A recent study by the International Organization for Migration (IOM) has highlighted the widespread issue of open defecation in the Ada East District, where 77% of 437 surveyed households lack access to proper sanitation.
The study revealed that most households in the district do not have toilets or pit latrines, leaving them with no choice but to defecate in open spaces such as fields, bushes, and canals. In contrast, only 23% of the sampled homes have access to appropriate toilet facilities.
Conducted as part of the IOM Ghana Mission’s Population Mobility Mapping for Cholera Response, the survey covered 10 communities, including Azizanya, Totope, Pute, Otrokpe, and Azizakpe.
The findings indicated that areas along key trade routes and fishing hubs—such as Totope, Pute, and Azizanya are at higher risk of cholera outbreaks due to the frequent movement of traders, fishermen, and seasonal workers.
The report further noted that large public gatherings, including markets and festivals, have contributed to the spread of cholera through contaminated food and water.
Poor sanitation and inefficient waste disposal in highly mobile areas have worsened environmental contamination, increasing the risk of disease transmission.
“Additionally, the presence of large gatherings, including markets and festivals, has facilitated the spread of cholera through contaminated water and food sources. Limited access to proper sanitation in these high-mobility areas further exacerbates the challenge, as open defecation and poor waste management contribute to environmental contamination,” the report stated.
According to the IOM, climate-related vulnerabilities, economic hardships, and complex migration patterns are key factors intensifying the cholera crisis. Displacement from the October 2023 Volta Basin floods, the effects of the Sahel crisis, and commercial activities along the Abidjan-Lagos corridor have all played a role in worsening sanitation conditions.
Among the communities surveyed, Pute had the highest proportion of households without toilet facilities at 17%, followed by Azizanya (12%), Otrokpe (11%), Kasseh (7%), and Foah Zongo (5%). Additionally, no households in Azizakpe, Azizanya, and Kewunor reported having access to latrines.



