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Galamsey activities increasing buruli ulcer, yaws cases

BY: Augustina Tawiah
An early yaws case
A late yaws lesion

Intense illegal mining activities, otherwise known as galamsey, going on in various parts of the country are increasing cases of buruli ulcer and yaws, the National Buruli Ulcer Control and Yaws Eradication (NBUCYEP) Programme Manager, Dr Nana Konama Kotey, has disclosed.

She said communities that hitherto were not recording the two deadly skin diseases, buruli ulcer and yaws, were now recording them, while communities that were recording fewer cases were now recording increasing numbers due to intense galamsey activities that had sprung up in those areas.

Dr Kotey, who was speaking in an interview with the Daily Graphic, attributed the rising cases of the diseases in those communities to water bodies that had been contaminated and destroyed.

Graphic Online Augustina Tawiah talking to Dr. Nana Konama Kotey (National Buruli Ulcer Control and Yaws Eradication (NBUCYEP) Programme Manager)

“When it comes to buruli ulcer and yaws, you get them where the climate is hot and humid. For buruli ulcer, you are likely to get it where there is slow moving water bodies and where the integrity of the soil is disturbed.

“So in this country, even before intense galamsey activities began, buruli ulcer cases were on the increase in areas where we have mining, sand-winning and intense agricultural activities. But galamsey is making the cases more in these areas.

“For yaws, it is prevalent where there is inadequate water and you don’t get water even to bath. We call it a water-washed disease. So while the lack of water could make you get yaws, stagnant water all over the place will lead to buruli ulcer,” she explained.

What are buruli ulcer and yaws?

Yaws and buruli ulcer are among the 20 neglected tropical diseases (NTDs). They affect mainly the skin and can also affect bones, joints and cartilages.

Yaws is transmitted by skin contact. It is a multi-stage disease classified into early yaws (which is made up of previously known primary and secondary stages) and late yaws (previously tertiary stage), based on infections.

The early phase of yaws may present with pains in the bones and joints. Lesions include papillomas, ulcers, papules, macules, palmar/planter lesions, as well as bony/joint swellings and tenderness.

Buruli ulcer may start as a non-ulcerative lesion, such as a painless swelling (nodule), a large painless area of induration (plaque) or a diffuse painless swelling of the legs, arms or face (oedema). The disease process evolves generally with no pain or fever; when there is pain or fever, it is likely to suggest a super-imposed bacterial infection. Underlying bone may also occasionally be affected, leading to deformities.

Prevalence rate

Suspected cases of yaws recorded across the country in 2016 were 1,497; those for 2017 were 1,917; 7,459 for 2018; 4,694 for 2019; 7,812 for 2020; 3,671 for 2021 and 8,989 from January to May 2022.

For Buruli ulcer, the suspected case trend from 2011 to 2020 was 971 for 2011; 571 for 2012; 550 for 2013; 420 for 2014; 275 for 2015; 371 for 2016; 538 for 2017; 877 for 2018; 533 for 2019 and 129 for 2020.

Dr. Nana Konama Kotey (National Buruli Ulcer Control and Yaws Eradication (NBUCYEP) Programme Manager)

Dr. Nana Konama Kotey (National Buruli Ulcer Control and Yaws Eradication (NBUCYEP) Programme Manager)

Districts

Dr Kotey named the Aowin, Bibiani-Ahwiaso-Bekwai, Wassa Amenfi East and Mpohor districts in the Western and the Western North regions as some of the districts where cases of buruli ulcer and yaws were increasing in the country as a result of galamsey activities.

She explained that the development came to the attention of NBUCYEP in 2018 when, as part of a project by a group known as Anesvad to control buruli ulcer, sub-eliminate leprosy and eradicate yaws in 15 districts of the country, it visited those places.

She said the group noticed, during the visit, that most of the people in these galamsey communities, especially children under 15, had developed skin rashes, had small, small wounds, bumps, pityriasis and ring worm all over their bodies.

The group, therefore, conducted tests on all such cases and it came out that while some had yaws, others had buruli ulcer.

Solutions

Prescribing solutions to deal with the problem, Dr Kotey said in the short term, there should be an intersectoral collaboration among the ministries of Lands and Forestry, Environment, Local Government and Rural Development, Mines and Energy and Water Resources and

Sanitation to educate both community people and the galamseyers.

She also called for the construction of boreholes for communities where galamsey activities had destroyed water bodies, adding that there was the need for the people in such communities to bath at least once a day.

“With yaws, if you bath at least once a day, you are not likely to get it. You see it in very remote communities where they don’t have any good sources of water and so they drink sachet water and getting water to bath is a difficulty,” she said.

In the long-term, she called for galamsey activities in the country to be regulated, explaining that those activities could increase malaria cases, and that because the mosquito that transmit malaria was the same mosquito that transmitted lymphatic filariasis, there was going to be increasing cases of those conditions in those areas as well.

“What is happening now with galamsey, we may not be able to tell the consequences. Let’s give ourselves 10 years — we may not be able to tell the health implications of what they are doing in the communities; the diseases that will come as a result of this galamsey. Now it’s buruli ulcer and yaws,” she said.