\

WORLD HEALTHORGANIZATION

ORGANISATION MONDIALE

DE LA snNTE

Onchocerclasis Control ?rograme tn the

Vo1ta Rlner Sasin Area

Elideuiological E\ralrratlon Ur:ttTeahnical Docr.rment ocP/wn7.2l

SOCIO]OGICAI SINDI I{GS OF [iIE MIDB.trOIOGICAI, EVAI,UATION

OI' IHE OIICHOCERCI.ASIS COI{TROI ?ROGNA]'{!M I}i GHANB

by

B.C. SAYIADOGO

Or.ragatlougo:, 22 }lovember 1976

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CONTII{TS

IIITRODUCITIOTd

Ti{il SOcIolOcICAf, FACEI lli TIE EPIDIi;.[o]oGrc.LI ruA-Lu.!'IIoIi oF

III{] PROGIi.Airl}E

1. Its place e.nd its carnponents

2. tr{ethods

2.1 The census

2,2 Senl-dlrecti-ve ta-lks2.5 Direct obsenrations

rlOcrOI,ocrcAtr ri'rI.DrlIGS 0rr flrt EPr.)Ei^r0tOGruAt EvAtuATrcti

1. Vi1.lages srrrveyed and the ?rogra.mre region2. VilJ.ages eva-luatecl: size of hr:man writs5. Age and sex dlstribution of the populatlon exanii:,ed and

onchocerciasis(.) Sex structure(U) Age stnrcture(") Demographic stnrctures and oncjrocerciasis

4 Absences and leveI of attend.ance for eval-uationeCharacterj.stics of p:reeent ntgrsatiorr(") I'hmbers and clominant age groups

(u) The mqin clirections and average duration of rd.gration(.) Euigration and onchocerciasis

I Page

1

1-5

t-23 -5

5-185 -6o-(7 -9

7 -8B

9

10-11LL-12

ILILr12

12

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l_6 - 18

16-17t7

17-18

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III

1-44

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7.

DlspJ.acements of villages and natural moyement ofpopulatj-ons

(") Deserti.ons

(U) Natr:ral movement of populations(") Knorvleclge of onchocerciasis

A brief glance at the social and socioeconomic spheres(") Social organ-tzation(U) Econonic resources, activities and problems(") Social infrastzucture

J

IV POI}ITS D]SCUSSED

1. For the sociological facet, consistency of basic

methodolory rvith freedom of in:itiative for additionalinvestigations

2. the census techirique to ::ra.ke subsequent identification ofindividuals possible is based on the reliability and

pennanence, witltln the comriron nenory, of an ind:Fiduallsrelational identitS,

7. Selections wlthii^ a rillage Ieaci, ivhatever the criterj-autilized, to risks of refusal arrcl absenteeism

4. In ti:e present census, the rrfamill/rr regj-stered does not

always correspood to a coaceptual d.efiaition.

5. [he techniques for estinating a6e uti]lzed, in adclition tothe standard clental nger guid.enarks defined. rvithin the

Iocal cultural context

6. Ihe quair.titative tables were used. for a qua'litabivedemographlc analysis on the basis of quantitativelyevaluated tendenci-es.

V. COITCIUS.LO-:S

References

IAB]ES AliD GF,AliiS

I Breal<dovrn of adminis-brative districts of villages evaluated

II Distribution by river basins of villages eva-1uated.

III lilaps sirowing location of villag:s evaluated

IV VilJ.ages evaluated: d.emographic coord,inatee, adroinistrativeuialtt maj-n ethnic 8roup.

V Percentage of the two sexes 1n the rrilJ.ages evaluated

VI Graph showing uasculin-it;r ratio in the villages evaluated

ruI Graph showing rna"sculinitJ' ratio by flve-year age gro',ps inthe rrillages evaluated.

WII Age plmqyni d. of tota-l ;oopulation cou::ted in the villagesevaluated (percerrtages)

?age.

18-21

18-19

19

19-20

20-21

22

23

24

25

26

27

28

29

20

20

?J

10

Page

1LIx

xI

XI

Differences between vi-Ilages in percentages belonglng to five-

yeax age-groups

Sex differences in the percentages belong:ing to the five-year

age-groups in the villages evaluated.

Dlfferences in age ratio of the two sexes, for all the rillages

evaluated

Brea.kd.own by five-year age-Sfoups arrd by sex of the census

popr:Iation. Proportlons expressed as percentages of

different a€e-groups. Cr-unu-lative percentages

PopuJ_a.tion of vi]-lages evalua-bed.: residents present and

residents absent. Rate of presence arrcl absence

Brea]<down by ager sex and village of the population at present

eutgrated

Ebtgrairt population and- total popula.tion conpajredr by age and

by sex, in 17 villages concerrred'

Cornparative age p;rr:arni ds of the total population anci the

enlgrant population

Frequency of mai n places of irrmigration

Time elapsed since cleparture of erulgrants

Combjned diagfam showing durations of stay and tine elapsed since

return for case hlstories of nigrants

ftn{ gration and onchocercia,sis

status of socia.l, educational and hea-1th facilities in the

villages eva-luated

Age stnrctures of the popr.r-lation of the villages evaluated and

onchocerciasis, by percentages of the age-groups withln each

rrilJ.age.

Table for detemining cirj-ld.rents age from dental fo:mula

Ethrrtc code

Inte:rrriew gutd.e for a vil1age card

For demographic analysis: I tables giving sociodemograpidc

data on the vi]-lages rrisited.

7z

16

37

3B

79

40

4t

42

47

++

45

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E(

XII

XIII

xrv

XV'I

XIIII

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)GX

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table III

IIIIV

17

14-75

46

47

+8

49-56

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I a I}TTRODUCTION

Ghana is one of the seven countries participating in the Qrchocer-ciasis Control Progra:me in the Volta River basi-n. Its rnain econonlcactiulty is agricultare, which accounted tor \5% of the GNP in J975tenployed eCfr of the nanpower, and provided Tfl of the income fiom exports,e6% of which comes fron cacao alon-e (Wno, Report of PAG, lg77). Brt thj.sprosperous agriculture is.the privilege of the sorth. In the firo regions-coveiea

by tf,e Programe (uppei neg:ton and Iforthern Reglon) subsistenceagriculture is the norm. And yet there exists relatively abr:ndantr fertlleand Iittle-utilized 1and. in the river na11eys, w'here ::ai::falL condltionsare satisfactory and the possibilities for *rowtrc crops (ri"e, eottonlmajze, oils) and stock-:uising rea1. It is onchocerciasise rife 1n theseregions, where it constitutes a serious public health problern, which to alarge extent explains the jrobalances j.n the population dlstribution; whichare one of the rnajor obstacles to a reorganized., diversified and moreproductive agriculture.

fhe Eliderniological E\raluation Unit of the O:chocerciasis ControlPrograme eonducted, between November 1975 and April 1976, {-O evaluatlonsof villages or parts of vilIages. fhls sa:npIe providesr as far as Ghanais concerrred., sufficient clata for app::aising and judgir€r at least in anaverage maffi€Tr the results of the onchocerciasis control operatioas.

These evaluations eompr:Lsed three facets: a parasitologlcal facet,an ophthaLmological facet and a sociological facet

This paper presents the finclings of the sociological part.

ITIE SOCIOIOGICAI TACET I1{ friE PTDEI'IOI,OGICAI EVAIUAT]OII OT' THE

PItOGRALm'm

1. Its place and its cmponents

Accord.ing to the gene::aI methodology for epideniological evaluationsof the Frograme (Prost, Ihylefors, Pairault, 1975: op. cit.)e the flrstthing to clo in every rri1-lage chosen for e:ra^uination is to nake a census.Thj.s means an e:rkraustive census of the population wtth reg:lstration ofrestdents present, residents absent, visitors anc',. ld.entification, for eaehperson registered, of his relationships. trfhls"r states the document quotedlt'1s a vital phase of the sul:yeys the value of the lgngitudinal'stutly rnadew111 depend upon hon'carefirlly it is caried out." (op. cit, p.7/.

'lVhi.le the census thus constitutes the fi-rst component of the socio-logical facet i.:a epidemiological enaluations, i.t is not the only one. trlnso far as the 1evel of onchocerciasis endenlc in a particular rylace is neithepflced or necessarily always homogenous, transmlssion dynamics (lncreasing, istagrent or declin'ingJ tlepend i.:r part upon the klnd of life and socio-econoet$actlvity which are in thelr turn neither simple, nor flxed, nor necessarilyalways homogenous. Factors like these, iirelenant to'medicai dia6nosise beLoqgnevertheless to the field. of epideniotogy.tt (op. cit.l p.8).

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Fincling and collecting basic d.ata that can help to oqrlnin differentialIevels of endenlcit' constitute the second. component of the sociological facetof epid.errrtological evaluations. These data relate to several areas: confi.gr:ra-tion and d.lstance of dwelling uirits in relertion to lretesting blackfly habitats,loeation of fieltls, distriburtlon arnong the comr:nity (ty age and,/or sex) ofactivities bringtng the vrorkers into conta.ct with infesti:l.g blacldly habitats:work in the fieltts, herd.ilg, gathering wild frer.rj.t, hwrting, fishing, vraterearzXring, ete.

At the same timer it is aclslowl-edged. both among the participatingcountrj-es - Upper Vo1ta, Iiiali, Ivory Coa"st, Ghana, fogo, Berrln and iliger - anda,tltong the sponsoring agencies - trlor]-d Bank, IIIDP, FAO, \iHO and the donoreountries - that the ultimate justiflcation for thts r.a:dertaki.ng is thepossibility of

^opening up 65 OoO hm.z of good land for econor:ic clevelopnent once

the 700 0oo }fir4 of the Programme Br€o .1,-re freed frm onchocerclasis. Thisd.isease, perceived as a mejor public health prograrme, constj-tutes one of thenain causes of tkre econonlc urderdevelopment of the region.

Consequentlyr another ta.sk of the sociologists in tbe Epldemi olog1calEvaluation unlt is to co]lect certaln ba.sic info:mation or data wh:loh oan beused' ln the Lupleoentation or for"rn;lation of future d.evelopment projects: soclalorgapi.zatlon, '[:e system for decislon-naklng and its prineip?l agents,population ilolremelts (nlgrations), soci.al senri-ce facilities (heaIth, educati.onal,cr.rlturalr etc.) ar:.d econonic in-i'rastnrctures (existing prolecis, roads, market,etc. ) ,

tr'inaIIy, the sociologist uust foster relationsirips of nu'lrual confld,e,.rceand cooperation betvieen the peasants and the members of the nedical team, Iorrrgccupying a position nid',;ay as lt rvere betn-reen laboratory reseeich and nobilec]1nie woltkr an epideniolog:lcal evaluation aims, Iike labor.rtory research, atobtalning a scien'ciflc result vrh:ile, like mcbile c1ia1c irork, ul:-ng required toestablish a relationsldp of bnrut between the people studled'(tfr"y are notpatlents) and.-bite physrciairs (who do no, necess.,rily p::rform arlJr therapeuticfunction)". (op. cit.)

In order to create and maj-ntaln tha; trust, cou:.tesy visi ts must fi.rst bemade to the Ioca1 reprecentatives of the central arlmiirtstra.tion and therrillagers who .',re vislted mrst be reg.ssured. that their aduuii:is-brl,tlve aufl:oritieslmow about the qlssion and have gj-ven their assent. illext the sociologist, lvlrtlerespeeting the lrad.itional protocol of the vi11ages, mr_rst gi-.ae a. clearpreeentation of the objectives of the nission and the f,reens brought to bear,adtLtng a clear er.rlan:ati-on of what is expected of the rillagers. I,a.stly, # n'trstlisten to rvhat they have to say aird. ansrven ar$r questions.

In default of such an effort of adnirulstratirre cor:rtesy and patientpsychological preparation, the evaluations are liabl-e to be adversely affectedby absenteeis-.it wirich may conpronise the validity of certain fi5ures from thevery first visit. Since the ned.ical tenm j-s condu-ctiag a :-ongituainal survey,it is errident hol serious tkr-ls risk ls if the volturta.ryy informed. and notivateclcooperation of the populati_ons is .iot secured.

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2. Iththode

In the fieId, the three taslrs of the sociologlsts have been implenentedby means of:

the census

seul-directive talks

direct obserrations,

Ihere follorp a brief outline of the methodolog-ies.

2.1 The census

[he census nrtrst be a comlrlete one, registering 2'l'l the resid.ents present,those absent ( eutgrated or away on rrisiis) i"a p"*"5r,." for.rrcl irr the viliageand. likely sti]-l to be there when the team comes by agaln. It uust also beaecurate and. precise so that every person registered can be subsequentlyidentified and traced..

So that the census can meet these two conditions. it is eonclueted on'thebasis of the smallest sigrrifieant social unit (tire far"rily) ana the meobersl'situation witle respect to one another is specified in tems of kinshJ.p tles.

Ihe vi]-lage ls identifiecl by its narne and code (= serlal number of theexern'i nation)

- Ihe neighbourhoods ln the village that are exemined are naned and coded.(= serial nr:raber rrithin the viJ.I.age)

The farni lles in each neighbouri:ooc-- are iclentified and cotled, (e serlaInumber of ttreir presentation for tire census).

In eaoh fqrnify the reg'istration of the members is done 1n the follovrlngord.er:

the head of the famify or concession (- dwelli.ng unl.t or basic soeial unit)

hls first rrife

the ciiLdrrn of that ruife in order of seniority

the second. wife

the oiildren of that wife ln order of seniority

aa5r othor rlves and thetr ciri]-d.::en1 in thc s-ure order

rristtors.

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A particularJy tric$ part of the census, in these regions rrithout ritalrecorcls, 1s assigning ages to practisal'ly al-1 the indiv-itluals. [he methodused is that of ssf,imnf,fqn. fhere are several eriteria for this, ttepend.lr:.gon ages

From 0 to 12 yea.rs: T-re use the so-cal1ed dental age method. (see tablereproduced jrr Aru:ex I).Fron IJ to I8 years. fior girls: estimation by reference to thg average{r€e o{ narria'ge (= 17 or rB years depend.ing on th.e region and gtrudcgroup/.

tr'or boys: est'imation by reference to the girls of the same age. Theirown average age of marriage is difficu].t to utilize sj.:rce it variesvridely aceor*ing to the ind.ividual and to lris social baclqgror:nd. andecononlc Ievel.

Fron 18 to 45 years. For wouen: esti-mation by reference to the nwrberor children _or completed pregnancles, at the rate of one chtld ox onecompleted pregnancy evelTr two years. For raen: estination by referenceto a persouls vl-ife if it j.s irls first, or else by brothers, sisters andpeer groups.

Frm 46 to over JO years. For wonens sstimstion by reference to the yearof dellvery of tire last ci:ita (excludlng cases of sterility by referenteto women of the same age)o Formen: eitimation by refer"n""-to the ageof the vu'ife fi-rst manied, or to the age of brothers or frielrds.

In a.11 casesr and when the opportuurity arises, reference ls established toa historical. event preserved in the memories of the peasa:rtry: the yearthe country became indepenclent, the rlepositioa of President Kwameitrlcumah, etc.x

2.2 Senrl-d.irective ta-Iks

The sociological sulvey aims at collecting a variety of info:mration.

The senl-directive talk is tire first means of gathering the infornationneedetl.

It talres place in the presence of a group of informants. fhis groupshould, by the rarlGe and diversity cf its menbership be able to prov-ide ascompleter correct and. accurate lnformaticn as possible tirrough the i.:ete6a1contrad.lction sti-rred. up anonil the participants once the discussioi:. has beenlar.ueched ln an afuosphere of mutual tmst.

ft ls therefore attentled by the rrillage chief or his representatlve,aecompanied by the locar notables: couz't di6ia.taries, Iar:d. c ,iefegeighbourhood clriefs, 1i-neage c}:iefs, those in charge of various assocj-ations(youth crubs, former pupilsi association, coope""[i""rt";",), ,ne school-teacher, the nurse and the ulrlage agricurtural officer.

The matn subjects gone into are listed in Aruaex II. *-ts

;6 Census record's and. indlnidual ld,entity papcrs could have been used. Infaot, we hatl access to a very Um{tecl rnlnt"r of tntLirridr:a1 ld.entlty papers.)F* Aanex II 1s aetually a L1et of ethnlc groups wlth oorle nmbers. - rransLator.

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2.7 P:lrect obse:srations

Having the same objective in v:lew as the seml-directive talkr theysupplement, parti.cularize or inrmlidate certain parts of 1t.

Conducted mlth the help of a grridel they generally concern the conflgura-tion and. locati-on of dwell-ing units and fields i.:: relatloi to blacldly breedingsltes, the soclal inf::astnlcture (premlses, equlpment etc.) and economJ.eprojects such as large-scale land development, dams, etc.

Ihe rezults of these observations are, if necessary and. possible,recorded ln the fo:m of a plan of the village showing the location of thevarious features.

fff SOCIOLOGICAI tr'IIIDI1IGS OF TiiE PIDEiIOTOGICAI EVATUATIOI{

I Villases stutveyed _+r{ the Iryg1aggog_Aegiona

In Ghana the ?rogra.ume covers the two northern reglons of the countrysthe Upper Region antl the $orthern Region which r3roup 26 L6cal antt 10 DistriciCouncils. fhese two regions conprise 9Z 7O2 1fr2, or about 4fl of the totalarea of the country, and are irarabited by 1 59o 341 p"r"ons or t8.6rt of trrecountryls total population of B 559 1r7 (rgzo

""o",r").lhis popuiatlon is wrevenlJr^distribr.rted: whereas the mean d.ensity forthe oountry 1s 2].,.04 persons per h2, it is 71.66 for the Upper Reglon anhlo.+2 {or the Northern Region. fhe variations range fron a:-rnost urdrarabltecl

zones (onchocer-ciasis-i-nfepted ;;;" ;ii;y") to centres where tJre densltyexceed.s 170 persons per lm2 (fur:eo-Ibbdprn region)r-;;il i"-"""y *"urepresented graphiealLy in Fig. 1l of the article by Hrmterr :1giZ (op. eit.).

Ihe cri-teria wh:ich governed the selection of villages for epidemi 6-logical erraluation_haire already been exprai-aed (prost et "i., 1975 .rraBrinlaann, WT/76.II).

lhe rnllrages selected. and. zunreyed. are'tlistribr.l.tett aeong 19 ]oca1Councils belor:ging to the L0 District Councils. In them a totai of t7 4|i5Bersons were counted., 11 T4O uade:nvent parasitologlcal e:ra:n:i.:oations and L 55IophthaLnologlcal examinatl ons.*

Table I shows the iListribution of the villages eva}.rated among thenariors gdmlnJsf,rative dlstri-cts, in&tcating for each of the Latter the area.populatlon, clensity antt number of villages erialuated.. [ab1e II glves their t

distributlon by river basins, and Chart III shows how they appear on the napo

{+ Y111age \: 126 Akanyaleom (tee p"rsons counted, 158 examlned forparasites) wlyich fom,s part of the Brong-Ahafo region, is excluded fromthls totaL.

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From Table IV, r,vi:j.ch indicates for each vilJ.age evalua-bed. thegeograpirlcal coord.inates, tl:re arimi:ristrative tr:rlt and the d.ominant etlrrrlc#oupr lt wiJ.t be seen that I8 of the oountryrs etlnie groups wereencotmtered. ln the vilJ.ages evaluateC..

2. VlllAeqq !.fql41aiol: -qi,-zo 01' h- --gl,li.i

[he description of tne metl:.oi': has nade it clear th-at the geograpirlea.Iand hr.:.nan reference r,u:it o:3 -bhe eval-uet:i.ons is the vi11a.ge and tl:at thefnrrily is tire reg'istr;tic,n w:.-t. In respect of size, the rurits encor.mteredcarr be broken d.ova: a.s fol-Ioivs for 2a villages fuI1y evaluated.

lllz,ll 0l' ,11;4Gri3 (.n.:e'in O-u' ItiiiAiill[T'i;)

I{umber ofinhabi-tants

lth:mber of villagesconcerned.

Codes of vi3-lageseoncemed.

)6m'insnf, ethnlcgroups

ro0-rgg zCO-2)g 769A7rx

Dagari3lmoba

.,

* After the 4OOo199 c-r-asse c,,nj-y these';wo fi.g,r:^cc exlst; hence the dlsoontinultyof the progression by l:tulclreds.

SIZE Oir rrliltrlLlii (ii-;---.. 1 .; i-*- :sC:.;J): -.1-'.-]ifBUTIOIT OI

AISTIIETIC ll[ll,i]S Ai.'llcl r'ltrl 20 VILLAGXS

loo-799 400499

4 263

og7-ro6-rr0IT2

r08-096

Iaga.5-1L:.;a.seI(asena, SulsalTairkana

o95-rJ99-rO5 c93-094.-r00I07-iII

0c0-09f-0gBr0r-Ic5-I04

I1-^ r-^^

Iiasenaidani,,ara

Ifusasrj'ra-:l'::aIiaseira, i\,'eSi-s.r-Le.

I"asenatrampursi (3)].robl

Size offqmi Iles 6 "'' -? "g

Ifumber of vlJ-lagesooncerned

Dorrigrant ethn:i-cgroups

SubJect to certain r:marks contained. in the d.iscussion chapter, it can bestatecl that:

25.O and. 74,4

2

ro. o-rr , g i2,o-:t,"9 15.o-T8.2

6 5

IlusaseFra-fraIbsenafiairl.;anaowe (r)

2)(z)2)(r)

(

\

+ 7

SlnobaI(acena3u1saDa3ari

T)n rrr n'-Ia.bJe'lIG.senaIianlcana

BuJ-sa-Dagarj.lobJ,umpursi;Gondja

l jarnpursiSlsala

IIt

I

t

I

ln the med.ical e'Eluation sa:npIe, the slze of the villages is notdirectly and 1n all cases comelateal with the endenic prenalence ofon6hocerciasis: the tlrree ,,:naIlest villages have a prevalence of6L.q2, 68;1%- and, 65.f1 respectively, wher6as the three largest have74.3%, BO.5% and, 64.6% prevalence respectively. In other words, thesoallest villages are not necessarily the nost heavily infested.. Ifwe apply the loglc according to whlch, the snaller the ra:mber oflnd.liridua1s, the higher the endemi-c preralence rate caused by a givenm.uober of ir:fective blacirflies, we ha.ve to take into accor:nt at thesane tlme the average number of infectlve bites, the d.ispersal of thelitt:tng area in relation to the infesting blaclcfly breed.i.:rg site, thetl;ate of establ-ishnent of the hr.rnan settlements and the mobility of thepopulatlons (uigr^ations ) ;

the size of the villages seeuts to depend on the initial i-mporbance bothof the centre and. of the hinterland of the urban area: for example,the two largest villages su-rveyed. (nartugu anct T,isa) are a foruard. frlngeof very large inhabited. areas;

the size of the families seems to vary accordimg to ethnlc groltp: 1fthe two tables above are considered j-n conjunction, it ls the lWampursl,the Bulsa, the Sisala, the Gondja and the Dagari who seemed to have theblggest femtly untts.

7 Aee and sa tllstribution of the population examined. and. onchocerciasis

(") Sex stnlcture

In lB vl11a6es or parts of villages eraluated., the brealcdoirn of thepopulation by sex shows wid.e variations in the cnrde percentages. Fron Iable Yit can be seen that the e:rtreme values are found at:

tr\:nbisi (fo5; z 45% men, 55% women. Yj.llage populated by Brlsa;

sabari (rra)'. 5e% men, 42/" women. vlIlage poprrlatett by Dagonba;

Datulm (feg) represents the ideaI balance z 5O.So men, DO.q, wom€floVilJ.age iyrlrabited by l,ra-fra

. G::aph lll shows that 21 vl1ia6es, or 55.7% of our samplel have aPregond.e::ence of nales 15; or 59.5%t hav" a prepondezranc" of women, while trruo,or \5.7%) have a balanced tlistr:lhrtion of the sexes. &.it the most interestingset of relatlonshlps is the nascullr:ity :catio by agegrorps, which we find.undergoes enormous fluctuations :

Graph Yrr shows that there is a preponderance of m,les 1n the quinaryage-gr€ups from 0-4 to 15-19 years, from 40-44 to 4549 years, andover 55 yeals;

-B-

Ihere is a preponderancc of fernaLes in the age-groups from 20-24 to75-79 yeaxs ancl i.n the 50-55 year group. fhe follorlnlng Table, whloh1s more preclse than the Saphr shows the nagnitude of certaln derlar.tlons for the whole set of vi'llages.

o+ | r-o

iro-I4 I5-I9 20-24 25-29 n-34 75-79 4044 +49 50-54 *\as;;s +70

ee.?l r03.4 I4I.O I22.6 82.5 76.7 Bg,6 8[.2 IfI.4 II6.4 7a;5 99.5 r45.q 201.4 728.O

554

lhe IOJ4 and I5-I9 year a€e-gteoups have I4I and. T22 boys respectlve\r tc_ evetlr IO0 girls;

After the age of 50r it looks as if there rrere practlcally no wor!.en left:l+6? 2O7 and, 128 men per IOO women.

(u) A$e stnrctu.qg

Tlre overall shape of the age pyranld for all the uillages evaluated (seeGraph VIII) j-s no:crnaI except for a few variations.

Hovrever, 1n the set of graphs numbered I)i we find marked and oppositevariatlons frou one vilJ-age to another: these variations axe still moreclearly ]rislble ln the set of graphs nrurbered. X, where they are shovyn by Bex.

. the age ratio for both sexes (fatte lf,) confl:ms the irregr:larlty of theage distribution of the population: the ran3e of varC-ation 1s I2.7 for^ malesr16.7 for wo&,en and. I4.5 for both together.

In general, the diversity in the shapes of the age pJrramJds which wasobserrecl ln the viII-agee eva-luatecl colflresponds to the tliversity of thereglona-l p3rarnids in the atlas of Gtrena (wationa-t Atlas of Gtrena: L[ap N71 1960)and generally obsenred. in the cor:ntries of Africa, * Ihis j-s proof enough'thatthe fluctuations obse:nred are not due malnJ-y to errors of estim.atlon oonrmr tteclby the persons who conducted. the census, but correspond to ieal perturbations i.:rthe demographic jrdices of the census populatlons.

)F

see IIo. 7 ln the rlst of references.

-9-

(o) Deuoeraphic stmctures and onchocerciasis

What factors could hare produced. these deviations j-n the age and sexstnrcture of the population?

lhere are four'v' tqrpottreses which nay e:rplaln these pertr:rbations:

the econonic and eu]turaI leveI of the populations of the variousregions;

: the health situation and seleetive epidenics;

: differences ln ferbiJ.ity between ethnic groupsi

the effects of onchocerciasis, on the supposi-tion that i.ts severityclepends on a social dlrrislon, by age and sex, of tiie actirritles that8i33"

categories of ind.lriduals in contact vrith the blaclCly breed{ns

because of i:eadequate i:c,fo:mation on far,'iJ.y inccmes, on the baselinehealth situ.ation, on the trentl of the rrital statistics of the regionsand. on the denograpirtc tlata for all the etitr5.c groups encountered.,the respective or combinecl effects of the first three factorspostulated are difficult to evaluate.

I[hatever the possible lnfJ.uence of these factors may be, one is stnrekby the fact thet it ls villages where onchocercj.asis is llytrrerendeaicwl:.lch d.isplay the abnorua.l clemograpiric phenomena observed: lowerage-Sroups compLessea (Natong-Saboro, fbo), age-groups above 50 yearsmonll or even unrepresented on the fena-1e'side: lTidinaba (OSl),Apodabogo (095): sugu lroZ), iQrll:n (rtt). It Looks just as ifonchocerriasis lvere on the one hand causlng excess mortality amongelderly persons through general rveakening of the orgarrism, and on theother hand reducing fertility in the severcl.y affected. zones.

A last point to be noted in the age distribr.rtion of the population is thatin the villages evaluated. those ured.er 20 years o1d constitr:te ilfr ot t1epopulation: see the cr;mulative percentages shown in [able XII. fherertooenols[ous variations u.ay be obse:sred:ln the same trend.s as j.:nd.icated above.

Graph XXrr shows the age pSnrani cls for alr the rrirlagesr

x The speolfic case of the excess of boys aged. IO-I9 years ntght be'corurected with the fact ti:at most of the vilJ.ages evaluated bave schools. Thelnflr-x of boys from neighbourlag rriLlages may e:qrla-i-n the excess of ma1es, oneschool generally serrring several rrillages.

-10-

+. Absences and 1eye1 of attendance for evaluationst

Gene::al-Iy speakir:g, the attentlance rate of the,populations for eraluationshas been very satisfactorXr. Vlleenever tl:eir leaders (v:itlage chlefs, distrlctchlefs and. family chlefs) have been approached respectfully and ad.equatelyinforaed'about the purtrroses and. objectives of the visit, there has beeu a nassivetun:-out. Individual- refusals have, holvever, been met with from a few yor:ngwomen and trivo chiefsr wives who could not bear to unclress in front of a strar:geror had. a subjecttve dread. of the skin-srrip tweezers.' f\vo cases only of partialnass ref\rsal were also recorded. at [an:lna and Yagaba. fhese were due toinstrfficient mottvation in the first case and. an unsuitable manner of appr"oachi.ngthe rrillage in the second.

rhe attendance ::ates shown in Table xrrr are; however, no more thaninclicative because:

certain villages tvere elrarnined partlally (see tabl-e 4) i

not all absent persons registereg fr'the cenzus were taken lntoacco:rrt 1n calculatir:g the rate (e.9. those who had left over ayear ago were nct counted);

in the case of some eval-uations where the soclologist was away for Onereason or another, or the team was exkrausted after seve::a1 weekst staycontinuously, the registration of absences (residents present in thevillage and not attending for examination, residents abseirt from thevillage for varyitg periods) was not always properly done.

tr'ailure to talre aceount of these rese:rrations n:ight l-ead us to rejolce tooreadily at record percentages of attendance, ranging between 98 and 1OO.

llee ::ate of presence, i.e. the nmerical percentage of resid.ents presentover that of the total nr:mber of inhabitants, was also very satlsfactory, thepercentage belng 92.

lhis figure is also only lndicative, for, ln acld.ition to the last pointmade above:

some absences reeortled as tenporary are ernors of interpretationbetween the person conductlng the census and the responsible family membergldtg the info:matlon: they actually concern resiclents very tenporarilyabsent (on visits in particul-ar).

It ls very dlffioult to qua.:etify them, bl-rt their oclstence uust behunbly adnrl tted.

The ertrene duration of migrations (average duration after which anlgrant can be considered as ha'ning emlg::ated for good. and a1l variesaccord'ing to author and region. Since ln our str:d.y no precedents were availabl-efor Ghana, it rvas difflcult to settle on a lnalcjJrum duratlon.

t

In the absence of d.ata for other countries, it was studj-es onulgrations ln Upper Volta which provid.ed the basic references: average du::ationof n{Srations: three years (after that lapse of ti:me 5(i of the migrants areback/i extreme duration: 1o years (ty then, 844 or.rt of lOoo who have left areback, and the rest have euigrated for good ancl all).

tlfi.tth a view to establlshing a chronological record of actr:aI ulgrationsfor the villages erraluated, absences v',ere recorded. up to a 6uratioo oi f5 years.

-11 -

teri s of cont

and tlonfu:an -gr_ol-Bg

ons a'

5.

(") lnla

A total 0f 541 persons were recorded as haulng euigrated in 1? of thevillages evaluated. The einigration rate yarles from cne rrillaee to another:in five it is iess than 5%7 in another five about 5%, 1n one 77,, in three abogt2Vr in one ]:2.z% and in a'1ast-ii.-iGf.- ft.;";;e1.esate::ate for all thevil-lages is 7.6%.

the 541 persons are nad.e up of 59:. menand. 148 women, uir. S.+% ,ra Z..Z%respectiveLy of the total population of the villages: see Table xrv.

[he age distribution shows that mlgration is nainly confined to the aeefl3p? |ro* 15 lo ?9 years, wirich contribute respectively 1.2%, 1.6% and. t.i%,v:-z. 4.2% out of the total of 7.6%.

Table XY again takes the age dlstribution of the nisrants and comtrrares itto that of the total population of the villages concerned,. Graph xE-If glvesthe age pin:anid of migzants between 15 and. 4d y"uu, while crapii xlll-rflrperposes that p3rramld on the p}'ranld for the totai population. Here we seethat:

contrary. to presr.rmpti-ons, the na:ror4, age tlers of the persons ofnlgratory age d.o not co:respond to the broad age tlers of themJ glants.

the two-series of age cohozts have a dlrect correspondence j-n theirnagni_tude.

this is quite 1ogi.ca1 inaslnrch as the mig:nnts registered in the sameeensus are already included in the g1oba1 pprauid. For tneproportions to vary inversely, the pyra-uid. would have had to show onlythose residents present.

(u) on of

F-"- -.lllges of rulgration ln the sample have already been specified (seoagaln Iable xIV). They are not necessarily representative of the mostimportant departure zones of the Upper and'I,IoriLrezrr Rsglen, inasmuch as thecriteria for selectioir of villages for evaluetion were not established with aneye to measuring the extent and distrlbution of the phenomenon of migration.lhe most lnporlalg.point of amivalq 1s Kr:rnasi (S.Z%) foLlowed by lamIe(o.l%), Bolgatarry; @.7%)'";J-A;;;ii :;7"i .^"rr,*tnu history or earliernigrationse l(rsssi unquestionably stands out as tile fozme=""ugi.or1a1 metropolistovrards whlch al-nost aJ.l the migmtions converged. lfiowad.ays Iecondary centresdlversify the movement and att::act it to their respective zones of influence(see Iable X\rII).

t

-]-2-

Tab1e X\rIII shows from. lvhen departures d.ate. 55.5% of persons atpresent i-n nigrant st-atus left between one and three years igo. Overtrrreu quarters (lg.e%) have been auray for six.years at most.

Irom Table XIX it can be seen that 52.7% of fomer migrants returneclto the-ir villages after a maxj-mtm of'four yearrs absence, Nearly three quartersQl.S%)r were back after seven years.

I[e can therefore state that in the rriilages enaluated the averageduration of nigretions is three to fo'uir years.

fable XIX shovrs another imFortant eharacterlstic of the ntg::ations innorthenr Ghana: this combined d.iagra:n of duratj-ons and returns enables theapproxl-uate age of the nlgrations to be dete:roined. Reacl in conjrmction witha table of the age d.istribution of fonner ni-grants it also enabies us totraee the development of the phenomenon through the generations. Tkrus itseems that the uigzation phenomenon is very o1d and dates baok to the ti:me ofcaralan trade between the savanna and the coast. Pe:manent settlement becomesinereasingLy rare. Destir:ations get diversified. fhe nigrants are yor.urger and.your€er.

(") futg:ration and onchocerciasls

An interestlng question ts whether it ls onchocerciasis that gives rtseto the migratory movement, whicl.r ln that case would. reflect an attitude offligtrt avray from an eeological environment that is economj-ca1Iy viable butd.ar:ger<rus from the heal-th stand.point. Prudence requires that accornt be talrenof other possi-ble factors such as the level of effective production, vrorkingcond.itions, the attraction of new cultural patter:ns, etc. It mayp however,be noted that:

six of the seventeen villaees affected. bv euisration dlspLayh;rperendemic conditiorr" (g6,gfr - Zo.gi!):" lrsl (rge)r.necrraunsr (ror)rNaicong-satoro (tOo), Kayoro-\,.ruru (ogZ), wid.lxaba (og5) and sekotl(ogz).

in eight the disease is strongly mesoendenlc (69.>% - Ao.e%),Apod?bogo (ogl), Panug-r (qgO), ilayoro--Bariu. (oge), I[akong-Atlnla(@9), Itiasi (roz;, saan (ro9;, Kparrfa (rro; and, sabari (rre).

1n turo moderately mesoendeolc conditions preirail (Sl.Z% - Sl.7%)tI(ad.ena (roa1, Jar:ga (roe ).

only one of the villages affected. by the emigr"ation recorded lslocated in a zone'rvhere onchocerelasis pretalence is at the 1owmesoendemlc leveI. (it :-u at the fringe of the forest zone):Sabon-Gida, l-L7 s 45.5%.

Table 2O shows the position i-n detail.

I

_17 _

6. Displqcqnqr_ts of _vi.!1a6es end nqtural mpvenqqt o_f_gopqtqtrong

(") Desertions

Several ca,ses of d.esertion of foraer sites of villages or parts ofvi]-lages have been obsenred: at Tili (ogr), sekoti (oge), Tliclinaba (ogf)and Danr.rgu (oge ),

These represent specific cases where the prima:ry responsibility afonchocerciasis is not open to cloubt.

three ma'ln fsgf,ors are cited as reasons for morring, viz._ o:nchocerciasis, water shortage, and destmction of crops b;r elepherrts.

at both YTitLi.naba and Tili the sites abandoired are t}lose which werelocatetl closest to the r:lver antl the resettlements obse:sred both atSekoti and at Danugu-Sheskrte vrere renovals to sltes at a greater

_ dlstance fzpm the river.

i.:rfo:mation on the quantitative importance and apprcximate dates ofthe moves vras suppl:led bjr the peasants, among whora are fo:mer

- emigrants from the river.

at Ti]-i: Zoroto : some of the inhabitants of iffis f6salif,yretreatetl to TiLi about {.0 years ago.

BriLt : some withd.rawals to h'iAinaba, about 27 yearea8o '

Azontot : withdrawals to Sapolgo and Gbantogoe abort23 years ago.

Sawko : nrins sti11 vislble, withdrawals to [ukameaand Sinaba.

I'walsalro: withdravrals to Witli.::aba about 74 yea.rs ago.

[hese fo:mer large nelghbourhoods of fili were at a ma:ci-ur:m distance cfI h fron the river (nea Votta and Abuhrloga).

At lTidinaba : - the l{orbagal lQfsrrsi II and. Anihraga r'iJ-strictsdj-sappeared about J5 years agp.

L

-'l 4 -

At Sekoti : the foll-oliag districts which existed close to theriver uust have roade the folloruing moves after 1949.x

fopene had at least 20 concessions designatetl by naue,of vrhich l-0 are now in the centre, the latesta:rlrral tlating frorn six years ago.

$yor€a had at least 12, of which one carne to Ssksli.

Kparaboo: 21t irnc1:uding five at Sekoti.

thlrkpag z 28, including six at Sekotll one being ilexlstence at the present tj-me.

At Sheshie : 15 fanllies had to moye fron their inl-tial sites:

4 resettled in the same li.llage but some 500 to 8OO nfarther away from the river Mo::ago.

6 moved to Danugu, a village 1.5 lon away.

2 went to lfalerigu.

2 vrent to }trasrm-i, one to Narikabo and one to Bawku

(t) i,fiatrrraI movement of populations

The question to be answered here ls rvhetherr by comparison withprevious censuses of the vilJ-ages of G?rana, there has been an increase or adecrease in the population through the probable ancl relative effect ofonchocerciasi-s.

It would have been necessary to knorv the position of all the villagesin comparison to the 1970 census. hrt the search ls tedious and the resr.rltsuncertain: 1n the census book, the localities are not always villages tmtnetghborrhood.s, which poses a problem of identifyrr.g the variors localitiesconstituting a sir:gIe v:iI]age. Holvever, one example wi1l be given: sekoti.

{- The lnfo:matlon given here on the progressive w:lthdrawal of dweIIlngs atSekoti was obtained so1e1y by tatking to the peasants. Hovrever, it displays anastorrlshj-ng quatitative slmrlarity.urith the stuCies based on cartographlcd.oeunents by J.M. HUllTXn (op, cit.), in partieular the table: rrRetreat beforerlver blindrress in Sekotiir.

_r5 _

For 15 localities situatetl within the area of the vil*lagel onJ-y for:r ofwlrtch have been completely identifiect, the following table can be dral.m up:

District

Population Movenent of the population inpercentage per year

19+B r960 r970 r975 r948-60 rg60-70 r97o-75

I

r94e-70 194e-75rg60-75*

Senzurre

I'iyoga

Dasanga

I(parabook

[Iho1e of)Sekoti )

r 569

28i5

76r

2 2T5

798

718

175

I86

I eog

276

IOI

58

T51

r s78

616

2A

40

77

I IO2

-5.5

-4.0-5.4

-r.7

-IO,I-II.4-r0.5_ r.g

+o.4

+I7,4

-22.6-7.2_T2.9

-TO12

-7.6

-7.o

:3:B

-0.8

-1.4-T5.1x

-7.I-5 6

-2.6

The percenta,ge d.ecreases in the popr;lation are evid.ent: 2.6fi fot ibewhole of Sekotl and, Ii.7:fi for the aistrict of Nyogo. The reasons for thatclecrease EIay Yatry. the fact remalns tha.t the district most affectect ls theone most at r:lsk in respect of onchocerciasis.

(") of onehocerclasls

one ulght have thought that the peasarits a,re coml:1ete1Jr una\/are of thed'isease vikich afflicts all those who Ilve in the yicin:it;. of certain rivers.lhls is not in fact so:

they h:ow about the disease, describe its sJrmptou.s and. even have, incertain casesr a tratlitional w4v of treati-ng it. rhrs, at riIi,rrchameLeon blintlnessit 1s treated with a r?chameleon fetishrr.

The peasants of TiIl (O9I) betieve that 1t ls vyhen you are fr3.l'sltingaird' meet a chaneleoii on the way that you catch tne d.j-sease. The fetish wasseen at the abode of llr ]tro1eo libila Ayere. rt consists:

(*) of an earthenrware pot bearing the effi-gr of a palr of chame].eorls?as the instrument to exorcise the patient, ma-1e or fgmars'

(u) a d.ecoction mad.e from roots of trees supposed to be ,chanireleontreesrr (the nere and the Batrourga) ana

-oiner ingredients. Itseffi-cacy is not alr;ays attested, but it is sald to delay theonset of blii:dness (through its psychological effects?).Distingtrisl:ing ci:aneleon blindness from other e-\re diseases. forexample n:i-tom or ni-r:o4g (= the eye d.isease wiitr "or"s),

'they describe it as the condi-tion in whicir ?tthe eyes mart anditch, with sometlring nroring arou:rd insidei they do not nrn, andblintlness comes on gradually but sJ.rely.rt

-16-

tley $now about other marli"f,estations of the disea,se: the villages ofsekoti (ogz), sabare (ile) and }tumgu (tzl) h:ow about the viti].igo ancl the_cysts, cs]led EEi., d.awo, and }oaga in the l{abdaml Da6ornba an<l Gond.jalanguages.

In many rrillages the harufr,rJ. fly is cJ.early lt:olrn and j-d.entified. Itsbi.o1ogr" is described. more or less sotj-sfactorily: favourite place:the river;period. of abundance;higi] water; tiisappears when the fJ-ow ceases; bites by theriver antt in the adjacent fields, but also i-n the villages during periods ofprollferation. It 1s these characteristics vrh:lch narie it possible, in thetalksl to distingulsh blacHly from other ha:mful insects.

In the follonring tab:-e on-Iy the Local te:ms utilized for the blac}flLyand the tsetse-fly are glrren.

Ittentificaf,ion of the blaeldly in 1ocal 1ar:guages:

YiILage

0f course, e'11 these different elements were not 1n eridenee in q-t.I therlJ.lages and even the peasernts of the above-listed villages d.o not alivaysestablish tlte necessarTr comelatlons. Sti1l, tire lmowledge that there ertstsa baslc ar,i/areness of the disease is an imporia*t f,ctor for any mess acti-on thatnay be contemplated.

7. A brt glance at the social and socioecononic spheres

(") Socia-l sation

A11 the rrillages rrisited. have a centretized ad:rlnlstrative organlzation:the traditional cldeftainry. The ehief is t}:e essential inte:med.irrlr betvreena stranger and the ri11age.

Ethni.cgroup

HarmfuJ. insecto

Code

-rL-09z

IIOII5IIBII9r27

Nar,re BJ.acldly? Tsetse-fly? Cyst

SekotiI{panfa

I"pasenlcpe

Sabare

I(engua

Lfua"ugu

itrabdam

I..obi

lfqrnFUrsi

Dagcmba

Iionkomba

Gondja

3en-ya

Drup 1Dum$ema

l7urong

BerJ.lgo

Kenr

fula

ltlaaganga

i7uIun

Pig

Dawo

iQaea

lhe admlnistrafive clrlef j-s asslstett by a ooi:nciI of notables, ofneighbourhood. or femify chiefs, whom he consults and who transnlt or executedeclsions t&k"en. It is oir them th-tt finally depends, for exanple, goodattendance by families.

The reference social r:nit is the clan or, vriien thrrt is very 1xrggr thelineaI fnmify. Apart from very rare exceptlons (tne f,oili, for e:ranple), thenuclear fnmify does not possess indepeirdent personalif,y.

ilhrrlage ls generally exogamous in relation to the reference socia-l uraittbut it occurs anong relatives as close as first cousiils in certain ethr:-icgroups (tfre t',tarnpursi of Jangar for examp]-e).

(u) Econontc rqsourcest acti-rities qr1d. proll_eqg

AgrC-culture is the main activity of the vi1-lages. Ihe land. belongingto them comes under the autirority of a land clrtef, called _tu"aan", in manyethnj-c groups. thls person is the proprietor..nanager whose favourableopln:i-on is important for obtainlng nelv faruing plots. Iie has to be called lnfor propltiatory or explatory sacrifices.

As regards modern:l zation of agricultr.re and extension i'rorlr anong thepeasants, it should be noted that very fevu riJ-lages have promoters and veryfevr peasants have changed over from the tratlitional fa:mtng methods inrespect either of technolory or of teclrr-lquesr

The living space of eaeh vi11age, its territoryr is usualJ-y conrpact:the fieltls are loeated within a ratlius rarely e:rceed.i:rg I0 ]u. theclrreJ-lings are grouped. into separate maII units, the concessions, oftensulTouncled by the fields parcelLed out into holdings.

The overall positiontng of dwellings and fields is an inporbant factor1n the differe,rtial degr..e of erposllre of tire inl:abi'bants of one ln the saraerillage: a typical case is tirat of iiarba-Baf,oro, rrill.tge 20&-20! (Upper Volta)1vrhere by determi:ring the d.istances of flelds and dr-relllngs, it vras possible toidentify gfades of endenicit,v.

To these data for deterur:ining diffcrential l-eveJ-s of enden:icity, uust beacld.ed:

Other types of econonlc actirity: stock ralsing to supplement ineoues(catt1e, sheep or goats), fisLring (Srrgr.., IO7) anct rrtld fnrlts gathering.

Ihe social &Lvislon of labour accord.ing to age ancl sex: the lzomenusurilly takc part only i.n some of the fa:mdng activities: sming andha:srestlng. On the other frand, they go and fetch water frm the river andgather w-iltl produce, vJ-z. nere and karite. The child.ren, accordj.ug to rvhetherthey are ma-1e or female, accompany their parents or look after the ani-raa1s.

(") Socia1 ir:fraslnlcture

There exist in thc.rillages priraa:ry ar:drlor uidcl].e schools, c]:inics andttriIled welIs (boretroles). firon taUle 2Ir rvkr-ich g.ives the details, j-t can beseen that the crlteria for dlstribution are d"lffici.flt to pinpolnt:

-r8-

Neither the odstence of a school, nor the number of classes in aschool, nor the association of nittdle vrith prima:ry 1eve1, depends in q'l'l caseson the size of the popr:lations of the vilJ.ages or their distence from thenearest urban centre. The rrillage of &ranto (fZf )1 l,rith 25I inhabitants, hasa pri-maJry school !',ith three classes whereas l(panfal r,ririch lnas 444 inhabitantsand i-s more than ! lon alay from lTa, has none. Again, Sekotil with apopr:J-ation of over IOO0, does not yet have a school w.ith six classes, J.et alonea middle seirool, whereas Danugu has slx primary elasses and a nlddJ.e scl:ool,though the dlstances to the nearest urban centres (Solgatanga antl Sawla.rrespectively/ are about the sam.e.

The same applles t6 cJ.j.nies: the v:i11ages that have schools do notalways have cl-i.nicsl eogr lisa (fOe), despite haring a population of 7691llakong-Atinlal which is a long way away from Chiana, etc.

As regards lined vreI1s the posi-tion is sinllar: there 1s none atKpasinkpe; though it has a large population and a ma:ior hea-1th centre, nor atDanugu whtch has a priuarry and nldclle school, etc.

So there i-s some lack of correlation with size of popr:lation and ease ofaccess to neighbouring centres, It rm.rst also be mentioned that the state ofthe premlses and the rr-rnr:-lng of tire establislments ae in many cases deplorable:classes closed for lack of teachers (e.g. Tumbo, TZI) t or_contlnulng to be heLtt1n malceshift accomodation (tCengua, fI9)r cJ.lnlcs cloied (",g. Sabon-Glda,II7); the great majority of the clinics have nelther medicj-ne stores norpermanent staff. trastly, mentlon m.rst be made of the dubious wholesomeness ofthe drinklng water, since llnedl we1J.s are rare anrl tire peasants tlrayr theirwater from wrJ*lned vrells or directly from the rj.ver.

A social wolfare and public hea-lth progrnrnms rnust talce due acco.mt ofthese condlti-ons tn which the grass-roots comr.r:rlties }ive thelr dailJ Lj-ves.Sanltation, education, houslng, nutrition and conm-nlcatlons are inportantfactors of good health inasrnuch as they i-mprove the c1ua1lty of ILfe,

IV. DISCi'SSIOI{S

The goreral method.ologr for epideniological surreys under tire progranm6was definecl as harring tnvo essential characteristics:

(") It represents arroodmon basis for all surflreys? whtch is essential if theyare to be comparabletr (op. cit.), for a longitudtnai stud.y;

(U) 1t is anenable to successive i.:aprovements, rvhenever usefirl lessons havebeen learnt from a v:lslt.

The following points are therefore thought vrorth emphasizing:

I. Conststency of the sociological facet ln the rvork of the trvo teans ofthe r:nlt.

Thj.s j.s s;rmbolized by trvo elenents:

_19_

(") The acceptance of a cornmon eensus nethodology: the order ofregistration and the relational identity, vrithin the family franelvork, of theind.ivitluals registered ;

(t) The joint preparation, one year after the start of the evaluations, andconcerted. putting into use of an outline guide for the interrrlews in thesociological surweys (see Annex III), the rezuIts of which provide the roaterlalfor the "vll-lage cardsri.

fhis consistenc;, tlld not ruIe out, ln principle or in pr"aetice, leavingfreedom of in:itiative to the person responsible for this faeet in each tean.,It is to thls freedm that we owe the atundance ancl variety of the specificcontent of the village card.s: the various items in the guide are dealt withto the extent that they are applicable and perti.::ent to the I-oea11ty, some aredealt vrlth at greater length than others in certain data sheets and not inothers, and points of interest to one i-nvestigator or another are given specialpersonal attention. rkt example of this, 1n the case of Ghana, is the study ofthe d,emographlc characterlstj-cs of the population and of nlgratory movements,on the basis of eight analytical tables reproduced in annex IV; another isresearch. into the historical kinship of the 'various ethnic groups living inthe region and of certain cultural vehicles zuch as languages.

2. fhe eenstrs method.ology resozted to irt order to ualre possible thesubsequent identification of the individuals covered by the evaluation on thefirst vislt is based on the reletional identity of an indlvidual defined lnterms of:

(")

(r)h:is unit of residence: vi11age, districtr concession;

his natri-mon:ia1 situation (v,,"ith incli-cation of tire spousets lclentity)or lrj.s biological or classificatory kinship position: son or d.aughter,brother or slster, father or mother.

Other methods have been utilized elsewhere: issue of cards durirg thevisltr narking of concessions, etc. Such methods cerbainly have advantages,but they apparently tlo not take i:rto account the risk of isolated papersgetting fost (everybod.y loses papers soireti-mes) and soci-aI roobility: travelfor various purposes, nlgration, deaths.

7, fhe geographical ancl human unit for an epideu:iological evaluationv:lsit under the programme is the vil1age, and the standard population 7OOpersonso fhe tea:n has had to deal r'.ri'th villages that were epidenJ-ologicallyinterestlng but whose populations far exceeded the deslred cluster size. Aselection had to be uade in such cases, arrd tirls nras done in consideration ofthe probable degree of exposure of the inl:sbitants as detennined by thelocatlon of their clvrellings and fields in relation to the infectlve blackflybreeding sites.

'r'fhatever the criteria for selection, however, to take one part of avillage for an official and med.ical eiraluation alvrays raises problems that naybe hard to solve and result either in confused find.ings, or in colleetiverefusal, or j.n a high percentage of absenteeisn:

-20-

IIre populations of these vi1Iages, being mral dwe11ers1 generally livein very unsatisfactory health cond.itions, so vri:enever a medical team appearshigh hopes are aroused and everybod.y wants to take adirantage of 1ts senrices,whether in connexion with onchocerclasis or with any other i1Iness.

lhese same populatiorrs are i-rmersed in trad.itional, hlerarchicalemorally ordered and interd.ependent societies. frre chief talres very poorlyto havS-ng only hls own family or his own lineage examinetl without the otherfamilies in his village or at least those of his leadii:g d:ignitaries; foranother ttistrict than the chiefrs to be selected, on the other hand, tsutterly r.u:acceptable in the view both of the chief and of the peasants; whenthere is an internal conflict in the viliage, any selection is seen by theother party as an affront to its d.ignity.

With a 1ot of tact and patience; sufficient info:mation and erq>Lanations1t ls nevertheless possi-bl-e to obtain a good turnout for the first visit. &:twith later visits there are greater risks of absenteeism or refl;saI: therepetition of what was reluctantly accepted the first time nay be taJcen as aprovocation.

4. As regards rrfa^uiliestr, since the Lnportant thing in nakfu1g the censusvyas to establish a register in which indivlduals would be easy to ldentify onsubsequent visits, theoretical considerations were not allovred to get 1n therrrErlr Depending on how easy 1t seemed to be to find the individuals again, thecensus takers registered together or separately sever"al household.s in factconstituting an ertended IineaI or clanship fa:ni1y. fl:us in one village thechlefls femily conpri-sed !6 persons with three households, the chief hi-mseI:fharring 11 wives; in another viIIage, talring into account the size of thedwelling urait, the soclologlst preferred to break dovrn the chiefls femily into14 n.r:its some of vrhich consisterl of up t,o 20 persons.

5. One of the mostthe evaluations rnade inII-2-1, vrere uttllzed,both teams of the writ.person in charge of the

delicate aspects of tire census is estimatir:g age. InGhana, several techrr-iques, described. in paragraphOnly the dental age tech-ni-que is a standard one used inThe other techniques are left to the lnitlative of the

censLls.

6. fhe special attention paid here to demogr"apiiic analysis of thepopulation evaluated and to study of nigrations results from the initiativeof the sociologist in charge. Irlevertheless, in the present onc]roc_erciasiscontrol prognarnrne in the Volta P.lver Sasin area, the top priority eoncer:: ofthe epid.emiological evaluation urit is medical: see the threefold. objectivedefined on p"g" 2 of the general methodology (op. cit. ) ; it ls theresponsibility of the Progra:m,ers Economic Development Unit to ad.viser at itsmodest 1eve1, the gover:rments of the participating coiuitries and to a,ct as aclearir.,g house for documentatlon on development projects.

The work undertaken and perfo:med by the sociologist nevertheless ai-meat zupplying both partles with detailed ancl precise infonnetion, whieh isneYer altogetirer useless.

-2r-

lhe eight tables analysing the dernographS.c data (see Ar:nex IY) arcnot intend.ed exclusively 'bo serve the purpose of econonlc analysis:

The study sampJ-e, rriz. the ri1-lage of about IOO inhabitantsr 3emqirls smq,11;

Ihe selection of the enti-re set of villages y/as not govemed. pr:lnarily byrequlrements for clemographlc stud.y of the regionl

As regarrds ulgration, in particularl quantitative indices alone clo notd.escztbe or expJ-ain al] aspects of the phenomenonl

fhs fimif,s to reglstrati-on of residents present and of those absent arerecognizecl j-n pcrragraph lll-4; the limits to the reij.abillty ofestimates of age are cllscrrssed in paragraph llf.pl-b.

Ihese quantitative tables have nevertheLess been prepared and. utilizetlfor the purpose of helpi-ng tovrard.s better qualitative ana\rsis, on the basisof quantitatively evaluated trentls.

V. COI\ICilIS]OI{S

Orchocerciasis i-n Ghana is a public health prob1en and a han&icap to theecononlc and social tlevelopment of the courbryls regions:

The d:isease affects, on an ayerage, more tyar. b7/" of the inhabltantsof the ri11a6es evaluated;

In its savanna form, prevalent here, the debilitating effects of thed.j-sease on sufferers are many atrd evident: blindness, general weal<en:ingof the orgaulsm, various forus of skln lesioro, socia-l complor.

lhrough those same effects, lt constitutes a dual handicap to hea1th and.populatlon d.evelopmentr by el.irrlnating the men over !O years of age andreducing the reproductive capacity of severely affected. ad.rrlts.

As the net resr:lt of q]1 the foregofurg effects, it leads to the desertioarand progressive extinct--on of t. e severely affected. riJ-lages and to und.e*population of tire fertile rj-ver valleysr forcing people to rrithclravr to thetable-la;rds artd. resort to the ard.uous and r:nprofitable cultivation of banensoi]-s.

-22-BNIIDBT.ICES

Contrdle de 1t onchocercose d.ars Iq 11-6-gi-o-:r -d-r1 -B-qss-in .{e- }g -V-o-1.ta.

hap-p-oit-oe r"-l.rission aijissTst-a":cd -pi-A-pi,rat-oife

i,r:< c-ouvernenents t',e :C0te dtlvoire, Dahome',,, Ghaira., Haute-Vo1ta., Iis1i, i[iger, Togo. P-iUD, 1rAO,

BtlID, 0.r[S. Genbve 1975.

iTAO, EIIID

Dd""lg;p__"_*g-Ut_-"_c.-o-p_o-qi-qu_q -deq_z,o::.ej:--1_i-bi-q6_e.s _cle_ 1_to_n_c-hoc-e;rc-o-s.e- -qu: ])ahoneXr

_au_S!gper_enlqt-b_=/_o_1-_t_qr_eu- jil-ql j._-e-t-.qq'I-0_6o..ils/I! 1291, Rome, Octobre 1975.

r1A0

An introd.uction to socio-econonri-c-.-d-q.v-eJ-*o-pg*en-t-J}I+-rl-&-qg=-[e-c-i1t1i-c-qt;;iJffi;;To-tE orr-ctrot'ef"i-aB-s i'fe-eE*riines or trre Voltal"iver ]lasii:.15*@crT.-i.--*--rtr 95-L7aoue, nlay agT'o.

!opulqt-i_o]]_-c_e1qq1--o-f__t@g.--1-9f-9--V-o-l-w.re.1.

!lie_ 9qr_qt-!-e*e-{:_ - $p-Q1Qe_t-1-c-a.! -I-i-s_t -o-f- !,9-c.a.!i.t-igs--rytlit- -;1op-u1r;-ti.-o*n- ^nl!F-i1e.qof houses and mata sourcc of v;ater ..s.-L.lpjr_IJ.Ceasus Office, Accra, .Decenber, 1971.

a\i.L,/oc?/trE]/7>-z : tliolli A; f[IYTi,i'0i.i:j 3. & pArilAUlT c.Ii6thodes d. I 6valuation d.6nio1-o-*.qBe- de masse de llonchocercose.leur utilisation au cours d lun de lutte contre Ie vecteu:'.

oiLs/OCP/8.,:I/76-12 : [i1i:1.A3SGO n.C.lronc].rocercose et ses effets d.6irro_grap1tl_qqes _e-t*_h.mgi._ns- _tlq1s_.l_e-s_ vi-14_qG-e-s.

ErraruOs o[--chan-;-

o1!,s/oc?/Err/la.1t : 3nr-i[u{.;ii u.i;.Basl_q-ep-i_{g+i_o-1-o.fii_c-a1_

-e_v-a!r.1a_t-i-o-n_ f_o_r -b-i1e- -o-uc,ro-c-e-1c-i-qs_ip--eq{u11o_1 p-{o-q{+-}

in GLrai:a.

Sources et Aaal.fse d.es donn6e s__d-6.qo-q1ap-i_il-rlqe-s_.-^_4p*fl:-"-qLfqLq.lr-Af.1i-ciqe

{S:rgp-qgi-o: -f^rytq+_o-e- et- -{J'hd-a6as-_c-a,q. .Deuxibne partie :

IITIID - IiTtjEll - OilsTa,'i. .Peri; , 1975

I{ational Atlas of__Gr1tiitu_ --A-ge sttucture.1960 i,AP N7.

I-FJri'-fl-iR, J.hI.?iver blindness in llan5cdi, .llortherir Ghana : Aad va.nc e an d. re tre a"t in 1!iie- -[e-o_gqap-]]i-c-a.1- -It

ewi--ev.,

.hjus beue::t

ffiothesls of c;,rclical(rgeo) , 56, 198-41,6

]IIIITTEN. J.},i.Geograpkrtcal aspects of onclroc(irciasis control 1n nortiretn Ghama.Ret.rort of a mission carried but -fro:-e 5 Jrme to 4 August 1972r'rno/o\afi/76.!27 .

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N

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d>rtIH doJdo.-< tfdu.Olh a ?J)

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TflSXfFFHgtsgF6Oc.\iiO\\OtAr@Ne.l5++c-c-$u\lJ\U\o\6r'\a

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_24_

GI{ATA: DISTRIBUIIOII BY RI\rrlR BASIN S 0F VI],l GtrS EVA-IU/ITED*

Table II

* I\no rillages are not included in [ab1e: VilJ.age of 'Iarriqa (ff4)Village of Akanya^lcora (fZO)

ILLver

Upper Region fiorthene Region

$Lap1ceva-luation

Detalledeva1uation

Sirrplcevaluation

Detalledevaluation

Black VoLta

Red Volta

Morago

Slssi]-i-

Whlte Volta

IGmba

Ifulpamo

Daka

IiTasia

0ti!loleK:.].da

e (rog, rro)I (ogr t agz

J

I29t094

1 (096

t (ogtIOIr04

r (ro5

t@5)

,

J

)

099T02

,,

II

ooo1

,,

r (roe)

r (ogo)

r (o9r)

r (oge)

z (tz+, rzr)

7 (to7, ttz,tt1)

r (rra)e (tzz, r21)

(rzo, rer)(rre, rrl)

r (rzz)

r (rze)

z (toa, r:s)

r (rrz)

7

TotalT7 1 I4

20 I7

IIX. frrrtrilr r ftr fi9IILq $qr?IW E-gIIII9IIJIIALUIIF

toltmt tQo

,t

ro&

to+a'rof

e tol

@lrffi

ut

.rr ffi]Itot

zl

?teo

fl It

o;IrS rr?. ?,tt Itt?6 ler)t

t0r r&ta

It!t

tota

Es.g"l

Li*-i-lt9'

t

IL Irril

a Itrt:i,.(

rl*o 0l

ra3T00 C

'tt 5l!.2,

a

Eplilh rl?

0

I^f:$Emt.

Brlo

6n1

i10It1 r

R f/,1

8Ju

Bi?il0,.J I

Hitl

ftlrn\?$t; ]

I:13:J&:iit-!:iiryi1

!lrru'.t iltf, l+:r { }ifSg,ilLc*JJfP }

frtfnf lrn{rrfLrrf errolJ l,rtarry

lll !ir'rq* rr r'$uhI i i

Xrrlerl!-Ptaa I lse*I Couacll

Lr,rhulrir,.Ilpdcl Lorel Corrnr.tll,ai:tntrl ia*Ittnd<'qr tonql Cnuntlltrur l-tatl Courr*11

.q&ftdntil l.rcrl r-iounr-I l.

lltrron[r:. i.or *1 Cou',t i]{:U lrn$*Pnfirt l'14r'l t'Pri1e { !

Botgnl nr;a-Tongx [l-l'an fiotrtlr:: I

8r:rqt.r-l!*lrrlnn l,r,!'ql !'ri1'n': { !

(rrrrnllna*?t'trf ! ll 1t't'rrl t"o'rcLi l

f*n;rtttr*+lrrtr I,.r:r:eI Ccrr'tr-i !

BSu tlrhen ColnrllPurl*r+Prlll.n*tsrt Loorl Covne l !

r Ylltrli fll'el'd frr ;irplr rtdrrtlr'r

O lttl''{t rilnrttlt llr ilrlel}rrt rrrlurllra

r,,lr lr,q i.,*t} {'r

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t$r n

m

-26-

ggANA; IILLAGES E)GHINED: LOCATI0N, ADMIIIISTRATM UNIT, ilAIN ETIINIC GROUP

Table IV

Vlllage

i LI T

Sfu\

' KPANFA

Geograpbicalcoordirates

, @45

r 0o14

101 I1019

10m

0"580058

Adnlnistrative unitiI

Ii

II

LI

I

I

ilaln ethnlc group

iCode{ Nane

Code no.of

localityln 1970csBauS

-TI

Code I

t090

091

092093q4095

w6q7098

099

100

101

r102

103

104

105.1 06

107

108

'1 0g

110

111

112

'11 3114

'1 15

116

'1 171118

'119120

1d.122

123124

16126

II

--tI

N;}J

10049 | ? ,50

10"53

10r)48

10057

10043

10055

10044

1@56

10059

1 0048

1 0050

1003,1@21

1@N10o36 i

10036

I 0002

9051

1@43

10019

90481 0005

100 26

1 0030

905310g^26

10014

801 8

9017

9"361001 2

1 0004

9004

9005

90068q56

801 6

Loca1 Council

I.AUBUS.3IE-NA}IDOU

KUSANABA-ZEBILLA

BONGO-.II].BD'M

KUSANT\BA-ZEBILI,A

KUS.{NAU.-ZEBILLA

BONOLNABDAII

TEI'TPANE4ARU

CHIANA-PAGA

CEIANA-PAGA

CHIANA-PAGA

CEIANA-PAGA

SANDET{A

SANDEIIA

SANDEI.,IA

SAI{DEMA

NAVRONGO

I,iALE1IALE

SAYELI]OU

; I,AWRAJIMPA,

ITAVDALI.FI'NSI

1 HA (URBAN CoUNcrr)

i }IAI.IDALI-tr'i]NSI

I WALE1IALE

1,IALEI{ALE

uA (URBAN CouNcIt)IIALEWALE

WALHTIALE

SALAOA

SABOBA-ZABZUOU

SABOBA-ZABZUGU

GUSflTEOU-CIIEREPONI

OU$IIEGU.4HEHEPONI

BIilBII,ABIIBIIABOLE

BOtE

WENCHI

I DAMONGO

I GoREBA-SoUUr{

D.tllrKu

LAWRA

BAWKU

BOICATINGA

Bi,llKU

BAWKU

BOLGATANGA

BAWKI'

IL\YRONGO

l.IAvRONGO

NAVRONGO

r{ivR0M}0

M\NOIrcO

N^VRoNOo

MYRO}EO

NAVRONGO

l\]AVRONGO

GAUBAGA

TAMALE

IAWRA

i{A

WA

WA

GAUBAGA

GAMMGA

WA

GAUBAGA

GAUBAGA

SATAGA

YENDI

TTII{DI

IENDI

IENDI

YENDI

IENDIDAUoI&0

DAMONGO

IIIEI.ICHI

D1 e trlctCouncll

n--

I

i

ItI

IIII

I

I

I

i

I

OE]IGENKPE

TILISKOTII,IIDIIlABA

aPgDABgcg

AqEBgOA

DAT{I'GU

IIURI'NIA

EAIISLAIoIG=ATIgrA}IAKOMLSABORO

BECHAUNSI

IfIASI

NNBISIiGDEUA

sgA--{AUoASUGU

oo34

o"3,1

oo34oo27

10 24

1027

1020

1020

101 3

1 002

81 10D01

85001 I841 006

850C?,6

85o63o

841 045

851 01 1 ol

8]26400oq27$oo

832001

832002

83oo79

830002

830007

830020

831 030

74060000

'13004602

81 0?9000

801 031

800000 2

801 041

14oo9740041800033

74Oo3401

74oo07

71 001 7ol

7X ol 801

721o31

723045

?23035

?20050'120050

70004501

7000370163ooa9

U.R.

u.R.U.R.

U.R.u.R.U.R.u.R.I].R.I].R.u.R.U.R.

U.R.u.R.U.R.

I'.R.II.R.N.R.N.R.

050

026

406

026

402

402

407

o23

023

o23

o2)408

408

408

o24

o24

401

rsrl050

050

053

o27

401

401

410

401

401-

411

4q414

414

415

416

416

051

417

6831

416

418

402

DAGARI

KUSJ\SE

NABDAH

KUSASE

PRA-TBA

FRA-T'BA

BIUOBA

KASEM

KASEM

KASEM

KASMBI'LSA

BI'LSA

BIITSA

MNKANA

NANKAM

MAUPI'RSI

EWE &}TA}trURSI

2043

P4??p441 .

1o54t0053

@59'2F.^28

1 003

1016',@17

001 6E

oo22E"

001 7

001 gE

001 1

001 1

,,.36 .

2o)2 I

2o16

DAOARI

DAOARI

LOBI

SISAI.II

MAI,trIIRSI

}.IAT{PURSI

}TALA

}IAUPURSI

I,TAfiPURSI

CEI'ItsURII

DAGOI'IBA

KOI'IKOUBA

KONKOilBA

CHAKOSI

NANINGA

NANUMBA

BIAITOR

SATAI,AGA

EWE &DAGARI

OONDJA

TAf,PIILUA

FRA-FM

N.R.U.R.U.R.I'.R.N.R.N.R.U.R.

KITLLUi{

MBARIguu

LAUTEA_KPASEIIKPE

IAGABII

SABOI{4IDA

-$!sBr-LENOga_

znlmuA

TUA0

YAPAUI

YAPAI,A.BAGCTO

.E$!E_BI'ANI'O

AIGNYAXROI.{

IUGURU

'.R.

.R.

.8.'.R.

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.R.

.R.

.R.',R.

.R.

.R.

.R.

.R.

.R.

I

127

1 28 : SOttUN

12e . lugry,

Notes :

(21

9019 ' 1041

)o4j r 1oZ1 t

1@43 oo3, ,

701 00801

701010184066000

DAI'IONGO

DA.UONGO

BOICI.TANGA-TONGO

N

}I

u

(1 ) An asterlsk denotes vll1agea of rrhlch only s part ras sel€cted for emluation

(") Unbroken unilerllalng lndlcates villages rhere onchocerclasi!, is hyperendenic(prevalence rate over f0fi)

(b) Broken ur:derllaing indicates thet oachocerclasis 1s nesoendenlc (betreen a6 afi, 69.9f1(") In thoss aot underlined onohocerclasis ia bypoeudenic (betreen 1fi artd, 9.9fi1

the village of Tanl.ra refuled onaluation. The portion chere a oengu! ras taken (part of ohleftsaelShbourhood) navlng ao bonogeoelty, the saople has no stetlstical \relue and tlre flguree forthat villa€e are deducted fron the totals ln thle Table.

(3)

i

RegioalI

-27-

GH.ll[A: PERCENTiGES OF TI4 TtlO SEES IN TI{E IELIAGES EVALU"'TED

EPI census

Total l,Iea Wonen

Table V

Code Nane

090

091

092093

c94

095

096

097

098

099

100'l 01

102103

104

105

105

107

10a

109

110

111

112113

114

115

115

117

118

119

120

1n122123124

125

1N127

128

1D

373

343102

270

259

168

871

428

361

134

21 0

331

365

3n35',l

1',14

4'.15

213

769

2',11

414

n5456

195(1 07)

316

322

340

333

3'.loy4443y6

263

261

188

346262

266

r85

162

563

154

12',1

95431

230

184

'10

102165

187

148

185

90

245

122405

136

246

136

222qa

184

161

169

193

1821',l2

A117'.1

49,6fi47,2n

!1 ,1 tt

q4 nl/ l r-49 rO"

56 15"

50 12"

53,7"51,1"52r2"48,6r49 r8"51 r2u45r 0n

51 r8'51 ,7n51 ,6"57 13'52r7"50 12"

55.4n49 t5n48

'7'l5or8'

188

181

59116

132

13434

198

177

6+

108

166

1'.lB

181

17284

230

92

354135

198

1n234qA

riz161

171

140

188

162

232

189

13',7

1328',1

158

130

133

50 r4fr52r9n48rgn43rO'

51,0"4315"

49 r8"46 r3'l49, ott

4'l ,8n51 ,4"50,2"48,8rr

55,0"48 rzn48r3tl48r4rt43r2u

47 13"49 r8"44 r6n5015"

51 13'49 12"

51 ,1n

50r 0'50,3n42r0n

5or8'48 r51'

52r4n51 ,6"

52,1n50 16'46 13"45 r7"49,6n

5or ou

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188

132133

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--:

t-

GILINA: P0PUI,ATI0II 0F YILLAGES E)LIMINED: RESIDENTS PRESE}IT llDRESIDENTS AtsSENT. ATTENDANCE

-36-Table XIII

96 15

88, 2

82r6

97,491 ,881 ,393ra94 11

9or o

86,287 13

90r387 15

90rB9319

95,29311

91 ,997 r7981489 19

91 ,596 r396,793ro99,295,2oory//tl98r394 r7g8,7

98r699 15

1ooro

99 12

96,898r39'.1 ,3

1o0r0

99 12

94t2

rThls co1"..ls reproduceil fron Dr Brinkuannrs document (cp. cit.) to drav attention to thedivergence between the rates of presence arrd attendance. Note that, since sone ilata were obtaineal fron theconputer after that docuoent ras finalized, there are alifferences between the figures glven in the present

Crde

an

91

92

93

94

95

96

9'.l

98

99100

101

102

103

104

105

105

10'l108

109

110

111

11 2

113

114

115

116

1't7

118

119

120

121

122123

124

16126

127

12A

1D

Nane

Census

popu-

lation

Re sidentsexe.ained

c.de 1

Pre sentbut notexanlned

codes 213

n9

182

16

20

26

80

20

17

1,)u41

2a

19

8

10

18

16

4

43

23

18

6

1

)

1

tr

4

o

2

A

3

9

4

2

Re sidentsabsent

and/oreulgratedcodes 4rf

n19

92m

l4

2'139

51

20

5

,1

30

3'1

26

45

o

85

3

117

20

51

6

23

14

14

13

11

9

38

33

19

5

2

13

1rl

I4

3

Rate .fPr€senc€codes 1 r213

Rate ofatteDdaace

c.de 1

c.des 1 ,2r3r4'

GEI{GEJ.IIPE

TILISEKOT]

1rIDI}L"8.}.

i.PODABOGO

ASEBUGA

DANUGU

WIIRI'TTIA

BALTU

I.IAKONG-ATINLt

N,II(ONG-SABORO

BECEIIUNSI

WIASI

FU}fBISI

I(ADEIfu

N,"GA

JANGA

SUGU

LISA

JJUT

KPA]MA

8:IILLUN

NAB.\RI

DIru

T^NIMKPTISNKPE

TANGABA

SABON.GIDA

SABARI

KENGUi

ZiiNDUh

TU}iBO

YAPALT

YAPALA.BAOGYO

BALE

BUINFO

ltKrlNYAKR0M

HURUGU

s0Mur{

D,A-TUKII

5n343

1102

nob9168

871

428

361

134

210

331

365

3D35',l

174

475

x3769

2'11

444

vl5456

195

10'1

376

322

340

333

370

334

443

366

63261

188

346

262

266

1 3906

421

285

828

2b2b118

652

351

D9112144

2vm7

45D3158

3e0192635

24',l

fio246

415

175

93

360

D6330

Do33',1

311

423

351

69240

168

3D68261

85ro

95,591 ,'l89 r394 1685 ,184,o8513

94 15

96r3'15r7

90 '9

89 19

92r187 14

95,48211

9s 16

84 r't921688r5

9',1 ,+95,092rB86 13

9615

96 16

97 ro88,6

91 ,1g4,3

95 19

96r4

99,295,o91 ,og7,7

98t59819

11 899 809 11ge 92ro5

Table and ln the said docunent.

BN 8.--tr\O N l.-C{ N !'-or\C, t.-u\cO N (1 cO

Ln O O \O N $ N Ln L'\<t l-rr\ C) r rAO *I

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B. fi e' P $ l{:'= 9P K's E L^ s}r : r\o

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!

I

II

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tti*l lrt,ft*rrt lf,tirlrilfiri+rbtr talrlFrrulltrrl

f* '1ptitvt;

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I

tI

t

I

GtuIilA: FREAUENCY 0F MAIN PLACES 0f' II'IIIIGRATI0II

Places .f iruigration

-40-Table XIEI

Yl11age

Code

Distrlct oouncllBo1gp - Bawku

4

14

a

)

a

?anale Kuoasi Accra Suyani 0thers Total

092

093

095

096

097

098

099

100

101

102

104

105

108

109

110

117

118

Bongo-Nabdan

Kusanata-ZebilIa

Bongo-Nabdan

Tenyaue-Oaru

Chiana-Paga

Chiana-Paga

ChianaJaga

Chiana-Paga

Sandena

Sandena

Sandena

Walenale

Larrra^lirapa

Nadawli-tr'unsl

Wa

SaIaga

Saboba-Zabzugu

1

1

1

6

4

8

1

33

24

16

120

45

6

I

7

19

10

17

21

)z

3

23

1

17

2

I

?

2

b

3

1

38

2

4

1

2

3

1

5

,)

4

3

5

11

57

D

18

19

52

17

a

11

19

18

627

81

5

23

1

16

Total 6 22 378 79 1 35 541

f sanple population (541 ) 416 4 ,1 69 19 1416 or2 615 1oor0

fi to+at population of the13 viuages (|zn) 013 0r3 5r2 111 0r5 715

.{d

oF,

hsPqfl:-=9PK'F5^S-P +Lr\

ooo

HI l-+r\@tr\\ONl-l-Ln+F-nc\tf\-

[,\

r\

otnN

E6l -

(\(\0 F-N r O <n- Q\O N r\- N+N-@$reN\ON

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tlr,r

Lr\

H t I l- I I I I I I I I I I I I I o\N

f\O

o:{ I I l'+'+- lF I lcJ. ls I I t I co

I t l- I r I I I I I I t I I I I N

o \o Ln

O C--o\= I I I t I I l- I I I I Ilrl N

ooti>,

f+ tttlrllllllllllll I I

E I t I I I t I I I l- I I I I I t I

ot{hN

H I r I -- I r I r I I I I I t I I N

o\o @o

r c..o\= ltlllNlNlllllllN F-

@l|>r

14 I I tr I I r I r I t I t r I r I

+c!o @N

orr\o\I I lr I ll t I I I l- I I I I \o

(.,

oLo

Eq I I t- I I I I I r I I I I I I I

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h I I t l- I I I I I I t I I r I I N

o F- O\rO

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q

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N u\ t'\@r\t.-u:l$-\o-rll-Nl$F-trFl

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Fq ratlllllNtllllr\NN

N rt t\NO\ (n\oE 11-NO\L51c\ I lr- I c1- I I I I s $

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N NU\O\Lr\n+ Lf\(\\O tr\ 1 I N I - I a\.+ I N I I L.\ tr\

s@t{>r

N

Eq tNtlltco F r o\F I t I I t CAN\oo\

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:q a1 f\ I \o t I _ I I I _ (^_ q I I _ N

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Cro /od;d{rdolzItat oqtr-t .{o. .-to.40P>o

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I t t I I I I I I I I t I I I I

(f\ I I I I I I I I I I I I I N o fr

N I N I I c.l I I I I I rn l'- o\

o\

I I I N I I I I I IN

N

o\

e- N \o N N t I I N \o @(D

n@@

o\ I N I I N I I I I \o o\ tr-o\r

@ t <t c't t N t I I I I I s $ t'-

tr-

E- N N \o I I t \ot.. Nr

s N o tr- I N I t.- I I t Ns oe-

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rn @ I N N I I I I , nN \o S+

6

E- o N n I N I N I I I \o co

@ @

o N N N I $ N \D t I I Nrno

rno\

N o\ D- \o + N I I I \o\oN

\oo\coN

F-. \o o\ I c- I I I I C.lIJ\

c.-N

rc.l

trod+dtiAA1:t<

a+,o&

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sgrn

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a

-43-

GHAI{A: EIIIGRATION AilD 0NCHOCERCIASIS

PERCENTAGI OF E}1IGRANT FOPULATIOJ'I II,I RELATIO]' TO ?OTAL

P0PULATI0N AliD PREVALEI'{'CE 0F ONCiIOCIRCIASIS

Tabfe XX

% out oftotal population

Code

t

25

27

18

5

139

z)

17

16

)

18

57

D

52

11

1g

81

VillageEndenicltyEnigrant

populationNaue

Recent totaLpopulation

11'l

104

106

09,

109

096

110

098

118

099

102

092

093

097

100

101

108

4315

53r2

53,3

56 14

60rB

64 16

67,7

6811

6811

69,5

69 19

7o 19

72'8

7316

75rz

76r3

SorB

SABOII.GIDA

KADEMA

JI.NGA

ASEBUGA

SAA

DAi,'IUGU

KPANtr'A

BALIU

SABARI

NAKO}IG-ATII.EA

WIASI

SEKOTI

I,IIDINABA

I,IURUNIA

}IAKONG-SABORO

BECI]AUNSI

LISA

340

351

475

168

711

871

444

361

333

134

365

102

270

4m

210

331

769

013

'l r0

5 r'l

1o r'J

1rg

16,o

5r2

4r7

4rB

1r a

419

EO

10,'l

1Zr2

5r2

5r7

1o 15

-44-GHAIIA: SIATUS 0F SOCIAL, EDUCATIOIIAL AI{D HEAL'III FACILITIIIS IIi 'IIE

VILLhGES EVILUATED

niddle schoolriverse11

boroholefacility existsfacility lackirgdoubtful: infornatlon not obtained

Table XE

MS.

I,j =

BH.

?-

Vl1lageFopulation School CIinlc Maternity

lJaterBoreholes

Code Naue

09t)

c91

092

093

094

095

096

097

098noo

100

101

102

103

104

105

106

107

108

109

110

111

112113

114

115

111

117

118

119

1N121

122

123

124

125

126

12'l

1m1D

GI'NGENI{PE

TIL]SEKOTl

IJIDINABA

,IPCDABOGO

TiSEBUGA

D/ri{UGU

WIIRUI]IA

BALIU

NAKONG-ATINlA

NIKONG-SABORO

BECHAi]NSI

wtASa

r''UMBISI

i!.,DEI'IA

NAGA

J,[IIGA

SUGU

LISA

SAll

IPANFA

KULLIIN

NABARI

DW

T,1.NIlIA

KPASENIT,PE

YAGABA

ST\BON-GIDA

S,\DARI

]GNGUA

ZTiNDUA

TI,t{80

YAPALA )

YAPALA.BAC,GYO)

Bl'rl,E

BI]ANFO

AKAI'TTAKROI,I

IiIIJRUGU

s0MlrN

D,{TUI$

3?3

343102

270

259

158

8',11

4m361

134

n0331

365

3D357174

+12

213

759

2',11

444

275

$6

376aDo

340

333

370

334

443

366

263

261

188

346

262

266

?

1 rith J classes1 w-ith I classes1 with I classes1 ldth J classes?

1 rrlth

I with

1 rrtth

1 wlth?

?

?

1 rr.ith

1 wlth

5 classes + MS

I classes

3 olasses

J classes

6 clqsses + MS

j classes

1 rl'ith I classes1 nith I cJ.asses + MS

1 vith 3 classes + MS

1 with J classes + MS

1 ll-lth J classes1 vith 6 classes1 with 6 classesI rith 4 classes

Cfosed

uith 3 classeswlth 3 classesvlth 3 classesuith 3 c]ass€s

1 with I classes

+

+

+

+

?

?

?

?

+

+

1

closed

?

?

?

i.I&R1^I&R

BH

?

li&RR

R

i,I&R

1^I

1^I

t,&R

\I&RI,I&RR

I1I&R1.I

}I&Rw&Rtd&RR

R

R

Lake

Dau+R

BH

1.I&RR

}J

R

1^I&R

KEY:

-46'

TABLE FOR DEIERI'{INING CHILDREN'S AGE F'ROII lTiE DE]'ITAL FORI4IILA

(after TREBAUL)

IVI .1r,1rI. r V. v. 6

Annex I

v o

5-7yrs

8 yrs

9 yts

'l 0 yrs

11 yrs

12 yrs

6

4 6

The Ronan figures lndicate uilk teeth and the Arabic figures pernanent teeth.

Unless otherwise sholrn in this Tab1e, the four half jaws are sylrrletrical.Variations in the a€es of appearance given range fron two months for mill: teeth to one lrearfor pernanent teeth.

Milk teeth Permanent teeth

I I

OX

(= fron 6 months

to 1 yr)

IIt III1 yr'

I I

v 2-5yrs

-47-

ETHIiIC CODE

(new eclition OU77)

Any addition rrill be notified to R.5. S.\I,IADOGO or C. P:'.IRtULT

Annex II

000 l,lcsi001 Yaana (Yans6) and Zaos6002 Yarga (tarrd)00J Silni-nosi00zi Fuls6 or Kurumba

00! Deforo006 Ban6;r6

010 Gurnantch601 1 Sariba01 2 iloba

01! Bozoro or Bouzoura020 Gurunsl021 Kfla or Lila022 liuna or Nunuma

021 l.,as6na

024 Nankana

025 Ko

026 Kusas6

02f Sisala028 Pugu1i0D Pana

0J0 Bisa nr Busansd031 SaDo (northern)

040 Bobo not otherwisespe c ified

041 Bobrfing042 Bobo-ou16 or Bwa

or Ni6ni6gu6 orBobo-Iila

041 Boron044 Sarnbla

010 Dagari0!1 Birifor052 l.Ii,l60ll Lobi

054 D)'an

0!! Gan

0!6 Dorisi6 or Dcgsb,Iionono

0!f vigu6018 Tunl, T6gissi6, Loron,

Bodoro

0l! Kulango

060 S6nuf^

061 ,\lnlranka062 Taguana

06J Nanorgu6

064 Karaboro05! Toussians066 hrrka067 Gouin068 Tiefo069 0uara

110 Agnl111 Abron112 AbE

201 Malink6202 Baaana

400 Barda

401 l,ianpursi

402 Fra-tr'ra401 Deleted cl. 02O

404 Ew6

401 Deleted cf. 02)and 026

406 },labdan

40f Binoba408 Bulsa40! Dagonba

41 0 I'Iala411 Chunburu

41 2 Ashanti41J Deleted ct. O55

414 ](onkonba

415 Chakosi416 Goqja or Zebaka

41 J Safalaba418 Tanpulua419 I'lanumba

420 Kabsagna

421 Talensl!01 f'abyl (ex kabr6)102 Losso

!01 Kotokoli!04 Laurba

!0! Bassar

!06 Narlgo

507 l,iarba

508 Wen€ara

501 Baaende

502 Busa

070

071

0720'13

o75

016

o77

078

o79

080

081

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DiulaBobo-DluLaI'iarlca or DafingSaroogho

Dogon or Habb6

Bozo

NatioroKalans6 or Nongon

Siauou

816

0!0 Sonrhal0!1 }iaranod0t2 Haoussa

0!l Djerna0!4 Peul or Fou-l-b6

0t! Rinalb6O!6 Folnongani

101 Djtuinl102 Bantl6

!Ol Sarakole

999 0thers

-48-

OUTLINE GUIDE FOR A 1rILLNGE CARD

(new edltion replaclr:g previous ones)

To help in fl1Iing in the trviflag€ cardtt that has to be nade outafter each visit ( sltrple or detailed evaluation), the Eain ltemsare enunerated bel-ow. Please take then in the order given so thatthe presentation of the cartls w111 be standardized.ilhethcr sunoary or detailed, every card nust be signed by its author(s).

Armex IfI

Top right:Top left:

irlane of State (folloved by relevant code) Nane of village (fo[or.-ed by its oode No.)Latitude and longltudeCanton

CouncilDistrictr?egion

1. Date and No. of visit2. Purpose of vlsit: glnplc and/or detailed evaluation (uith justification zhere necessary).3. Focus of onchocerciasis; I'lame of river. llearest cltor.rologlcel mpture polnt (with code No.).4. Access: Itlnerary, state of track.5. I^Iorki:r* conditions: installations.6. Naoe of villaee chlef7. EthnJc eroup(s) and subgroups lf app1lcab1e.B. popul-atioa: Available census data (iudicate source and date)

EPI census data (Lrith any coucuts)Note: As far as possible, present all these data in ono Table.

9. Historv ard structure of vilIa^se (arrnex nap lf necessary)9.1 0rigin of inhabitants, stages ln population settlelent, period of set'l,Ieaent and reasons

therefore, contacts rrith indlgenous fuhabltants and/or nodalities of occupation of thearea, najor events.Conflguration of dwelling area, division of village into neighbourhoods.Social facil-lties: sehool, cIlnic, youth centre, etc.Soclopolitical profile: social units (fanily, lineage, clan) and political organlzation(traditional authoritier, Ilodern poruer structure).

Econonic actlvities. resources apd problens10.1 Agriculture: land-holding systerx, location of fields, orga.nisation of work (men, wonep,

children), extension or pronotion agencies (governnental or nongovernnental), crops harvested.10.2 0ther activities: stock raising (ireraing, grazing at a distance fro:1 dwellings ), crafts,

fishing, etc.10.3 Connercial exchange irrfrastructure and structures: roads, narkets, sales agencies, etc.Current niprati.ons

11.1 Inralgration; Since when? 0rigins and notivations, nodalities of settleuent, aunerical voluoe,age:grouPs aad s€r ooncerned, period of residence envisaged, activities of l:aulgrants.

11.2 Enigration: Slnce when? Numerical volune, a€eigroups and sex concerned, destination,notivations, dluration envisaged.

Note: As far as possible, enter aII theso data in a single Tab1e.Specific oroblens

12.1 water. What nater ls used (for uhat purposes?) ln the different seasons of the yoar? Lined wel]s?Relatlonship to the rlver and to watering places (nen, woaen, chiJ-dren).

12.2 Schoolchilalren. The young in goneral.12.3 0ther specific problens: health, hygiene (tatrines?)1 nutrltion, clothing, recreations, etc.Illscellaneous noles: Questions unsettled concerni.ng the survey, epldcniology, etc.Cartoeraphlcal docu-Eents' Give preclse references, in particul..-t on 1/2oo 000 scaleAnnexes: sketoh-naps, photographs (aerial or other), translations of recorded interviews, age

pyrauid, etc,

Q.)

9.39,4

10.

11.

12.

13.14.15.

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SCCILDEIIOGR,\PHIC FEA S OF ELL|GES \ISIIED

,lnnex IV-7

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Ilaue of viIIage.....

Date of visIt.......

Code of vi1Iage..

Si''ple or d.etail0C evaluation

Vlsit No.

EI'{IGRJ.TIO}i.I ElSTCRY OF PRESENT POPUL\T1OIi,/L,IST EI'IICIL'.T]ON: POPUL.-TION H,TW,\G

EMIGR/rTED AT LETiST ONCE: CC}IBI).IED DL.GR,rli SilOi'IiiG JUR,ITIONS 0I STAY

r,1ID TIIi{E EL;PSED SI}J.]E R]i]TI]RJi

Duration

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