ti r t JOINT COORDINATING COMMITTEE Onchocerciasis Control Progremme in tle Volta River Basin Area Ofice of the Independent Chairman c/o World Health Organization l2ll Geneva 27, Switzerland TcI.346061 Tclcx Z
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rt
JOINT COORDINATING COMMITTEEOnchocerciasis Control Progremme
in tle Volta River Basin Area
Ofice of the Independent Chairman
c/o World Health Organizationl2ll Geneva 27, Switzerland
TcI.346061 Tclcx Z
@WORLD HEALTH ORGANIZATTON
ORGANTSATION MONDIALE DE LA SANTE
SIATT'S OF SOCIOECONOMIC AND
DEVTLOPMENT PROGRAM}TE AND
DEVELOPMENT . .
ORIGINAL: ENGLISH
OTIIER STI'DIES FI'NDED BY T]IE UNITED I{ATTONS
I'ITE UNIlED STAIES AGENCY FOR INIERI{ATIOI.IAL
ocefwuf tt.t
a
SOCIOECONO}trC DEVELOPMENT ASPECTS OF TIIE PROGRAMME
ANNUAL REPORT, 1977
presented by the 0nchocerciasis Control Prograurnein the Volta River Basin area
TABLE OF CONTENTS
TI{E ECONOI'{IC DEVELOPI,{ENT UNIT
INSTTI'I'TIOI{AL ARRANGEI,IENTS FOR PIANNING AND DEVELOPMENT OF TTIE
ONCHOCERCIASIS ZONE . . .
INTRODUCTION
SECTION I.
SECTION II.
SECTTON III.
SECTION IV.
SECTION V.
SECTION VI.
ANNEX I.
ANNEX II.
ANNEX II1.
Page
2
3
4
7
8DE\ELOPMENT PROJECTS AND ACTT\IITTES IN TIIE ONCHOCERCIASIS ZONE
SOCIOECONOMIC AND OTTIER ASPECTS OF DEVELOPMENT OF TTIE ONCHOCERCIASISZONE
SELECTED TOPICS FOR INVESTTEATION .
MAPS
50
54
59
68
84
SOME CONSIDERATIONS ON TliE I{EALIH AND SOCIAL FACTORS AEFECTINGDEVELOPMENT IN THE OCP ZONE .
OUTLIM FOR ANALYSIS OF SOCIAL AND HEALTII ASPECTS OF ECONOMIC
DEVELOPMENT PROJECTS IN COUNTRIES CO\ERED BY IHE PROGRAMME
a
ocYfrruftt.tpage 2
INTB,ODUCTTON
Ihis is the first report on socioeconomic development in the Onchocerciasis ControlProgramme area produced by the Prograrmners Economic Development Unit. The decision totransfer responsibility for the preparation of the report from UNDP to the Onchocerci.asisControl Prograrune r^ras announced by Mr Michel Doo Kingu6, UNDP Assistant Administrator andRegional Director for Africa, at the third session of the Joint Coordinating Conrnittee(1-2 December L976).
In preparation for this task letters were sent, starting in December 1976, to representa-tives of all bilateral and multinational aid donors connected with the Progrartme, includingUNDP and the World Bank, and to all regional organizations active in the Progranrne area,requesting them to transmi.t all available information on development projects undertaken orenvisaged by them within the limits of the Prograrme area. At the same time, returns wereexpected and received from the beneficiary Governments in response to the quarterly question-naire prepared by the Prograrrne and previously circulated to them. The present report isprepared on the basis of the information received from these sources to all of whom thanks aredue for whatever contribution they have made in this respect.
It is necessary to recall the basic functions of the Economic Development Unit, which ischarged with the surveillance of developments in the oncho zone of the Progranrme. These maybe surmnarized as follows, namely to:
- monitor the development activities taking place in the oncho zone;
- collect and disseminate basic socioeconomic data which may be useful for planning anddevelopment actions by both beneficiary and donor countries;
- on the basis of the socioeconomic daEa collected, assist in the establishment of asocioeconomic data bank for the Programme area;
study and advise on development projects being execuEed or planned for the oncho zone,articulating all relevant socioeconomic aspects and consequences;
- maintain contacts with aIl parties to the Programne and interested agencies (beneficia-ri-es, donors, sponsoring agencies, bilateral and mulEinaEional aid and financingagencie s ) .
In short, the Unit at the present time carries out liaison, coordination, inforrnation andadvisory functions.
The presentation adopted in this report conforms to the following order. First, theorientation and staffing of the Unit are discussed, followed by an account of its activities.Second, the institutional arrangements for planning and development of the oncho zone in thecountries of the Prograrmne area are briefly described. Third, is outlined the sEatus of thesocioeconomic and other studies funded by UNDP and USAID for the collection of baseline datafor planning the devel-opment of the oncho zone. Fourth, details of the various developmentprojects and activities in the oncho zone are presented on a country basis, the whole prefacedby a suuunary list of the projecEs arranged by country, type of project and other classifications.Fifth, the socioeconomic and other aspects of development of thq oncho zor.e are briefly setforth. Sixth, and finally, a preview is given of a selection of topics which the Unit proposesfor investigation in the course of its work, and by others, in the ensuing years.
a
Documentary and cartographic annexes conplete the report.a
ocefYouftt.tpage 3
SECTION I
IIIE ECONOMIC DEVELOPMENT UNIT
Ihe Head of the Economic Development Unit assumed his duties in February L976 and operatedon a very restricted basis for lack of supporting staff. It was envisaged, however, thaE foreffective operation the Unit would not only have to be expanded but also given a rnultidiscipll-nary orientation in accordance with the various aspects of the developmenE process.
At the third session of the Joint Coordinating Conrnittee of the Onchocerciasis ControlPrograrune which was held in Ouagadougou on 1-2 December L976, much emphasis was placed on thedeveloprnent aspects of the Progrannne as the rnain focus of its future activities.
Mul ti dis c1D 1i orientation
In line with the new orientation the Prograume Director held a meeting with the Chiefs ofUnits and their personnel with a view to coordinating the vector conE.rol, epldemiologicalsurveillance, health, sociological and economic aspects of development, to work out a patternof collaboration and a joint approach Eo development activities, and to attempt to esEablishfor the Economi.c Development Unit the broad outlines of a work programne emphasizing thesemul tidiscip linary aspects.
One of the by-products of this developrrent was the preparation of a project history sheetwhich would serve as a guide to the collection and analysis of data relating to developmentprojects wiEh strong socioeconomic components.
Staffing of the Unit
In addition to the Eransfer of the Programme Documentalist to the Unit during December 1976and, with effect from 1 January L977, the transfer of a sociologist from the EpidemiologicalEvaluation Unit, an agro-economist was recruited.
Responsibility for keeping track of developoents in the various countri.es of the Prograrmewas assigned to individual members for specific countries except Upper Volta. In the case ofUpper Volta a joint responsibility was mainEained.
Missions and visits in the Pro area
Visits were made by rnembers of the Unit to the various countries of the Progranrnerespectively assigned to them for the purpose of updating information on development activities,observing the situation in the oncho zone, familiarization tours of developmenE projects atvarious locations, and for discussi.ons with members of the National Onchocerciasis Conmittees,ministers and officials connected with the development of the oncho zone.
In the course of these visits various issues were raised and discussed, problems noted,and advice sought and given as requesEed. An lmportant part of these visits was the con;actestablished with bilateral and oultinational aid agencies having an interest andfot supportingdevelopurent projects in the oncho zone.
Equally imPortant was the occasional sharing of information relating to activities andprojects in the oncho zone of other participating countries of the prograrrne.
Conta cts with reqional orqanizations
Close working relationships were established with various regional organizati.ons in theProgramme area, most of which have their headquarters i.n ouagadougou. Ihese contacts weremade through individual visits or attendance at periodic meetings of these organi.zations. ThePurPose of these contacts was to learn about their programnes of activities with a view tocoordinati-ng thq trork as well as to obtain information on development actions proceeding in theoncho zone under their auspices, whether supported by governmental, inter-state, bilateral ormultlnational aid agencies.
a
oefxouf tt.tpage 4
The principal organizations involved were:
(a) Liptako-Gourrna InEegrated Developroent Authority (ALG) ;
(b) Inter-State Committee for Drought Control in the Sahel (CILSS);
(c) lnter-African Centre for Hydraulic Studies (CIEH);
(d) West African Economic Conrmunity (CEAO);
(e) Economic Community for Cattle and Lleat (CesV);
(f) Inter-State School for Rural Engineers (EIIR) ;
(g) Organization for Coordination and Cooperation in the Campaign against the MajorEndemic Disease (OccGE).
MeeEings attended
Members of the Unit attended, participated or represented the Programme at variousmeetings, including those of the:
- Ecological Panel of the Progranrne, Ouagadougou
t-4 llarch 1977Scientific and Technical Advisory Conrnitteeof the Progranrne, Ouagadougou
- Health Economists at the world Bank, washington, D.c., 2-3 Marclrl L977
))))
- Economic Development Advisory Panel of the Prograrmne,Ouagadougou,
Rome,8-10 March 1977
29-3L August 1977
Seminar for Officials of Rural Radios of theparticipating countries of the OCP, Ouagadougou, 4-6 May L977
- Meeting of RePresentativesCommittees,
of National OnchocerciasisAbidjan, 15-17 June 1977
Various papers were prePared and presented at these meetings by members of the Unit'
SECTION II
INS T1 T'I]TIONAL ARRANGEMENTS FOR PLANNING AND DE VELOPMENT
OF T1IE ONCHOCERCIASIS ZONE
In each of the seven countries of the Programme matters connected with the control and
development of the oncho zone are coordinated by the National onchocerciasis committee which
has been esEabrished for each country. The comnittee is backed by an executive organ for the
implementation of decisions relating to p1-anning and execution of developurent projects in the
contro].zone.Theexecutivearrangementsvaryfromonecountrytoanother.
a
octfnouf tt .rpage 5
Benin
In Benin t.he Ministry of Rural Development takes full responsibility for rural development
in the six Regions of the country through the intermediary of the six C,ARDERs (Centre drAction
R6gional pour le D6veloppement Rural) which have been established as regional develoPment
organizations, one for each Region. Each CARDER is the administrative organization for the
planning and execution of development in its respecEive Region. Established by presidentialdecree it seeks to Promote development within the means available' In this connexion the
Ministry of Rural Development, under whose auspices the C'ARDERs oPerate, col-laborates very
closely with the Ministry of Health and uses the cooperatives and cormnunes as agencies for the
execution of development projects.
Ihe oncho zone falls within the Regions of Atacora and Borgou and therefore Planning and
development matLers for the zone come under the jurisdiction of the CARDERs of the two Regions'
Ihere is, therefore, no special authority charged with the planning and development of
the oncho zone as such, this activity falling within the purview of already establishedinstitutions operating in the oncho zone. With the exception of Upper Volta and possibly
Mali, a similar situation exists in the other countries'
Ghana
Developrnent and planning matters come under the jurisdiction of the Ministry of Economic
planning which is administratively articulated into regional branches, according to the
regional set-up of the countryrs administration. The oncho zone lying within the Northern
and Upper Regions of the country, planning and develoPmenE matters are effectively under the
jurisdiction of Ehe Northern and Upper Region branches of the l"linistry'
Because of the paramountcy of the Regional Administration in each Region, however, the
Office of the Regional Cormnissioner has a decisive say in mrtters relating to Planning and
development in the Region as a r,rhoIe, including such rnatters relating to the oncho zone'
Mention rnay be rnade of the Regional Development Corporations which play an active Part as
executing agencies for develoPment projects in their respective Regions.
Ivory Coast
planning and developnent matters in the Ivory Coast fa1l under the suPervision of the
Ministry of Planning where a special section, known as DATAR, is responsible' DATAR
(Direction de ltAm6nagement du Territoire et des Actions R6gionales) is resPonsible for the
preparation of the master plans for the comprehensive physical planning of the Ivory coast
in eight cofiPonent Regions, one of which, the R6gion du Nord, contai'ns the oncho zone'
The master plan for the Northern Region, whose capital is Korhogo, envisages the rePoPu-
lation of the valleys which have been sparsely populated or abandoned on account of the scourge
of onchocerciasis.
Various studies for the oncho zorre are contracEed out to consulting firms (bureaux
d'6tudes) chief of these being the Bureau National drEtudes Techniques de D6velopPement
(fnnm) and the Development Resource Corporation (oRC) of New York. In additlon, there are
various State developrnent companies, mostly attached to the Ministry of Agriculture, forproduction and processing of specific agricultural and animal products.
ocYf muf tt.tpage 6
Mali
MaLi has established a Cellule de Planification, under the Beneral supervision of theDirector-General of Planning and Statistlcs, responsi.ble for planning the development of theoncho zone. To this planning cell each of the ministries, by general agreement of theNational Onchocerciasis Conrnittee, has seconded a member on a more or less permanent basis.
The Government seems to have given favourable consideration to
(a) the creation of an authority to develop the oncho zone;
(b) the establishment of an oncho zone development fund jointly administered by theMinistries of Finance and Rural Development;
(c) the establishment, when necessary, of planned settlements in Ehe oncho zone i"riththe achievement of effective control through the antivectorial operations.
Niger
Planning the development of the oncho zone, which lies exclusively within theArrondissement de Say, is the work of the Service D6partemental R6gional drAm6nagement duTerritoire (SDRAT), recently renamed Service D6partmental du Plan (SDP). This organ, whichis a part of the Ministry of Planning, is assisted by the United Nations Development Programmeand the French Technical Cooperation Mission.
The SDP is advised by a Comit6 Technique D6partemental (COTEDEP) or technical comnitEeeof the various departmental services, and this, in turn, is coordinated at the Arrondissementleve1 by the Comit6 Technique drArrondissement under the chairmanship of the Prefect.
Togo
The oncho zone of Togo is located in the Kara and Savanes Regions, two of the fiveadministrative regions of the country (the other three being Maritime, Plateau, Centrale).The Kara and Savanes Regions togeEher with the R6gion Centrale constiEute Togo Nord, theplanning for which comes under the jurisdiction of the Directeur-G6n6ra1 du Plan for Togo Nord,within the Ministry of Planning. Ihus pLanning of the oncho zone takes place in the contextof the planning of Togo Nord.
National responsibility for the Onchocerciasis Control Programme and Ehe installaLion ofa health structure in the oncho-control-led area devolves on the Ministry of Health in thecontext of the general development programne for Togo Nord.
Upper Volta
Ihe planning and development of the oncho zone of Upper Volta is entrusted by presidentialdecree to the Autorit6 des Am6nagements des Va116es des Volta (AW), a special authoritycreated for this purpose, under the general supervision of the Ministry of Rural Developrnent.
The AW derives most of its funding from French Technical Co-operation with supplementaryassistance from other bilateral aid agencies such as the Netherlands and USAID, and frommultinational agencies such as the United Nations Development Prograrmne.
ocefuouftt.rpage 7
SECTION III
STATUS OF SOCIOECONOMIC AND OI]IIER STUDIES TT]NDED BY THE
UNITED NATICh{S DEVELOPMENT PROGRAMI.IE AND THE IJNITED STATESAGENCY FOR INTERNATIONAL DEVELOPMENT
Ihe amount of US$ 5OO 0OO originally provided by the United Nations Development Progranrmefor each of the seven countries of the Onchocerciasis Control Programre was intended to assistthem in the planning and progranming of the development of their respective oncho zones. Inall cases the funds were destined for studies and investigations in the socioeconomic field,for strengthening of their development planning mechanisms and for Ehe preparation of 1o-yeardevelopment plans for the oncho zones.
While a detailed accounting of the use of the funds to daEe is available from UNDP itmay suffice for the purpose of this report to say that the original studies have been completedfor Togo, and nearly so for Upper Volta and for Niger. About half the funds have beenused up in Benin and the Ivory Coast, while the bulk of their allocaEions are sti11 availablefor use by Ghana and Mali.
Pending the resolution of the financial crisis which overtook UNDP in L975-76 chefunds for Ghana and l,lali were frozen until 1977. In the meantime, stop-gap financing for theMali oncho zone studies was provided by the World Bank by the inclusion of the sum of US$ 1.1million for this purpose with the funds for the financing of Ehe Mali Sud agricultural develop-ment project.
Under its Regional Orchocerciasis Area Planning (tOgp) Project the UniEed States Agencyfor International Development contributed, additionally, for studies by land satellite of theoncho areas lying in Ghana, Upper Volta and Benin. These studies, to be carried out under thesupervision of the African Development Bank, are soon to begin and will make available varioustypes of information useful for planning, namely:
(a) geological structure of the area, identification of areas of petroleum and othermineral deposits;(b) vegetati.on and soi1s, with reference to land use plannlng and classification systemof land suitability;(c) surface and ground water features; -,
(d) forest cover, range 1and, reservoirs and rivers for fisheries developnent;(e) data for transport planning;(f) data for evaluation of climatic changes.
The study will result in maps of scale l;25O OOO for Ghana and 1:2OO 0OO for Upper Vol-taand Benin, providing general information. More detailed information will be provided by mapsof scale 1:5O OOo for areas of priority for development projects in the field of agriculture,animal production as well as other fields.
The USAID has also made available under its ROAP Project about US$ 75O OOO for specialstudies outside the range of those financed by E.he LINDP contribution. Such special studiesare intended to be problem-related as well as leading to innovative solutions to problemscommon to most colonization and settlemenE projects in the area.
Ihe kinds of topics originally proposed for the special studies are the following:
- the prevalence and distribution of trypanosomiasis in onchocerciasis-free areas;
- transporE options for development of onchocerciasis-free zones;
- attitudes towards migration to settlement zones;
ocrfmuf tt.rpage 8
- the control of schistosomiasis in onchocerciasis settlement zones;
- problems associated with transferral of local leadership to colonization areas;
- cost-effective health delivery systems for colonization areas;
- the need for urban support facilities in rural development project areas;
- non-formal educaEion options for onchocerciasis-free zones;
- rehabilitation of the b1ind.
Within the last year or so the Government of Togo has requested assistance from theUnited States Government for financing, under the ROAP Project, of the following studyproposals:
(a) Proposal for topographical and hydrological studies for
(1) Mandouri Plain (a part of the Oti Valley), covering over 50 OOO hectares
(2) Middle Oti Valley, covering over 10 0OO hectares
(3) Binah and Patalou in the Kara Region, covering 1O 000 hectares
(4) Mo Plain, covering 75 OOO hectares.
(b) Proposal for improving health services and non-traditional education in theLa Ikra Pilot Settlement areas.
SECTION IV
DEVELOPMENT PROJECTS AND ACTIVITIES IN TTIE
ONCHOCERCIASIS ZONE
In this Section are treated all the principal ongoing Projects and activities in the oncho
zone as well as all activities and projects planned or ProPosed for the oncho zone, for whichinformation of any kind is currenEly available. Idea11y, this Section should be both exhaus-
tive and up-to-date. This can only be the case if al1 existing inforrnation was made available.But this depends on the degree of cooperation in the supply of information extended by the
various agencies operating in the oncho zone.
The degree of cooperation achieved has been considerable. This is reflected in the
volume of information presented. The information presented for the Government sector of Ghana
has been called from the official annual budget estimates supplied to the Programme and
relates to capital expenditure estimaEes. Ihere is, however' no PreEence to comPleteness ofthe information since details of projects are not usually contained in the estimates, nor isthere any hard and fast distinction beEween capital and current expenditure since currentexpenditure frequently contains capital elements. For this reason there is no question ofsuruning up the individual totals of capital expenditure estim,tes in the expectation that thiswould trul-y represent the fu11 extent of Government caPital expenditures scheduled for the
oncho zone.
In other cases information obtained whether by questionnaire or by other means has been
scrappy and incomplete for some of the projects. Ihis is not entirel-y unexpected in an
enteiprise such as this, which involves an attempt to build up and make available a wide range
of reliable inforrnation over a period of time'
ocefnouftt.tpage 9
No doubt, with the passage of tire and as the need for corylete informntion as an aid toeffective planning and further investment becomes ful1y recogni-zed, there will core a PromPtand fuller response to requests for relevant data on all develoPment actions occurring in, orenvisaged for, the oncho zone.
Operational area of the ciasis Control Program
The area covered by Ehe operations of the Onchocerci.asis Control Prograrrme is about7OO OOO hl, di"tributed among the seven participating countries as folloros:
Country
Benin
Ghana
Ivory Coast
Mali
Niger
Togo
Upper Volta
Progranme area
Oncho zone
@r56
98
118
t25
15
18
270
700
2In this area of 7OO 0oO km lying almost entirely within the savanna belt, live an
estimated 10 million peopLe of whom 1 million or LO% are affected by onchocerciasis, and ofthis number about 70 OO0 are estimated to be blind from the di.sease.
It is also estimated that about 20 million people throughout the wortd are affected byonchocerciasis, the largest endemic areas being located in tropical Africa where they extendacross the continent from Senegal to Ethiopia in Ehe north and from Angola to Tanzania in thesouth, the Volta River Basin being one of the \^rorsE affected areas in the world.
Treatment phases and controlled areas
For Ereatment purposes the Programrrrc area was divided into three phases. Treatmentcorenced in Phase I in 1975, in Phase II in L976 atd in Phase III in 1977. Ihus the entirePrograme area is now covered and protected by a network of treatment and entomological and
epidemiological survei.llance operations. A definition of valid criteri.a for declaring an
area controlled and safe for development activity is presented separately.
Development of the oncho zone in the context of national deve lopment goals
Itre joint FAO/IBRD methodology for the developrrEnt of the Prograrme area stresses:
(a) the collection of basic planning data relating to Ehe oncho zone in each country;
(b) the preparation of 5-10 year develoPlnent plans for each oncho zonel
(c) the preparation and eventual implerentation of specific investment plans.
While the basic view underlying this methodology is the developoent of each countryrs oncho
zone as a separate exercise, events in the countries themselves are evolving along a coursewhich tends to make the rationale underlying the oethodology (though not the methodologyitself) increasingly out of date.
ocef mvf tt.rpage 1O
In the three Sahel countries - Mali, Upper Vol-ta and Niger - development of the oncho zoneis regarded in the context of a short-term solution to the drought-induced problems of theSahel, not as a separate exercise in itself. In Ghana, the oncho zone is regarded as animportant contributor to the national caryaign to grouT more food and industrial raw materials.In the Ivory Coast the oncho zone is viewed in the overall context of reducing the north-souEhregional imbalance in favour of more development of the Northern Region. In Togo thereduction of north-south disparities is again paramount in the development of the northernpart of the country, while in Benin a sirnilar rationale and approach are discernible.
These developments may well call for a review of the orientation of the rethodology forthe development of the oncho zone and its relationship to overall national planning anddevelopment goals.
The total cost of the methodological studies was originally estimated at US$ 6.7 mi1lion,to be contributed by various sources as follows:
US$ million
IDAI]NDP
USAIDGovernments of Prograrmne countries
6.7
USAID has subsequently contributed an additional US$ 1.47 million for special problem-oriented studies leading to innovative solutions capable of general application. Itsoriginal US$ f million contribution r{as to cover the cost of landsat studies in Benin, Ghanaand Upper Vo1ta.
Projects in the Progranrne area
3.02.41.O0.3
A number of projects at the idea stage, at the study stage (study in progress or a1completed), in execution or completed have been identified for the various countri.es ofProgranrne. These projects are located or intended for location in the Progranrme area.
repdythre
Ideally, a distinction should be rnade among projects according Eo whether Ehey are:
(a) projects only at the idea stage;
(b) projects at the study stage;
(c) projects for which studies have been completed but which await decision as to theirprospects for project formulation;
(d) projects in execution at various stages towards completion (the stages being definedaccording to proportion of total expenditure already engaged or according to proportionof construction period elapsed);
(e) projects already cornpleted.
Ihese various categories are necessary Lo an understanding of the nature and scope of develop-ment activities taking place.
oef muf tt.tpage 11
Category (a) projects give an idea of the reservoir of potential projects in the onchozol].e of the particular country.
Category (b) projects give an idea of the range of potential projects which merit carefulexamina ti on.
CaEegory (c) projects corne r^Tithin the range and scope of projects with potential forformulation and development.
Category (d) projects give an idea of the range and volume of i.r".a*nt currentlytaking place.
category (e) projects give an idea of the existing project context into which projecEscurrently in execution and future projecLs have to be fitted, as well as the existing linkagepotential for such current and future projects.
Idea1ly, also, Category (a) and Category (b) projects rnerely need to be kept under review.Projects in Categories (c), (d) and (e) would norrnally constitute the input for Ehe prograurrerssocioeconomic data bank. Furthermore, the list of projects should include not only governmentsector projects and joint government-private sector projects but also private sector projects.
Unfortunately, however, even with the lists restricted to government and joint government-private sector projects there have been a number of projects for which it has been impossibleto specify, with any degree of certainty, the Category into which they fall. This has beendue to the incorryleteness of the information provided. Not only the category of projectevol-ution but also financial details are often lacking. For these reasons, and since onlyprojects with sufficient details, including cost estimates, could usefully form the basis ofany intelligent discussion, the projects presented in tabular form constitute only a portionor sample of the total number of projects which would have been included had the informoEionbeen coruplete, or reasonably so.
Conclusions based on the tables musE therefore be incomplete and subject to manyimportant reservations. Ihe corments which follow are intended to explain the informationpresented. This is particularly important since it is not possible to say in every case inwhich category a project properly belongs.
For all its incompleteness the information available indicates what would normally beexpected, namly, that in the Prograflme area as a whole the bulk of the projects lie in thedomain of agriculture and related activities (livestock) with road construction, transportand communications projects, agro-industrial projects, health projects and education projectsfol-lowing in that order. Itre greater number of the items appearing in the rrOtherfr cateloryconsists of studies of various kinds and in various stages tornrards coqletion.
The principal external financing sources in terms of the number of projects and studiesundertaken with their assistance are the United Nations Development prograrune, Ehe EuropeanDevelopment Fund and the French Aid and Cooperation Fund.
A. BENIN
There are no specific projects at this time for the oncho zone which is situated in thetwo northern Provinces of Atacora and Borgou, the planning for which is effected by theirrespective CARDER. Onchocerciasis vector control operations which started in June 1977 wiIlimprove the develoPment ProsPects of the oncho zone as well as the country as a whole.
Socioeconomic studies
Apart from the studies envisaged for financing under the reO/Bno merhodo logy, there areFrench consultingentitled5. The studiesc opinion surveys.
ongoing studies which have been undertaken for the province of Atacora by thefirm of Marcomer, and a report on the province of Borgou prepared by IRAT andDevelopment of Agriculture in the Borgou Provlnce was published in October 197for Atacora Province will include monographs, agriculEural inquiries and publi
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Other
L4
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Projects located in the Provinces of Atacora and Borgou for which cost details areavailable include three agricultural projects for rice and cotton production totalling12OO million CFA francs (one in Borgou Province and two in Atacora Province) ; four livestockprojects totalling 18OO million CFA francs, in operation or planned for L977 onwards; whil-e inEhe category of agro-industry comes a tomato paste factory at Natitingou involving an
investment of at least'l5O million CFA francs.
I\ro state enterprises occupy an important place in agricultural production: the Soci6t6Nationale des Fruits et L6gumes (SONAFEL) and the Soci6t6 Nationale dtlrrigation etdrAm6nagement Hydro-Agricole (SONIAH), both created in 1975. A third state enterPrise, the
Soci6t6 Nationale pour Ie D6veloppement de lrAgriculture is responsible for the Zou-Borgouproject for cultivation of cott.on and rice.
Responsibility for the development of livestock projects has been assigned to a staEeenterprise, the soci6t6 Nationale pour le D6velopPement des Ressources Animales (soDERA)'
In addition to the foregoing projects, a prograrrne of road improvement linked with thepromotion of tourism is projected. This will result in improvement of existing roads as wellas construction of rural roads.
The management of game and national parks constituEes an ongoing project financed by UNDP
up to 1979.
Natitingou and Malanville already appear as Potential development poles, the effectiveemergence of which will depend on, among other things, the creation of an effective road and
communications network.
planning for the development of the oncho zone will depend on Ehe outcome of basic studiesyet to be undertaken. These include a landsat study of resources financed by USAID, Ehe basicsocioeconomic studies for which UNDP has provided a total of US$ 5OO OOO, and cartographicstudies for which financing is to be obtained from the European Development Fund.
The European Development Fund, UNDP and the French Aid and Cooperati-on Fund
constitute important exEernal sources of project funding, as the following figures indicate,taking into account total amounts contribuEed by each source, including conEributions toprojects jointly financed by several sources.
Sources of Pro ect Fundi
Million CFA Francs
CIDAEuropean Development FundFrench Aid and Cooperation Fund (FAC)
IBRDNational Budget and other local sourcesUnited Nations Developrnent PrograruneUSAIDOther
1
3 063200
321 186
L62. s33. 3
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B. GHANA
Economic planning and development activities in the oncho zone of Ghana are noL new, forthey have been proceeding as far back as could be remembered, in tandem with similar activitiesin other parts of the country. What is new is that with the creation of the OnchocerciasisControl Prograrme (OCP) a special eryhasis has been put on the economic consequences of thedisease, on the necessity of its control and, consequently, on the Potential- for increaseddevelopment of the areas where the disease is brought under control. Thus the effectiveimpact of the OCP is likely to be an acceleration of the Pace of development in the oncho zone
of Ghana.
That part of the oncho zone of Ghana corrprised in the area of the Programne coversentirely, and is co-extensive with, Ehe countryrs Northern and Upper Regions.
In Ghana there have been, and are, development projects in and for the Northern and Upper
Regions but not developmenE projects specifically designed for its oncho zone, as such.
The development efforts of the Governmpnt have been supplemented in Inany ways by private,bilateral and internationat effort. In the bilateral field the chief agencies have been theaid agencies of the Federal Republic of Germany (Northern and Upper Regions) and Canada (Upper
Region). In the international arena, the World Bank (Upper Region) and the United NationsDevelopment Prograrnme (Northern and Upper Regions) have been most prominent.
Ihe Federal Republic of Germany, in partnership with the Governoent, introduced a
fertllizer project for rice cultivation in 1970 which expanded into other agricultural opera-tions and became known as the Ghanaian-German Agricultural Devel-opment Project. Itsactivities now include seed multiplication, ri.ce milling, bullock ploughing, construction ofsrnall dams, etc. Ihe Canadian International Development Agency (CIDA) is implerrenting a
project for the supply of drinking-water from boreholes drilled at locations throughout theUpper Region. Its prograrme calls for the construction of 25OO boreholes oPerated by hand-pu6ps, more than 14OO of which have been drilled Lt 1977. Ghana, like Benin and Upper Volta,will benefit from a landsaE study to be financed by the USAID under arrangements with theAfrican Development Bank.
Ihe oajor project of the World Bank is the Upper Region Agricultural Development Project,nord getting into gear (L977). It will provide agricultural inputs and services for thenajority of the 125 OOO farm fauilies of the Upper Region, suPPort to agricultural banking and
regional developrent institutions, farm extension information and planning services. The
United Nations Development Prograrrme has three ongoing Projects in the oncho zone which areconcerned, respecti.vely, with agricultural information, fruit and vegetable production, and
agricultural mechanization. Meanwhile, approval from UMP/New York is pending for the startof the socioeconomic studies which will provide basic information for better future planningof development in the two Regions.
Ihe bulk of the investpent inforoation obtained for Ghana relates to the annual budget
expenditures of the Governnent for the Northern and Upper Regions for the fiscal year L976f77.Consequently, the inforoation for Ghana rests on a seParate basis from that for the datarelating to the other six countries which have not been pro-raLed on an annual basis in theabsence of sufficient lnformation to enable this t.o be done.
Furthermore, given the nature of the Governnrentts budget expenditures which are made on
the basis of expenditure heads, rather than on a project basis, it is not possible to relatesuch expenditures to projects. Therefore, nothing can be said about the number of projectsinvolved.
ocPfEDufTT.rPage 18
The only project that can be discussed as such is the World Bank-Ghana Upper RegionAgricultural DevelopmenE Project which is planned to operate over a period of. 25 years. Inorder to rnake the figures unlform and comparable, the total investment for the Upper RegionAgricultural Development Project which is contributed by the Bank (US$ 21 rnillion), theGhana Government (uS$ 13.7 million), the United Kingdom (us$ 11 million) and Iocal banks(US$ 8.9 million) has been pro-rated on an annual basis in cedi equivalent (US$ I equalsCedi 1.15) to yield the foll-owing contributions in million cedis:
World Bank
Ghana Government
United Kingdom
Local banks
LO.4
3.7
L.6
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Financing Source
1.0IBRD
Ghana Government
UNDP
United Kingdom
Other (1ocaI banks)
Total
1.O
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0.5
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Thus the investment information available on the basis of Ehepresented by sector and by sources of finance as follows:
Sector i11ion Cedis )
Agricul- ture
Agricul tureLive s tockIrrigation
40
1
9
45.
Roads, transport,conununications
Health
Education and training
Other (studies)
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5
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0.5
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18.8 18.8
Although the necessary investment figure is not available except for the World Bank-GhanaGovernment Upper Region Agricultural Development Project it may be said with a fair amount ofcertainty that the three main projects which are like1y to affect significantly the futurepace of development in the oncho zone of Ghana are:
(a) Ihe Ghanaian-German Agricultural Development Project (Northern and Upper Regions),
(b) The Upper Region (CIDA) Water Development Project,
(c) The Upper Region Agricultural Development Project.
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C. IVORY COAST
Ot 23 Projects known to be located in the oncho zone of the Ivory Coast only 14 furnishsufficient inforrnation to permit their inclusion in the table which has been prepared. Theremaining nine consist of five agricultural projects, one agro-industrial project (a sugarcomplex) and three livestock projects.
The 14 projects for which sufficient inforsation is given comprise three animal feedingprojects, five agricultural and agro-pastoral projects, one fishery project and onereafforestation Project, all involving a total estimaLed investment of nearly 18 OOO millionCFA francs; two agro-industrial projects totalling 60 OOO million CFA francs, one healthproject for 15OO million CFA francs and one electricity project costing abouE L5 OOO millionCFA francs.
(a) t^ro agro-industrial Projects, the sugar complexes of Ferkess6dougou I and II, areexecuted by the Soci6t6 pour le D6veloppement des plantations des cannes d Sucre (SoDESUCRE)which uses the London-Rhodesia Company (LONRHO) as managing agent for Ferkess6dougou I, and theCanadian company, REDPATII (a subsidiary of Tate & Lyle) as managing agent for Ferkess6dougou II(or Badikaha).
Ferkess6dougou I is a ful1-scale socioeconomic venture comprising several 1evels: workersrhousing, schools, adult education classes, professional training, dispensaries and healthpersonnel, and piped water supply. By contrast, other than the construction of some workerslhousing, there are no social inputs into Ferkess6dougou II.
(b) The animal breeding projects are part of a plan to augment production of meat to satisfythe national requirements as well as with export prospects in view. Ihree projects areimportant in this regard: a ranch at Ferkess6dougou to be stocked with animals from Mali andUpper Volta, with by-products of sugar and cotton providing animal feed, and an abaEtoir forslaughtering the animals; establishment of cattle farms; and the creation of a sylvo-pastoral zone (wooded pastures) at Pa16 in norEh-r^rest Boundiali.
(c) Agricultural projects cover the production of cotton in the Northern Region, a seed farmat Badikaha, and irrigated rice production in the upper and middle Bou Va1ley; agro-pastoral-Projects are envisaged for the savanna areas of north-west Ivory Coast and centred around theLobi tribe; while in the Upper Lokpoho it is hoped to settle (rrsedentarizett) the Peulhs ascattle farrners in pl-ace of their traditional nomadic ways.
(d) Training of fishernen and fish farmers and a pilot reafforestation project in theDepartments of Korhogo and Odienne complete the projects in the primary sector.
(e) lJith the help of Canadian Technical Assistance it is planned to establish village well-sand improve health education in northern lvory Coast.
(f) A large investment of 15 OOO million CFA francs, shared equally by Canada and the IvoryCoast Government, will provide high tension transmission lines for the supply of electricityto northern Ivory Coast, with possibility of extension to Mali and Upper Volta.
The financing of Ehe investment in these projects, which totals around 94 OOO million CFAfrancs is contributed by various sources as follows:
owf wuf tt.tpage 21
Be lgiumCanada (crDA)Federal Republic of GermanyFrance (FAC)
IBRDNational BudgetUNDP
USAIDOther
9 agricultural projects11 livestock projects (including 4 studies)5 forestry projects6 agro-industrial projects6 road and transportation projectst hydro-electric project in the Upper Niger Va1ley
l1i1lion CFA Francs
IrL 448.2
165L9
7 31613 900
75359
60 970.8
Total 94 2s4
The I'Otherrrcategory is made up mostly of two sugar complexes involving investments of25 00O milLion CFA francs and 35 OOO million CFA francs for a total of 6O 0O0 million CFA francscontributed jointly by various sources.
Ivory Coast is unique among Ehe countries of the Prograrmre for its extensive use of Stateenterprises (mostly under the auspices of the Ministry of Agricutture) and rrmixedn enterprisesinvolving joint State and private capital.
The developrrent of the oncho zone of the Ivory Coast is set in Ehe context of a policyaiming at redressing regional disparities in favour of the NorEhern Region (containing theoncho zone) and it is fair to say that the process of development of the oncho zone is 1-ike1yto proceed fast and far in the Ivory Coast.
D. }4ALI
The oncho zone of Mali is an area already served by many projects mostly in the domain ofagricutture, anirnal breeding and agro-industry. About 30% of the total investment of justover 3O0 milliard l,IaLian Francs envisaged in the Eive Year Plan (1974-1978) is destined forthese sectors. Indeed, they occupy a place of the highest importance in regard to achievingEhe national objective of rneeting food requirements.
Information, including cost, is available for a relatively large number of projects in theMali oncho zone. Ihese projects are distributed among the various sectors as fol-lows:
MiLlion Malian Francs
4L7
1
7
1526
9465t4628962.4986ooo
These projects involve a total investment of 101 035 million Malian francs or approxiuntely50 518 million CFA francs. Ihe sources of finance contemplated are for the most part externaland largely unspecified because the sources have not yet been identifled or confirrred.
Mention rnay be rnade of the Mali Sud Agricul-tural Project being financed by the World BankEo the tune of US$ 15 million and by the European Development Fund in thi amount of 4600 millionMalian francs; and of the USAID-FAC project for an overall resource inventory the cost ofwhich is to be borne to the amount of US$ 2.1 million by USAID and US$ 1.1 million by theFrench Aid and Cooperation Fund (FAC). The resource inventory will facilitate the futureplanning of the I'Ialian oncho zone.
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Note: Acronyms used
RIC
BSIE
SODESUCRE:
IVORY COAST
SODEFEL:
SODEPRA:
SODERIZ:
SODEFOR:
FOREXI:
CIDT:
EECI:
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OCP:
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IBR.D:
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USAID:
FAC:
CCCE:
FRG:
KI1T:
Republic of Ivory Coast
Budget Sp6cial dtlnvestissement et d'Entreprise (Budget National)
Soci6t6 pour 1e D6veloppement des plantations de canne A sucre
Soci6t6 pour le D6veloppement des Fruits et L6gumes
Soci6t6 pour le D6veloppement des Productions Animales
Soci6t6 pour 1e D6veloppement de la Culture du Riz
Soci6t6 pour le D6veloppement des Eaux et ForBts
Soci6t6 (des fcrages) de CAte drrvoire
Compagnie Ivoirienne pour 1-e D6veloppement des Fibres Textiles
Energie Electrique de COte drlvoire
Service Autonome drHydraulique
Office National pour le Promotion Rurale
Fonds R6gionaux d rAm6nagement Ruraux
onchocerciasis control Prograrune in the Volta River Basin area
Economic Conrnunity for Cattle and Meat
United Nations Development Prograrmle
International Bank for ReconstrucEion and DeveloPment (World Bank)
Canadian International DeveloPment Agency
United States Agency for International Development
Funds for Aid and CooPeration
Caisse Centrale de Coop6ration Economique (France)
Federal RePublic of GermanY
Credit Institute for Devel-oPment (Federal Republic of Germany)
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(a) Among the iqortant agricultural projects, other than the project Mali Sud (itself alarge, integrated agro-pastoral project) are:
- Operation Riz-Mopti (F'M 33 milliard), a rice-production and animal breeding projectstarted Ln 1972 on a tripartite financing plan provided by the World Bankts IDA, FrenchTechnical Assistance (FAC) and Ehe I'ialian Governrent. It ai.ms at settled farmoperattons (rrsedentarizatlonrr) by a mixed population of l,la1inkas, Sarako16s, peulhs andBambaras, aided by extension and rnarketlng services.
- operatton Riz-Sikasso (Flt 4.5 milliard), an irrigated rice producti.on project, willbenefit from an expansidn of the cultivated area, and lts increased output is expectedtorsards the end of the Five Year Plan period, and beyond.
In the Upper Ntger Valley, between Bamako and the frontier with Guinea, a vari-edcropping systeln involving cotton, tobacco, groundnuts, cereals, frults and vegetableshas been established and i.ntegrated with aninal breedlng. In the Dogon plateau andthe Seno Plain, the Seno-Dogon Project was established in 1976 wi.Lh cereal productionand market gardening as principal activity aided by water from iryoundments. This isan area with a high prevalence of onchocerciasis and schistosomiasis.
- A sugar plantation at Sikasso.
(b) Livestock and dairy projects (other than that of the project Mali Sud, involving someFM 4.6 milliard) count the following among others:
- the Yanfolila Project for breeding selected NtDama stock, a l}-year project cosEingFlI 1 milliard;
- fattening grounds at Sikasso for cattle destined for exportation;- milk production projecrs in rhe Upper Valley to supply Bamako.
(c) Development of forest resources plays a role not only in supplying timber and fi.rewoodbut also in halting the spread of desertification. ltre principal projects are:
- forest classification and managen€nt projects at Sikasso and Mopti;
- forest managenEnt at Bamako and Sikasso.
(d) Agro-industry gives added value to agricultural producti.on in various forms:
- a tea factory at Farako;
- Preservation of fruits and vegetables at Sikasso and in the Upper Valley;- a vegetable oil factory at I'Iarkala.
(e) With the aim of integrating the economy of the country and promoting tourism a roadconstruction and iqroveoent prograrrp which will invest some t'M 16 milliard will benefit thefollowing secti.ons, among others:
- Bamako-Bougouni (156 km);
- S6var6-Koro (18O krn) to link Mopti and Ouahigouya in Upper Volta;- Sikasso-Koutiala (130 kn), a link to Ivory Coast;
- Sikasso-Kignan-DiotLa (255 km) linking Mali with Ivory Coast and Upper Volta, as well asproviding an evacuatlon route for agricultural products;
- Bougouni-Yanfolila-Kalana (135 kxo), linking Bougouni and Yanfolila, providing access roGuinea and to the gold mines at Kalana.
(f) A hydro-electric Project based on a barrage at 361ingu6 is the largest single project andw111 augrent the water and power resources of the country.
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E. NIGER
Only a comparatively small part of Niger, the Arrondissement de Say, which borders theright bank of Ehe Niger River and contains suny of its tributaries, is affected by Ehe scourgeof onchocerciasis. 0nchocerciasis vector control operations started in the rainy season of1977 .
Activities connected with the development of this area are sti1l at the study and planningstage. The essential studies and the master plan for the development of the Arrondissement deSay should be finally cornpleted by the middle of 1977 and a11 consequential arrangements nadeto initiate development actions by the end of L977 or the beginning of 1978 at the earliest.Meanwhile, the vari.ous Ministries most closely concerned are in the process of outlining andformulating specific development projects which would be suitable for the oncho zone.
The account which follows therefore sets out the current situation regarding the studiesand planning activities which have been undertaken to date.
A sum of US$ 5OO 0OO provided by UNDP for basic socioeconomic studies and surveys costingabout US$ 7OO OO0, the remaining US$ 2OO OOO to be conEributed by USAIn/Niamey.
Other projects of interest to the oncho zone are
(i) A United Nations Development Advisory Team (UNDAT) for the lJest African Region basedin Niamey which gives planning and development advice to the Government of Niger, amongothers, profiting from the experiences of neighbouring countries - Upper Volta, Togo, Benin
(ii)
(iii)
A UNDP/FAO project
A UMP/FAO aninral
for the establishment of a system of agricultural statistics.
trypanosomiasis control project (1976f77) in the oncho zone
Further details of the foregoing and other activities focused on the oncho zone and theprogress achieved are given in what follows.
The detailed planning of the Arrondissement de Say has involved the identification oftypes of projects:
(a) those covering the whole arrondissement (mostly infrastructure projects and resourcesurveys);
(b) those covering parts of the arrondisserent, the so-called I'zones dractionsconcentr6es" (ZAC). I
Projects (studies and surveys) covering the entire arrondissement are the following:
(1) photo-interpretation (already completed at a cost of US$ 170 OO0);
(2) sociological studies (conducted by the Institut de Rechgrche en Sciences Humaines
at a cost of US$ 71 OOO);
(3) hydro-geological studies and associated pedological studies in Goroubir/Tapoa and
forodir/Sirba zones (to be executed by USAID at a cost of US$ 600 OOO - estimated startingdate was beginning of 1977);
G) provision of an estirnated 100 we1ls by USAID due to start about Fiscal 1978
(October LgTTfsepcember 1978 - rough estimate of cost: US$ 5.5 million);
two
1 ""a".
renamed ,zones dtaction prioritairett (zAP).
ocefeouf tt.tpage 31
(5) Provision of volunteers by Netherlands Government to implerent pilot agriculturalprojects;
(6) Belgian aid estimated at around CFA 6 million for hydro-agricultural development ofthe Arrondissement de Say;
(7) West German Governrrent aid estimated at around CFA 6 million for hydro-pastoralnanagement of' the headwaters area of the Tiaguirir6;
(8) Islamic aid for establishment of an Islamic University of West Africa at Say. Ihisproject is being financed by the Arab countries. The first instalment of cost comes toabout US$ 1.50 mil-lion estirnated to be about 2O7" of the toEal project cost. Theuniversity,already under construction, is scheduled to corEnence operations in November 1977 and willincorporate several schools and faculties including an Institute of Languages (English,French, Arabic) and a Polytechnic Institute (engineering, hydraulics, economics, etc.).The university is the West African counterpart of a projected Tslamic University of EastA fri ca.
(9) other projects involve:(a) research and development of phosphate deposits in the ArrondissemenE de Say;
(b) experimental operations;(c) animation and extension work in Koulbou and Torodi.
For projects covering parts of the arrondissement, the latter has been divided up intoabout 6O micro-regions, the so-cal1ed Unit6s dtAnalyse et de Programmation (UAP) based onexisting government administrative sub-divisions, the Regroupements de Villages Anim6s (RVA)
which are groups of villages around a central village or pole used as a basic unit for provisionof services on an economic scale.
Three types of ZAC have been established
(i) settlement zones for establishing new populations;
(2) enclaves with great agricultural potential to be developed and integrated with therest of the economy;
(3) areas with special- resource endovrments - e.g., agricultural low1ands, areas suitablefor sugar plantations.
Supplementary UNDP oncho area studies
With USAID stePping in financially for the execut.ion of the hydro-geological and asso-ciated pedological studies, the UNDP funds thereby saved were rescheduled for suppl-ementarystudies related to the formulation of the naster plan for the Arrondissement de Say, as follows
1
2
3
4
Additional photo-inEerpretation studyTopographical surveysSociological studies (IRSH)Assistance to development of master plan(a) Resettlement (colonization) of 6O OO0population over 10 years(b) Local participation in plan execution(UUOAt offering advice on appropriate models)(c) Livestock survey(d) Survey of peasant attitudes towardsGovemment action in the development field
us$
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F. TOGO
Projects involving a total investmenE of 84 OOO million CFA francs are identified for theoncho zone of Togo. They fall into two categories:
(a) those already completed or in execution - numbering nine projects for a toLalinvestment of sooe 23 OOO million CFA francs, and
(b) those to be impl-emented under Togors current Third Development Plan covering theperiod 1976-1980 - that is, eight projects totalling some 61 OOO million CFA francs.
For the second category of projects at least 15 O0O million CFA francs is budgeted for under thePlan, that is, at least 6% of total Plan expenditure.
Taken all together, the bulk of the investmenE is directed to agricultural projects (nineprojects totalling some 57 OOO million CFA francs), and to livestock Projects (two projectsEotalling some 2OOO million CFA francs). A large rural electrification Project to be based onpower from the Kara (estirnated to cost 21 2OO million CFA francs), an industrial estate Project(724 ni-lrl-Lon CFA francs), a project for construction of 400 wells (1OOO million CFA francs) and
three health projects (1545 million CFA francs) make uP the rest.
Financing of the projects to be implemented under the Plan is predicated heavily on
external assistance the greater part of which, about 53 O0O million CFA francs, has yet to be
engaged. Smaller conrnitments totalling about 4OOO million CFA francs seem assured from theEuropean Development Fund, the French Aid and Cooperation Fund and UNDP. It is hoped tocontribute some 16 OOO million CFA francs from the national budget, or nearly one-quarter ofthe total project cost.
(1) culturaL ro e cts
(a) An important agricultural project concerrrs the three rural development settlementsof Northern Togo: Atalot6-ossacre, Boufa16 (Binah Va1ley) and Landa-Pozenda'
1'hese settlements are integrated agricultural projects giving an all-round emphasison agriculture, livestock, forestry and fishing activities. A total investnent of540 million CFA francs will be involved.
(b) .The developoent of the Kara Valley continues, with a Plan to spend a sum of 75O
miltion CFA francs in the period 1977-8L. In this period it is hoped to install 800
farm families in the vaIley for the cultivation of food croPs.
(c) Cultivation of cotton is to be extended in the Central, Kata and Savanes Regions.An investment of 75OO million CFA francs is envisaged.
(d) Extension of cultivation of food crops in these same three Regions will require an
investmenE of 10 516 million CFA francs.
(e) Tn the same three Regions fruit cultivation will be extended and will involve an
estimated investment of about 343 million CFA francs . In the Central Region a total of2185 ha will- be planted i-n cashew nuts, mangoes, citrus fruits, pineapples, bananas and
other fruits - usi.ng the system of large plantations. In the IGra Region large plantatj.onstotalling 15@ ha will also carry cashew nuts, citrus fruitsr mango€s' etc" while'in the Savanes Region, L69O ha of plantations wi1l. be planted in mangoes, ciErus and diversfruits. It is intended eventually to establish a cashew nut processing factory.
Associated with the development of the Kara Va11ey is a rural electrificati-on project which,with other developments, will cost some 2L 2OO million CFA francs, 6 million of which will be
for a dam to retain 48O m' of water in the Kara Valley and for the production and transPortationof electric power. The Project will supply power to the principal Eowns and villages in theKara and Central Regions.
ocef muf tt.rpage 35
(f) The Third Plan envisages the developrnent of the middle Oti Valley (food and cashcrops for 9522 milrlrion CFA francs), the valleys of the Binah and Patalou (rice for an
i.nvestment of TOOO million CFA francs), the Mo Plain (food and cash croPs for 11 830
million CFA francs) and the agro-industrial complex of Mandouri Plain (involving an invest-ment of 933O million CFA francs) - all after the control of onchocerciasis has been
achieved in these areas, that is, from abouL 1979. A11 of these activities will be basedon large plantations.
(2) Livestock pro iects
The creation of two ranches at Borgou (l-5 OOO head of cattle a year on 90 OOO ha of land)and Dako (5OOO head of cattle per year on 70 OOO ha of land) respectively in 1978 and L979 isintended to alleviate the insufficiency of meat, currently imported on the hoof from UpperVolta, Benin and Niger.
(3) Rural electrification
(4) He4Lth plo.jellr
Basic health services have been assisted by WHO in the Kara Region with funds provided byUNDP (USg 440 ooo). A 35o-bed hospital at Sokod6 (1200 million CFA francs) is envisagedunder the Third Plan, while urban water supplies will be extended at Sokod6 (125 million CFA
francs) and at Dapaon (110 million CFA francs). New hTater supplies will be provided for Mango,Lama-Kara and its environs, and at Niamtougou, Pagouda, Kende and K6tao - all in the CentralRegion.
G. UPPER VOLTA
Upper Vo1ta, the most afflicted of the countries of the Prograrmne, seerns to have attractedthe most external assistance for the developrnent of its oncho areas. Together with IvoryCoast and }Iali it was the scene of vigorous antivectorial activities aimed at curbing Ehe
Simulium f1y and pursued under a French-assisted programme for several years before the presenEOnchocerciasis Control Prograrmne was inaugurated. Also, like lvory Coast and Ma1i, UpperVolta has benefited from this head start.
Perhaps the most irnportant factor in attracting investment into the oncho zone of UpperVolta was the establishment of the Volta Va11ey Developrrent Authority (AVV) in September L974as the sole Authority responsible for the development of oncho-controlled areas in the valleysof the Volta rivers within well-defined perimeters.
The AW has been mostly engaged in promoting the establishment of smaIl farm settlementsof peasant producers under regulated conditi-ons in the controlled areas of the Red and WhiteVolta basins, and hopes to initiate andfor support such activities in the Black Volta Basin assoon as the necessary preparatory work has been completed and the basic infrasEructuralfacilities have been established.
ocefeouftt.rpage 36
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It'has been estlmated that 7OO 0OO people could be settled in the Volta Valleys inUpper Volta alone. Ihe AWfs plans call for the settlement of nearly this number of persons(650 OOO) in a 15-2O year period, as follows:
Area Numbers to be settled
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0n the whole, this means a total of 650 O0O people in 1OO0 viIlages, for an average of 650persons per village. It also inplies an annual settlenent rate of 43 OOO persons on a
l5-year basis, or 32 OO0 on a ?O-year basis.
The actual pace of settlement proceeds slowly, however, in the AW-sponsored settlementsalready established - an estimated 736 families (some 4-5OOO persons) settled in the period1973-L976, as cornpared to a figure estimated in excess of 8OO-900 families a year migratingspontaneously to the Black Volta Valley.
The experimental phase of the AW is nor^7 over (1976). While iE continues to operate oninterim financing from the French Aid and Cooperation Fund in the current year (1977 ) a team ofconsultants, BEI-AGRER, financed by the European Developrrent Fund of the European EconomicCommunity and with the assistance of specialists provided by USAID, is preparing a five-year development programrrc of activities and studies Eo be undertaken during the second phaseof the AW (1978-L982). This plan will contain proposals for the orientation of the activitiesof the AW.
Settlement activities and crop production by small peasants are only a Part (although, sofar, the most irryortant part) of the operations of the AW. Ihe Authority also has its sightson other types of activities of an agro-industrial and agro-pastoral nature. These include a
project for the development of traditional-style cattle ranches for smal1 livestock farmersl inthe White Volta Va1ley, afforestation projects at Wayen (also in the White Volta VaIIey)financed by the French Caisse Centrale de Coop6ration Economique; a Village Development Ftr,lnd
of USg 1 million (financed by USAID) for rnaking 75% gratEs to settlers in sorne 133 village1(the settlers putting up the asm.aining 25% of capital) to Promote the establishment of sorcl 2OO
income-generating enterprises decided upon by the settlers thenselves and incLuding thefollowing categories:
- motorized grain mills and peanut decorticators;
- breeding of poultry and smalt livestockl
- village consumer stores;
- artisan operations (bl-acksmithing, mason work, carPentry' etc. ) i
- village pharmacies.
There is also a project for a factory to manufacture animal drawn farm irnplements, a comPost
factory, a salt lick factory to supply salt licks for cattle, and for pl-antations of cashew
nuts and other fruit tree6.
Ihe AW is not the only statutory authority i.nvolved in the execution of development in the
oncho controlled areas of Upper Volta. Ihe technical ministries and departments also carry out
development activities, with both domestic and foreign financing in those Parts of the oncho
zone lying outside the valleys of Ehe Volta rivers and their tributaries.
oceflouftt.rpage 39
Projects identified in the oncho zone in general (including the projects being execrrEedby the AW) cover a wide range of activities. In a list of 56 projects totalling up to28 milliard CFA francs (1 ml1liard = 1OO0 million) agricultural projects constitute thelargest group (10 projects totalling 6 milliard CFA francs) followed by livestock projects(seven projects totalling 4 milliard CFA francs), and transport and conrnunications projects(two projects totalling 3.5 milliard CFA francs).
Excluding the'two Canadian financed projects, the bulk of investment support corrcsthe European Development Fund, France, the Netherlands, the Federal Republic of Germany,lJor1d Bank and the United States of America.
DE\ELOPMENT PROJECTS IN ONCHO ZONE OF UPPER VOLTA
SOURCES OF IN\IEST!4ENT FOR ONCHO ZONE PROJECTS IN T]PPER VOLTA
fromthe
Sec tors No. of projects Cost (Million CFA Francs)
AgricultureLivestockFores tryMiningIndustry (artisan)Industry (agro-industry, etc. )Education & IrainingHeal thWelIs, boreholes, barragesRoads, transport & connnunicationsOther
107
2
2
1
2
3
442
19
594Lt2
18. 3
848465
I
1
I3
8
190
855tt7 .515056051027 6.5
Iota 1 56 28 110.3
Source No. of projects Cost (Million CFA Francs)
CanadaEEC (EDT)
Federal Republic of GermanyFrance: FAC
cccEIBRDNe therlandsT]NDP
USA (AID , e rc. )
3
9
5
42
2
8
85
2 2009 2773 3202 656I 7982 5344 270
311L 744.3
28 110.3Total 56
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SECIION V
SOCIOECONO}fIC AND OI]TER ASPECTS OF DEVELOPMENT
OF THE ONCHOCERCIASIS ZONE
Ihe Onchocerci.asis Control Prograrmne is directed to the conquest in seven countries ofWest Africa of one of the six rnajor tropical diseases to which the World Health Organizationhas decided to devote particular attention. The other five diseases are malaria, leprosy,schi.stosomiasis, trypanosomiasis and leishmaniasis.
Ihe onchocerciasis prograflme is distinguished by its twin aspects of disease control anddevelopment of the area in which the disease transmission has been effectively interrupted.
1. Health impediments, other than onchocerciasis , to oncho zone development and the non-
i
I
economlc a spects of development
From the disease control point of view it is the hope that success in the OnchocerciasisControl Prograrme will open the way to a similar attack on the other tropical diseases. Fromthe develoPment angle, however, the original assr:mpt.ions may have been somewhat simplistic.First of all, the drift of the discussion of the disease control aspect left the clear impres-slon that onchocerciasis was the principal health obstacle to the development of the onchozone and that, once conquered, the road would Iie wide open to irmnediate (if not instant)development of the areas concerned. This, of course, is far from being the case for thereare, already, other diseases in the so-called oncho zone which are equally effective barriersto the development of the same areas, primarily trypanosomiasi.s, both anirnal and hurnan, butalso to a less extent schistosomiasisr mqlaria and leprosy.
Ihus, once one passes from oncho control to development the health hazard is seen tomultip1y. The development planner is faced not only with the necessity for continued controland surveillance of onchocerciasis, but also with the need to combat and control a range ofother diseases. Hopefully, of course, similar control campaigns could be mounted for theseother diseases. But the important thing to note is that effective control of onchocerci.asisleads to an i.ncreased, not a decreased, need for further health control measures.
This is particularly the case when one considers that the very act of implementingdevelopment, e.g. by the construction of dams and barrages, the incidence of not only oncho-cerciasis (through breeding sites created by spill-ways) but also of schi.stosomiasis, guinea-worm and hookworm could be increased. Thus development is apt to create new, or intensifyexisting, health hazards.
Another simplistic approach in the original discussi-on was to think of developmentprimarily in terms of economic devel-opmenE rather than in terms of the entire gamut ofdevelopment facets - economic as wel-I as non-economic. The very idea of colonizatlon orresettlement which has been considered as one possible approach to the development of theoncho-controlled areas is replete with as rnElny, if not more, non-economic as economic aspects,e.g., investment in health and other social infrastructure (clinics, maternity and child healthcentres, schools, corununity centres, etc.), provision of \^rater, roads, and so on, besidesproduction of food and cash crops. In fact there is likely to be a prior demand for foodeven before the settlers could begin to produce it.
Apart from the tendency to over-rate the importance of onchocerciasis as an obstacle tothe development of the oncho zorLe - albeit an effective obstacle and more difficult to copewith than the other health hazards - and the simplistic approach to the concept of development,there are several other problems which coure to Ehe fore as further thought is given to theiurplications and ramifications of the development of the oncho zone.
ocefnouftt.rpage 51
2. Return of population from the plateaux to the valleys
Ihere has been, from the start of the Onchocerciasis Control Progranrne, an implicitassumption that control of the blackfly would enable the popul-ation thaE escaped from theaffected valleys to the surrounding plateaux to return. Indeed, it has been argued at thesame time that the oncho blind and those seriously weakened by the disease ruay be counted outas incapable of undertaking any further agricultural pursuits, so that the controlled area isreally for the behefit of those who are not tainted by the disease, or only slightly so.(There may be an exception here to the extent that institutions for the oncho blind and thoseblind from other causes may be able to train these disabled persons for agricultural pursuits. )
Another implicit assumption has been that, with the tainted population removed, the fociof infection which would otherwise threaten the settlers coming from non-oncho-endemic areaswould also be removed.
It is important to bring these assumptions out into the open as there is a historicparalle1- here to the case of slum clearance for low-cost housing projects. In theory, slumsare cleared to make way for 1ow-cost housing for the (temporarily) displaced persons. Inpractice the beneficiaries are often all but Ehose who were intended to benefit from the slumcl-earance and new housing Project. So is it likely to be with resettlement projects in theoncho zone.
Consequently, in so far as the oncho affected population is concerned, the presentProgramne can only become relevant to their needs when it becomes possible to treat Ehem bythe discovery and use of a drug suitable for mass chemotherapy.
3. Overall resource planni n8
The facile assumption that, with the interruption of disease transmission in the onchoareas, all the land not foruerly utilized becomes automatically available for development isnot entirely eorrect because it loses sight of the conservation aspects of development. Itis true that resource i.nvenLory and surveys have been built into Ehe conception and overalldesign of the development of the oncho zone. But until the results of the surveys are in -and even before then - it is necessary to keep in mind that, in the interest of resourceconservation, a good part of the land available should not be used and a considerable part inwatershed areas would have to be imnobilized for water conservation purposes, for afforesEationand reafforestation in order to promote soil as well as water conservation. Furthermore,some of the land made available ur,ay not be suitable for agriculture because of poor soil andlack of water.
Even the requirements of certain types of development, such as tourism dictate that agood and suitable amount of land be irmobilized as national parks rather than sacrificed toagricultural or industrial expl-oitation.
Ihese are some of the important considerati.ons of overall resource planning and use whichmay make necessary, sooner or Iater, an urgent review and reassessment of existing and proposeddevelopment plans for the oncho zone.
4. Built-in social components in develop ment pro iects
A very effective aid to the devising of development projects responsive to cormunity needsconsists in an assessment of the Projectrs environmental impact. Thus the health hazards frombarrages could be minimized where possible by the construction of ponds exclusively forwatering animals and agricultural uses, and dams exclusively for water for drinkinl ana otherdomestic uses- Thus it may be necessary to construct several instead of a single barrage tominimize the hazards ' or one big dam with overflow feeding into an underground reservoir fromwhich water could be pumped for domestic use while the surface reservoi.r may provide water forfish farming and for generating electricity.
ocPfLDufTT.LPaee 52
Similarly, hydro-electric projects should include in their planning the necessary invqsti-gations and plans for the settlement of populations displaced by flooding. Such advancedlsocial planning is seldom encountered in this type of project. The cost of the investigationsand the settlement properly count as a part of the cost of construction of the project andmakes it possible to avoid hasty, i11-conceived and eventually more costly settlement projectswhich are likely to end in disaster and r^raste of public funds.
Cases exist in the Programne area where large agro-industrial complexes have beencreated without a thought for the social amenities - housing, schools, dispensaries, clinics,etc. - required for the labour force which would be recruited. With the passage of time theabsence of these ameni.ties, unless provided by the State, is likely to generate adverse reper-cussions on the projectrs operations: disaffection among the labour force, labour disputesand strikes regarding working conditions. The actual and potential loss of production couldbe sufficiently large to have warranted a social irnpact study of the project from the outset,and consequent inclusion of the needed social components in its design.
5. Forrnal and non-formal education tions for oncho zone devel t
The issue of education options is not confined to the oncho zone. It has also arisen inconnexion with the Sahelian zone where the way of life of the nomad population makes irrelevantthe conventional concePt of the fixed-locati.on school-house. Its relevance to the oncho zonecomes from the demands mrde upon the time of the rural population by agricultural activitlesand animal husbandry. These activities involve not only the men but also the women andchildren, according to the demands of the season, the crops and the anim"ls. In addition,the women and girls have added responsibilities looking after the domestic welfare of thefamily - fetching wood and water and preparing rneals.
A11 these activities are apt to leave little time for the education of girls and womenand, depending on the season, may pre-empt time which would normally be spent in school.Therefore it is considered by some scholars that the required solution is to adapt the method,content and system of education to the l-ife and activities of the people, rather than thepeople to the requi.rements of the conventional type of education. This is one possibililty,but there is another related to the technological aspect of development. I
6. Appropriate technology i
As is so often the case, the effective solution to a given problem is not the obvioJsone, nor is it achieved by a frontal attack but by indirecEion. The educational problem, forexample, is seen to be a question of availability (or non-availability) of time in which'topursue an educaEion in a rural environment. It would seem, Eherefore, in the case of Elfe
education of women and girls, that lightening the domestic workload of women and girls inregard to fetching wood and water and preparing meals would leave them more tine in whicli totake care of the children and engage in other social pursuiEs, including obtaining literacyand an education.
Similarly, improved siryle agricultural technology - bullock-drawn ploughs, cooperativeuse of mechanized implements for land preparation, eLc. - could lessen the dernands on thetime of the children leaving them some to devote to schooling.
There are mrny other areas in which application of appropriate technology could promotethe development of the oncho zone: simple hand-operated or mechanized grain nil1s1 dorresticwaLer storage systems; sinrple, cheap but effective granaries which cut down,on loss frominsects and rodentsl simple crop drylng and food preservation devices; unglazed earthenwarerilater filters; sirnple and sanitary latrine and garbage disposal systems - the list isextensive. These are alL mrtters to be considered ln the development process.
ocef muf tt.tpage 53
7 Inter-State cooperation amone beneficiary countri.es of the Programne area
The development aspects of the Onchocerciasis ConErol Prograurne often underline thenecessity for close collaboration and cooperation among members of the Progranune. This isessentially the case in at least two iEportant areas:
(i) intercountry movement of population in response to development opportunities(e.g. as between Mali and Upper Volta, on the one hand, and Ivory Coast, on the other);
(ii) cattle development projects and trade in cattle.
Ihe first case calls for cooperation in the supply and reception of migranE labour andin assuring them proper and adequate economic and social condj.tions of work. This shows thatdevelopment of the oncho zone cannot be regarded as strictly a national problem for eachcountry.
The same conclusion arises in the case of development and Erade in cattle in so far asthis involves movements of the aniuals across frontiers for both breeding and purposes oftrade. Here, also, cooperation is required among the veterinary services of the countriesconcerned in order to effectively control the incidence and spread of cattle diseases.
8. Inter-organizational c ation
The Onchocerciasis Control Programne is not the only organization working within theconfines of its own perirneter. Very often, its control activities have implications for theprogranrmes of other organizations (e.g. the development of ranches in oncho controlled areasby the Communaut6 Economique du 86tail et de Ia Viande). Similarly, its development functionsmay overlap with the develoPnent objectives of the Inter-State Conrnittee for Drought Control inthe Sahe1. This overlapping of interests and functions makes desirable and necessary theclosest possible cooperation between the Prograrme and other regional orgatizations workingin the same or adjacent areas.
I\uo very iryortant cases of interest to the Prograrme where such cooperation is imperativemay be cited.
(a) Misration and settlement in the oncho z€ne as a relief to populaEion p ressure in thedrought- s Eri cken areas of the Sahel
In those countries of the Prograrnnre which fall partly or mainly in the Sahelian zone _Ma1i, Upper Volta and Niger - the areas to be rendered safe from onchocerciasis are likely tobe regarded, in the short- and mediurrterm, as an i-mportant part of the solution of theSahelian drought problem since the oncho zone is usually well watered and can thereforeprovide both food and habitation for the suffering population victimized by the drought.
rhe likelihood therefore arises that developmenE of the oncho zone rnEly be viewed not asa sectional sol-ution to the problems of the oncho-affected population or of those borderingon the oncho areas, but as a solution within a national context to the problems of populationfrom disadvantaged parts of the country.
Ihis situation merely underlines the need for close and effective cooperation betweenthe Prograrmre and the rnter-state Qsmmillss for Drought control in the sahel (crlss). Thiscooperation lllay take the form of periodic consultation and exchange of informrtion, but itcan also be institutionalized in the form of mutual representation on their respectiveconsultative organs.
ocefrorftt.rpage 54.
(b) Large-scale dam construction and its impact on onchocerciasis control and deve Iopmentoperations
A similar situation arises, in another connexion, with the Niger River Commission whichis engaged in studies that may lead to the construction of dams along the river for impoundingwater for the generation of electricity and for agricultural and industrial development. Tothe extent that the construction of dams mry drown some existing Simulium sites along theNiger River, and the altered water leveI and flow nay give rise to Simulium breeding sites atother points along it, close collaboration is also necessary between the Progranrne and theRiver Niger Connnission.
SECTION VI
SELECTED TOPICS FOR INVESTIGATTON
In the light of the experi.ences acquired to date and of observations made in the courseof visits in the Prograrune area certain topics suggest themselves as priority candidates forinvestigative studies.
1. Demographic evolution, population distribution and labour migration within and betweencountries of the Onchocerciasis Control Programme
The development of the oncho zone is not always a matter completely within Ehe nationaljurisdiction, and in the case of emigrant labour call-s for inter-State cooperation betweenthe sending and receiving countries in order to ensure orderly movements of labour, andprotection of the economic and social rights of the migrant worker.
The proposed study will bring together the facts relating to demographic evolution,population distribution and labour migration within and between countries of the Progranrnearea, as well as demonstrate the relati.onships among all these factors.
2. A cornparative study of settlement projects in the Programme area
Inevitably, one of the consequences of effective oncho control measures in areas whichhad previously been abandoned because of the disease is the establishment or re-establishmentof hurnan settlements, whether planned or spontaneous. Such settlements already exist in theoncho zones or oncho controlled zones of some of the countries of the Progranme area. InUpper Volta there are the AW settlements; in Ghana the Damongo Settlement Project, the Tono
Settlement Project, the Navrongo Settlement Project, and others which may yet develop underthe countryrs National Reconstruct,ion Corps programe; in Togo there is the la Kara SettlementProject, and in Niger a proposal to establish settlements in the oncho controlled zone. The
number of such settlements is 1ikely to increase in the future.
There are also what have been called rrreservoir settlementsrr, that is forced displacementand resettlement of population in new areas as a result of large-scale hydro-electric projectsinvolving extensive flooding of previously inhabited areas for the PurPose of creating theirreservoirs or man-made 1akes. Thus the Volta reservoir settlement in Ghana resulEed from thecreation of the Volta Lake, the largesL rnan-made 1ake in the world and its accompanying hydro-electric project. Similar reservoir settlements are like1y to be created in the Progranune
area and may be envisaged for the Mono River (Togo and Benin), the Black Volta at Noumbiel(Upper Volta) and at Bui (Ghana), the Niger River (Niger and Mali).
ocef wuf tt.rpage 55
Such man-made takes, whether on the scale of the Volta Lake or 1ess, have biological andsocial effects apart from the enforced resettlement of the population whose lands are flooded.A1so, the cost of the reservoir settlements - both the cost of investigation and establishmentof the settlement - should figure, ideal-ly, in the cost of the hydro-electric projects to be
constructed. This, however, is seldom the case, and reservoir settlements have tended, as a
ruIe, to be hastily conceived and badly executed projects.
The number of such settlements, both reservoir and other, is likely to increase and playa significant role in the future development of the oncho controlled zone. Yet little isknown, so far, of the experiences involved in their creati.on, their relative costs and mode
of establishment, their respective advantages and disadvantages, their usefulness and limita-tions as models for replication. The time seems, therefore, appropriate for an attemPt ata comparative study of settlement projects in the oncho zone with a view to documenting, andprofiting from, past experiences of failure and, if at all, success.
3. Cost-effective health delivery systems for the oncho zone
Closely related to the problem of effective low-cost settlements is that of cost-effectivehealth delivery systems for the oncho zone. For many reasons, including 1ow-density use ofhealth facilities in rural as compared to urban areas, health as well as other social infra-structure for rural areas are rather high-investment operations. Tt is doubtful wheEher, inthe ci-rcumstances, such infrastructure can ever be cheaply constructed. What is thereforemore to the point is that lt should be cost-effective, whatever the system devised.
4. Socioeconomic effects and implications of d extensions of the current limits ofthe Onchocerci-asis Control Prograrmne
A prelirninary study of the implications of extensions of the current limits of thePrograrnme area in entomological, epidemiological and socioeconomic terms has already beenprepared. The socioeconomic aspects will be further explored, accordingly.
s15 Appropria te alternative strate es for devel nt of the oncho zone taken in the conEextof the overall national devel oDmen to Dl ectives and policies of the respective countriesof Ehe Prograrmne area
There is continuing discussion of the appropriate strategy for the development of theoncho control-1ed zor.e, a discussion initiated by the Preparatory Assistance Mission toGovernme nts.
Differences of opinion still seem to persist in regard to the appropriate strategy to beadopted, differences which experience shows to be prirnarily due to a lack of clarificat.ion ofthe nature and implications of alternative strategies.
Apart from this consideration it i-s necessary to set Ehe development of the oneho zonewithin the context of overall national devel-opment objectives and policies since the signifi-cance of the section of national territory included in the Progranrne varies partly with (butnot necessarily in proportion to) its extent and partly with the role assigned to the sectionin the national development perspective. This, in turn, has different implications andconsequences for development assistance required by each country in respect of its oncho zone
6 Appropria Ee technol for oncho zone developnrent. i ncludi ns asro- industrial technoloevand simple technoloei es for providins clean. potab le water from surface water resourcesespeciallv with a view to lightening the workload of women in rural areas and increasingtheir contribution to development
The pressing problems connected with the development process are ofEen both complicatedand interrelated. Ihe development problems of the oncho zone are no exception. Womenrseducation in rural areas is a case in point. It is well known that the range and quality ofthe educational opportunities available to rural women leaves much to be desired and thusrestricts the scope of the contribution which they are potentially capable of rnking to the
,
ocYf wuf tt.rpage 56
development process. Ihe gravity of the problem is easily recognized when it is consideredthat, in general, women constitute at leasE one-half (sometimes more) of the total populationin most cormnunities. Thus the problem assumes pressing significance, especially in caseswhere new cortrnunities have to be established in the oncho controlled zone.
YeE, as is well known, a frontal attack on the problem of womenrs education is likely toresult in frustration and failure to inprove their educational status. This is because thebasic inhibiting factors with which the problem is inEerrelaEed and complicated are less thoseof availability of education for women than of availabillty of time in which to pursue it.Ihus, it is well known that in most rural cormnunities women spend up to perhaps half the dayin exhausting toil fetching wood and water, preparing grain for the family mea1, besides timespent in season on the farms. This leaves very little time in which to pursue an education.It follows, therefore, that an important approach to the release of time for womenrs educationas well as oEher woments activities is the rather indirect and roundabout one of lighteningtheir dooestic chores by appropriate technology, thereby releasing more time for other pursuits.
7 Integration of women into the deve lopment process in the oncho zone
While rural men could undeniably argue that rural uTomen are already effectively integratedin the economic activities of the rural cormunity, the real point at issue is whether or notwomen (as indeed the mass of the population, as well) play any effectiv.e role in the decision-making processes relating to development. It is a fact that women are not always consulted,let alone intimately involved in the decision-m:king processes for example in the siting andconstruction of schools, clinics, dispensaries; in the organization and contenE of adulteducation classes, and so on.
A study such as in here proposed will investigate methods of effectively integratingwomen at all levels of decision-making and consequently into the subsequent developmentactivities.
8. Pilot project in the efficacy of appropriate technologies and Protective clothing as a
means of reducing the incidence of onchocerciasis
The approach adopted by the Onchocerciasis Control Prograrune is one of area developrentthrough disease control using biomedical technology. This, however, leaves room for thecoroplementary approach of disease control- through development. This approach seeks toinvestigate specific opportunities for socioeconomic interventions which rny alter the life-style and the relationship of people to water and water-relaEed diseases, thereby leading tomore effective control of such diseases.
In this connexion the use of clothing ana appropriate technologies as a means of reducingthe incidence of onchocerciasis will be investigated and field-tested, in close collaborationwith the Socio-economic Working Group of WHOrs Special Prograrune for Research and Training inTropical Diseases.
9. Viable alte rnative approaches to low- cost settlement proiects for the oncho zone
including relevant low-cost housing technolosies
While much has been written about the desirability of establishing settlements in theoncho zone, not much is known and documented about the costs of such settlements excePt thatthey invariably turn out to be more costly than was at first estirnated. These unexpectedlyhigh costs irnpose a severe limit on the extent to which they can be widely adopted. In orderthat the settlement concept be widely adopted, especially i.n cases where population Pressurehas to be relieved at the same time by Eaking on the overflow from areas outside the oncho
zo11e, a very wide range of low-cost alternatives must be available. Ihe comparative study ofsettlement projects in the oncho zone should contribuEe much to this investigation but it willnot necessarily be oriented to the 1ow-cost alternative asPect. Here also 1ow-cost housing
technologies appropriate to the oncho zone will be investigated, taking into fu11 account thework of the Centre for Housing of the united Nations and the results and foll-ow-up activitiesof the United Nations Conference on Human SettleflEnts.
10
ocef wuf tt.tPage 57
Rehabilitation and training opportunities for the oncho blind with special reference toopportunities within the ProgrannE area
It is true that the traditional extended family arrangements, obligations and responsibi-lities currently provide for the care of the oncho bIind. It is also Erue that thisindigenous wetfare system does nothing but increase the dependency status of the blind or, inmany cases, convert them into mendicants on their oqrn account or on the account of others.
Ihe aim of the proposed study is to investigate training and employment opportunities forblind people within the Progrartrne area, taking account of sinilar opportunities elsewhere, andhow the existing opportunities could be expanded to serve the needs,of the oncho blind foremployment, income and independence.
11. Non-formal education options cor@a tible with the agricultural development of Ehe onchozone
Current efforts in bringing education to the inhabitants of the oncho zone are largelyconfined to formal adult literacy classes and instructions in the care and feeding of infantsand, for the children, sone version of the conventional offerings made available under theformal education system. Ihe need for more effective approaches to the education of bothadults and children and youth in the oncho zone - taking account of the wide contrast betweenthe life-stytes of settled farmers and nomodic herdsmen - presents a challenge not only toeducationists, but also to economists, social workers, nuEritionj.sts, technologists and others.
It is therefore relevant to consider not only the wide range of inputs which may berequired in order to devise an effective system of education appropriate boEh to Ehe onchozone and the contiguous Sahelian zone but also whether and to what extent it may be necessaryto satisfy the need for education and training by inserting an education and training cotrponentinto each activity being carried out; in short, whether the activity rmy not become simul-taneously the vehicle as well as the content of the education and training effort required inthe oncho-Sahelian zone.
Ihis and other non-forn,1 educational approaches compatible with the development of theoncho-sahelian zone will constitute the objective of the proposed study.
L2. Aero- industrial opportunities wi thin the oncho zone
A paper already presented by FAO to the Second Meeting of the Economi c DevelopmentAdvisory Panel of the Progranme sumnarizes the present state of knowledge and activity relatingto agro-industry in the oncho zone. It is intended with the collaboration of FAO and UNICEFto continue the study of the topic in greater detail boEh in the realm of food processingtechnology and in other, non-food, aspects of agro-industry.
13. Availability and effectiveness of agricultura 1 credit and marketing facilities
Another prelininary PaPer presented by FAO to the Second l,Ieeting of the EconomicDevelopment Advisory Panel of the Progranrme examines the agricultural credit facilitiesavailable to farmers in the oncho zone. While the subject will be kept under review it isproposed to link it with an examinaEion of agricultural marketing facilities in the prograrmearea since the two topics are very closely related, and because agricultural merksgingfacilities are essential to the success of agricultural- credit.
ocPfEDvfTT.r
Page 58
14. .Involvement of local popul ation in onchocerciasis contro l !"d oncho zone development
Ihe success of any Pro8rarme of disease control depends on the support which it obtainsfrom Ehe affected population and this, in Lurn, on the degree of involvement of that populationin all asPects of the campaign. Areas of involverrent which may be cited as examples arepopular participation in the destruction of Simulium breeding sites; publicity and informationabout the progress of the antivectorial
".rp"S-ind the location, type ana extent of areaswhich have come under control; measures of protection which may be taken to ward off thebites of the Simulium fIy.
It is proposed to launch a study of the various ways in which the local population couldeffectively participate in the conduct of onchocerciasis control operati.ons as well as in thedevelopment of controlled areas. This will involve an examination of appropriate mechanismswhich could usefully be employed.
15. Requirements and costs of energy for processinq industri.es in the oncho zone
The oncho zone located in the Volta River Valley Basin is an area with a considerablePotential in water Power resources but also subject to the unpredictable fluctuations in bothprecipitation and river f1ow. Furthermore, the zone tends to share to some extent in theperiodic drought conditions which afflict the Sahel and certainly in the consequences. Atthe present time the oncho-Sahelian zone is short of power for processing and other industries -a situation dernanding a close look at water as well as alternative power sources, such assolar energy, and their availability within the time perspective of the progranune.
16. A series of Iora to seminars to be or nized on the tnain ics selected forial studies the USAID ional Onchocerciasis Area Plann Pro ecL
The roundabout or serendipitous approach to progress is seen to be at the heart of allhum'n, social and ecological problems. Progress comes about through rnarginal changes ordisplacerrents in related problems and variables, not through drastic changes or frontalattack on the main and obvious problem.
It follows, therefore, from this central fact that it is necessary to identify correctlyancillary problems or variables which should be dealt with in achieving solutions to the ulainand pressing problem. Experience also teaches that, discussion seminars and roundtablesessions are effective methods of identifying correctly the issues on which to concentrate.
The seminar approach is therefore reconmended as a means of identifying those studiescapable of leading to innovative solutions to cormon probl-ems and suitable for generalapplication in the oncho zone. Such seminar discussions invotving exchange of viewpoints andexperiences by those most closely connected with the problems should help determine whether thetopics selected coul-d usefully be retained in their original form, modified or replaced bymore relevant formulations capable of leading to effective solutions. The same approach isapplicable to the other topics itemized in this Section.
oef eouf tt.rpage 59
ANNEX I
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ANNEX II
ORIGII'IAL: FRENCH
MIO ONCIIOCERCIASIS CONTROL PROGRAMME
IN I]IIE VOLTA RIVER BASIN
SOME CONSIDERATIONS OF TI{E HEALTII AND SOCIAL FACTORS
AFFECIING DEVELOPMENT IN TIIE OCP ZONE
INlts.ODUCTION
Ihe abbreviation OCP (- Onchocerciasis Control Prograuune) designates the programne forthe control of onchocerciasis in the Volta River Basin area. This prograrure, for which WHO
is the Executing Agency and with which UNDP, the World Bank and FAO are associated, was decidedupon in 1970 at the request of seven West African governments, those of Dahomey (now Benin),Ghana, Ivory Coast, Mali, Niger, Togo and Upper Volta. It has been in operation since thebeginning of L975.
In the period between the initial deeieion and the beginning of field operations a
Preparatory Assistance to Governrents Mission (PAG) did extensive work with a twofoldobjective: rrln the health sector, it was requested to prepare a plan of work to achievecontrol of onchocerciasis over the entire reconmended project zone, taking i.nto account economicdevelopment of reclaimed areas, to work out the expected costs and benefits of the scherne andto determine the possible financial resources available. In the economic sector, the Missionwas later calIed upon to identify areas within the project zone which, owing to their economicpotential and locaEion in relatj.on to centres of population density, offered developmentpossibilities; iE was requested also to draft preliminary terms of reference for feasibilltystudies to be conducted later in these areas. t'I
UnderstandabLy at the time the report confined the I'health pIan" to determination of a
strategy for onchocerciasis control and therrdevelopnent possibilitiesrrto those of theeconomic progress that would open up for certain regj.ons in the OCP area.
Six years Later2 the problems of health and development characterizing the programme zone
are worth formulaEing in a less restrictive manner. In other words it would be nai.ve todayto imagine that OCP, by carrying out_technical supervision for 20 years over the destrucEionof blackfly in an area of 7OO OOO km2 (soon to be extended), will have done enough for publichealth. It would be no less an over-simplification to believe that the 10 or 12 millionpeople inhabitlng the area are certain to benefit from the sectoriat studies conducted, and tobe conducted in the futurerby numerous foreign economists and engineers under the auspices ofthe international agencies invol-ved in the Prograrnme.
The health of a population, and more generally its development, depend on factors and
resources that are neither strictly technical nor strictly economic. This paper ls designedas a corurentdry on this siryle obvious fact.
1. HEALfiI FACIORS
Each of the present goverilnents has set up a ministry of health, which uses certain means
to extend its activities to the whole of the country. A knowledge of these means is important,because the way in which they interact determlnes a series of factors that have to be takeni.nto account. However, these are not the only factors: ecology, dieteticsr-hygiene andpreventive care go far beyond the scope of any individual governmenE department.
1' PAG Report, Geneva, August 1973, p.3.
' ,O" teros of reference of the Preparatory Assistance Eo Governments I'lission were drawnup in July 1970 (cf. PAG Report, Geneva 1973, Annex O-1).
ocYfnouftt.rpage 69
Annex II
1.1 Problems of i.nfrastructure and staff
At a time when the OCP is reaching its full geographical extent the Second DevelopmentDecade is entering upon its last Ehree years. The time has certainly corne to review thefunctioning of the health services in the seven States covered by the Progranrne.Unfortunately, such a review cannot be glven in the following paragraphs because Ehere has been
no centre in OCP to collect the necessary inforrnation. If the information is to be usable iEshould be concerned with both quantitative and qualitative asPects. The following matterscould then be considered and followed up.'
(a) Central and regional structures of the various national minisEries of health
A fact that must certainly be taken into account is the fairly wide variety of orgarriza-tional structures that exist. These structures must be known and any changes in them mustbe noted as they occur.
(b) Facilities
It would be worthwhlle plotting the number and spatial distribution of health establish-ments (hospitals, clinics, maternj.ty homes, health centres, beds available, etc.) on a map andjust as a map conposed of views from the air must be cornpleted on the ground, so a oap ofhealth establ-ishments requiresrrfieldrrdata to supplement those available in ministries andadministrative departments. fn a work published by Dr J. Bryant in 1969,2 fo, exarple, thereis a table on page 305 showing rrMedical facilities provided by church-related hospitals andclinics" in six African States. Facts of this kind are iflportant and it is not certain thatthey are always taken into account in official statj.stics. Horrever, to gain sorc knoreledgeof the real situation it is worthwhile listing the services provided by nongovernmentalorganizations (NGO).
(c ) I"Laintenance
The case of a hospital which has (or used to have) an aEtractive exterior, where thedifferent departments correspond to a rational design, but where maintenance and operationLeave a dreadful lot to be desired - or were not even provided for - is unfortunately no figmentof the imagination. Nevertheless, it is clearly irnpossible to define a strategy for healthwithout a knowledge of the volume and utilization of existing operational budgets, whether iEis a question of the maintenance of equipment and depreciation allowances or of the pharma-ceutical supply and distribution system.
(d) Personnel
On this point, in particular, statistical information represents a first stage - a neces-sary one but not in itself sufficient to reach dorm to Ehe real facts. For exaqle, an OCP
PreParatory p"p..3 mentions Ehat in 1971 there was one midwife per 21 600 inhabitants in theIvory Coast.
1 In the case of Upper Volta, Mali and Niger, these matters were dealt with recently in adraft document prepared by a conrnittee of the rrHurnan resources'r team of the Club des Amis duSahel"Ilurna
e u informatif sur sant6-eau-nutrition dans les s du Sahel, plenary meeting of theThis study led then resourcesrr team, Dakar, 28-31 I'larch L977, 72 pages, duplicated
following month to a Lechnical review prepared by the same conrnittee: El6ments de strat6giesant6 -eau-nutrition dans Ie cadre drun devel nt socio-6conomiq ue harmonieux des pays duSahel, Ouagadougou, CILSS, Club des Amis du Sahel, 25 April L977,70 pages, duplicated.
2 r. rohn Bryant, Health and the developing world, Cornell University Press, Ithaca andLondonr 1969.
3 L. J. Charles, Onchocerciasis Control Pro-ject in the Volta Rj.ver Basin area Existinshealth programDes and infrastructures in the seven countries concerned and possible future plans
On Accr 72.3 (Lo pp.mim. ).uatel take account of the iruninent ain the health field which would
oef wuf tt 1
page 70
Annex II
First of all, hovrever, this figure is put in a peculiar light when it is conPared with thefollowing table drawn up on the basis of data for 1969, when the Ivory Coast had "an averaget'of one midwife per 27 3OO inhabitants.
DisEribution of midwives in the Ivory Coast (L969)9
Region Population Hosp i ta 1
medicineSocia 1
medicine!0ne
midwife per
South (exceptAbidjan)
CenEre
North
Eas t
West
Centre-We s t
Abidj an
872 900
L 222 600
768 000
31r 100
530 000
413 300
489 200
L7
24
6
9
4
L2
65
o
0
1
o
o
o
31
51 3sO
50 900
109 700
34 600
132 500
34 400
5 100
g Figrr."" extracEed from: Etude sur les moyens de la Sant6Publique, analyse de 1969, Republic of the Ivory Coast, llinistry ofPublic Health and Population, SAPS, Abidjan.
! ,rU"n as a whole (= doctors * pharmacists + dentists * midwives+ nurses * paramedical personnel + administrative staff + sundryothers), the document quoted indicates that there are 3.1 personsemployed in hospital medicine for everyone employed in social medlcine.It may also be noted that the city of Abidjan, which at the time con-tained LO% of the total population of the country, accounted for 38.2%
of hospital medical staff ar.d 32% of social medicine staff.
Secondly, the efficiency of public health staff depends not only on the number employed(officials and auxiliaries) but also on their training, qualifications and professionalconscientiousness. From that point of view the figures collected, even if they are exact'give scarcely any information concerning the val-ue of the staff concerned, the impact of the
health services on the welfare of the population. The training of staff and their qualifica-tions and conscientiousness are among the data which must be borne in rnind if it is wished totake proper cognizance of "health factors" during the drawing up of any development Projectwhatsoever. l
HouTever, to make these data available they must be brought to light and coordinated and
Ehis requires much more than asking adminisLrative offices to send papers they may or may not
have.
1 ,,r, the developing countries continue to base their health nnnPower development on
the traditional medical and nursing training of the affluent wor1d, no amount of socialplanning and selection of health technologies for attaining social goals w111 be of avail.The social revoluti.on in public health wilL remain a PaPer revolution.rr (Or tt. Mahler,,rA sociaL revolution in public health", WHO Chronicle, Vo1-. 30, Geneva, Dec. L976, p. 475)'
t
ocefwuf tt.rpage 7L
Annex II
As a corollary, it should be noted that mechanically comparing the present staffinglevels with the targets set for the IIHO African Region by 19801 would provide illusory results.
L.2 Ecoloev. d ietetics and hygiene
Ecology is concerned with the relationships between living beings and their environment.If the living being, for exampl-e, is a vil1-age socieEy, the health of Ehat society will beclosely dependent on the foodstuffs that its natural environrent enables it to gather, cultivateor raise. There are some vj-llages without fruit, others without oi1, for the simple reasonthat plantings that would have been possible have not been carried out, or that nature roakes itinpossible for the oil palm to grornr above a certain latitude, or that several successive yearsof drought have damaged the surrounding plantations of sheanut trees, or that there are nofacilities for buying goods conrnerciali-y to rriake up for the natural deficiencies. It mustbe added that one of the natural products on which health is directly and very largelydependent is water, which must be in plentiful supply and of good quality.
Ne\^7 technical or economi.c relationships establ-ished as a result of a development projectcannot be I'heal-thi1y" maintained unless careful attention is paid to solving the correlatedproblems of housing, food crops and easy accessibility of water.
Experience shows that this does not always happen. In some places, we1ls drilled in anewly developed area dry up for part of the year, or produce undrinkabl-e water, or are too farfrom certain groups of houses. Elsewhere, in a State undertaking, production demands havetaken precedence over ensuring acceptable family housing for the people recruited and apossibility of their obtaining a balanced diet. In yet another p1ace, the doctor responsiblefor a sector where water, being scarce and polluted, is responsible for disease is rappedsharply over the knuckles by the administration enploying him for rrwasting his timer trying tosolve the problem by dealing in person with villagers and well-sinkers.
A 1itt1e cortrnon sense, however, would show the iruportance and profitability of ecologicaldisease preventj-on r" i.e. the need to ensure that no development project is drawn up withoutsteps simuLtaneously being taken to ensure that a satisfactory diet and hygienically satis-factory housing are available.
Moreover, any atternpt at development rnakes it necessary to forecast its repercussi.ons inthe guise of changes in the biotope or the relationships between man and his environment andEo do something about them. otherwise the following diseases will appear (or increase orrecur):
I For the readerrs information the list is as followsDoctorsNursesMidwivesTechniciansAuxiliary sanitariansSanitariansSanitary engineers
These quantitative objectives are far from having been achieved in L977 and even were theyto be achieved by 1980, public health would not neceslarily have made progress.2 rt i" true that a cost analysis setting the expenditure on a health caryalgn against anexisting disease i's more satisfactory to technological economists than evaluati.on (difficurt toexPress in figures) of the benefit gained by investing non-nedical resources which enable therisk of the disease to be avoided.
1 per 10 OOO inhabitants1 per 5 OOO
1 per 5 OOO
1 per 5 OOO
I per I O0O
1 per 15 OOO
1 per 250 OOO
octfeoufn.tpage 72
Annex II
rnalaria in rice-growing developroenEs ;
schlstosomiasis in dasmed lakes;
trypanosomiasis in villages re-established in areas with a high concentration of tsetseflies ;
trachoma in overpopulated areas near which waste acctrmulates.
In respect, of onchocerciasis, the building of a dam fiEIy or may not rePresent an operationof ecological disease prevention. l
1.3 Are we moving towards mass. preventive and educational medicine?
For 10 years or more WHO, worrled by Ehe quite widespread failure of maLaria controlcarnpaigns, has been emphasizing the need to Promotetrprirnary health care" andrrbasic healthservicestt. Ttris emphasis deserves to be taken seriously, because once services of this klndare set up in an area the health factors characterizing that area aPPear in a new light.When a village or urban corununity assumes responsibiliEy for its affairs, i.t so to sPeak makes
these factors its own business and approaches the physician no longer as a Potential diseaee
object but as a positive health factor. In the States covered by OCP the formula of basichealth service development lansoffiiects has been widely applied.2 whi1. the results so farobtained seem disappointingJ it would seem to be of more value to try to make a seriousdiagnostic of the failure rather than to engage in theoretical argtunents on Ehe theory of the
system.
Sore projects in progress aE different points in the OCP zone show that atterPts tointroduce mnss preventive and educational medicine can succeed if the following conditions are
Eet:
(a) correct identification of the priority needs of the local- population;
(b) the perrnanent presence of one or more persons capable of encouraging the activlties,in a particular population, of a few of its rembers who become aware of their own
capabilities for promoting an inprovenent in the comon welfare and who help the othersto becorne aware themselves;
(c) the rnaximum amount of "de-official-izingtt, t'de-bureaucratizingrr and decentralization,with a positive enphasis on freedom to use practical ways for the cormnunity to help itsel-f;
(d) integration of the undertaking in atteflpts to tackle developmenE problems going
beyond questions of health.
1 cf. G. Qu6lennec, E. Simonkovich &14. Ovazza rrRecher che drun type de d6versoire de
barrage d6favorable A lrinP1968, pp. 943-956.
2 ,o, the principles underlying such development see document AFVRC18/8 submitted to the
Regional Conrn'ittee at iEs eighteenth sessi.on in September 1968.
3 L. J. Charles (op. cit.) noted Lt 1972t rrlt must be acknowledged fron the outset,however, that Ehe majority of tt" countries of the Region have not rnade striking progress intheir developrnent activiEies in this area during the 6-7 years that emphasis has been placed
on this elerent of the health services".
lantation de Simulium damnosumrr Bull-. W]-d Hlth Ore. , ]Q, Geneva,,
ocefzouftt.tpage 73
Annex II
With due respect to Ehe best handbooks and any general methodology' Inass preventive and
educational medicine can only become rooted in the villages Ehrough continued personal contactsadapted to the specific situations. That is why, paradoxically, i.t was easier to eradicate
"r*llpo* (teams of good technicians and money were sufficient) than Eo establish basic health
services with any measure of consistency.
Of course, such services presuppose in each place a criEical consideration of therespective roles that I'modern therapyrr and t'traditional therapy" can play effectively.rrWestern medicine i.s not a homogeneous whole. Sone activities or approaches ate a survivalfrom traditional European medicine, others are quite sinply the expression - in the healthfield - of the consumer society. At the same time, there are some scientifically justifiedactivities, and these can make a positive contribution in all countries of the world.tlTraditional medicine 'ris not a whole either. It is sonetinps difficult to distinguish between
the people (tradigional birth attendants, healers, bonesetters, etc.) whose knowledge, however
enpirical, however linrlted, may benefit the conrnunity, and those who, through ignorance, greed
or deceit, are likeIy to cause harm. In rnany counEries traditional medicine has access tomethods and drugs that are just as effective as those of modern medicine for certain forms ofsynptomatic therapy, and also for the treatment of psychosomaEic conpl-aints and certain nentaldiseases. "l
In the case of resettlement areas opened up by onchocerciasis control, it must be
remembered that eradication of the disease is not considered, ttthe question may well be rai.sedas to whether the proven requirements for organizing basic health services in these areasshould not form an integral part of the plan of action of Ehe OCP at least when the stage isreached for formulating detailed plans of the development of the depopulated river valleysr'.2It is doubtful, however, whether the OCP can validly discuss this poinE unEil the States reallyconsider it to be of prine importance for themselves and while in practice they insist on
maintaining, at any cost, the entrenched strucEures of their public health system (structuresin which, moreover, they probably feel as iIl at ease as littIe David in Saulrs armour beforehe went to fight the giant Goliath).
2. SOCIAL FACT"ORS
The expressionrrsocial factors'r is to tell the truth a nebulous one. It rnay resemble a
cloud behind which something unspecified is hiding or it may refer Eo a Lype of constellationin which all the elements can be detected by appropriate analysis. Here it is in the lattersense that, it will be taken and an attempt will be made to indicate a few analyEical landrnarks.
2.L Home territories and seasons
This subtitle is meant to indicate that the tradition of any rural society organizesspace (the village land) and ti-me (according to the rhythms of the sun and moon), which make upits cultural biotope. It is inpossible without risk to tinker with this essential relation-ship between ran and nature. It is correlated with a mode of life which it conditions asmuch as it is conditioned by it.
1See Afrique m6dicale , Dakar, L977, pp. 183-4.
2 ," ,. charles, op. cit., p. 9.The drawing up of any resettlement project is by definition an integral part of the
canpaign at present being waged against onchocerciasis. There should be no waiting for theend of the campaign before considering the social and geographical factors associated with thedisease/health entity. Conpare, from this point of view, the valuable indications on rnethodcontained in:
J. M. Hunter, Man-environrnental holie4 ee an approach to the study of disease Eransnissionand control , Geneva, WD/RCT-IDR, August, Lg76 (35 pp-;.
F. L. Dunn, Human behavioral strdies in parasiEic ,}fD/RcT-TDn, s.pt
Geneva,
ocPfEDu/ 77 IPage 74
Annex 
ocefnouftt.rpage 75
Annex II
One exanple: a certain extensive project for small dams and inpounding dykes recentlyundertaken with foreign assistance in one of the States of the OCP zone ended in failure becauseno serious attention had been paid at all to the usual attiEudes and customs of the populationsto be assisted by the donors I good intentions.
Tt cannot be said that this is an isolated case.ki-nd cannot all be dismissed as past errors.
It is significant that mishaps of this
2.3 Mobilit
2.3.1 Mention has already been made (2.1) of migrati.ons. It should be clearly understoodthat the physical mobility of individuals, farnllies or even of whole villages within the OCP
area is a phenomenon the causes of which have long been of the natural kind (demographicfactors, soils, climate) as well as cultural (economic, poliEical and family factors). Itreopening-up of the envisaged resettlement zones may certainly change the extent and directionof the migratory movements now in progress but their planned managerrent presupposes twoconditi-ons, the former concerning the present, the latter affecting the future:
(1) It is essential to know and follow up the variations at present taking place in migratoryflows. A certain number of studies have already been made (cf. ORSTOM on the Mosi and Bisa,paPers of the CVRS concerning Upper Vo1ta, the documentation on the Niger office, Akosombo,the Bandama Va1ley Devel-opment Authority, etc.). However, to the best of the wriEertsknowledge no regional study has been undertaken since the countries became independent and itis only within national frontiers that it has been possible to study the phenomenon closely.In this respect the recent ORSTOM invedtigation is a typical example.
(2) The second condition is more obviously a case of political decision. In cases in whicha government considers it preferable to organize nr-lgration (as in the development areas of theAW in Upper Volta) what populati.ons will it suggest should be transferred? Will it base itschoice on geographical, on demographic or on ethnic criteria, or on all three, or on none ofthem? Once it is decided, for exampl-e, to establish inter-ethnic conrnunities, new problemsarise and as far as possible their elements should be clearly determined at the outset. Tofail to tackle this sort of problem will lead to social difficulties laEer which it will notbe easy to control.
If however - and this can easily be envi.saged since it is happening already in a certainnumber of places - those responsible decide on a lai.sser faire policy of spontaneous migration,it is sti11 true that effective surveillance of what is happening is highly desirable if onlyto know where it is leading the country.
2.3.2 It should be emphasized, moreover, that the social mobility Ehat can now be detectedin the shape of migrations i.s accompanied by a no less marked cultural mobil-ity.
(a) The work required of a rural population to ensure the success of a development projectin which it is involved differs not onLy in the way it is carried out but in its very essencefrom the work to which the population has been accustomed. In the eyes of that population,if it is rewarding, it will certainly not bring back the very unpleasant memories of t'forcedlabourrr. Hovrever, the rewards are now paid in money, and this is not the customary pattern.
Here again, most of the time, there i.s an astonishing emphasis on indusEry in the pLannersforecasts. For them, to take the extreme case, there would no longer be a problem once thehead of a family farm could earn, for exarnple, 150 OOO CFA francs a year. Now moderntechnocrats do not rea1-ize, or only very vaguely rea1-j.ze, the extent and rapidity of the
octf eouf tt.rpage 76
Annex II
cultural change required of a population which r,rithout transition or Precautions is expectedto pass from providing for itself Eo a world where work is more or less standardLzed and isrewarded in money at various rates (through wages or by sale of produce).1
theKou.
An exarryle is the inadequacy that characterized, tTro years ago, (and perhaps till today)so-calledrrco-operativetrinstitution opened for settlers in the rice-growing va11ey of the
Another exaryle: in one savanna area the launching of cotton-growing by a State comPany
was unsuccessful, An effort had been made, the plant grew very welt but the scheme r^ras notcontinued. Ttre explanation given by the village chief was rryou cannot eat cottonrr.
This lasL exaql-e makes it possible, incidentally, to emPhasize the attention that must
be paid to the utility of the work required for a rural development project. For any vi119ge
man or wofl1an the most useful work is that which produces food crops and this wi1-1 always be the
case until the limiEs of mere dietary subsistence have been greatly exceeded. From this pointof view it is therefore not enough for a planner to Prove to the national authorities thefinancial usefuLness of a cash crop (cotton, sugar-cane, etc.) for the work involved ingror"ring iE to be deemed useful by Ehe people called uPon to do it. On the other hand iC iscertain that if the help of the villagers is enlisted, the introduction of ne\^7 factors intofood growing will be considered as useful by ttthose men and women who, although they are not
scientists, have a deep knor^rledge of the earth and its vegetationrt.2
As for unpaid work, here and there inposed from above under the heading of |thuman
investnentrt, its practice in rural areas has shown rather thatitmight just as well be called
"inhu-rn investupnt" when organized by authorities that are inclined to act without any
consideration.
(b) .@1 , with all that it symbolizes, contains and encourages, is a focus of mobility.p.r.doffiffy, although it is a factor of social change, it is quite often renarkable for the
archaic nature of its equiprnent and syllabus.
One exarryle: while it is admitted that the subjects of work and money, mentioned in the
previous paragraph, are suitable as a theme for teaching, where are they in factrrtaught" inthe primary or secondary school syllabuses? Do these syl-labuses pay sufficient attention tohealth education in the widest sense?
In a development scheme, the educational role of the school would normally complement the
training in various sectors given by technical supervisory sEaff. However, it may quitewell happen that the question is reduced, in reality, to the fol-lowing alternatives:
either Ehe existing school has nothing to do with what the staff of the developurent
Progralune are trying to inculcate,
or it is argued that the presence of supervisory staff with a Eeaching role makes the
school suPerfl-uous.3
'l +L^ ^-^^-i'^+'- It should also be noted that modern work organization rnakes necessary the organizationof leisure as its corollary, whereas under the traditionaL conditions both work and leisureaerffi@l a comoon source social savoir vivre.
?z cf. Hugues Dupriez, reproduced in Construire ensemble, Bobo-Dioulasso, CESAO,1976.5,
p. 33. The author go"" or, (page 35) t "The st.tes for their part should understand that the
race for foreign "rri"n"y, by tying African agriculturalists to international technology,
causes a profound deterioration in agrarian societies. And yet foreign currency could be
obtained by means of activities rooted in corununity PercePtj-ons and knowledge".
3 o.r" variaut of this is(which is soon considered as a
that a special type of school is created for the counEryside,,SubSchooltr or aS a stepping stone towards the rrother sChooltt).
oefxouf tt.rpage 77
Annex II
In fact the first of Ehe two alternatives shows inconsistency while Ehe second may leadto serious social damage.
(c) The family is not a facLor but rather a seat of mobility. It is common knowledge thatthe old customs are changing with regard to the ruain pillars of the family institution(rnarriage, distribution of donestic Easks, educatlon of the children, number of family rrembers
living and working together). Ttris does not rEan that they have been abolished, but develop-ment almost always leads to repercussions on the family structures and their functioning.Thus, wherever neril agriculturaL or trading techniques appear, the role of wotpn in the house-hold econory nay very well be disturbed irnperceptibly, and under those conditions the bestpossible teaching efforts, if they are not supported by clearsighted extensi.on work, will corne
to nought.
General-ly speaking, the success of the changes introduced depends on the way in which thefamily cel1, as a who1e, takes to then and benefits from them.
For exaurple,'rsmalltrfamilies (of the nuclear type) established on a new site in thevillage of B6makaha, in the north of the lvory Coast, have not because of their resettlemenEbroken their ties with vilLages often 4O or 50 kn away in which their respective family linesare stil1 established. Hence, journeys and absences are frequent in B6makaha and are moreovercornpatible with the type of work carried out on the new sj.te.
Another exauple: on one development site the distribution of the ptots for housing and ofthe crop lands failed to take into account the growth that is bound gradually Eo take place inthe size of the families settl-ed there. The result of Ehis Lack of foresight is reflected inan unhealthy splitting-up of the traditional family unit or in pure and sirnple abandonrnent ofthe site. It is moreover sli4tomatic that the terminology conunonly used in developrnent areasspeaks of rroperating unitsrt and not of rrfamlly uniEs'r, Perhaps the forner satisfies theeconomists but it is onl-y the latter that reflects the realities of rural life.
(d) Custornary !flr particularly in regard to land tenure, deserves just as much considerationas the written law of the new States. Custornary 1aw is not dj.rectly accessible to peoplefrom other countries, but being more varied and more strongly entrenched Ehan written law itoay ca1I, when certain projects are being drawn up, for adjustments Ehat have no justlfication,or may even be contra-indicated, from a technical point of view. In fact the mutation of theobligations of traditional 1aw into those of the new written law requires tirne. It does notoccur every^rhere simultaneously or at the same rate and it requires support by means of publicexplanation and suitable couunentaries.
One exaruple is the diversion of a tarred road - part of a national route - in order tospare a particular zone because of its "sacredtr status.
Another exarryle: a decision to m,ke an apparently minor change in the way in which riperice was cut encountered serious obstacles, among a certaj.n ethnic group, because the changeiqLied a redistribution of the male and fem,le profits as compared with what was laid downin a traditional code.
A third exanple is that jurisdiction over the land always raises questions in the case oforganized or spontaneous agricultural migrations.l
Consequently, a national migration policy can only take shape if it is accorryanied by anational definition of the Iaw of land tenure.
ItPilot settlement schemes must begin by addressing the land tenure questionrr statedA. L. Duersten in a preliminary report (November 1976) on spontaneous roigrations tolrards therural developnrent zones of D6dougou and Bobo-Dioulasso. this statement is of generalapp lication.
1
ocef wuf tt.tpage 78
Annex II
(e) The political factor is inportant priroarily in the aecisions taken concerni.ng developmenEprojects but it also forms part of daily real-ities in the prograruned operations and in thatrespect itself becomes a social factor.
In regard to loca1 politics, the remark made in regard to law is valid: depending on theplace and circumstances the integration of customary policies into national politics ischaracterizedby a transfer which is acknowledged to varying degrees, is acconrpanied by varyingdegrees of syncretism, actually operates to varying degrees.
As a general ru1e, development projects are carried out through the agency of the natj.onalpolitical authorities and the respect that norrnally has to be shown by international, multf,-national and bilateral assistance agencies towards the governnrental and administrativeauthorities in each State is well known. Yet internal- inconsistencies in a State policy orin the sErategy of an assistance agency (sudden changes among the responsible staff, suddefnstoPPage of the source of money supply, group conflicts, diplomatic pressures, struggles fforinfluence, etc.) cannot occur without to a greater or lesser extent affecting the birth orsuccess of a project.
A recent example is that during the conflict beEween Mali and Upper Volta in 1975 the OCPhelicopters were for some time unable to obtain permission to rnake the direct flight from Boboto Sikasso and vice versa. They had to pass through Korhogo and at the tire thls increagedthe cost of insecticide treatmenE.
It is deliberately that the example given here was of a corparatively mild nature. Itwould be possible to mention many other specific examples with more regrettable consequenceswhich acted to Ehe detriment of the rural populations without Ehem even being aware of thefact. However, in this respect, the reticence r,rhich is the rule in regard to certai.n typesof assistance linked by hypocrisy on both sides doubtless requires the writer to remain silent.
However, it is worthv,rhj-le pointing out a general case: that of regional projects.These, although possibly highly effective (e.g. in livestock raising, hydroelectric dams, meansof corununication, industrial settlenents, etc.) are still for what are obviously politicalreasons too unconEnon or too resourceless and hence have little irpact.
In another sense, warped but rea1, politics acts as a social factor in a developmentproject when it serves the ends of favouritism a! the expense of merit, of vague palaveringinstead of action for the corrrnon good and of administrative authoritarianism in conteupt ofthe initiatives that are shown in village couununities.
An exanple: a certain foreign crediE was granted for the construction of a social-centre in a locality selected on the basis of objective criteria. However, the regionalorigins of a highly placed person, then in a position of responsibility, 1ed to a "subjectiverlchange in the site selected. Nevertheless, because of the t'respect" normally shown for theauthorities on the spot, the foreign credit was granted all the same.
Another example is that of an isolated village where the word 'rpolitiquert had just rnade
its appearance by pure and simple borrowing of the French word, it was used to meanttquarrel,disputerr.
A third example is that of an intervillage association that was particularly dynamic andhence worried a 1oca1 representative of the Government, who was incl-ined to Ehink: rrlf thepeasants get organized and take their own destiny in hand I shall no longer be able toexercise authority and there will- be trouble".
oefxouf tt.rpage 79
Annex II
3. COROLI.ARIES
Emphasis has been laid in Ehe preceding pages, in general, on the health and socialcomPonents which a development project must needs take into account. In positive terms theconsiderations sketched above suggest a certain number of possible r^rays in which the strategyand tactics of OCP-couId develop.
3.1 To revert to the "health facLorsrl
3.1.1 Whatever the value of lhe rrtolerance thresholdsrr that can be defined by the oncho-cerciasis campaign techniciansl the popul-ations are migrating and will continue to migrate asthey pLease and the rumour is already spreading among them that the number of blackflies isdecreasing. The time of modern procedures and preliminary studies is one thing but that ofthe migratory movements may very well be quite another.
The first task of a public health adviser assigned to OCP might be to draw up withprecision the inventory mentioned in 1.1 and then consider to what extent the infrastructureand personnel are adapting or failing to adapt to the siEuation ln the areas being resettled.From this point of view two quite distinct possibilities arise:
(a) zones of organized resettlement;
(b) zones of spontaneous resettlement or of marked increase in population.
In the former case it is difficult to see why the organizati-on of resettlement should not beaccomPanied by the establishrnent of new health servi.ces. In the latEer it would be less aquesti.on of establishing new services than of readjusting the existing ones.
3.L,2 Section 1.1, moreover, euphasized that to be useful an inventory of infrastructuresand health staff must neiEher be a mere enumerati.on nor purely statistical.
(a) After identification, the various situations must be fol-Lowed up with a view tostudying the changes that gradually take place;
(b) figures and percentages are essential but they are not adequate indicators on whichto base an appreci.ation of the real facts.
on the basis of this twofold approach (a longitudinal and a qualitative inventory) theassi.stance that could be given a public health adviser in his task by the EpidemiologicalEvaluation Unit (EPI) is irreplaceabl-e. So far the help of the Unit has not been requested,even for considering what internal structures the states should set up in order to follow-uponchocerciasis control (a question which is, of course, essential if the OCp is to be a realsuccess).
3.1.3 Because he is to form part of the Economic Development Unit (nCO)2 rhe public healthadviser will have direct access to the docurnentation which it seems to be one of the UnitrsEasks to gather together. To the extent that other bodies take part in the development of theOCP area or adjacent areas:
cf. document, The Biomedical Criteria for Resettlement in the Vo1ta Basin Onchocerciasis1
Control Prograrme area,(OCfl Xspert of a Scientific Advisory panel Working Group, Geneva,6-8 June Lg77 , ocpfsLpf77,L.
2- His assignment to this Unit was decided on early Ln L977 after reformulation of theterms of reference describing the post of public health adviser.
c
ocPfBDufTT.tPage 80
Annex II
CILSS: Comit6 Inter-Etats de Lutte contre la sGcheresse dans 1e SahelCIEH: Conit6 Inter-Etats drEtudes llydraullquesAW: Autorit6 d'Aro6nagerent des Va116es des VoltasAVB: Autorit6 de la Va116e du Bandama
VRA: Volta River AuthorityBMTD: Bureau National dtEtudes Techniques de D6velopPerentSDMT: Service du D6velopPement Rural et drAdnagellpnt du TerritoireState UndertakingsOCCGE: Organization de Coop6ration et de Coordinatlon Pour la lutte contre 1es
Grandes End6niesNOC: National Onchocerciasis Cornndtteesthe Niger OfficeCFN: Coruntssion du Fleuve NigerCEAO: Conmunaut6 Economique de l tAfrique de l fouest
CDEAO: Corununaut6 des Etats de lrAfrique de lrOuestN@: Non Governsental Organizationsetc. ,
health aspects rnay have been the subject of studies or trials which, whatever their va1ue,
deserve at least to be knornrn.
3.L.4 In view of the consideratj.ons set forth in 1.2, item 7 of the terms of reference forthe public health adviserrl i" "
good reflection of the iryortance of the health diagnosls tobe carried out on every project in course of gestation whether it is a question of planning,equiprrent or devetoPment.
Ttris point, however, will remai.n a pi.ous wish if the various States particlpating in OCP
and the nurrprous other bodies concerned do not begin by explicitly recognLzing the fact thaE
it is well founded (cf. 2.3.2.e).
3.1.5 Ttre present status of therrDevelopment of Basic Health Servicesrr (cf. 1.3) should,above aL1, be of supreoe interest to those responsible for OCP.
Indeed the large sums of money assigned by the States, even those being assisEed, to the
various public health services are not on the whole achieving the anticlPated results. Witha few exceptions, all the oore welcone because they are so rare, public health is stiI1 today
much too forral an undertaking. For example, a hospital- exists but does not have personnel
in sufficlent nuobers or of high enough coryetence to ensure that it functions norrnally. ore.lse the doctor in charge of a dispensary gives his custorrers pharmaceutical prescriptionswhose cost is beyond their maagre resources. Or else a maternal and child heaLth unit isfunctioni.ng in theory but, through lack of neans of transport or supervision, those responsibleshut theoselves off in the unj-t as if it were an office and its effect on the surroundingvillages is nil.
To the extent that a situation of this kind worries the national authorities, they could
take advantage of the Programne to ask OCP to work in the seven States towards concertedprogress in the strategy of prioary health care. It is true that the division of resPonsibi-lities between the different sectors and between the dlfferent counEries and the frequentarnrlgan of administrative red taPe, objective difficulties and l-ack of imagination constituteobstacles. But are they insurmountable?
It Ihe wording of ltem 7 i-s as follows: rrTogether with ECO, and, where necessary with VCU,
he will analyse economic and other projects that might influence the state of health of thepopulation and identify any shortcomings, while trying to have the principle acknowledged thata health or disease-preventi.on component be included in every Project of this kind. "
,
oc*f r,ouf tt.rpage 81
Annex II
In the great area iE covers, OCP would be able
(1) to take into consideration the local ventures (public or private) which for some
time have been striving in some dlstricts to organize a real prioary health careorganization I
(2) to study thelr achlevernents and corryare them;
(3) to develop, particularly for the resettlerent zones, pracEical and lastingsolutions at the least possible cost; and
G) to ensure that following-up the onchocerciasis control campaign forms an integralpart of cormunity medicine.
3.2 Another look at the rrsocial factorsrt
3.2.1 I'herrmonitoringrrof migrations affecEing Lhe OCP area would in itself justify erploymentof a member of ECO fu1l-time. lhe ecological, geographical, demographic, ethnic and culturalaspects of these migratory moveflEnts were mentioned in Chapter 2 (see in particuLar 2.1 and2.3). To folIow them up and keep an eye on their developnent is a task as urgent as it iscoruplex. It would consist in determining regularly the following points:
(1) In regard to internal migraEions (i.e. oigrations wiEhin a single country):
(a) the stability or instability of the migration fronts;
(b) the technologlcal, social and economic evolution of family units, the conditions ofland tenure or occupati.on, Ehe rnake-up of the family farming rn;rnpohrer and changes inmatrimonial practices or the persistence of the customary ones;
(c) the f.iving condltions and stability of the populations thaE have migrated to theland round hydro-agricultural and agro-industrial developments as wetl as to areas whereranching is envisagedl
(d) the exodus of young people to$rards urban centres.
(2) In regard to migrations with a view to worklng in other countries:
(a) the changes or lack of changes in the annual number of mlgrants and the money flowsconnected with them;
(b) the reallty or other:vrise of the advantages gained by the migrants;
(c) the attitude of agricultural emigrants (i.e. category (1) particularly the young)in regard to migrations with a view to working abroad.
(3) In regard to nomadic habits and the seasonal moverpnts of livestock:
(a) the maintenance or alteration of the known routes;
(b) the way ln which the cattle are sold;
(c) the process of sedentation.
ocYfrouf tt.rpage 82
Annex 'II
The success of rrmonitoringrr of this kind depends on reliable and easily handled documen-tation, on great liberty of movement and on experience which must be constantly widened bymeans of field contacts. No one person can investigate on his orun such a wide field but hecan, by using suitable means, review the subject andrrforcerrothers to do so, including thosewho would prefer to leave the migration problem alone because it is such an embarassi.ng one.
In this resPect, an international official is in theory in a privileged position toventure on such a task. It is for him possibly, with assistance from qualified consultants,Eo set uP an infornration network which would gradually be extended and operate for Ehe benefitof all the countries concerned. This last point is roorth serious reflection since it must beclearly understood that in respect of migration on ostrich-like policy can never be beneficialin the long run.
3.2.2 Generally speaking, the Economic Developnent Unit will fulfi1 its purpose within OCP
if it persists in meEhodically pursuing a threefold objective:
(1) In the seven States covered by t.he Progranme the development projects to be drawn up oralready in progress are dependent on various bodies. It could in no way be an ambition ofOCP to become one more such body. However, by reason of its place within the Prograrmne ECO
is in a position to promo te and facilitate a coordination which , despite the (too) numerousstructures designed to ensure it, is often lacking in practice, particularly on the regionals ca Ie.
Backed up by the presence of EPI (Epidemiological Evaluation Unit) and VCU (Vector ControlUnit) the Economic Development Unit. would then constitute a multipurpose centre to an extentthat would make its services or advice appreciated. The fact that the services would begeared to local conditions, would be technicalLy competent and would not serve narrow nationalinEerests, would give them a certain weight.
For exanple, livestock policies are being devel-oped to a greater or Lesser extent in mostof the countries covered by the Prograrmne. How does their combined effect benefit livesSockrearers and agriculturalists throughout the OCP area? Another example (in the southern p{rtof the Progranme area): the Lobi counEry is astride the frontiers of three States: UppetVolta, Ghana and Tvory Coast. In fact these poliLical frontiers have scarcely any existencefor the Lobi. If a particular development operation is envisaged for Eheir benefit in ohe ofthe three States its consequences would affect the Lobi areas in the two others; hence itwould be advisable to have a coordinated three-State strategy.
In brief, in a certain number of carefully selected cases, ECO could act as a catalystcapabl-e of ensuring cormrunication between similar and too often adjacent sectors. In otherwords, pursuit of practical coordinati.on would be airned, as far as possible, at unblockingcertain situations and at broadening development straEegies.
(2) An essential task consists aE the same Eime in promoting the consistency of develoPmentprojects in the course of their preparation.
ocefxouftt.rpage 83
Annex IIBy consistency here is nreant
Ihe we1l-foundedness of an operation or series of operations envisaged, in terms of the1oca1, national andfor regional economy. An examination of this point becomes essentialin cases where a state has no clear-cut national planning system.
The way in which the means envisaged for irnplementation are or can become real1ycompatible with the socio-cultural characteristics of the populations concerned (cf. 2.).
ltre way in which projects are presented. In some cases the presentation is so faultythat a body which might have financed a project delays approval or sirryly rejects it,leading to a sadly ironic situation in which fi.nance is available but remains blockedbecause the potential user, through his ownfault, does not knor"r how to go aboutobtaining it or does not dare to do so.
(3) Projects in progress also require sustained attention from ECO. National projects,loca1 initiatives or private ventures are always the better for periodical evaluation. It isfor the Economic Development Unit to promote or encourage, in this respect, any seriousevaluation of the results achieved after a certai.n lapse of tine. Sometimes developmentProjects have not lacked feasibility studies - themselves following on "prefeasibililystudiesrr- or theoretical progranrning. I,Ihat they do lack, however, is subsequent evaluationreally worthy of the name and in default stagnation regrettably sets in without being evennoticed.
a
t
oef nouf tt.rpage 84
ANMX III
1{TIO ONCHOCERCIASIS CONTROL PROGRAilME
IN ITIE VOLTA RIVER BASIN AREA
OUII,INE FOR ANALYSIS OF SOCIAL AND HEALTH ASPECTS OF ECONOMIC
DEVELOPMENT PROJECTS IN COUNIts.IES COI/ERED BY ]TIE PROGRAMME
Title and loca tion of proiect:'
Purpose and duration of proiect
Ittp lementation phases and cost
Financing : amount and source in local currency and foreign currency
Executing aggrlgJ: administrative structure or body
6. Executing agent: coryany, loca1 population, inrmigrant population
7 Infrastructure in the reception area
7.L Housi space
Housing and living environrnent: type and number of huts per conPound, number ofpersons per coqound.
- Internal features of courtyards: lists, layout and problems.
- Characteristics and size of basic population regroupings: organizati.on andequipment of villages.
7.2 Social facilities
7.2.L Education and tra I-nLnq
- Existing infrastructure - type - Ievel - coverage rate: population attending school/population of schooL age, number of villages served and population, average distance.
- Other institutions or types of educaEion envisaged in the Project-
- Occupational training of rural populations: tyPe, category concerned, frequency,infras tructure.
7.2.2 Health
Types of disease encountered in the region, morbidity and mortality.
Existing infrastructure: dispensary, maternity centre, MCH centre, village pharmacy.
For each type indicate the number, theoretical capacity, number of people actuallyreached, health personnel, faciLities, funds (sources, voh:me), regularity of supplies,actual operating conditions, coverage rate (acLion radius, population concerned).
7.2.3 Situation o f patients afflicted by blindness
- Case-finding infrastructure provided for by the project: type, facilities, coveragerate.
I
1.
2.
3.
4.
5.
- Treatment infrastructure: type, number, capacity, coverage rate.
t
a
ocefztuftt.tpage 85
Annex III
- Types of activity planned for the rehabilitation of PatienEs already treated orundergoing treatment:
- production activities: agriculture, crafts, eEc-;
- extension and educational activities;- other assistance = finance, food, equiprnenE, etc.
7.2.4 Hygiene and sanitation
- Water for drinking and other uses:
- source: piped, protected or unprotected wells, river branches, others. In allcases indicate the number, the cleanness of the water. Is Ehe source Permanentor terrporary? If ternporary, where is water obtained after the source dries up?
- water hygiene: use of filters? Other water treatment Processes.
- latrines: are there any? Are they individual or collective? Number andextent of use?
7.2.5 Leisure
- Corununity infrastrucEure: purposes and use, capacity, Eypes (youth centres womenrsc1ubs, etc.), number of members, facilities.
7.3
7.3.L
7.3.2
- Cultural organizations by social category: young people, adults, women, men.
NuEritional situaEion
Objectives of the project with regard to food production: type, quantiEy.
Approximate assessrnent of the nutritional status of families.
Product Annual production Own annual consumption
- Cereals: millet, sorghum
- Rice
- Tubers
- Local vegetables
- European vegetables
- CatEle
- Small livestock
7.3.3 Length of the pre-harvest period of food shortage and extent of undernutrition.
7.3.4 Is there any system of the storage of cereals? Number, amount, operation.
7.3.5 Food assistance for the projecE from other organizations: purposes, amounts.
7.3.6 Does the project have a nutrition cornponent? In what form? Supervisory staff,facilities, financing of producEion.
octfnouf tt.rpage 86
Annex fII
8. Community organization
8.1 Social harmony and productivity indigenous social units, inunigrant social units,geographical and ethnic origin, demographic characteristics, status of women in soci.ety andin the project.
- Suggested activities for women: economic activities (type and objectives), educational,social, cormunity activities.
- Womenrs organizations, whether existing or to be encouraged: types of organization,objectives, number of membersf total population.
a
8.2 Structures
- Individual work premises: type, atea, use.
- Collective work premises: type, area, use.
- Production unit: boundaries or plots; sizes, use.
- Occupational organization of the economy: associations, groupings, pre-cooperativegroups, cooperatives. Briefly indicate in each case the objectives, number of members,irnpact on the cormnunity.
- 0rganization of conrnunity life: institutions, infrastructure.
8.3 Method of exploitation
- Land tenure problems.
- Technology used.
- Organization of production:
- altocation of land: by individual? By family? By sex? By produce?
- distribution of thsks: by sex? By age? By produce?
- equipment: by social grouP (men, women) and by product
- credit: by social group (men, women) and by purpose
- Brants and other assisLance
- orga1;-1.zation of activities following production: marketing, Processing ofagricultural products (type, extent, method of managernent)
8.4 Secondary activitie s accepted and planned: crops, crafts, trade, facilities available,problems presented.
8.5 SuDervisory and extension strucLures P d and set up type? Beneficiaries?Number of extension workers?
9. ProjecE Personnq!
- CateSories.
- Professional training and specialities.
- Structure and Eraining offered by the project for senior staff: initial training;further training.
a
a
oefwuf tt.rpage 87
Annex III
10. Comnunieation and inforrnatlon systems in rural areas
- Rural radio: number of listenersr clubs, number of parEicipants, number of sessionsper week.
- Other methods of social cormunicaEion: newspapers, technical 1eaf1ets, fi1ms, slides,posters, brochures, eEc.
fnformation media: audiovisual, press, broadcasting, etc.
Social and microecononric data already recorded11.
11.1
LL.2
11. 3
Income from chief occupation types and amount?
Income from secondary occupations types and amount?
Allocation of family income
- By expenditure items: subsistence, status, reinvestmrnt, etc.
- By member of family: men, women, children.
11.4 Improvement of the level and quality of life
- New assets
- Health
- Sanitation
- Education.
housing, Leisure, cloEhing, equi.pmont, status
a
ocYfwuf 'n.rpage 62
Annex'I N
+ocATtoN oF ECONOMTC DEVELOPMENT pROJECTS tN IVORY COAST
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Annex IGHANA
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