Ghana, 'galamsey' and sustainable wellbeing

People outside of Ghana might not have heard of the term ‘galamsey’. It’s derived from the phrase ‘gather them and sell’ which was used during colonial times to refer to miners illegally gathering minerals such as gold and selling them. Stamping out galamsey is now a major rallying cry and something that all Ghanaians are aware of. There are adverts on the main television news, Joy News, with an appeal to the citizenship values of the Ghanaian people. The practice is regard as leading to environmental destruction, water pollution, deforestation and is moreover seen as anti-social, selfish and running counter to African community values. I learnt more about galamsey during the last few weeks as nearly all of our 19 Ghanaians enrolled on our new Masters’ course which we have just started to deliver in Ho, Volta Region, mentioned it in their formative essays. It’s clearly at the forefront of their minds!

It’s also on the government’s mind, as this official government site shows: http://www.ghana.gov.gh/index.php/2012-02-08-08-32-47/features/1234-galamsey-operations-and-sustainable-development-in-ghana

One colleague has joined the course from Sierra Leone, but otherwise all our new students are from Ghana. We are delivering the course at the new public University of Health and Allied Sciences, which is currently being built under the able leadership of the Vice-Chancellor, Professor Fred Binka. Students will gain a Leeds Met Masters degree, along the lines of the course delivery we currently offer in Zambia and The Gambia.

Health promotion is relatively strong in Ghana, though there has been a slow approach to implementing the government’s health promotion policy, which has been in draft form since 2005. Recently, there was a high level meeting to consider how to progress health promotion and adopt more joined up thinking and a more upstream approach cross the entire policy spectrum. Our role in educating more health promoters will contribute to this scaling-up, and we already propose that we will have a further intake in October 2014. The Commonwealth Scholarships Commission has willingly sponsored 15 students in the first intake.

Galamsey is not the only major health hazard facing sustainable development in Ghana. It is however, often the act of desperate people – most people do not ‘choose’ to behave in lawless ways unless they are constrained in the ‘choices’ available to them. Ghana has recently made much of the fact that it has been proclaimed as a middle-income country. The economy is doing well, the government is stable – President Mahama has recently laid down strict guidance on ethical behavior for all those in public office. So although there is still plenty of poverty and the ‘core poor’ make up a good proportion of the population, there area signs that overall Ghana is ‘doing well’. The emergence of a larger middle class, those who are in salaried jobs, and moreover, have not joined the exodus of well-educated Ghanaians that characterized the brain drain of recent decades, has changed the face of Ghana. There are now classes who, freed from the precariousness of everyday life, are able to envision a future, to plan, to save, and to enjoy aspects of life enjoyed by the leisured classes in other countries. There are new shopping malls, and the first mall has opened in Ho. Ghana is going through both an epidemiological transition as well as a demographic one, as these more affluent families plan for fewer children.

Much has also been made of the emergence of non-communicable disease in sub-Saharan Africa. It’s debatable how long these health problems have been around, as they are not particularly well documented, but certainly in West Africa, heart disease, hypertension, cancer and diabetes are prominent in the media. In one newspaper, Hajia Mary Salifu Boforo, MP for Savelugu and Chair of the Women’s Caucus, is reported discussing Breast Cancer Awareness Month in October, and she described the discrimination faced by women diagnosed with breast cancer, and that it’s still seen as a source of shame. She said that over 20% of women face divorce shortly after diagnosis. There are many issues to overcome before a full screening programme can be established, and we all know that breast cancer caught early stands a much better outcome.

Sodzi Sodzi-Tettey had a full-page article in the Daily Graphic on November 9^th calling for more integrated health programmes to tackle diabetes, obesity, hypertension and cancers. In a well written and thought provoking article, he refers to a recent paper in the BMJ by Patricio Marquez and Jill Farrington on how communicable and non-communicable diseases can be tackled alongside each other in those countries where both need tackling. It’s interesting to me that an article in one of the world’s top medical journals has been picked up and translated into a useful piece of health education in a daily newspaper in Ghana.  For the article in the BMJ, see: http://www.bmj.com/content/345/bmj.e5812

These kinds of disease often run alongside the trappings of a westernized lifestyle, and not all of its characteristics are to be welcomed. There can be a reduction in overall life satisfaction and happiness – does being able to shop in a new mall really bring greater well-being? Maybe it does, but countries like Ghana are clearly on the cusp of needing to think about what kind of priorities it wants, how to retain its strong Ghanaian, African identity in a globalizing world, and what well-being means in the twenty first century. As Kwame Nkrumah said so many years ago, “We shall measure our progress by the improvement in the health of our people. The welfare of our people is our chief pride, and it is by this that we ask to be judged.”

Sustainability is an obvious concept to arise in a global South context, and together with the paradigm drift that we’re witnessing, into ‘well-being’ alongside ‘health’, the obvious question to raise is: how can Ghana continue on a path of sustainable well-being for all of its citizens?