$Unique_ID{COW01429} $Pretitle{353} $Title{Ghana Chapter 6A. Living Conditions} $Subtitle{} $Author{} $Affiliation{HQ, Department of the Army} $Subject{areas housing urban food facilities construction foods income rural government} $Date{1970} $Log{} Country: Ghana Book: Area Handbook for Ghana Affiliation: HQ, Department of the Army Date: 1970 Chapter 6A. Living Conditions In 1970 the standard of health and welfare of the people was one of the major concerns of the government. The rapid urbanization that had taken place since the end of World War II had led to the development of population centers without adequate sanitation facilities. Some government projects and medium and higher priced private housing in urban areas did provide adequate facilities; however, compact areas of what initially had been constructed as temporary housing without sanitation facilities have mushroomed and continued to be occupied on a permanent basis. These areas represented one of the major obstacles government officials faced in their efforts to improve the health level of urban areas. Government efforts to raise the standard of living of the population have included such programs as the construction of low-cost housing, the provision of pure water from piped supplies and wells in both rural and urban areas, the expansion and improvement of medical facilities, and a widespread program of health education aimed at changing the attitudes of the tradition-bound older generation. Particular efforts were focused on diet and the widespread existence of nutritional deficiencies that have been the cause of much of the country's poor health. Health service programs have constituted important parts of the various development plans that had been drawn up since independence. Major priorities have included: increasing the number of qualified medical personnel at all levels; intensifying the campaign against the most serious communicable diseases through curative and preventive measures and through educating the public; extending and improving the maternity welfare programs already in operation; and constructing additional medical facilities. Although in 1970 none of these goals had been fully achieved, progress had been made in all four areas. Missionaries and missionary societies first introduced modern medicine in the nineteenth century, and until after World War I they were almost alone in the fight against disease. Since the end of World War II the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) have provided much financial and technical aid for the elimination of disease and the raising of health standards. A serious shortage of medical specialists existed, and local facilities for training medical personnel needed expansion and updating. Many Ghanaians continued to rely on traditional doctors and herbalists. In 1965 the first legislation went into effect providing for social security on a national basis. Under this plan a provident fund scheme (lump-sum payment) was established that lasted until 1970, when a conversion to a pension scheme was scheduled. By 1970 legislation also provided for sickness, maternity, and work injury benefits. Government welfare programs were the responsibility of the Department of Social Welfare under the Ministry of Labor and Social Welfare. In the rural areas and, to a considerable extent, in the urban centers, however, the traditional patterns of social security based on kin obligations still prevailed. The Level of Living The determination of the level of living was hampered by the lack of statistical information. Perhaps half of the population lived at an agricultural subsistence level. Cash crop farmers, however, enjoyed a relatively high level of living not only for the country but also for Africa as a whole. National income for fiscal year 1966/67 was placed at about NC214 (1 new cedi equals US$0.98-see Glossary). Available figures indicated an uneven distribution of wealth and showed a higher range of income for the southern half of the country, where the great bulk of cash crops was raised and most industrial activity took place (see ch. 11, Character and Structure of the Economy). Most wage-earning families had more than one wage earner or had a supplementary income from trading or some other source. Per capita income had steadily increased since World War II, but the continuously rising cost of living had prevented any appreciable increase in real income. An adequate analysis of consumer spending was difficult to develop not only because of the scarcity of representative statistics but also because of the reluctance of many wage earners to reveal information about their total income and spending habits. Surveys in the mid-1960s showed that the major percentage of the average budget was spent for food; other major expenditures included clothing, tobacco, beverages, heating and lighting, household items, school expenses, and payments on loans for funeral expenses or other family obligations. For the wealthier consumers, miscellaneous expenditures, half of which were for travel, increased. With increasing total expenditure, the proportion spent on clothing, beverages, tobacco, and services tends to rise, and that spent on food, rent, fuel, lighting falls. Surveys indicate that when faced with increases in food costs, Ghanaians are more likely to reduce the amount of food consumed than to change the kinds of foods they eat. Consumer price indexes for the early and mid-1960s showed significant variations in urban and rural costs. Transportation, communication, and fuel and lighting were higher for urban consumers; clothing and certain foods were higher for rural consumers. The cost of living in Accra, however, was actually lower than the national average, whereas the figures for Tamale, Ho, and Cape Coast were significantly higher-by 7 to 15 percent. The differences in some costs between major urban and rural areas are linked to differences in availability of certain amenities. For example, electricity for lighting is available only in a number of urban communities. Also the need for, and daily use of, vehicular transportation is confined to the larger urban areas. On the other hand, the lower cost of living in Accra compared with that in some other towns may be partly attributed to the higher costs of transportation to the latter. Consumer habits are changing rapidly. In the past they were dictated by local production and small-scale trading with neighboring areas but, as contact with Europeans increased, consumer tastes changed accordingly. Canned foods, soap, cosmetics, imported cloth, and imported liquor can be found in the markets, even in remote rural areas, and lend prestige to both purchaser and seller. Electrical appliances, bicycles, and automobiles are important status symbols and may be purchased on the installment plan. The attraction of imported goods and services, including the demand for education, all of which are quite expensive, is causing a considerable number to live beyond their means. The habit of saving for major expenditures is almost unknown, and moneylenders are able to charge exorbitant interest rates. After receiving payment for their produce, rural Ghanaians have often gone on seasonal purchasing sprees with little thought for long-range needs or to the potential advantages of the purchases made. Housing and Sanitation Diverse materials and techniques are used in the construction of housing throughout the country. Mud and wattle or adobe brick walls with thatch or corrugated metal roofs contrast with modern garden apartments and bungalows. In the rural areas each family usually constructs and maintains its own dwelling, which most frequently consists of several huts arranged into a compound. The number of huts depends on the size of the family. Cooking is generally done in the yard, and one room in the compound may be reserved for washing and bathing. Urban housing offers even greater contrasts. Economic opportunities and the attractions of city life have been drawing an ever-increasing number of workers from the rural areas. Housing construction has been unable to keep up with this flow, and the result is dire overcrowding and the rapid growth of slums. The demand for housing of any kind in urban areas is so great that landlords can charge exorbitant rents for the most primitive facilities. Although rents are theoretically subject to regulation by local authorities and an aggrieved tenant can petition to his Rent Control Committee for relief, few tenants dare to complain for fear of being evicted. The majority of urban dwellers are tenants. Several families usually live in one house; kitchens and bathrooms must generally be shared and are usually much too small for the number of people who must use them. Consequently, families cook and bathe in the same room in which they live, in the yard, on open verandas, or sometimes even in the street. It is not uncommon for a landlord, eager to collect additional rent, to transform kitchens and bathrooms into added living space and to provide no cooking or washing facilities for his tenants. Private latrines are seldom found in any but very modern or high-income housing. In the late 1960s running water and electricity were limited to the more modern and higher priced housing. Piped water was available in the larger towns from communal standpipes and was paid for by the consumer at a rate designed to cover maintenance costs. It was not always in adequate supply and was generally not safe to drink. Rainwater was caught on roofs by many for drinking purposes. About 43 percent of the population in 1966 was served by public water-supply systems, compared with about 30 percent in 1960. About 78 percent of these public water-supply systems were wells, and there were 175 piped supply systems in the country. Electricity is generally not adequate to meet demand. In 1966 there were about 77,800 consumers compared with about 50,000 consumers in 1960. As of 1970 much of the electricity supplied by the hydroelectric complex connected with the Akosombo Dam was furnished to industrial users. Enclosed drainage or sewage systems had not been installed, and sewage in the larger cities was usually carried in open ditches in the streets. In the mid-1960s only Tema had a waterlane sewer system. Septic tanks were used in some of the more modern sections, but the majority of bulk waste was collected at night and buried in shallow trenches and pits at the edge of town or incinerated. Hard-surfaced streets were few and usually limited to commercial sections of urban areas and, depending on the season, most streets were characterized by dust or standing water. Several cities having modern sections and high-income housing with modern facilities are surrounded by what constitutes suburban slums. Nima and Ashiaman, set a few miles from Accra and Tema, respectively, are typical examples of low-income urban congestion. In 1960 Ashiaman was a village of about 2,600; by 1970 its population had grown to an estimated 30,000. About 75 percent of the men were engaged in manual labor, and 14 percent were unemployed. There were some modern structures with average facilities, many of which were constructed under the Tema Development Corporation (TDC). Many of the unpaved, often muddy roads, however, were lined with structures made of packing cases and metal roofing. Between the houses were pools of fetid water, providing breeding places for mosquitoes and disease. Housing built under the Tema Development Corporation had adequate sanitation facilities, but the rest of the city had one latrine for each 7,500 people. Water was more readily available, but most of the residents carried water from one of six standpipes or purchased it from closer and more reliable sources. Government aid to housing construction during the 1960s was made either through financial assistance to the many building societies and cooperatives in the country or by direct financing of public projects whose units could be bought or rented. The building societies made loans to their members for land and home construction from a fund raised by conscription from members and by the sale of stock to government and insurance companies. The terms and conditions of the loans were governed by the charter of the society, and each society was strictly controlled by the Building Society Registrar provided under the Building Societies Ordinance. Government projects were constructed and operated through the Ghana Housing Corporation, created in 1956. The corporation was a nonprofit, public agency governed by a board appointed by the minister of housing. Housing could be either rented with an option to buy or purchased with a long-term mortgage. Three different income levels were scheduled, and some subsidies were available to aid low-income workers. Corporation houses could not be sublet while being rented or for the first two years after purchase. This restriction was designed to prevent, at least temporarily, the conversion of new housing units into crowded boardinghouses or multifamily compounds. Between 1961 and 1966 the state corporation completed the construction of 2,148 units, about 70 percent of which were built in Accra. Included in the 393 units constructed in Accra in 1966 were two supermarkets. About 50 percent of all construction between 1961 and 1966 consisted of two- and three-room units; about 15 percent were one-room units. In the first year construction emphasized one-room units, but between 1962 and 1966 only 72 one-room houses were built. Housing facilities were also provided under the Volta River Authority, established in 1961 for the resettlement of farmers whose land was scheduled for flooding as a result of the Volta River Project. By 1968 the authority had expended an estimated NC21.7 million. About 60 percent of this figure was for housing construction, including townsite clearing, construction, equipment, and overhead costs. Additional expenditures provided for schools, markets, streets, sanitation, and water supply systems, as well as for engineering and administrative services. Construction techniques utilized precast concrete beams, cement block walls, and corrugated metal roofs. Individual units were to be built in stages, with varying floor plans providing one room and covered areas in the first stage and additional sleeping rooms and then kitchen and bath facilities in later stages. Diet and Nutrition Estimates of the average daily caloric food intake for the late 1960s ranged from about 2,100 to 2,500 calories, the lower estimate being the more probable. About 1,800 calories of the total caloric intake consisted of carbohydrates. The staple foods were cassava (manioc), yams, millet, Guinea corn, and rice. The grains were generally dried, ground into flour, and eaten in the form of a gruel or mush. The roots were dried, boiled, and then beaten into a dough-like substance that was eaten with a highly seasoned soup or stew made from red peppers, spinach, or okra and occasionally small quantities of meat or fish. The main regular source of protein was eggs and, in certain areas, fish, but these were consumed in small quantities. Although readily available, green vegetables and fruits (except for plantain, which was another carbohydrate) were consumed in negligible quantities, as was milk. Poultry was consumed by some ethnic groups, and the Anlo, an Ewe group, shipped poultry for consumption by urban dwellers in Accra. The country as a whole has an adequate supply of food, and food production has kept up with the expansion in population, but poor distribution, resulting from insufficient roads and a lack of storage and transport facilities, leads to periodic food shortages and high prices in the rapidly expanding urban centers. Food for the cities must often be transported from long distances because local production cannot keep up with the rapid urban expansion. Drought conditions sometimes result in serious local shortages, particularly in the northern areas. Seasonal hunger in certain northern areas results in annual mean losses of body weight from December to June of from five to ten pounds. Although variations in dietary habits occur on the basis of location and social and economic level, the variance is relatively minor. Geographical factors dictate a higher consumption of grains in the north and of root crops in the south. People in coastal areas consume greater amounts of cereals, and those in forest areas consume greater amounts of starches. There is a slight tendency among the higher income brackets to eat higher priced and better value foods, but expenditures on food generally do not vary with income; increased income is usually spent on luxury goods rather than on more and better food. Even the educated segment of the population pays little attention to balancing meals. Men, by custom, have first right to available food, and women and children eat what remains. Children are therefore often both malnourished and undernourished. Seasonal variations also occur. In the south the proportion of food expenditures for starches increase, and the portion for animal foods decreases between May and August. In the north food expenditures increase absolutely at harvesttime to feed the young men who return temporarily, from southern urban centers where they have migrated, to help with the harvest. The portion of food expenditures for particular items also varies with location so that coastal fishing villages, for example, spend less proportionately on animal foods than people of the interior. Nutritional balance is a particular problem for low-income, rural immigrants in urban areas. The small income these people earn must pay for such items as rent, fuel, lighting and, in some cases, water, which they had obtained without charge in their village of origin. What meager housing accommodations they can afford, moreover, rarely provide garden plots with which to supplement their diet. Rural immigrants hesitate to change their food habits and pay high prices for millet, for example, although maize (corn) is much cheaper. When they do change their consumption habits, however, they are more likely to buy urban status foods, such as tea, soft drinks, and sugar, which have little nutritional value. Many of the male immigrants, moreover, have left their families behind and are further disadvantaged in not knowing what foods to prepare and how to prepare them. Nutritional deficiencies are the cause of much of the poor health. The most serious nutritional problem is protein deficiency, which is the principal cause of the high infant mortality rate. Vitamin deficiency, particularly of vitamins A and C, is another problem. The lack of vitamin A probably causes much of the blindness; the lack of vitamin C is a factor contributing to the large incidence of respiratory diseases. These nutritional deficiencies occur throughout the country. The government has for some years carried out an intensive educational campaign aimed at changing the dietary habits of the people. The campaign is part of the adult education program and is carefully planned to reach particularly the older women who cling resolutely to the old ways. The program is teaching women the nutritional values of the common foods and methods of preparing them that yield the maximum value. Special courses, organized for women of influence in the community, are given more publicity and are planned to confer prestige on the participants. The National Food and Nutrition Board serves as an advisory agency to schools, hospitals, and other institutions on nutritional matters and does research into the nutritional values of local foods. The board has made surveys of the food habits in different parts of the country and has gathered the basic data needed for future corrective work. The board works closely with the Nutrition Unit of the Ministry of Health, whose special function is to investigate malnutrition among children. The unit operates clinics that issue food supplements to mothers and has a milk program in schools with milk donated by UNICEF and various private relief organizations. Markets, restaurants, and slaughterhouses in larger towns were supposedly subject to rigid controls and regularly inspected by either government or municipal authorities. Supervision of cold-storage plants, carbonated-water bottling plants, and large produce plants was in force. Sanitary regulations also existed for the bottling and storage of milk, but their enforcement was suspect.