Community-based study on knowledge, attitude and practice on the mode of transmission, prevention and treatment of the Buruli ulcer in Ga West District, Ghana

Buruli ulcer disease (BUD), a devastating tropical disease caused by Mycobacterium ulcerans, occurs in more than 80% of the administrative districts of Ghana. To elucidate community perceptions and
understanding of the aetiology of BUD, attitudes towards Buruli patients and treatment-seeking behaviours, we conducted a survey with 504 heads of households and seven focus group discussions in Ga West District, Ghana. Although 67% of participants regarded BUD as a health problem, 53% did not know its cause. Sixteen per cent attributed the cause to drinking non-potable water, 8.1% mentioned poor personal hygiene or dirty surroundings, and 5.5% identified swimming or wading in ponds as a risk factor. About 5.2% thought that witchcraft and curses cause BUD, and 71.8% indicated that BU sufferers first seek treatment from herbalists and only refer to the hospital as a last resort. The main
reasons were prospects of prolonged hospital stay, cost of transport, loss of earnings and opportunity associated with parents attending their children’s hospitalization over extended period, delays in being
attended by medical staff, and not knowing the cause of the disease or required treatment. The level of acceptance of BUD sufferers was high in adults but less so in children. The challenge facing health workers is to break the vicious cycle of poor medical outcomes leading to poor attitudes to hospital treatment in the community. Because herbalists are often the first people consulted by those who contract the disease, they need to be trained in early recognition of the pre-ulcerative stage of Buruli lesions.

History of the Geelong Regional Commission

This thesis is the first systematic history of the Geelong Regional Commission (GRC), and only the second history of a regional development organisation formed as a result of the growth centres policy of the Commonwealth Labor Government in the first half of the 1970s. In particular, the thesis examines the historical performance of the GRC from the time of its establishment in August 1977 to its abolition in May 1993. The GRC Commissioners were subject to ongoing criticism by some elements of the region's political, business, rural and local government sectors. This criticism focused on the Commissioners' policies on land-use planning, their interventionist stance on industrial land development, major projects and industry protection and their activities in revitalising the Geelong central business district. This thesis examines these criticisms in the light of the Commission's overall performance. This thesis found that, as a statutory authority of the Victorian Government, the GRC was successful over its lifetime, when measured against the requirements of the Geelong Regional Commission Act, the Commission's corporate planning objectives and performance indicators, the corporate performance standards of private enterprise in the late 1990s, and the performance indicator standards of today's regional economic development organisations in the United States of America, parts of the United Kingdom and Australia. With the change of Government in Victoria in October 1992 came a new approach to regional development. The new Government enacted legislation to amalgamate six of the nine local government councils of the Geelong region and returned regional planning responsibilities to the newly formed City of Greater Geelong Council. The new Government also made economic development a major objective of local government. As a result, the raison d'etre for the GRC came to an end and the organisation was abolished.