercises, the government of Ghana left people without any support.
Alhaji Mohammed Atangiba is the principal nurse in charge of the Eye Ward in the Presbyterian Hospital in Garu. He disclosed that in the first six months of this year, the hospital recorded a total of 6,500 eye conditions, including glaucoma, matured cataract, corneal sears, refractive errors, conjunctivitis, optic atrophy, and traumatic lesions.
Out of this number, “Half of the people are likely to suffer permanent impairment if medical operation is not done quickly,” one of the nurses on duty explained. However, Atangiba added that the real number may be much larger.
Sitting in his small dark office behind the main hospital building, Atangiba said that eye conditions are now critical in the area and need urgent attention. He doesn’t know why such an unprecedented number of eye infections occurs here, but said proper research should be done, and new medicine may be needed to deal with the situation.
Another challenge Atangiba pointed out is that the hospital is so overburdened with eye cases that some of them have to be referred to other health facilities. However, even that does not solve the problem. “The majority of the people are poor, and eye care services and operations are not covered by health insurance. So a lot of the people – poor women, children and the elderly – don’t accept referrals because they can’t afford to pay for the operations.”
This hospital, which is the nearest facility to affected communities, is under-resourced. It lacks ophthalmologists to perform surgery, which means some patients will suffer permanent sight impairment. According to Atangiba, there are only two eye specialists in the Upper East region. Their services are in high demand, but the capacity to help people are limited.
With transportation, financial and staff difficulties, the Presbyterian primary eye care education unit is grinding to a halt.
The hospital urgently needs equipment, transport, and new wards to continue its primary eye care programme. Atangiba said the villages of Woriyanga, Farfar, Sisie, Songo, Bugri, Binduri, Zabu, Pusiga, and Basyonde were in the greatest need of resources and medical help.
Onchocerciasis is believed to be the world’s second-leading disease that causes blindness. Black flies transmit the disease by carrying infected worms to the human body, which spread and cause severe itching in the eye, and can destroy optical tissue if not treated immediately.
The vast majority of onchocerciasis infections occur in Sub-Sahara Africa, Yemen, and Central and South America. The disease is believed to have affected around 18 million people worldwide.
In the 1970s, when investigations of endemic onchocerciasis in the villages and districts of West Africa began, scientists made some disturbing discoveries – more than 60 per cent of the savanna population carried the parasite; ten per cent of the adult population and half of the male population over the age of 40 blind. Thirsty per cent of people were visually impaired, and early signs of onchocerciasis were common among children.
The socio-economic consequences of such high infection rates leave too few able-bodied people to tend the fields. Food shortages and economic collapse forced residents to abandon their lands in fertile river valleys, moving to highlands and forested areas which offered some protection from infection, but then farmers struggled with poor soil and water shortages.
River blindness leaves a permanent footprint in Ghana’s Garu-Tampane district in the Upper East region. It places vulnerable communities under even more pressure. These people, most of whom are farmers, now have to walk to and from their farms with the aid of a stick. For this situation to be improved, new equipment, wards and ophthalmologists would be required.