At one end of a stream in Bortianor stood a lady washing wringing her clothes from soapy water into the stream. A few minutes later, some children who had gone to harvest sugarcane from the farm, clad in uniforms, washed their shoes, faces, arms and legs at another side of the river.

Behind a tree that is partly rooted in the river, one of the schoolgirls hides and relieves herself of urine which trickles into the same stream. After all this, the team of “sugarcane adventurers” wash their sugarcane in that same stream – ready for consumption. These activities seem unrelated but for the common denominator – the stream. Similar stories can be told of other suburbs in the Greater Accra Region. It is no surprise that Bortianor recorded numerous cases during the massive cholera outbreak in 2014. The Greater Accra Region was the hardest hit with cholera, recording about 5,000 cases and 45 deaths as at August that year.

Cholera, a bacterial disease caused by Vibrio Cholerae, is commonly transmitted to individuals through contaminated water. It is fatal, especially to women and children within hours, as a result of dehydration caused by diarrhoea and vomiting. Though curable, preventive measures such as clean environments, water purification for drinking and cooking, and proper handwashing (after visiting the toilet, before and after eating etc) are preferable and sustainable options for preventing the spread of the disease.

The 2014 outbreak was brought under control by the collaborative intervention of Global Communities, the Ghana Health Service, Ministry of Sanitation and Water Resources, Environmental Health Directorate and the Red Cross Society. WASH interventions were intensified in 2016 and are still underway. Since September 2016, there have been no recorded case of cholera in the region, largely due to the efforts of actors in the Water, Sanitation and Hygiene (WASH) sector, such the USAID funded WASH for Health project implemented by Global Communities.

USAID has funded various projects in the WASH sector; including WASH for Urban Poor (WASH-UP) and WASH for Health projects. These projects support preventive measures such as house-to-house education on cholera, distribution of Aquatabs (a brand of chlorine tablets for purifying 20 liters of water per tablet in 30 minutes), disinfection of cholera-prone communities, distribution of Social and Behavior Change Communication (BCC) materials, as well as radio and television spots. Currently, cholera prevention activities are being carried out under the WASH for Health project initiated in 2015 and implemented across communities in 30 districts in five regions of Ghana (Greater Accra, Central, Western, Northern and Volta).

Almost two years after the intervention, residents in the cholera prone areas continue to adopt hygienic practices. The fact that Accra has been cholera-free for two years in a row is testament to the hard work of community members in sustaining the practice of these effective WASH interventions. Madam Bebli, a fishmonger at Tsokomey sums this up by saying, “It’s been long since I last noticed a cholera outbreak in Tsokomey. I personally ensure that our working area is thoroughly cleaned after the fishes are smoked. I also ensure that my family, especially the children, wash their hands regularly.”