CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Every country's socioeconomic and political growth is aided by transport. As a result, transport may be considered the "lifeline" of every economy. It is very vital throughout the lives of any people within any geographical location because it allows different spatial locations to interact effectively (Hoyle & Knowles, 1992). The importance of transport in Ghana's socioeconomic growth cannot be overstated. Transport has played an important part in Ghana's economic growth throughout the pre-colonial era, continuing through the colonial era and independence to the present day. Transport has connected the country to worldwide markets, allowing it to export natural resources and create foreign money. Transport has also allowed the interplay of internal markets, allowing individuals to sell their goods and generate some income for their economic well-being. Furthermore, transport has aided social connection and national cohesiveness. Over the years, transport has played a significant role in generating job possibilities for tens of thousands of Ghanaians. Currently, the transport sector employs a large number of people and has the potential to employ much more.

However, transport is also considered risky in the sense that it has the capacity to cause harm to both persons and property (Abane, 2012). Every mode of transport, whether by land, air, or sea, has some level of danger. As a result, there is a need to make transport safer by implementing mechanisms that govern individual behavior in order to minimize the degree of harm to persons and property.

The absence of danger or harm to individuals as well as damage to property is defined as safety. According to Faulks (1990), the role of transport is to transfer people from where they are to where they wish to be and products to where their relative worth will be greater. As a result, the object or end product of transport is the arrival. Just as a well-fitting suit is the result of a tailor or seamstress, so is safe arrival the product of transport. Obviously, this arrival must be safe; that is, passengers and commodities must be transported safely and without harm or damage to their destinations.

Ghana has a variety of forms of transport, including air, sea, and land, Rail, inland waterways, pipelines, and roads are all modes of transportation. Each of these forms of transport has distinct benefits and limitations that make it ideal for one journey but unsuitable for another. By far the most popular method of transportation in the country is road transport, which has the benefit of offering door-to-door service. Indeed, road transport transports more than 95 percent of all internal passenger travel (Ministry of Transport, 2008). Approximately 85 percent of these people are transported by public transport (Gbeckor-Kove, 2010). As a result, public transport (defined in this context as any transport service offered by a third party for a commercial purpose) in Ghana has aided in meeting the transport demands of the vast majority of the populace for a variety of economic and social reasons. In Ghana, where the majority of citizens cannot afford to own their own private automobiles, it is impossible to avoid using public transport. Using public transport involves interacting with a variety of individuals on a regular basis, which has consequences for their health and comfort. The spread of communicable diseases is a major source of concern. Communicable illnesses continue to arise on a regular basis across the world, particularly in Africa (World Health Organisation, 2015). Despite persistent efforts to eliminate infectious illnesses via the introduction of vaccines for immunization, African nations continue to suffer from epidemics and pandemics (WHO).

Several outbreaks of infectious illnesses have occurred globally in the previous two decades. In 2003, for example, there were reports of severe acute respiratory syndrome (SARS) in several countries, primarily in Asia and South America. In 2009, there was an H1N1 pandemic (dubbed Swine Flu) that affected countries in North America, Europe, Asia, and Africa. In addition, in 2014, there was an epidemic of the Ebola virus in many West African nations, the majority of which had strong links to Ghana. The death toll was 11,295 out of a total of 28,000 recorded cases (WHO, 2015).

In Ghana, for example, cholera has become endemic, with people dying virtually every year. In 2014, there was a severe cholera outbreak that impacted 28,922 people and resulted in 243 fatalities. The epidemic was recorded in 130 of the 216 districts throughout the country's ten regions, with the Greater Accra Region having the greatest number of deaths (Ghana Health Service & Ministry of Health, 2015). In early 2016, there was another outbreak of pneumococcal meningitis in some parts of the country, and over 100 people died. All of these publications show that, despite the World Health Organization's (WHO) and other stakeholders' persistent efforts to eradicate communicable illnesses, new viruses continue to develop while old ones resurface, with African nations being the most vulnerable. Transport has been recognized as a mode of transmission for infectious illnesses (Allen, 2015; Feske, Musser & Graviss, 2011).

Wilson (Wilson 1995). For example, in 1998, there were allegations of TB spread aboard some airplanes, which prompted a partnership between the The International Air Transport Association (IATA), the International Civil Aviation Organization (ICAO), and the World Health Organization (WHO) will collaborate to create a standard paper on best practices in the aviation sector for avoiding infectious disease transmission (WHO, 1998; 2006; 2008).

There are numerous methods for infectious illnesses to spread from one person to the next. While certain communicable diseases may only be spread through sexual contact or blood transfusion, others can be transmitted simply by breathing contaminated air or coming into touch with an infected individual. Fomites (contaminated beddings, clothes, medical tools, sanitary equipment, and so on) are another mode of infectious disease transmission. It has been demonstrated, for example, that the fatal Ebola virus may be transmitted by coming into touch with any bodily fluid of an infected individual (WHO, 2014b). Some illnesses, however, such as TB, common colds, and H1N1, are airborne and may be caught by breathing contaminated air from an infected person coughing or sneezing (WHO).

1.2 STATEMENT OF THE PROBLEM

One the large number of people that use public transport at any given moment, as well as their proclivity to travel between cities, these transport networks might be a possible source for the spread of any infectious disease outbreak. According to anecdotal data, public passenger transport companies have had no official plan in place to manage infectious illnesses that have erupted throughout the years. Most truck stations in Ghana, particularly in Accra, have poor hygienic standards, which may contribute to the spread of infectious illnesses even inside the station environment. It has also been noticed that the majority of vehicles utilized for people mobility in Ghana were initially intended for goods transit.

The lack of common criteria for the conversion of these vehicles, or the lack of adherence and enforcement of those that do exist, has resulted in cars with poorly built windows and inadequate seating capacity and layout. This causes inadequate ventilation and overcrowding in these vehicles, which may contribute to the spread of infectious illnesses. This problem is exacerbated by the filthy interiors of some of the automobiles (Abane, 2009, 2012). Furthermore, where air-conditioned buses are utilized, there is a risk of communicable disease transmission because such vehicles lack a sufficient ventilation system like those found on airplanes. Furthermore, people's behavior on public transportation (e.g., coughing or sneezing without covering the mouth and nose, and openly spitting while onboard a vehicle) has the potential to contribute to the spread of infectious illnesses in Ghana's road passenger transport sector.

Despite all of the issues mentioned, there has been little study into strategies to limit the spread of infectious illnesses in Ghana's road passenger transport industry. Furthermore, there are gaps in the literature regarding both the scope of the problem and the preventive measures implemented by transportation organizations to address it. The majority of public health research in the road transport sector (for example, Jorgensen & Abane, 1999; Abane, 2012; Afukaar, 2001, 2003) are concerned with road collisions. Recent outbreaks of cholera and meningitis in Ghana, as well as Ebola in other neighboring African nations, necessitate the urgent need for studies that can record existing practices and methods of dealing with the problem. As a result, this study attempted to fill a vacuum by concentrating on the possible transmission and control of infectious illnesses in Ghana's road passenger transport industry.

1.3 OBJECTIVE OF THE STUDY

i. To raise awareness on the role of commuters in spreading communicable diseases in public places.

ii. To examine the knowledge of commuters on the awareness of their active involvement in the spread of communicable diseases.

iii. To suggest effective strategies to mitigate the spread of communicable diseases by commuters in public places.

1.4 RESEARCH QUESTIONS

The following questions guide this study;

i. In what ways do commuters spread communicable diseases in public places?

ii. Are commuters aware of their active role in the spread of communicable diseases in public places?

iii. What effective strategies can be employed to mitigate the spread of communicable disease by commuters in public places.

1.5 SIGNIFICANCE OF THE STUDY

Through its efforts, the research has the potential to assist road passenger transport operators in developing and improving best practices in infection prevention and control. The study also aimed to uncover additional subtle methods, which may not be evident, through which infectious illnesses might be acquired on public transportation. This would alert the general public and transport providers, allowing them to take preventative steps. The findings might also help policymakers establish new regulations and reassess old ones for limiting disease transmission in public spaces, particularly in the road passenger transport industry. Furthermore, the study might serve as the foundation for future in-depth research into the prevention of communicable disease transmission through vehicle travel in Ghana.

1.6 SCOPE OF THE STUDY

This study will only focus on transport operators and passengers on the spread of communicable diseases on the public road transport system. Only Accra will be looked into as a result of its busy nature.

1.7 LIMITATION OF THE STUDY

The researcher during the course of undertaking this study was faced with financial constraints.

1.8 DEFINITION OF TERMS

1. TRANSPORT: A system or means of conveying people or goods from place to place.

2. TRANSPORT OPERATORS: Transport Operator means any employer engaged in the business of the transport of freight by road, or who employs persons to transport freight by road.

3. PASSENGERS: A traveller on a public or private conveyance other than the driver, pilot, or crew.

4. COMMUNICABLE DISEASES: Communicable diseases, also known as infectious diseases or transmissible diseases, are illnesses that result from the infection, presence and growth of pathogenic (capable of causing disease) biologic agents in an individual human or other animal host.

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