PRESS RELEASE: THE CALM BEFORE THE STORM; POST-FLOODING IMPACT ON PUBLIC HEALTH

The recent June 29^th floodings seems to have divided social commentators and key actors for managing the environment and preventing such disasters. Two popularly held assertions are the engineering and behavioural thoughts as the main causes of these perennial flooding of the capital city and now being experienced in some towns several kilometres from Accra. The Engineering thought holds the view that this yearly disaster is a technical failure of the city’s drainage system which has outlived its capacity to hold the torrential downpour over the city and those running down the hilly surroundings. Additionally, fingers are being pointed at the narrowing of wetlands meant to hold such flood waters and gradually funnel them into the sea. On the other hand, is the school of thought that argue that this vicious cycle known to plague the capital only in the month of June is purely due to the indiscipline of residence who disregard sanitation orders and wantonly dispose of refuse in drains. These deposits eventually coalesce and blocks waterways redirecting rushing water, flooding homes and other buildings. An extension to this stance is the point on the proliferation of buildings in waterways which are preceded by the filling of these sites before erecting of structures.

It is common knowledge that after these floodings, disaster management teams are set in motion to dredge waterways, clear deposited wastes and provide relief items. Concurrently, there may be probes to identify possible issues of negligence and how to find a lasting solution to this yearly inconvenience that seems to have somehow won its right to coexist with us. After somedays of vigorous work to fight the effects of these floodings we are tempted to recline into the business-as-usual mode. This seemingly peaceful phase is rather “the calm before the storm”. It is the opportune time for the incubation of several waterborne and vector mediated diseases whose outbreaks could take a significant toll on an already stretched public health system and health expenditure.

The aftermath of flooding leaves in its wake contaminated water bodies and flood overwhelmed sewage systems which releases pathogens from faecal matter such as Vibrio cholerae and Salmonella typhi into the environment. Exposures through the use of contaminated water bodies and environmental contacts promotes infections by these pathogens leading to cholera and typhoid outbreaks. In retrospect, between August and November 2024, a month after flooding in Accra, the Ghana Health Service reported 1,732 confirmed cases of cholera in 32 districts with 16 fatalities. The Greater Accra region accounted for 68 of the confirmed cases.

Not only do these flood waters leave behind a trail of infectious enteropathogens, the collected flood waters which may take days to drain, hold the potential to breed vectors such as mosquitoes that may flare up malaria incidence. This is evident in a regional analysis from data spanning from 2012 to 2023, which indicates a bi-modal peak, the first ending in July, in malaria cases in the Greater Accra region with a significant drop in August after the rains.

In addition to the morbidity and mortality burdens due to these post flooding infections, is the financial drain and impact on a coping health surveillance system. For instance, the 2024 cholera outbreak necessitated reallocation of part of the Ministry of Health’s budget to support surveillance, case management and funding of logistical needs. The Ghana Health Service, in partnership with WHO and UNICEF, had to procure

150,000 cholera vaccines for public health campaigns to limit the spread. Furthermore, an European Union Grant (€ 100,000) was critical for providing disinfectant, handwashing devices and public health education in the affected districts. With respect to health surveillance, the current system plagued by several challenges is limited in being apt and prompt to its task due to issues of underfunding, paper-and-digital bottlenecks, poor coordination and high workloads leading to compromised data quality.

It is therefore imperative that as the engineering and behavioural interventions are at the forefront in looking for a lasting solution to the perennial floods, the public health implications should be given a well-deserved attention. Government and responsible agencies must put in place mechanisms to ensure access to safe, treated drinking water for affected areas. Secondly, repairing of sanitation systems and safe disposal of human waste should be a priority to eliminate environmental reservoirs for transmission of these diseases. Moreover, there should be conscious promotion for WASH practices to significantly reduce the chances of these pathogens being transmitted from reservoir-to-person and person-to-person. Finally, the health surveillance system should be supported with the necessary logistics and placed on red alert for early detection of outbreaks to inform rapid and effective management.

This is no time to point accusing fingers but to ACT. The collective resolve of every Ghanaian in this matter is required and the time to act is NOW. Let us not forget that beyond these two highlighted proponents of the causes of floods is the ‘climate change’ theory. As mentioned earlier, the issue is NOT about placing blame but solving the problem. Interestingly, our collective actions contribute to climate change theory much as it does for the other two theories. All of it is humanistic!!!

ISSUED BY FRIMPONG-MANSO INSTITUTE

Rev. Prof. Paul Frimpong-Manso (President)

Prof Ellis Owusu-Dabo (FMI Thematic Chair Science Technology and Health)

Dr. Samuel Nkansah Darko (FMI Fellow; Science Technology and Health) For comments and queries contact Dr. Samuel Nkansah Darko – 024 218 5228 Thank you.

REFERENCES

International Organization for Migration. Population Mobility Mapping. 2025; FEBRUARY:1–17.
Akurugu E, Awine T, Seidu B, Peprah NY, Mohammed W. Temporal and climatic drivers of uncomplicated malaria in Ghana : A Regional Generalised Additive Model analysis. 2026.
From Outbreak to Containment: How Ghana Beat the 2024 Cholera Surge | WHO | Regional Office for Africa. https://www.afro.who.int/photo-story/outbreak-containment-how-ghana-beat-2024-cholerasurge. Accessed 17 Jul 2026.
Asiedu-Berkoe F, Chandi GM, Bandoh DA, Atsu BK, Lokossou VK, Antara SN, et al. State of Public Health Emergency Preparedness and Response Capacity of Ghana. J Interv Epidemiol Public Heal.

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