Poor city planning, metropolitan administrative incompetence and a cash crunch have turned Accra into an open air sewer, making life a living hell for its estimated 2.9 million residents.
The onset of seasonal rains has further worsened the problem with clogged and damaged sewage lines spilling rubbish, including human waste, on the streets and into houses.
Nana Yaw Somuah, a resident of Accra's low-lying Abossey Okai suburb, said the blocked sewage lines "force many of us out of our homes. These flood waters bring in faeces and other waste carelessly dumped by residents of dwellings without toilet facilities," he said.
Accra has suffered from severe sanitation problems in many years. Overstretched drains which had not been repaired for decades, are mostly clogged all year round. This has led to flooding of low-lying areas of the city with the slightest rainfall. Most streets in Accra, including the downtown Kojo Thompson Road's starting point at the 31st December Makola Market, are littered all year round with faeces emanating from burst pipes. Passers-by hold their noses as they tip-toe across dirty pavements along Agbogbloshie, Nima, Maamobi, New Town, Abossey Okai, Sabon Zongo and Bukom.
The situation has become worse as the number of residents has jumped from about 750,000 in the early 1970s to about three million now, with thousands of internal economic refugees fleeing to the relative safety of the capital to escape abject poverty in the countryside.
The sanitation problem has reached a flashpoint. And the cash-trapped government of President John Agyekum Kufuor cannot afford to do anything to solve the crisis. At least, not in the immediate future.
Apart from the drainage problem, it is commonplace to see piled-up garbage across the city. Sheik I. C. Quaye, who was appointed the Greater Accra Regional Minister recently, admitted that Accra was "unhealthy for habitation" and said urgent steps were needed to clean "150 000 tons of garbage that have choked Accra".
Waste management (both liquid and solid) has rarely attracted the necessary priority attention over the years. The construction of a central sewer pumping system started in the early 1970s was abandoned after the overthrow of the Busia government. The construction of a new system along the Korle lagoon that was begun about three years ago is yet to be completed.
Many houses in the category "C" neighbourhoods are without toilet facilities and residents in such areas have had to depend on public toilets. Out of desperation, some residents fill plastic bags with liquid waste and dump them into drainage systems.
According to UK-based Ghanaian Environment Chemist, Julius Owusu-Sekyere (currently in Accra) it would cost billions of cedis to bring the system in Accra to working standard, capable of restoring the city to a filth-free status.
He said dumped waste pollute water sources over long distances, leading to an increasing incidence of skin and other diseases, including typhoid carried by rodents attracted by the mounds of garbage. Malaria, too, is rampant especially during the monsoon, which begins around June. Mosquitoes in the swampy areas of Accra are so many that residents in certain parts of the city cannot sleep well without mosquito nets, spray or coils. Out patients' survey from the Ministry of Health has put malaria cases at between 37 and 40% of all health cases at medical centers across the country..
"This nastiness in the city center is an indictment of both the government and the entire citizenry. Any stranger coming to Accra, will leave with negative impression," said collegian Henry Adjei Danso.