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BACKGROUND: Family caregivers, mostly parents, are greatly involved in the care of their children with end stage kidney disease (ESKD) globally. Yet, the experiences of these caregivers and the demands placed on them by the caregiving role have not been explored or documented in Ghana. This study explored how caregiving affects the psychological, physical, social, and spiritual well-being of family caregivers of children with end stage kidney disease (ESKD) in Ghana. METHODS: A phenomenological approach with the purposive sampling technique was used to gather data from 12 family caregivers of children with ESKD at a pediatric renal unit in Ghana. A semi-structured interview guide was constructed based on the constructs of the City of Hope Quality of Life (QoL) Family Caregiver Model and the research objectives. Colaizzi's thematic analysis approach was utilized to analyze data for this study. Themes were organized under the domains of the chosen model, and a new theme outside these domains was also generated. RESULTS: The majority of the family caregivers experienced anxiety, fear, uncertainty, and hopelessness in response to the children's diagnosis and care. The thought of the possibility of the children dying was deeply traumatizing for our participants. Most participants reported bodily pains and physical ailments because of lifting and caring for the children. Financial constraint was also a key issue for all the family caregivers. Most of them received diverse support from their families and loved ones. Due to the demanding nature of the care, most family caregivers had to change or quit their jobs. They coped with the challenges through prayers, participating in religious activities, and being hopeful in God for healing. CONCLUSION: All the family caregivers had their psychological well-being compromised as a result of the challenges they encountered physically, socially, and spiritually. Continuous psychosocial support, funding support, and review of policies on leave for civil workers with children diagnosed with ESKD are urgently required.
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The surge in mining operations to meet the global demand for mineral resources adversely impacts ecosystem services and dependent households, but the issue barely attracts attention. This study evaluated the dynamics of mining-induced changes in the value of ecosystem services (ES) and the consequent economic and relational cost to rural households in the Ahafo region of Ghana. Face-to-face structured interviews with 200 householders were conducted in three mining communities. We determined relational values in the landscape through focus group discussion and the economic cost of the ecosystem services lost by applying replacement and contingency cost estimations. Old-growth forests, degraded forests, teak plantations, cultivated land, wetlands, and grassland were ecosystems identified in the mining landscape. The most valued ecosystem was old-growth forest, while the least was grassland. Provisioning service was the most valued ES, while supporting service was the least. Provisioning ES was rated the most impacted by the mine, whereas cultural services were the least affected. Mining activities caused a significant loss of 14 ecosystem services (including crops, livestock, capture fisheries, wild food, bush meat, biomass fuel, and freshwater) that were of priority to the communities. The affected households experienced relatively high monthly economic costs, approximating $300 per household, from the loss of priority ecosystem services. Canonical correspondence analysis revealed connections between ecosystem services valuation and the socio-demographic characteristics of the respondents. There was a perceived mine-adverse effect on the relational values of the people relating to cultural identity, sovereignty, symbolic value, security, subsistence and livelihood, sense of place, social cohesion, social memory, female emotional/mental health, and womanhood training opportunities. Actors in the mining industry should consider policies and management interventions that will limit ecosystem services loss, widely ascertain ecosystem benefits, and comprehensively mitigate the impact of their loss on households.
RESUMEN
This study investigated the dynamics of mining effects on land use land cover changes and the chemical and physical characteristics of soil and surface water in the Ahafo mining area in Ghana. Landsat imagery was used to analyze land use-land cover changes (LULC) using a supervised classification technique. Soil samples were collected within 600 m from active mining operations and at depths of up to 75 cm, as well as surface water samples from upstream and downstream of the mine. Atomic Absorption Spectrometry was used to determine the concentration of heavy metals in the soil and water samples. The results demonstrated a significant loss of forest and other vegetation covers, which decreased from 44% to 31% to 8% and 20%, respectively, with corresponding increases in the mining site, mine water, settlement/bare surface, cropland and plantation. Organic matter, organic carbon, exchangeable bases, cation exchange capacity, available phosphorus, and pH were all moderate in the soil surrounding the mine. Except for As (4.027 mg/kg) and Hg (1 mg/kg), all heavy metals found in the soil were within FAO/WHO guidelines. Total Dissolved Solids (TDS) (416.18 mg/L), Total Suspended Solids (55.08 mg/L), Turbidity (54.49 NTU), Ca (84.49 mg/L), Mg (31.97 mg/L), nitrate (10.23 mg/L), and sulphate (606.83 mg/L) in the downstream water were higher than those in the upstream and USEPA/WHO limits for drinking water except for TDS. Because of the geology of the area, there were high concentrations of iron, manganese, and aluminum in the surface water. The results show that mining induced severe land cover changes and impaired surface water and soil quality in the mine's vicinity. The findings have implications for stakeholder education, appropriate community water interventions, and company-community-regulator participatory monitoring to avoid health risk exposure and further water and soil quality and vegetation degradation.
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BACKGROUND: Indiscriminate use of pesticides is a common practice amongst farmers in Low and Middle Income Countries (LMIC) across the globe. However, there is little evidence defining whether pesticide use is associated with respiratory symptoms. OBJECTIVES: This cross-sectional study was conducted with 300 vegetable farmers in southern Ghana (Akumadan). Data on pesticide use was collected with an interviewed-administered questionnaire. The concentration of seven organochlorine pesticides and 3 pyrethroid pesticides was assayed in urine collected from a sub-population of 100 vegetable farmers by a gas chromatograph equipped with an electron capture detector (GC-ECD). RESULTS: A statistically significant exposure-response relationship of years per day spent mixing/applying fumigant with wheezing [30-60 days/year: prevalence ratio (PR)=1.80 (95% CI 1.30, 2.50); >60days/year: 3.25 (1.70-6.33), p for trend=0.003] and hours per day spent mixing/applying fumigant with wheezing [1-2h/day: 1.20 (1.02-1.41), 3-5h/day: 1.45 (1.05-1.99), >5h/day: 1.74 (1.07-2.81), p for trend=0.0225]; days per year spent mixing/applying fungicide with wheezing [30-60 days/year: 2.04 (1.31-3.17); >60days/year: 4.16 (1.72-10.08), p for trend=0.0017] and h per day spent mixing/applying fungicide with phlegm production [1-2h/day: 1.25 (1.05-1.47), 3-5h/day: 1.55 (1.11-2.17), >5h/day: 1.93 (1.17-3.19), p for trend=0.0028] and with wheezing [1-2h/day: 1.10 (1.00-1.50), 3-5h/day: 1.20 (1.11-1.72), >5h/day: 1.32 (1.09-2.53), p for trend=0.0088]; h per day spent mixing/applying insecticide with phlegm production [1-2h/day: 1.23 (1.09-1.62), 3-5h/day: 1.51 (1.20-2.58), >5h/day: 1.85 (1.31-4.15), p for trend=0.0387] and wheezing [1-2h/day: 1.22 (1.02-1.46), 3-5h/day: 1.49 (1.04-2.12), >5h/day: 1.81 (1.07-3.08), p for trend=0.0185] were observed. Statistically significant exposure-response association was also observed for a combination of activities that exposes farmers to pesticide with all 3 respiratory symptoms. Furthermore, significant exposure-response associations for 3 organochlorine insecticides: beta-HCH, heptachlor and endosulfan sulfate were noted. CONCLUSIONS: In conclusion, vegetable farmers in Ghana may be at increased risk for respiratory symptoms as a result of exposure to pesticides.