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Can the sanitation success story of KMA be sustained?
The mission statement of the Kumasi Metropolitan Assembly (KMA) is aimed at “keeping the city clean and healthy by the provision and delivery of effective and efficient waste collection services and programmes, and environmentally accepted disposal.”
Among others, KMA is supposed to provide conveniently situated refuse disposal points, all in the name of proper sanitation without which the health of its population is at risk.
It is in view of these that when MrOsei- Assibey- Antwi, assumed office as the Chief Executive of the KMA, in March 2017,all eyes were on him to create an enabling environment for development and healthy living.
In fact, he took office at the time Kumasi metropolis had been engulfed in filth. There were mountains of refuse at vintage points in the metropolis much to the dismay of residents who were expecting a lot from his leadership to help ensure proper sanitation of the metropolis and its environs.
Some residents had, even taken the law onto themselves to do their own thing at the expense of the beauty of the once touted “Garden City of West Africa”.
Bringing sanity to the Kumasi metropolis, would demand leadership with strong and bold decisions coupled with measures and action plans devoid of politics.
It is quite interesting to note that, the dynamism employed by the Chief Executive saw Kumasi, the second largest city in Ghana, named among the top 15 cleanest cities in Africa in 2020, according to a ranking which considers cities which prioritise cleanliness and solid waste collection.
Kumasi occupied the 12th position after Accra the national capital placed third on the list topped by Kigali, the capital of Rwanda.
The list contained the following cities : Kigali-Rwanda, Windhoek-Namibia, Accra Ghana, Gaborone – Botswana, Dar-es- Salaam-Tanzania, Johannesburg-South Africa, Port Louis Mauritius, Tunis-Tunisia, Cape Town-South Africa, Nairobi-Kenya, Libreville-Gabon, Kumasi -Ghana, Algiers-Algeria, Asmara-Eritrea, Ouagadougou -Burkina Faso, in that order.The feat was as a result of a sustained sanitation strategies by KMA.
Over the years the KMA had followed some sustainable strategies and a series of activities in the area of solid waste collection including the provision of the door-to-door and communal waste collection services.
Defending the ranking, MrAssibey-Antwi said the KMA took steps to regularise the operations of tricycles (Aboboyaa) to further improve solid waste collection within the metropolis by identifying these service providers through colours and registering them with serial numbers to ensure the effective use of Personal Protective Equipment (PPE) at all times and to ensure that all tricycles filled with waste were covered with nets to avoid spillage.
His leadership style has brought improvement also in the private sector participation by regularising the solid waste collection contracts and procuring solid waste containers to be placed at the communal collection sites to maintain its position on the continent.
A number of communal collection sites were improved through the provision of skip pads with roofing under the partnership with private waste companies in the provision of trucks and bins to enable the Assembly carry out its house-to-house refuse collection.
In line with the President’s vision of making Ghana clean and the Assembly’s own mandate of providing a conducive environment for the inhabitants and businesses, the Assibey-Antwi led administration launched the, “Keep Kumasi Clean and Green Project”, with the aim of restoring Kumasi to its past glory of “Garden City”.
The project saw the planting of hundreds of seedlings of different species at various locations and the installation of hundreds of bins at vantage points within the Central Business District.
To power the project, the Assembly received DAF refuse compaction truck, 40ft ford compaction truck, two Pick-ups, 10 tricycles and five tricycles donated by VIP Bus Company Limited and Zoomlion Ghana Limited to support the street sweeping and drain cleaning .
Recognising that effective waste management does not only entail storage, collection and transportation of waste but also providing the appropriate place for proper disposal or reuse of the waste materials, KMA under the leadership of MrAssibey- Antwi, single handedly managed the Landfill when the Contractor, J. Stanley Owusu Limited vacated the site due to non-payment by devising a means of ensuring that things were properly managed within limited resources by procuring a landfill dozer and communal containers under the Ghana Urban Management Pilot Project.
It was as a result of the measures effectively put in place that the KMA was, in 2019, adjudged the best Liquid Waste Management Strategy in Ghana, in a Sanitation Challenge or competition organised by the Ministry of Sanitation and Water Resources, with support from foreign partners which about 139 other Metropolitan, Municipal and District Assemblies (MMDAs) across the country participated.
The remarkable feat came with an award of 400,000.00 Pounds Sterling in a competition which was geared towards bringing transformational change to the city.
With financial support from the Sanitation Challenge for Ghana, the KMA implemented a number of projects and programmes to improve liquid waste management in the metropolis.
These include improving Water,Sanitation and Hygiene (WASH) in four public schools in the construction of four 10-seater gender sensitive, disability friendly institutional water closet toilets with mechanised borehole and overhead tanks for four schools namely, Amankwatia, Anyaano, Bantama State Boys and St. Cyprians M/A Cluster of Schools.
The project strengthened the enforcement of sanitation bye-laws and provision of logistical support, procurement and distribution of 15 motorbikes to all the Sub-Metro Environmental Health and Sanitation Units to facilitate their movements to the communities.
Under this package, the Assembly improved the Liquid Waste Stabilisation Pond at the Oti Landfill Site through the desilting of ponds and storm drains, construction of concrete platform and headworks for direct discharge, installation of coupling hoses and gravelling of kilometre haul area to the site.
Additionally, the Assembly constructed a one kilometre fence wall around the AsafoCentralised Sewer System to halt encroachment by slum dwellers and auto-mechanics.
There is no doubt that waste management that remained the greatest headache of the Assembly, has now been reduced to the barest minimum and the rate at which the citizenry flouted environmental-sanitation bye-laws, has also gone down.
A close view of the sanitation success story of the Assibey- Antwi led KMA can be underlined by the organisation of periodic health education programmes in churches, schools, lorry terminals, mosques, radio stations and routine house-to-house inspections through the Environmental Health and Sanitation Unit of the Assembly.
It is, therefore, very important for the sustainability of the sanitation success story as Kumasi desreves to be clean and healthy. Whoever takes over should bear in mind the improvement of sanitation in the metropolis.
For cleanliness, they say, is next to Godliness; and Kumasi deserves the best.
By Kingsley E. Hope.
The driver stopped the vehicle at the gate of the large, fenced property along the Nsawam Highway, and Kakraba stepped out to meet the several workers who had gathered to wait for him.
He greeted them and went straight to the point.
“Gentlemen, I am glad to see that you have almost completed the clearing of the land. I’m happy to report that we have concluded all arrangements with Nana Serebour, and construction of the palace will start in a few days.
“I will need you to go and level the ground, and then come back to start this project. Some workers from a construction company will come and join us.
“My plan is to build twenty houses in four months. Then we will do twenty more until we reach two hundred.
“I am relying on you to help me deliver good-quality work to satisfy our clients and, as I have already indicated to you, I will reward you for your work.”
After an hour’s discussion, he closed the meeting and moved to drive away. Wofa Yaw drew closer.
“Director, can you please spare me five minutes? I would like to discuss a small issue.”
“Why, Wofa Yaw? Your wife has threatened to leave you?”
“No, Director. My wife will never leave me. This concerns a young niece of mine.”
“I hope it’s something I can help with. Please sit in the car and let me hear you.”
“Boss, my niece, Beesiwa, is a polytechnic graduate, very beautiful and with very good character.
“Unfortunately, her parents virtually forced her into a relationship with an idiot based in the US, which affected her badly. She has now recovered from that experience and, Boss, I am respectfully asking if you would find a job for her.
“I promise you that you will never regret it.”
“Well, Wofa Yaw, let me meet her and speak with her. I may be able to help, maybe not in the way you expect, but let me meet her.
“I will not be back here for another week, but I will be at the office throughout next week. You can come with her.”
On Monday morning, Wofa Yaw and Beesiwa were seated at the office by nine o’clock. Three young ladies welcomed them warmly, offered them soft drinks and assured them that Kakraba would be there shortly.
They then returned to their desks and sat behind computers with large screens displaying various building designs.
Kakraba walked in and greeted them warmly. After chatting briefly with the three ladies, he ushered Wofa Yaw and Beesiwa into his office.
“Director, this is my niece, Beesiwa. I mentioned her to you when you came to Nsawam.”
“Yes, indeed. Madam Beesiwa, you are very beautiful, just as your uncle said. Wofa Yaw is my colleague.
“We have just started a building project that will take about three to four years. He mentioned that you have a small problem, so I said I would like to meet you and see how I can help.
“So, Beesiwa, please tell me a little about yourself.”
Beesiwa described her childhood, her school experience, her brief work at the bank and the nasty episode with Sammy Abrokwa, which shattered her peaceful life. She also explained how she had been recovering from the experience.
“I am really sorry to hear this,” Kakraba said. “Now, here is what we are going to do.
“We are a small but very busy company. The three ladies out there spend most of the day on site and come back to report on their work in the morning.
“I have three main projects. The big one is an estate project in Nsawam, where your uncle is one of my main colleagues. I need a personal assistant who can take care of my activities, especially when I am not in town.
“Now, we will have to start with trust. Based on what I know about Wofa Yaw, and based on what you yourself have told me, I think we can start on a sound basis.
“So, Wofa Yaw will take you to my home. You can move into one of the four guest rooms.”
“Sir, I have taken some computer lessons, and I have even done graphics and web design,” Beesiwa said.
“Fantastic! I will give you a good phone and a laptop. I will also arrange computer lessons for you.”
“Now, Wofa Yaw, take her home. My sister, Kuukuwa, will meet you and show you around, and then you can return to Koforidua.
“When would you like to start work?”
“Sir, I would like to start today, but I would need to go and bring my things.”
“No problem. Take a taxi to my house, meet my sister, and let me know what you decide.”
Later that day, Kakraba and the three ladies met with some bank officials to conclude the sale of the three buildings at Adabraka.
They closed at five-thirty and, after rewarding the ladies for their hard work, Kakraba got home just after dark.
He was surprised to find Kuukuwa and Beesiwa sitting at the table enjoying supper.
“What’s happening here?” he asked. “Beesiwa, I thought you would return to Koforidua.”
“She changed her mind,” Kuukuwa said. “We went to the mall and bought a few things for her. Then we came back to cook. She has made some nice changes to your bedroom and cooked a couple of interesting dishes. Sit down; we will serve you.”
“Well, I certainly can’t refuse that. It’s been a busy day.
“So, what’s the plan now? Will Beesiwa go to Koforidua tomorrow, gather her things together and come down?”
“No, I will stay here for a while,” Beesiwa replied. “Kuukuwa bought me the things I need, so I may go back next week. I’m ready to start work. What would you like me to start with?”
“Well, you can come to the office tomorrow morning, meet the three girls and get a feel for what we do.
“Since you are living here, at least for now, we can discuss the plans for the next few weeks.
“Sometimes there are gaps when I travel up north. You can take care of things from now. I think the girls would like having someone like you around.”
By Ekow de Heer
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A frequent question following breast surgery is whether human tissue possesses the regenerative capacity to restore an excised organ.
From a strict physiological standpoint, a completely removed breast cannot regrow. Unlike certain organisms that can regenerate complex limbs or organs, adult human tissues—particularly specialised glandular structures—lack the cellular machinery required to rebuild an entire organ after its total surgical removal.
Instead, the body heals the surgical site through processes such as scar tissue formation and re-epithelialisation rather than complete cellular regeneration.
What a mastectomy actually removes
To understand why natural tissue regeneration does not occur, it is important to examine the surgical scope of a mastectomy.
Depending on the type of procedure and the medical reason for surgery, a mastectomy may involve the removal of:
Glandular architecture: The milk-producing lobules and ducts that form the functional core of the mammary gland.
Adipose tissue: The fatty tissue that contributes to breast volume, projection and contour.
Other breast tissue: The extent of tissue removal varies according to the type of mastectomy and the need to achieve appropriate surgical clearance.
Because specialised breast structures are physically removed, the body does not rebuild a complete mammary gland. Instead, healing occurs through tissue repair and scar formation.
Distinguishing residual tissue from “regrowth”
Patients or observers may notice changes in the chest area after surgery, sometimes leading to misconceptions about tissue regeneration.
Skin- and nipple-sparing procedures
Modern breast surgery may preserve the outer skin envelope or, in selected cases, the nipple-areola complex. Small amounts of breast tissue may remain depending on the surgical technique. Any changes in remaining tissue due to hormonal fluctuations represent residual tissue responding to the body, rather than the regrowth of a completely removed breast.
Adipose accumulation
Weight gain after surgery can increase the amount of subcutaneous fat across the chest wall. However, this is part of general body fat distribution and does not represent the regeneration of a mammary gland.
Modern reconstructive pathways
Because a completely removed breast does not naturally regenerate, modern medicine offers reconstructive options aimed at restoring physical symmetry, contour and body image.
The two main approaches are implant-based reconstruction and autologous, or tissue-based, reconstruction.
Implant-based reconstruction
Implant-based reconstruction uses synthetic medical devices, typically filled with silicone gel or saline, to rebuild the breast mound following a mastectomy.
The two-stage process: This approach may begin with the placement of a temporary tissue expander to gradually create space and stretch the surrounding tissues. A later procedure may then be performed to place a permanent implant.
Recovery profile: Implant-based reconstruction generally involves a shorter initial surgery and recovery period compared with procedures that require tissue to be harvested from another part of the body.
Long-term considerations: Breast implants are not lifetime devices and require ongoing medical monitoring. Some patients may need additional procedures over time because of complications or changes in the implant or surrounding tissue.
Autologous or tissue-based reconstruction
Autologous reconstruction uses the patient’s own living tissue to create a new breast mound. Tissue may be transferred from another part of the body, commonly the lower abdomen, using procedures such as a DIEP flap.
Natural look and feel: Because the reconstruction uses living tissue, it can provide a natural warmth, texture and softness. The tissue may also change with the patient’s body weight over time.
Long-term durability: Once healing is complete, autologous reconstruction can provide a long-lasting result without the need to replace an implant. However, some patients may still require further procedures.
Complex surgery: This option usually involves a longer operation and recovery period. In microsurgical procedures, surgeons may need to reconnect tiny blood vessels to establish blood flow to the transferred tissue.
Direct comparison
When choosing between these two reconstructive pathways, patients and their surgical teams must consider several physical, medical and lifestyle factors.
Surgical burden: Implant surgery is generally less invasive, while flap reconstruction involves surgery at both the chest and the donor site.
Foreign material versus native tissue: Implants involve the use of a medical device, while autologous reconstruction uses the patient’s own tissue.
Recovery: The recovery timelines and rehabilitation requirements differ significantly between the two procedures.
Recovery and physical rehabilitation
Recovering from breast reconstruction requires patience, careful pacing and, in some cases, structured physical rehabilitation.
Because implant-based and autologous tissue-flap procedures involve different surgical techniques, their healing timelines and physical therapy milestones can vary considerably.
Understanding these differences is important for patients considering reconstruction, as the choice involves more than restoring physical appearance. It also requires careful consideration of recovery, long-term monitoring, lifestyle and individual medical needs.
Part 2 will examine recovery timelines, physical therapy milestones and other factors patients should consider when choosing between reconstructive options.
By Robert Ekow Grimmond-Thompson
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