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Opinions Tue, 9 Mar 2021

MOH must establish a National Environmental Health Research Centre in Ghana post Coronavirus era

Environmental Health is the branch of Public Health that is concerned with all aspects of the natural and built environment that may affect human health.

According to the World Health Organization, in its broadest sense, Environmental Health comprises those aspects of human health, disease, and injury that are determined or influenced by factors in the environment. Environmental Health also refers to the theory and practice of assessing, correcting, controlling and preventing those factors in the environment that can potentially adversely affect the health of present and future generations.

It is noted however that Environmental Health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments.

The objects of the Environmental Health Profession are; to assess, correct, control and prevent those factors in the environment that can potentially affect adversely the health of present and future generations; to preserve, protect, and improve the quality of life for human beings; to control those elements of the environment which cause, or may cause deleterious effects to the health and well-being of human populations or to the food and drink, lands, waters, atmosphere, shelter and other resources upon which humanity is dependent for survival; to prevent and control infectious, communicable and non-communicable diseases which have afflicted humankind through the centuries.

According to Eldridge and Tenkate, 2006; Ryan et al., 2013, Environmental Health Practitioners (EHPs) play a significant role in all stages of disaster management due to their many and varied areas of expertise. Degutis, 2008 opined that, EHPs are well-placed to assess the impact of disasters on populations and conduct evaluations of responses due to their population-based focus and holistic approach.

Falk and Baldwin, 2006; Ryan et al.,2013; Ministério da Saúde, 2017 indicated that, reports from past disasters around the world, such as Hurricane Katrina (United States), Pedrógão Grande fires (Portugal) or the Chemical Fire at Waste Control Pty Limited in Bellevue (Australia), emphasized the value of Environmental Health interventions and practice. These include:

(1). Reducing the vulnerability of communities to hazards and increasing their ability to respond, withstand disruption and recover rapidly;

(2). Collaborating on hazard identification and risk assessment;

(3). Strengthening routine services so that the potential health effects of emergencies and disasters are minimized;

(4). Considering elements such as drinking water, hazardous waste, general waste, sanitation, food safety, communicable diseases, vector issues, or mass gatherings in the context of disaster response;

(5). Precautionary safety measures such as ensuring social distancing and hygiene practices during food handling.

The Environmental Health Profession has never been more vital than it is today. The twin challenges of Ghana and Africa being plagued with environmentally related diseases and infections such as malaria, cholera, typhoid etc. and of the recent Coronavirus (COVID-19) global pandemic, has shone a light on the essential role Environmental Health Professionals/Practitioners (EHPs) play in supporting and protecting our lives, businesses, keeping our communities safe, and protecting our environment.

Ranging from premises surveillance and inspection, waste management, food safety to housing standards, and from public health to environmental protection.

EHPs are at the forefront of efforts to improve the health of Ghanaians long before and during this public health pandemic. The year 2020 and beyond has made their role all the clearer due to the COVID-19 global pandemic.

The impact of the COVID-19 pandemic has been monumental in highlighting the need for health and local authorities to be properly resourced and for their local expertise to help shape the Central Government’s approach to public health. The response to COVID-19, by governments across the globe including Ghana, of imposing a series of national and regional lockdowns, alongside mass testing and tracing, necessitated a significant reliance on local authorities to implement these policies.

There has also been a growing appreciation of the importance of the Environmental Health Profession by the Central Government during this COVID-19 pandemic era. EHPs have been on the frontline in enforcing business compliance with lockdown restrictions and providing guidance and support for businesses to become COVID-19 secure. EHPs have also proven to be a valuable resource in supporting tests and trace.

EHPs under the Ministry of Health and its Agencies as well as at the Local Government (i.e., Metropolitan, Municipal, and District Assemblies, MMDAs) and other sectors across the country, were at post because they fell under the essential services stipulated by the National Labour Act (2003, Act 651) and they were further exempted by the President of the Republic of Ghana’s directives on the COVID-19 restrictions and lockdown as essential services providers, providing Environmental Health and Sanitation Services.

EHPs who are working under the Accra Metropolitan Assembly (AMA) and other Sub-Metros in the Greater Accra Region where COVID-19 cases keep Surging and as such, these areas are classified as the Epicentres of the infection with its related higher deaths, are overwhelmed with frequent daily Burial of Dead Bodies of persons who succumb to the deadly Coronavirus.

The work of these EHPs with regards to burial of dead bodies as well as terminal disinfection of the Isolations Centres and treatment sites for the COVID-19 infected persons has put enormous pressure and stress in terms of workload on these Officers since the outbreak of the pandemic.

The urgent need for a National Environmental Health Research Centre (NEHRC) in Ghana Post COVID-19 era:

During this COVID-19 global public health pandemic, with Ghana recording cases since March 2020, the prescribed measures and protocols to prevent people from being infected and subsequent spread of the deadly disease in communities and institutions are all based on Environmental Health and Hygiene interventions. Namely;

1). Strict wearing of appropriate face masks at all times;

(2). Frequent hand washing with soap under clean running water at all times;

(3). Sanitizing of hands with alcohol-based hand sanitizers with 70% alcohol;

(4) Observing social distancing between ourselves and others at least one (1) metre apart at all times;

(5). Strictly observing hygiene cough etiquette at all times;

(6). Sanitary disposal of used personal protective equipment (PPEs) such as used face masks and tissue papers into appropriate waste bins.

However, Environmental Health Professionals/Practitioners (EHPs) serve as backliners who perform various activities such as terminal disinfection of isolation centres where persons who died from the COVID-19 infection were being treated or cured. EHPs are the very authorized Public Health professionals who are involved in the burial of COVID-19 dead bodies as well as other infectious diseases like Cholera. These point to the fact that EPHs are both fronliners and backliners in public health emergencies and pandemics of infectious nature like COVID-19.

Since the onset of the COVID-19 pandemic and the subsequent declaration of a public health emergency by the world health organization (WHO), the very key measures being adopted by every state health authorities and Governments are that, every person (s) who is going to or in the public place (s) must wear an appropriate personal protective equipment (PPEs) such as disposal nose/face masks or reusable locally made three (3) layers face/nose mask to safeguards themselves from contracting the novel Coronavirus disease (COVID-19) and these prescribed measures are being adhered to and complied with by every citizens across the globe.

However, among the PPEs most used by everyone to prevent contracting and spreading the COVID-19, is the face/nose mask. It is unclear with scanty of data that cannot show vividly the quantities of the face/nose masks that were in stock in the country before the outbreak of the Coronavirus pandemic and the current quantities of these same face/masks that have been procured by government as well as produced locally, by our local producers since the onset of the pandemic in our territory, Ghana which are been patronized by people due to the mandatory wearing of the PPEs of which failure to do so attracts serious punishment.

The mass usage of these PPEs has resulted in the generation of huge volumes and tons of infectious and general wastes in the communities due to the increased demand of these face/nose masks. The inappropriate and indiscriminate disposal of these PPEs has serious and dire consequences and implications on the health, environment and lives of everyone according to public health experts.

Therefore, the establishment of a National Environmental Health Research Centre (NEHRC) in Ghana, under the Ministry of Health (MOH), would help managers of the NEHRC, EHPs and other interested actors in the Environmental Health and Public Health sector to conduct scientific research and projects to determine the impact of the COVID-19 on human health, environment, occupational health, food hygiene and safety, sanitation, port health services and other specialized areas of the Environmental Health Sector that are of much importance and concern during this COVD-19 era.

Also, the NEHRC among its duties will carry out comprehensive assessment of various categories and classification of wastes (infectious and general) in Ghana that has been generated during the COVID-19 pandemic. In addition, the determinants of community and institutional spread of COVID-19, the adherence and compliance of the prescribed Environmental Health and Hygiene measures and protocols by community members, where and who needs handwashing and sanitary facilities to ensure effective practicing of hand washing could be discovered.

Furthermore, aside the Coronavirus (COVID-19) pandemic and its related deaths, the World Health Organization (WHO), estimates that 12.6 million deaths (about or 23%) of all global deaths could be linked to environmental risk factors such as poor sanitation, air pollution, climate change, pesticides and vector-borne diseases.

Children's Environmental Health, vector-borne diseases and contamination of drinking water sources have been identified as the top three major and growing Environmental Health threats in Malaysia that warrant urgent intervention.

This was revealed in the Health Ministry's National Environmental Health Action Plan's latest publication, Priority List of Environmental Health Issues in Malaysia. The list detailing ten (10) key concerns, was developed by Thematic Working Group 10: Environmental Health Experts which was led by its chairman, Professor Dr Jamal Hisham Hashim.

Other issues in rank order in the study were urban health; climate change; food safety and contamination; exposure to pesticides and other environmental chemicals; zoonotic diseases; exposure to ionising and non-ionising radiation; and particulate and ground-level ozone pollution.

It is my strong believe, conviction and anticipation that, the establishment of the National Environmental Health Research Centre (NEHRC) in Ghana, under the Ministry of Health (MOH), will serve as robust and reliable research hub on Environmental Health issues in the country, that will help the MOH to determine the various Environmental risk factors plaguing the nation and its citizens that needed urgent attention and intervention as Malaysia and other countries has done, that will go a long way to protect and safeguard the health and lives of the Ghanaian populace.
Columnist: Samuel Yaw Agyemang-Badu