Sociological findings of the epidemiological evaluation of the Onchocerciasis Control Programme in Ghana

\ WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA snNTE Onchocerclasis Control ?rograme tn the Vo1ta Rlner Sasin Area Elideuiological E\ralrratlon Ur:tt Teahnical Docr.rment ocP/wn7.2l SOCIO]OGICAI SINDI I{GS OF [iIE MIDB.trOIOGICAI, EVAI,UATION OI' IHE OIICHOCERCI.ASIS COI{TROI ?ROGNA]'{!M I}i GHANB by B.C. SAYIADOGO Or.ragatlougo:, 22 }lovember 1976 t v I i t t \ CONTII{TS IIITRODUCITIOTd Ti{il SOcIolOcICAf, FACEI lli TIE EPIDIi;.[o]oGrc.LI ruA-Lu.!'IIoIi oF III{] PROGIi.Airl}E 1. Its place e.nd its carnponents 2. tr{ethods 2.1 The census 2,2 Senl-dlrecti-ve ta-lks 2.5 Direct obsenrations rlOcrOI,ocrcAtr ri'rI.DrlIGS 0rr flrt EPr.)Ei^r0tOGruAt EvAtuATrcti 1. Vi1.lages srrrveyed and the ?rogra.mre region 2. VilJ.ages eva-luatecl: size of hr:man writs 5. Age and sex dlstribution of the populatlon exanii:,ed and onchocerciasis (.) Sex structure (U) Age stnrcture (") Demographic stnrctures and oncjrocerciasis 4 Absences and leveI of attend.ance for eval-uatione Characterj.stics of p:reeent ntgrsatiorr (") I'hmbers and clominant age groups (u) The mqin clirections and average duration of rd.gration (.) Euigration and onchocerciasis I Page 1 1-5 t-2 3 -5 5-18 5 -6 o-( 7 -9 7 -8 B 9 10-11 LL-12 IL ILr12 12 1r-16 ].1-t4 14-15 15-16 l_6 - 18 16-17 t7 17-18 r. 1I III 1-4 4 2 r t a 5. t 6. 7. DlspJ.acements of villages and natural moyement of populatj-ons (") Deserti.ons (U) Natr:ral movement of populations (") Knorvleclge of onchocerciasis A brief glance at the social and socioeconomic spheres (") Social organ-tzation (U) Econonic resources, activities and problems (") Social infrastzucture JIV POI}ITS D]SCUSSED 1. For the sociological facet, consistency of basic methodolory rvith freedom of in:itiative for additional investigations 2. the census techirique to ::ra.ke subsequent identification of individuals possible is based on the reliability and pennanence, witltln the comriron nenory, of an ind:Fidualls relational identitS, 7. Selections wlthii^ a rillage Ieaci, ivhatever the criterj-a utilized, to risks of refusal arrcl absenteeism 4. In ti:e present census, the rrfamill/rr regj-stered does not always correspood to a coaceptual d.efiaition. 5. [he techniques for estinating a6e uti]lzed, in adclition to the standard clental nger guid.enarks defined. rvithin the Iocal cultural context 6. Ihe quair.titative tables were used. for a qua'litabive demographlc analysis on the basis of quantitatively evaluated tendenci-es. V. COITCIUS.LO-:S References IAB]ES AliD GF,AliiS I Breal<dovrn of adminis-brative districts of villages evaluated II Distribution by river basins of villages eva-1uated. III lilaps sirowing location of villag:s evaluated IV VilJ.ages evaluated: d.emographic coord,inatee, adroinistrative uialtt maj-n ethnic 8roup. V Percentage of the two sexes 1n the rrilJ.ages evaluated VI Graph showing uasculin-it;r ratio in the villages evaluated ruI Graph showing rna"sculinitJ' ratio by flve-year age gro',ps in the rrillages evaluated. WII Age plmqyni d. of tota-l ;oopulation cou::ted in the villages evaluated (percerrtages) ?age. 18-21 18-19 19 19-20 20-21 22 23 24 25 26 27 28 29 20 20 ?J 10 Page 1LIx xI XI Differences between vi-Ilages in percentages belonglng to five- yeax age-groups Sex differences in the percentages belong:ing to the five-year age-groups in the villages evaluated. Dlfferences in age ratio of the two sexes, for all the rillages evaluated Brea.kd.own by five-year age-Sfoups arrd by sex of the census popr:Iation. Proportlons expressed as percentages of different a€e-groups. Cr-unu-lative percentages PopuJ_a.tion of vi]-lages evalua-bed.: residents present and residents absent. Rate of presence arrcl absence Brea]<down by ager sex and village of the population at present eutgrated Ebtgrairt population and- total popula.tion conpajredr by age and by sex, in 17 villages concerrred' Cornparative age p;rr:arni ds of the total population anci the enlgrant population Frequency of mai n places of irrmigration Time elapsed since cleparture of erulgrants Combjned diagfam showing durations of stay and tine elapsed since return for case hlstories of nigrants ftn{ gration and onchocercia,sis status of socia.l, educational and hea-1th facilities in the villages eva-luated Age stnrctures of the popr.r-lation of the villages evaluated and onchocerciasis, by percentages of the age-groups withln each rrilJ.age. Table for detemining cirj-ld.rents age from dental fo:mula Ethrrtc code Inte:rrriew gutd.e for a vil1age card For demographic analysis: I tables giving sociodemograpidc data on the vi]-lages rrisited. 7z 16 37 3B 79 40 4t 42 47 ++ 45 lff E( XII XIII xrv XV'I XIIII ]flTIII )GX ffiI )x(II A}II{DCDS table I II III IV 17 14-75 46 47 +8 49-56 JI a I}TTRODUCTION Ghana is one of the seven countries participating in the Qrchocer- ciasis Control Progra:me in the Volta River basi-n. Its rnain econonlc actiulty is agricultare, which accounted tor \5% of the GNP in J975t enployed eCfr of the nanpower, and provided Tfl of the income fiom exports, e6% of which comes fron cacao alon-e (Wno, Report of PAG, lg77). Brt thj.s prosperous agriculture is.the privilege of the sorth. In the firo regions -coveiea by tf,e Programe (uppei neg:ton and Iforthern Reglon) subsistence agriculture is the norm. And yet there exists relatively abr:ndantr fertlle and Iittle-utilized 1and. in the river na11eys, w'here ::ai::falL condltions are satisfactory and the possibilities for *rowtrc crops (ri"e, eottonl majze, oils) and stock-:uising rea1. It is onchocerciasise rife 1n these regions, where it constitutes a serious public health problern, which to a large extent explains the jrobalances j.n the population dlstribution; which are one of the rnajor obstacles to a reorganized., diversified and more productive agriculture. fhe Eliderniological E\raluation Unit of the O:chocerciasis Control Programe eonducted, between November 1975 and April 1976, {-O evaluatlons of villages or parts of vilIages. fhls sa:npIe providesr as far as Ghana is concerrred., sufficient clata for app::aising and judgir€r at least in an average maffi€Tr the results of the onchocerciasis control operatioas. These evaluations eompr:Lsed three facets: a parasitologlcal facet, an ophthaLmological facet and a sociological facet This paper presents the finclings of the sociological part. ITIE SOCIOIOGICAI TACET I1{ friE PTDEI'IOI,OGICAI EVAIUAT]OII OT' THE PItOGRALm'm 1. Its place and its cmponents Accord.ing to the gene::aI methodology for epideniological evaluations of the Frograme (Prost, Ihylefors, Pairault, 1975: op. cit.)e the flrst thing to clo in every rri1-lage chosen for e:ra^uination is to nake a census. Thj.s means an e:rkraustive census of the population wtth reg:lstration of restdents present, residents absent, visitors anc',. ld.entification, for eaeh person registered, of his relationships. trfhls"r states the document quotedlt'1s a vital phase of the sul:yeys the value of the lgngitudinal'stutly rnade w111 depend upon hon'carefirlly it is caried out." (op. cit, p.7/. 'lVhi.le the census thus constitutes the fi-rst component of the socio- logical facet i.:a epidemiological enaluations, i.t is not the only one. trln so far as the 1evel of onchocerciasis endenlc in a particular rylace is neithepflced or necessarily always homogenous, transmlssion dynamics (lncreasing, i stagrent or declin'ingJ tlepend i.:r part upon the klnd of life and socio-econoet$ actlvity which are in thelr turn neither simple, nor flxed, nor necessarily always homogenous. Factors like these, iirelenant to'medicai dia6nosise beLoqg nevertheless to the field. of epideniotogy.tt (op. cit.l p.8). II I-2- Fincling and collecting basic d.ata that can help to oqrlnin differentialIevels of endenlcit' constitute the second. component of the sociological facet of epid.errrtological evaluations. These data relate to several areas: confi.gr:ra-tion and d.lstance of dwelling uirits in relertion to lretesting blackfly habitats, loeation of fieltls, distriburtlon arnong the comr:nity (ty age and,/or sex) of activities bringtng the vrorkers into conta.ct with infesti:l.g blacldly habitats: work in the fieltts, herd.ilg, gathering wild frer.rj.t, hwrting, fishing, vrater earzXring, ete. At the same timer it is aclslowl-edged. both among the participating countrj-es - Upper Vo1ta, Iiiali, Ivory Coa"st, Ghana, fogo, Berrln and iliger - and a,tltong the sponsoring agencies - trlor]-d Bank, IIIDP, FAO, \iHO and the donor eountries - that the ultimate justiflcation for thts r.a:dertaki.ng is thepossibility of ^opening up 65 OoO hm.z of good land for econor:ic clevelopnent oncethe 700 0oo }fir4 of the Programme Br€o .1,-re freed frm onchocerclasis. This d.isease, perceived as a mejor public health prograrme, constj-tutes one of the nain causes of tkre econonlc urderdevelopment of the region. Consequentlyr another ta.sk of the sociologists in tbe Epldemi olog1calEvaluation unlt is to co]lect certaln ba.sic info:mation or data wh:loh oan be used' ln the Lupleoentation or for"rn;lation of future d.evelopment projects: soclal orgapi.zatlon, '[:e system for decislon-naklng and its prineip?l agents,population ilolremelts (nlgrations), soci.al senri-ce facilities (heaIth, educati.onal, cr.rlturalr etc.) ar:.d econonic in-i'rastnrctures (existing prolecis, roads, market, etc. ) , tr'inaIIy, the sociologist uust foster relationsirips of nu'lrual confld,e,.rce and cooperation betvieen the peasants and the members of the nedical team, Iorrrgccupying a position nid',;ay as lt rvere betn-reen laboratory reseeich and nobile c]1nie woltkr an epideniolog:lcal evaluation aims, Iike labor.rtory research, at obtalning a scien'ciflc result vrh:ile, like mcbile c1ia1c irork, ul:-ng required toestablish a relationsldp of bnrut between the people studled'(tfr"y are notpatlents) and.-bite physrciairs (who do no, necess.,rily p::rform arlJr therapeuticfunction)". (op. cit.) In order to create and maj-ntaln tha; trust, cou:.tesy visi ts must fi.rst be made to the Ioca1 reprecentatives of the central arlmiirtstra.tion and the rrillagers who .',re vislted mrst be reg.ssured. that their aduuii:is-brl,tlve aufl:oritieslmow about the qlssion and have gj-ven their assent. illext the sociologist, lvlrtle respeeting the lrad.itional protocol of the vi11ages, mr_rst gi-.ae a. clearpreeentation of the objectives of the nission and the f,reens brought to bear, adtLtng a clear er.rlan:ati-on of what is expected of the rillagers. I,a.stly, # n'trstlisten to rvhat they have to say aird. ansrven ar$r questions. In default of such an effort of adnirulstratirre cor:rtesy and patientpsychological preparation, the evaluations are liabl-e to be adversely affectedby absenteeis-.it wirich may conpronise the validity of certain fi5ures from the very first visit. Since the ned.ical tenm j-s condu-ctiag a :-ongituainal survey,it is errident hol serious tkr-ls risk ls if the volturta.ryy informed. and notivatecl cooperation of the populati_ons is .iot secured. I -7 - 2. Iththode In the fieId, the three taslrs of the sociologlsts have been implenented by means of: the census seul-directive talks direct obserrations, Ihere follorp a brief outline of the methodolog-ies. 2.1 The census [he census nrtrst be a comlrlete one, registering 2'l'l the resid.ents present, those absent ( eutgrated or away on rrisiis) i"a p"*"5r,." for.rrcl irr the viliage and. likely sti]-l to be there when the team comes by agaln. It uust also be aecurate and. precise so that every person registered can be subsequentlyidentified and traced.. So that the census can meet these two conditions. it is eonclueted on'thebasis of the smallest sigrrifieant social unit (tire far"rily) ana the meobersl' situation witle respect to one another is specified in tems of kinshJ.p tles. Ihe vi]-lage ls identifiecl by its narne and code (= serlal number of the exern'i nation) - Ihe neighbourhoods ln the village that are exemined are naned and coded.(= serial nr:raber rrithin the viJ.I.age) The farni lles in each neighbouri:ooc-- are iclentified and cotled, (e serlaI number of ttreir presentation for tire census). In eaoh fqrnify the reg'istration of the members is done 1n the follovrlng ord.er: the head of the famify or concession (- dwelli.ng unl.t or basic soeial unit) hls first rrife the ciiLdrrn of that ruife in order of seniority the second. wife the oiildren of that wife ln order of seniority aa5r othor rlves and thetr ciri]-d.::en1 in thc s-ure order rristtors. !-4- A particularJy tric$ part of the census, in these regions rrithout rital recorcls, 1s assigning ages to practisal'ly al-1 the indiv-itluals. [he method used is that of ssf,imnf,fqn. fhere are several eriteria for this, ttepend.lr:.g on ages From 0 to 12 yea.rs: T-re use the so-cal1ed dental age method. (see table reproduced jrr Aru:ex I). Fron IJ to I8 years. fior girls: estimation by reference to thg average{r€e o{ narria'ge (= 17 or rB years depend.ing on th.e region and gtrudcgroup/. tr'or boys: est'imation by reference to the girls of the same age. Their own average age of marriage is difficu].t to utilize sj.:rce it varies vridely aceor*ing to the ind.ividual and to lris social baclqgror:nd. and econonlc Ievel. Fron 18 to 45 years. For wouen: esti-mation by reference to the nwrber or children _or completed pregnancles, at the rate of one chtld ox one completed pregnancy evelTr two years. For raen: estination by referenceto a persouls vl-ife if it j.s irls first, or else by brothers, sisters andpeer groups. Frm 46 to over JO years. For wonens sstimstion by reference to the year of dellvery of tire last ci:ita (excludlng cases of sterility by referenteto women of the same age)o Formen: eitimation by refer"n""-to the age of the vu'ife fi-rst manied, or to the age of brothers or frielrds. In a.11 casesr and when the opportuurity arises, reference ls established to a historical. event preserved in the memories of the peasa:rtry: the yearthe country became indepenclent, the rlepositioa of President Kwame itrlcumah, etc.x 2.2 Senrl-d.irective ta-Iks The sociological sulvey aims at collecting a variety of info:mration. The senl-directive talk is tire first means of gathering the infornation needetl. It talres place in the presence of a group of informants. fhis group should, by the rarlGe and diversity cf its menbership be able to prov-ide as completer correct and. accurate lnformaticn as possible tirrough the i.:ete6a1 contrad.lction sti-rred. up anonil the participants once the discussioi:. has been lar.ueched ln an afuosphere of mutual tmst. ft ls therefore attentled by the rrillage chief or his representatlve, aecompanied by the locar notables: couz't di6ia.taries, Iar:d. c ,iefe geighbourhood clriefs, 1i-neage c}:iefs, those in charge of various assocj-ations(youth crubs, former pupilsi association, coope""[i""rt";",), ,ne school-teacher, the nurse and the ulrlage agricurtural officer. The matn subjects gone into are listed in Aruaex II. *-ts ;6 Census record's and. indlnidual ld,entity papcrs could have been used. Infaot, we hatl access to a very Um{tecl rnlnt"r of tntLirridr:a1 ld.entlty papers.)F* Aanex II 1s aetually a L1et of ethnlc groups wlth oorle nmbers. - rransLator. -r- 2.7 P:lrect obse:srations Having the same objective in v:lew as the seml-directive talkr they supplement, parti.cularize or inrmlidate certain parts of 1t. Conducted mlth the help of a grridel they generally concern the conflgura- tion and. locati-on of dwell-ing units and fields i.:: relatloi to blacldly breeding sltes, the soclal inf::astnlcture (premlses, equlpment etc.) and economJ.e projects such as large-scale land development, dams, etc. Ihe rezults of these observations are, if necessary and. possible, recorded ln the fo:m of a plan of the village showing the location of the various features. fff SOCIOLOGICAI tr'IIIDI1IGS OF TiiE PIDEiIOTOGICAI EVATUATIOI{ I Villases stutveyed _+r{ the Iryg1aggog_Aegiona In Ghana the ?rogra.ume covers the two northern reglons of the countrysthe Upper Region antl the $orthern Region which r3roup 26 L6cal antt 10 DistriciCouncils. fhese two regions conprise 9Z 7O2 1fr2, or about 4fl of the totalarea of the country, and are irarabited by 1 59o 341 p"r"ons or t8.6rt of trrecountryls total population of B 559 1r7 (rgzo ""o",r"). lhis popuiatlon is wrevenlJr^distribr.rted: whereas the mean d.ensity forthe oountry 1s 2].,.04 persons per h2, it is 71.66 for the Upper Reglon anhlo.+2 {or the Northern Region. fhe variations range fron a:-rnost urdrarabltecl zones (onchocer-ciasis-i-nfepted ;;;" ;ii;y") to centres where tJre denslty exceed.s 170 persons per lm2 (fur:eo-Ibbdprn region)r-;;il i"-"""y *"u represented graphiealLy in Fig. 1l of the article by Hrmterr :1giZ (op. eit.). Ihe cri-teria wh:ich governed the selection of villages for epidemi 6-logical erraluation_haire already been exprai-aed (prost et "i., 1975 .rraBrinlaann, WT/76.II). lhe rnllrages selected. and. zunreyed. are'tlistribr.l.tett aeong 19 ]oca1Councils belor:ging to the L0 District Councils. In them a totai of t7 4|i5Bersons were counted., 11 T4O uade:nvent parasitologlcal e:ra:n:i.:oations and L 55IophthaLnologlcal examinatl ons.* Table I shows the iListribution of the villages eva}.rated among thenariors gdmlnJsf,rative dlstri-cts, in&tcating for each of the Latter the area.populatlon, clensity antt number of villages erialuated.. [ab1e II glves their tdistributlon by river basins, and Chart III shows how they appear on the napo {+ Y111age \: 126 Akanyaleom (tee p"rsons counted, 158 examlned forparasites) wlyich fom,s part of the Brong-Ahafo region, is excluded fromthls totaL. -6 From Table IV, r,vi:j.ch indicates for each vilJ.age evalua-bed. the geograpirlcal coord.inates, tl:re arimi:ristrative tr:rlt and the d.ominant etlrrrlc #oupr lt wiJ.t be seen that I8 of the oountryrs etlnie groups were encotmtered. ln the vilJ.ages evaluateC.. 2. VlllAeqq !.fql41aiol: -qi,-zo 01' h- --gl,li.i [he description of tne metl:.oi': has nade it clear th-at the geograpirlea.I and hr.:.nan reference r,u:it o:3 -bhe eval-uet:i.ons is the vi11a.ge and tl:at the fnrrily is tire reg'istr;tic,n w:.-t. In respect of size, the rurits encor.mtered carr be broken d.ova: a.s fol-Ioivs for 2a villages fuI1y evaluated. lllz,ll 0l' ,11;4Gri3 (.n.:e'in O-u' ItiiiAiill[T'i;) I{umber of inhabi-tants lth:mber of villages concerned. Codes of vi3-lages eoncemed. )6m'insnf, ethnlc groups ro0-rgg zCO-2)g 769A7rx Dagari 3lmoba ., * After the 4OOo199 c-r-asse c,,nj-y these';wo fi.g,r:^cc exlst; hence the dlsoontinulty of the progression by l:tulclreds. SIZE Oir rrliltrlLlii (ii-;---.. 1 .; i-*- :sC:.;J): -.1-'.-]ifBUTIOIT OI AISTIIETIC ll[ll,i]S Ai.'llcl r'ltrl 20 VILLAGXS loo-799 400499 4 263 og7-ro6-rr0 IT2 r08-096 Iaga.5- 1L:.;a.se I(asena, Sulsa lTairkana o95-rJ99-rO5 c93-094.-r00 I07-iII 0c0-09f-0gB r0r-Ic5-I04 I1-^ r-^^ Iiasena idani,,ara Ifusasrj'ra-:l'::a Iiaseira, i\,'e Si-s.r-Le. I"asena trampursi (3) ].robl Size of fqmi Iles 6 "'' -? "g Ifumber of vlJ-lages ooncerned Dorrigrant ethn:i-c groups SubJect to certain r:marks contained. in the d.iscussion chapter, it can be statecl that: 25.O and. 74,4 2 ro. o-rr , g i2,o-:t,"9 15.o-T8.2 6 5 Ilusase Fra-fra Ibsena fiairl.;ana owe (r) 2)(z) 2)(r) ( \ + 7 Slnoba I(acena 3u1sa Da3ari T)n rrr n' -Ia.bJe'l IG.sena Iianlcana BuJ-sa-Dagarj. lobJ,umpursi; Gondja l jarnpursi Slsala I It I t I ln the med.ical e'Eluation sa:npIe, the slze of the villages is not directly and 1n all cases comelateal with the endenic prenalence of on6hocerciasis: the tlrree ,,:naIlest villages have a prevalence of 6L.q2, 68;1%- and, 65.f1 respectively, wher6as the three largest have 74.3%, BO.5% and, 64.6% prevalence respectively. In other words, the soallest villages are not necessarily the nost heavily infested.. If we apply the loglc according to whlch, the snaller the ra:mber of lnd.liridua1s, the higher the endemi-c preralence rate caused by a given m.uober of ir:fective blacirflies, we ha.ve to take into accor:nt at the sane tlme the average number of infectlve bites, the d.ispersal of the litt:tng area in relation to the infesting blaclcfly breed.i.:rg site, the tl;ate of establ-ishnent of the hr.rnan settlements and the mobility of the populatlons (uigr^ations ) ; the size of the villages seeuts to depend on the initial i-mporbance both of the centre and. of the hinterland of the urban area: for example, the two largest villages su-rveyed. (nartugu anct T,isa) are a foruard. frlnge of very large inhabited. areas; the size of the families seems to vary accordimg to ethnlc groltp: 1f the two tables above are considered j-n conjunction, it ls the lWampursl, the Bulsa, the Sisala, the Gondja and the Dagari who seemed to have the blggest femtly untts. 7 Aee and sa tllstribution of the population examined. and. onchocerciasis (") Sex stnlcture In lB vl11a6es or parts of villages eraluated., the brealcdoirn of thepopulation by sex shows wid.e variations in the cnrde percentages. Fron Iable Yit can be seen that the e:rtreme values are found at: tr\:nbisi (fo5; z 45% men, 55% women. Yj.llage populated by Brlsa; sabari (rra)'. 5e% men, 42/" women. vlIlage poprrlatett by Dagonba; Datulm (feg) represents the ideaI balance z 5O.So men, DO.q, wom€flo VilJ.age iyrlrabited by l,ra-fra . G::aph lll shows that 21 vl1ia6es, or 55.7% of our samplel have a Pregond.e::ence of nales 15; or 59.5%t hav" a prepondezranc" of women, while trruo, or \5.7%) have a balanced tlistr:lhrtion of the sexes. &.it the most interesting set of relatlonshlps is the nascullr:ity :catio by agegrorps, which we find. undergoes enormous fluctuations : Graph Yrr shows that there is a preponderance of m,les 1n the quinary age-gr€ups from 0-4 to 15-19 years, from 40-44 to 4549 years, and over 55 yeals; -B- Ihere is a preponderancc of fernaLes in the age-groups from 20-24 to 75-79 yeaxs ancl i.n the 50-55 year group. fhe follorlnlng Table, whloh 1s more preclse than the Saphr shows the nagnitude of certaln derlar.tlons for the whole set of vi'llages. o+ | r-o i ro-I4 I5-I9 20-24 25-29 n-34 75-79 4044 +49 50-54 *\as;;s +70 ee.?l r03.4 I4I.O I22.6 82.5 76.7 Bg,6 8[.2 IfI.4 II6.4 7a;5 99.5 r45.q 201.4 728.O 554 lhe IOJ4 and I5-I9 year a€e-gteoups have I4I and. T22 boys respectlve\r tc _ evetlr IO0 girls; After the age of 50r it looks as if there rrere practlcally no wor!.en left: l+6? 2O7 and, 128 men per IOO women. (u) A$e stnrctu.qg Tlre overall shape of the age pyranld for all the uillages evaluated (see Graph VIII) j-s no:crnaI except for a few variations. Hovrever, 1n the set of graphs numbered I)i we find marked and opposite variatlons frou one vilJ-age to another: these variations axe still more clearly ]rislble ln the set of graphs nrurbered. X, where they are shovyn by Bex. . the age ratio for both sexes (fatte lf,) confl:ms the irregr:larlty of the age distribution of the population: the ran3e of varC-ation 1s I2.7 for^ malesr 16.7 for wo&,en and. I4.5 for both together. In general, the diversity in the shapes of the age pJrramJds which was obserrecl ln the viII-agee eva-luatecl colflresponds to the tliversity of the reglona-l p3rarnids in the atlas of Gtrena (wationa-t Atlas of Gtrena: L[ap N71 1960) and generally obsenred. in the cor:ntries of Africa, * Ihis j-s proof enough'that the fluctuations obse:nred are not due malnJ-y to errors of estim.atlon oonrmr tteclby the persons who conducted. the census, but correspond to ieal perturbations i.:rthe demographic jrdices of the census populatlons. )F see IIo. 7 ln the rlst of references. -9- (o) Deuoeraphic stmctures and onchocerciasis What factors could hare produced. these deviations j-n the age and sex stnrcture of the population? lhere are four'v' tqrpottreses which nay e:rplaln these pertr:rbations: the econonic and eu]turaI leveI of the populations of the various regions; : the health situation and seleetive epidenics; : differences ln ferbiJ.ity between ethnic groupsi the effects of onchocerciasis, on the supposi-tion that i.ts severity clepends on a social dlrrislon, by age and sex, of tiie actirritles that 8i33" categories of ind.lriduals in contact vrith the blaclCly breed{ns because of i:eadequate i:c,fo:mation on far,'iJ.y inccmes, on the baseline health situ.ation, on the trentl of the rrital statistics of the regions and. on the denograpirtc tlata for all the etitr5.c groups encountered., the respective or combinecl effects of the first three factorspostulated are difficult to evaluate. I[hatever the possible lnfJ.uence of these factors may be, one is stnrek by the fact thet it ls villages where onchocercj.asis is llytrrerendeaic wl:.lch d.isplay the abnorua.l clemograpiric phenomena observed: lower age-Sroups compLessea (Natong-Saboro, fbo), age-groups above 50 years monll or even unrepresented on the fena-1e'side: lTidinaba (OSl), Apodabogo (095): sugu lroZ), iQrll:n (rtt). It Looks just as if onchocerriasis lvere on the one hand causlng excess mortality among elderly persons through general rveakening of the orgarrism, and on the other hand reducing fertility in the severcl.y affected. zones. A last point to be noted in the age distribr.rtion of the population is thatin the villages evaluated. those ured.er 20 years o1d constitr:te ilfr ot t1epopulation: see the cr;mulative percentages shown in [able XII. fherertoo enols[ous variations u.ay be obse:sred:ln the same trend.s as j.:nd.icated above. Graph XXrr shows the age pSnrani cls for alr the rrirlagesr x The speolfic case of the excess of boys aged. IO-I9 years ntght be' corurected with the fact ti:at most of the vilJ.ages evaluated bave schools. Thelnflr-x of boys from neighbourlag rriLlages may e:qrla-i-n the excess of ma1es, one school generally serrring several rrillages. -10- +. Absences and 1eye1 of attendance for evaluations t Gene::al-Iy speakir:g, the attentlance rate of the,populations for eraluations has been very satisfactorXr. Vlleenever tl:eir leaders (v:itlage chlefs, distrlct chlefs and. family chlefs) have been approached respectfully and ad.equately inforaed'about the purtrroses and. objectives of the visit, there has beeu a nassive tun:-out. Individual- refusals have, holvever, been met with from a few yor:ng women and trivo chiefsr wives who could not bear to unclress in front of a strar:ger or had. a subjecttve dread. of the skin-srrip tweezers.' f\vo cases only of partial nass ref\rsal were also recorded. at [an:lna and Yagaba. fhese were due toinstrfficient mottvation in the first case and. an unsuitable manner of appr"oachi.ng the rrillage in the second. rhe attendance ::ates shown in Table xrrr are; however, no more thaninclicative because: certain villages tvere elrarnined partlally (see tabl-e 4) i not all absent persons registereg fr'the cenzus were taken lnto acco:rrt 1n calculatir:g the rate (e.9. those who had left over a year ago were nct counted); in the case of some eval-uations where the soclologist was away for One reason or another, or the team was exkrausted after seve::a1 weekst stay continuously, the registration of absences (residents present in the village and not attending for examination, residents abseirt from the village for varyitg periods) was not always properly done. tr'ailure to talre aceount of these rese:rrations n:ight l-ead us to rejolce too readily at record percentages of attendance, ranging between 98 and 1OO. llee ::ate of presence, i.e. the nmerical percentage of resid.ents present over that of the total nr:mber of inhabitants, was also very satlsfactory, thepercentage belng 92. lhis figure is also only lndicative, for, ln acld.ition to the last point made above: some absences reeortled as tenporary are ernors of interpretation between the person conductlng the census and the responsible family membergldtg the info:matlon: they actually concern resiclents very tenporarily absent (on visits in particul-ar). It ls very dlffioult to qua.:etify them, bl-rt their oclstence uust behunbly adnrl tted. The ertrene duration of migrations (average duration after which a nlgrant can be considered as ha'ning emlg::ated for good. and a1l varies accord'ing to author and region. Since ln our str:d.y no precedents were availabl-efor Ghana, it rvas difflcult to settle on a lnalcjJrum duratlon. tIn the absence of d.ata for other countries, it was studj-es on ulgrations ln Upper Volta which provid.ed the basic references: average du::ation of n{Srations: three years (after that lapse of ti:me 5(i of the migrants areback/i extreme duration: 1o years (ty then, 844 or.rt of lOoo who have left areback, and the rest have euigrated for good ancl all). tlfi.tth a view to establlshing a chronological record of actr:aI ulgrationsfor the villages erraluated, absences v',ere recorded. up to a 6uratioo oi f5 years. -11 - teri s of cont and tlonfu:an -gr_ol-Bg ons a' 5. (") lnla A total 0f 541 persons were recorded as haulng euigrated in 1? of thevillages evaluated. The einigration rate yarles from cne rrillaee to another:in five it is iess than 5%7 in another five about 5%, 1n one 77,, in three abogt2Vr in one ]:2.z% and in a'1ast-ii.-iGf.- ft.;";;e1.esate::ate for all the vil-lages is 7.6%. the 541 persons are nad.e up of 59:. menand. 148 women, uir. S.+% ,ra Z..Z%respectiveLy of the total population of the villages: see Table xrv. [he age distribution shows that mlgration is nainly confined to the aee fl3p? |ro* 15 lo ?9 years, wirich contribute respectively 1.2%, 1.6% and. t.i%,v:-z. 4.2% out of the total of 7.6%. Table XY again takes the age dlstribution of the nisrants and comtrrares itto that of the total population of the villages concerned,. Graph xE-If glvesthe age pin:anid of migzants between 15 and. 4d y"uu, while crapii xlll-rflrperposes that p3rramld on the p}'ranld for the totai population. Here we seethat: contrary. to presr.rmpti-ons, the na:ror4, age tlers of the persons ofnlgratory age d.o not co:respond to the broad age tlers of the mJ glants. the two-series of age cohozts have a dlrect correspondence j-n their nagni_tude. this is quite 1ogi.ca1 inaslnrch as the mig:nnts registered in the same eensus are already included in the g1oba1 pprauid. For tneproportions to vary inversely, the pyra-uid. would have had to show onlythose residents present. (u) on of F-"- -.lllges of rulgration ln the sample have already been specified (seoagaln Iable xIV). They are not necessarily representative of the mostimportant departure zones of the Upper and'I,IoriLrezrr Rsglen, inasmuch as thecriteria for selectioir of villages for evaluetion were not established with aneye to measuring the extent and distrlbution of the phenomenon of migration. lhe most lnporlalg.point of amivalq 1s Kr:rnasi (S.Z%) foLlowed by lamIe(o.l%), Bolgatarry; @.7%)'";J-A;;;ii :;7"i .^"rr,*tnu history or earliernigrationse l(rsssi unquestionably stands out as tile fozme=""ugi.or1a1 metropolistovrards whlch al-nost aJ.l the migmtions converged. lfiowad.ays Iecondary centresdlversify the movement and att::act it to their respective zones of influence(see Iable X\rII). t-]-2- Tab1e X\rIII shows from. lvhen departures d.ate. 55.5% of persons at present i-n nigrant st-atus left between one and three years igo. Over trrreu quarters (lg.e%) have been auray for six.years at most. Irom Table XIX it can be seen that 52.7% of fomer migrants returnecl to the-ir villages after a maxj-mtm of'four yearrs absence, Nearly three quarters Ql.S%)r were back after seven years. I[e can therefore state that in the rriilages enaluated the average duration of nigretions is three to fo'uir years. fable XIX shovrs another imFortant eharacterlstic of the ntg::ations in northenr Ghana: this combined d.iagra:n of duratj-ons and returns enables the approxl-uate age of the nlgrations to be dete:roined. Reacl in conjrmction with a table of the age d.istribution of fonner ni-grants it also enabies us to traee the development of the phenomenon through the generations. Tkrus it seems that the uigzation phenomenon is very o1d and dates baok to the ti:me of caralan trade between the savanna and the coast. Pe:manent settlement becomes inereasingLy rare. Destir:ations get diversified. fhe nigrants are yor.urger and. your€er. (") futg:ration and onchocerciasls An interestlng question ts whether it ls onchocerciasis that gives rtse to the migratory movement, whicl.r ln that case would. reflect an attitude of fligtrt avray from an eeological environment that is economj-ca1Iy viable but d.ar:ger<rus from the heal-th stand.point. Prudence requires that accornt be talren of other possi-ble factors such as the level of effective production, vrorking cond.itions, the attraction of new cultural patter:ns, etc. It mayp however, be noted that: six of the seventeen villaees affected. bv euisration dlspLay h;rperendemic conditiorr" (g6,gfr - Zo.gi!):" lrsl (rge)r.necrraunsr (ror)rNaicong-satoro (tOo), Kayoro-\,.ruru (ogZ), wid.lxaba (og5) and sekotl(ogz). in eight the disease is strongly mesoendenlc (69.>% - Ao.e%), Apod?bogo (ogl), Panug-r (qgO), ilayoro--Bariu. (oge), I[akong-Atlnla(@9), Itiasi (roz;, saan (ro9;, Kparrfa (rro; and, sabari (rre). 1n turo moderately mesoendeolc conditions preirail (Sl.Z% - Sl.7%)t I(ad.ena (roa1, Jar:ga (roe ). only one of the villages affected. by the emigr"ation recorded ls located in a zone'rvhere onchocerelasis pretalence is at the 1ow mesoendemlc leveI. (it :-u at the fringe of the forest zone): Sabon-Gida, l-L7 s 45.5%. Table 2O shows the position i-n detail. I_17 _ 6. Displqcqnqr_ts of _vi.!1a6es end nqtural mpvenqqt o_f_gopqtqtrong (") Desertions Several ca,ses of d.esertion of foraer sites of villages or parts of vi]-lages have been obsenred: at Tili (ogr), sekoti (oge), Tliclinaba (ogf) and Danr.rgu (oge ), These represent specific cases where the prima:ry responsibility af onchocerciasis is not open to cloubt. three ma'ln fsgf,ors are cited as reasons for morring, viz. _ o:nchocerciasis, water shortage, and destmction of crops b;r elepherrts. at both YTitLi.naba and Tili the sites abandoired are t}lose which were locatetl closest to the r:lver antl the resettlements obse:sred both at Sekoti and at Danugu-Sheskrte vrere renovals to sltes at a greater _ dlstance fzpm the river. i.:rfo:mation on the quantitative importance and apprcximate dates of the moves vras suppl:led bjr the peasants, among whora are fo:mer - emigrants from the river. at Ti]-i: Zoroto : some of the inhabitants of iffis f6salif,y retreatetl to TiLi about {.0 years ago. BriLt : some withd.rawals to h'iAinaba, about 27 yeare a8o ' Azontot : withdrawals to Sapolgo and Gbantogoe abort 23 years ago. Sawko : nrins sti11 vislble, withdrawals to [ukamea and Sinaba. I'walsalro: withdravrals to Witli.::aba about 74 yea.rs ago. [hese fo:mer large nelghbourhoods of fili were at a ma:ci-ur:m distance cfI h fron the river (nea Votta and Abuhrloga). At lTidinaba : - the l{orbagal lQfsrrsi II and. Anihraga r'iJ-stricts dj-sappeared about J5 years agp. L-'l 4 - At Sekoti : the foll-oliag districts which existed close to the river uust have roade the folloruing moves after 1949.x fopene had at least 20 concessions designatetl by naue, of vrhich l-0 are now in the centre, the latest a:rlrral tlating frorn six years ago. $yor€a had at least 12, of which one carne to Ssksli. Kparaboo: 21t irnc1:uding five at Sekoti. thlrkpag z 28, including six at Sekotll one being il exlstence at the present tj-me. At Sheshie : 15 fanllies had to moye fron their inl-tial sites: 4 resettled in the same li.llage but some 500 to 8OO nfarther away from the river Mo::ago. 6 moved to Danugu, a village 1.5 lon away. 2 went to lfalerigu. 2 vrent to }trasrm-i, one to Narikabo and one to Bawku (t) i,fiatrrraI movement of populations The question to be answered here ls rvhetherr by comparison withprevious censuses of the vilJ-ages of G?rana, there has been an increase or a decrease in the population through the probable ancl relative effect of onchocerciasi-s. It would have been necessary to knorv the position of all the villagesin comparison to the 1970 census. hrt the search ls tedious and the resr.rlts uncertain: 1n the census book, the localities are not always villages tmt netghborrhood.s, which poses a problem of identifyrr.g the variors localities constituting a sir:gIe v:iI]age. Holvever, one example wi1l be given: sekoti. {- The lnfo:matlon given here on the progressive w:lthdrawal of dweIIlngs atSekoti was obtained so1e1y by tatking to the peasants. Hovrever, it displays an astorrlshj-ng quatitative slmrlarity.urith the stuCies based on cartographlc d.oeunents by J.M. HUllTXn (op, cit.), in partieular the table: rrRetreat before rlver blindrress in Sekotiir. _r5 _ For 15 localities situatetl within the area of the vil*lagel onJ-y for:r of wlrtch have been completely identifiect, the following table can be dral.m up: District Population Movenent of the population inpercentage per year 19+B r960 r970 r975 r948-60 rg60-70 r97o-75 I r94e-70 194e-75 rg60-75* Senzurre I'iyoga Dasanga I(parabook [Iho1e of)Sekoti ) r 569 28i5 76r 2 2T5 798 718 175 I86 I eog 276 IOI 58 T51 r s78 616 2A 40 77 I IO2 -5.5 -4.0 -5.4 -r.7 -IO,I -II.4 -r0.5 _ r.g +o.4 +I7,4 -22.6 -7.2 _T2.9 -TO12 -7.6 -7.o :3:B -0.8 -1.4 -T5.1x -7.I -5 6 -2.6 The percenta,ge d.ecreases in the popr;lation are evid.ent: 2.6fi fot ibe whole of Sekotl and, Ii.7:fi for the aistrict of Nyogo. The reasons for that clecrease EIay Yatry. the fact remalns tha.t the district most affectect ls the one most at r:lsk in respect of onchocerciasis. (") of onehocerclasls one ulght have thought that the peasarits a,re coml:1ete1Jr una\/are of the d'isease vikich afflicts all those who Ilve in the yicin:it;. of certain rivers.lhls is not in fact so: they h:ow about the disease, describe its sJrmptou.s and. even have, in certain casesr a tratlitional w4v of treati-ng it. rhrs, at riIi,rrchameLeon blintlnessit 1s treated with a r?chameleon fetishrr. The peasants of TiIl (O9I) betieve that 1t ls vyhen you are fr3.l'slting aird' meet a chaneleoii on the way that you catch tne d.j-sease. The fetish was seen at the abode of llr ]tro1eo libila Ayere. rt consists: (*) of an earthenrware pot bearing the effi-gr of a palr of chame].eorls? as the instrument to exorcise the patient, ma-1e or fgmars' (u) a d.ecoction mad.e from roots of trees supposed to be ,chanireleon treesrr (the nere and the Batrourga) ana -oiner ingredients. Its effi-cacy is not alr;ays attested, but it is sald to delay the onset of blii:dness (through its psychological effects?).Distingtrisl:ing ci:aneleon blindness from other e-\re diseases. for example n:i-tom or ni-r:o4g (= the eye d.isease wiitr "or"s), 'they describe it as the condi-tion in whicir ?tthe eyes mart anditch, with sometlring nroring arou:rd insidei they do not nrn, andblintlness comes on gradually but sJ.rely.rt -16- tley $now about other marli"f,estations of the disea,se: the villages ofsekoti (ogz), sabare (ile) and }tumgu (tzl) h:ow about the viti].igo ancl the _cysts, cs]led EEi., d.awo, and }oaga in the l{abdaml Da6ornba an<l Gond.jalanguages. In many rrillages the harufr,rJ. fly is cJ.early lt:olrn and j-d.entified. Its bi.o1ogr" is described. more or less sotj-sfactorily: favourite place:the river;period. of abundance;higi] water; tiisappears when the fJ-ow ceases; bites by the river antt in the adjacent fields, but also i-n the villages during periods ofprollferation. It 1s these characteristics vrh:lch narie it possible, in thetalksl to distingulsh blacHly from other ha:mful insects. In the follonring tab:-e on-Iy the Local te:ms utilized for the blac}flLy and the tsetse-fly are glrren. Ittentificaf,ion of the blaeldly in 1ocal 1ar:guages: YiILage 0f course, e'11 these different elements were not 1n eridenee in q-t.I therlJ.lages and even the peasernts of the above-listed villages d.o not alivays establish tlte necessarTr comelatlons. Sti1l, tire lmowledge that there ertstsa baslc ar,i/areness of the disease is an imporia*t f,ctor for any mess acti-on that nay be contemplated. 7. A brt glance at the social and socioecononic spheres (") Socia-l sation A11 the rrillages rrisited. have a centretized ad:rlnlstrative organlzation:the traditional cldeftainry. The ehief is t}:e essential inte:med.irrlr betvreena stranger and the ri11age. Ethni.c group HarmfuJ. insecto Code -rL- 09z IIO II5 IIB II9 r27 Nar,re BJ.acldly? Tsetse-fly? Cyst Sekoti I{panfa I"pasenlcpe Sabare I(engua Lfua"ugu itrabdam I..obi lfqrnFUrsi Dagcmba Iionkomba Gondja 3en-ya Drup 1 Dum$ema l7urong BerJ.lgo Kenr fula ltlaaganga i7uIun Pig Dawo iQaea lhe admlnistrafive clrlef j-s asslstett by a ooi:nciI of notables, of neighbourhood. or femify chiefs, whom he consults and who transnlt or execute declsions t&k"en. It is oir them th-tt finally depends, for exanple, good attendance by families. The reference social r:nit is the clan or, vriien thrrt is very 1xrggr the lineaI fnmify. Apart from very rare exceptlons (tne f,oili, for e:ranple), the nuclear fnmify does not possess indepeirdent personalif,y. ilhrrlage ls generally exogamous in relation to the reference socia-l uraitt but it occurs anong relatives as close as first cousiils in certain ethr:-ic groups (tfre t',tarnpursi of Jangar for examp]-e). (u) Econontc rqsourcest acti-rities qr1d. proll_eqg AgrC-culture is the main activity of the vi1-lages. Ihe land. belonging to them comes under the autirority of a land clrtef, called _tu"aan", in many ethnj-c groups. thls person is the proprietor..nanager whose favourable opln:i-on is important for obtainlng nelv faruing plots. Iie has to be called ln for propltiatory or explatory sacrifices. As regards modern:l zation of agricultr.re and extension i'rorlr anong the peasants, it should be noted that very fevu riJ-lages have promoters and very fevr peasants have changed over from the tratlitional fa:mtng methods in respect either of technolory or of teclrr-lquesr The living space of eaeh vi11age, its territoryr is usualJ-y conrpact: the fieltls are loeated within a ratlius rarely e:rceed.i:rg I0 ]u. the clrreJ-lings are grouped. into separate maII units, the concessions, often sulTouncled by the fields parcelLed out into holdings. The overall positiontng of dwellings and fields is an inporbant factor 1n the differe,rtial degr..e of erposllre of tire inl:abi'bants of one ln the sarae rillage: a typical case is tirat of iiarba-Baf,oro, rrill.tge 20&-20! (Upper Volta)1 vrhere by determi:ring the d.istances of flelds and dr-relllngs, it vras possible to identify gfades of endenicit,v. To these data for deterur:ining diffcrential l-eveJ-s of enden:icity, uust be acld.ed: Other types of econonlc actirity: stock ralsing to supplement ineoues(catt1e, sheep or goats), fisLring (Srrgr.., IO7) anct rrtld fnrlts gathering. Ihe social &Lvislon of labour accord.ing to age ancl sex: the lzomen usurilly takc part only i.n some of the fa:mdng activities: sming and ha:srestlng. On the other frand, they go and fetch water frm the river and gather w-iltl produce, vJ-z. nere and karite. The child.ren, accordj.ug to rvhether they are ma-1e or female, accompany their parents or look after the ani-raa1s. (") Socia1 ir:fraslnlcture There exist in thc.rillages priraa:ry ar:drlor uidcl].e schools, c]:inics and ttriIled welIs (boretroles). firon taUle 2Ir rvkr-ich g.ives the details, j-t can be seen that the crlteria for dlstribution are d"lffici.flt to pinpolnt: -r8- Neither the odstence of a school, nor the number of classes in a school, nor the association of nittdle vrith prima:ry 1eve1, depends in q'l'l cases on the size of the popr:lations of the vilJ.ages or their distence from the nearest urban centre. The rrillage of &ranto (fZf )1 l,rith 25I inhabitants, has a pri-maJry school !',ith three classes whereas l(panfal r,ririch lnas 444 inhabitants and i-s more than ! lon alay from lTa, has none. Again, Sekotil with a popr:J-ation of over IOO0, does not yet have a school w.ith six classes, J.et alone a middle seirool, whereas Danugu has slx primary elasses and a nlddJ.e scl:ool, though the dlstances to the nearest urban centres (Solgatanga antl Sawla.r respectively/ are about the sam.e. The same applles t6 cJ.j.nies: the v:i11ages that have schools do not always have cl-i.nicsl eogr lisa (fOe), despite haring a population of 7691llakong-Atinlal which is a long way away from Chiana, etc. As regards lined vreI1s the posi-tion is sinllar: there 1s none at Kpasinkpe; though it has a large population and a ma:ior hea-1th centre, nor at Danugu whtch has a priuarry and nldclle school, etc. So there i-s some lack of correlation with size of popr:lation and ease of access to neighbouring centres, It rm.rst also be mentioned that the state of the premlses and the rr-rnr:-lng of tire establislments ae in many cases deplorable: classes closed for lack of teachers (e.g. Tumbo, TZI) t or_contlnulng to be heLtt1n malceshift accomodation (tCengua, fI9)r cJ.lnlcs cloied (",g. Sabon-Glda,II7); the great majority of the clinics have nelther medicj-ne stores nor permanent staff. trastly, mentlon m.rst be made of the dubious wholesomeness of the drinklng water, since llnedl we1J.s are rare anrl tire peasants tlrayr their water from wrJ*lned vrells or directly from the rj.ver. A social wolfare and public hea-lth progrnrnms rnust talce due acco.mt of these condlti-ons tn which the grass-roots comr.r:rlties }ive thelr dailJ Lj-ves.Sanltation, education, houslng, nutrition and conm-nlcatlons are inportantfactors of good health inasrnuch as they i-mprove the c1ua1lty of ILfe, IV. DISCi'SSIOI{S The goreral method.ologr for epideniological surreys under tire progranm6 was definecl as harring tnvo essential characteristics: (") It represents arroodmon basis for all surflreys? whtch is essential if they are to be comparabletr (op. cit.), for a longitudtnai stud.y; (U) 1t is anenable to successive i.:aprovements, rvhenever usefirl lessons have been learnt from a v:lslt. The following points are therefore thought vrorth emphasizing: I. Conststency of the sociological facet ln the rvork of the trvo teans of the r:nlt. Thj.s j.s s;rmbolized by trvo elenents: _19_ (") The acceptance of a cornmon eensus nethodology: the order of registration and the relational identity, vrithin the family franelvork, of the ind.ivitluals registered ; (t) The joint preparation, one year after the start of the evaluations, and concerted. putting into use of an outline guide for the interrrlews in the sociological surweys (see Annex III), the rezuIts of which provide the roaterlal for the "vll-lage cardsri. fhis consistenc;, tlld not ruIe out, ln principle or in pr"aetice, leaving freedom of in:itiative to the person responsible for this faeet in each tean., It is to thls freedm that we owe the atundance ancl variety of the specific content of the village card.s: the various items in the guide are dealt with to the extent that they are applicable and perti.::ent to the I-oea11ty, some are dealt vrlth at greater length than others in certain data sheets and not in others, and points of interest to one i-nvestigator or another are given special personal attention. rkt example of this, 1n the case of Ghana, is the study of the d,emographlc characterlstj-cs of the population and of nlgratory movements, on the basis of eight analytical tables reproduced in annex IV; another is research. into the historical kinship of the 'various ethnic groups living in the region and of certain cultural vehicles zuch as languages. 2. fhe eenstrs method.ology resozted to irt order to ualre possible the subsequent identification of the individuals covered by the evaluation on the first vislt is based on the reletional identity of an indlvidual defined ln terms of: (") (r) h:is unit of residence: vi11age, districtr concession; his natri-mon:ia1 situation (v,,"ith incli-cation of tire spousets lclentity) or lrj.s biological or classificatory kinship position: son or d.aughter, brother or slster, father or mother. Other methods have been utilized elsewhere: issue of cards durirg the visltr narking of concessions, etc. Such methods cerbainly have advantages, but they apparently tlo not take i:rto account the risk of isolated papersgetting fost (everybod.y loses papers soireti-mes) and soci-aI roobility: travel for various purposes, nlgration, deaths. 7, fhe geographical ancl human unit for an epideu:iological evaluation v:lsit under the programme is the vil1age, and the standard population 7OO personso fhe tea:n has had to deal r'.ri'th villages that were epidenJ-ologically interestlng but whose populations far exceeded the deslred cluster size. A selection had to be uade in such cases, arrd tirls nras done in consideration of the probable degree of exposure of the inl:sbitants as detennined by the locatlon of their clvrellings and fields in relation to the infectlve blackfly breeding sites. 'r'fhatever the criteria for selection, however, to take one part of a village for an official and med.ical eiraluation alvrays raises problems that nay be hard to solve and result either in confused find.ings, or in colleetive refusal, or j.n a high percentage of absenteeisn: -20- IIre populations of these vi1Iages, being mral dwe11ers1 generally live in very unsatisfactory health cond.itions, so vri:enever a medical team appears high hopes are aroused and everybod.y wants to take adirantage of 1ts senrices, whether in connexion with onchocerclasis or with any other i1Iness. lhese same populatiorrs are i-rmersed in trad.itional, hlerarchicale morally ordered and interd.ependent societies. frre chief talres very poorly to havS-ng only hls own family or his own lineage examinetl without the other families in his village or at least those of his leadii:g d:ignitaries; for another ttistrict than the chiefrs to be selected, on the other hand, ts utterly r.u:acceptable in the view both of the chief and of the peasants; when there is an internal conflict in the viliage, any selection is seen by the other party as an affront to its d.ignity. With a 1ot of tact and patience; sufficient info:mation and erq>Lanations 1t ls nevertheless possi-bl-e to obtain a good turnout for the first visit. &:t with later visits there are greater risks of absenteeism or refl;saI: the repetition of what was reluctantly accepted the first time nay be taJcen as a provocation. 4. As regards rrfa^uiliestr, since the Lnportant thing in nakfu1g the census vyas to establish a register in which indivlduals would be easy to ldentify on subsequent visits, theoretical considerations were not allovred to get 1n the rrrErlr Depending on how easy 1t seemed to be to find the individuals again, the census takers registered together or separately sever"al household.s in fact constituting an ertended IineaI or clanship fa:ni1y. fl:us in one village the chlefls femily conpri-sed !6 persons with three households, the chief hi-mseI:f harring 11 wives; in another viIIage, talring into account the size of the dwelling urait, the soclologlst preferred to break dovrn the chiefls femily into 14 n.r:its some of vrhich consisterl of up t,o 20 persons. 5. One of the most the evaluations rnade in II-2-1, vrere uttllzed, both teams of the writ. person in charge of the delicate aspects of tire census is estimatir:g age. In Ghana, several techrr-iques, described. in paragraph Only the dental age tech-ni-que is a standard one used in The other techniques are left to the lnitlative of the censLls. 6. fhe special attention paid here to demogr"apiiic analysis of the population evaluated and to study of nigrations results from the initiative of the sociologist in charge. Irlevertheless, in the present onc]roc_erciasis control prognarnrne in the Volta P.lver Sasin area, the top priority eoncer:: of the epid.emiological evaluation urit is medical: see the threefold. objective defined on p"g" 2 of the general methodology (op. cit. ) ; it ls the responsibility of the Progra:m,ers Economic Development Unit to ad.viser at its modest 1eve1, the gover:rments of the participating coiuitries and to a,ct as a clearir.,g house for documentatlon on development projects. The work undertaken and perfo:med by the sociologist nevertheless ai-me at zupplying both partles with detailed ancl precise infonnetion, whieh is neYer altogetirer useless. -2r- lhe eight tables analysing the dernographS.c data (see Ar:nex IY) arc not intend.ed exclusively 'bo serve the purpose of econonlc analysis: The study sampJ-e, rriz. the ri1-lage of about IOO inhabitantsr 3emqirls smq,11; Ihe selection of the enti-re set of villages y/as not govemed. pr:lnarily by requlrements for clemographlc stud.y of the regionl As regarrds ulgration, in particularl quantitative indices alone clo not d.escztbe or expJ-ain al] aspects of the phenomenonl fhs fimif,s to reglstrati-on of residents present and of those absent are recognizecl j-n pcrragraph lll-4; the limits to the reij.abillty of estimates of age are cllscrrssed in paragraph llf.pl-b. Ihese quantitative tables have nevertheLess been prepared and. utilizetl for the purpose of helpi-ng tovrard.s better qualitative ana\rsis, on the basis of quantitatively evaluated trentls. V. COI\ICilIS]OI{S Orchocerciasis i-n Ghana is a public health prob1en and a han&icap to the econonlc and social tlevelopment of the courbryls regions: The d:isease affects, on an ayerage, more tyar. b7/" of the inhabltants of the ri11a6es evaluated; In its savanna form, prevalent here, the debilitating effects of the d.j-sease on sufferers are many atrd evident: blindness, general weal<en:ing of the orgaulsm, various forus of skln lesioro, socia-l complor. lhrough those same effects, lt constitutes a dual handicap to hea1th and. populatlon d.evelopmentr by el.irrlnating the men over !O years of age and reducing the reproductive capacity of severely affected. ad.rrlts. As the net resr:lt of q]1 the foregofurg effects, it leads to the desertioar and progressive extinct--on of t. e severely affected. riJ-lages and to und.e* population of tire fertile rj-ver valleysr forcing people to rrithclravr to the table-la;rds artd. resort to the ard.uous and r:nprofitable cultivation of banen soi]-s. -22- BNIIDBT.ICES Contrdle de 1t onchocercose d.ars Iq 11-6-gi-o-:r -d-r1 -B-qss-in .{e- }g -V-o-1.ta.hap-p-oit-oe r"-l.rission aijissTst-a":cd -pi-A-pi,rat-oife i,r:< c-ouvernenents t',e : C0te dtlvoire, Dahome',,, Ghaira., Haute-Vo1ta., Iis1i, i[iger, Togo. P-iUD, 1rAO, BtlID, 0.r[S. Genbve 1975. iTAO, EIIID Dd""lg;p__"_*g-Ut_-"_c.-o-p_o-qi-qu_q -deq_z,o::.ej:--1_i-bi-q6_e.s _cle_ 1_to_n_c-hoc-e;rc-o-s.e- -qu: ])ahoneXr _au_S!gper_enlqt-b_=/_o_1-_t_qr_eu- jil-ql j._-e-t-.qq'I-0_6o..ils/I! 1291, Rome, Octobre 1975. r1A0 An introd.uction to socio-econonri-c-.-d-q.v-eJ-*o-pg*en-t-J}I+-rl-&-qg=-[e-c-i1t1i-c-qt ;;iJffi;;To-tE orr-ctrot'ef"i-aB-s i'fe-eE*riines or trre Voltal"iver ]lasii:. 15*@crT.-i.--*-- rtr 95-L7aoue, nlay agT'o. !opulqt-i_o]]_-c_e1qq1--o-f__t@g.--1-9f-9--V-o-l-w.re.1. !lie_ 9qr_qt-!-e*e-{:_ - $p-Q1Qe_t-1-c-a.! -I-i-s_t -o-f- !,9-c.a.!i.t-igs--rytlit- -;1op-u1r;-ti.-o*n- ^nl!F-i1e.qof houses and mata sourcc of v;ater ..s.-L.lpjr_IJ. Ceasus Office, Accra, .Decenber, 1971. a\i.L,/oc?/trE]/7>-z : tliolli A; f[IYTi,i'0i.i:j 3. & pArilAUlT c. Ii6thodes d. I 6valuation d.6nio1-o-*.qBe- de masse de llonchocercose.leur utilisation au cours d lun de lutte contre Ie vecteu:'. oiLs/OCP/8.,:I/76-12 : [i1i:1.A3SGO n.C. lronc].rocercose et ses effets d.6irro_grap1tl_qqes _e-t*_h.mgi._ns- _tlq1s_.l_e-s_ vi-14_qG-e-s. ErraruOs o[--chan-;- o1!,s/oc?/Err/la.1t : 3nr-i[u{.;ii u.i;. Basl_q-ep-i_{g+i_o-1-o.fii_c-a1_ -e_v-a!r.1a_t-i-o-n_ f_o_r -b-i1e- -o-uc,ro-c-e-1c-i-qs_ip--eq{u11o_1 p-{o-q{+-}in GLrai:a. Sources et Aaal.fse d.es donn6e s__d-6.qo-q1ap-i_il-rlqe-s_.-^_4p*fl:-"-qLfqLq.lr-Af.1i-ciqe {S:rgp-qgi-o: -f^rytq+_o-e- et- -{J'hd-a6as-_c-a,q. .Deuxibne partie :IITIID - IiTtjEll - OilsTa,'i. .Peri; , 1975 I{ational Atlas of__Gr1tiitu_ --A-ge sttucture.1960 i,AP N7. I-FJri'-fl-iR, J.hI. ?iver blindness in llan5cdi, .llortherir Ghana : A ad va.nc e an d. re tre a"t in 1!iie- -[e-o_gqap-]]i-c-a.1- -It ewi--ev., .hjus beue::t ffiothesls of c;,rclical(rgeo) , 56, 198-41,6 ]IIIITTEN. J.},i. Geograpkrtcal aspects of onclroc(irciasis control 1n nortiretn Ghama. Ret.rort of a mission carried but -fro:-e 5 Jrme to 4 August 1972 r'rno/o\afi/76.!27 . IN I 6r\0o\qs 6 5 Sn ? n sf hNOF-\o@ +c!(n O\C-F \oN\o $6\(.i\O- haG(q@ O\+tt\O<t -.- -.r+--l F-\oAt xdt0 r{O r< .tl oOEd.{ ..{ dE-Cd+,x-of':l go H q) t<Id e- \ootO: rlrr ro, - e\OIAN\o s c.\ rJ\C.l 0l\ C.- \O @+ hF rOr tsN ch .du odt@otr+, r1 'AE@dtdXtl trl dA RS.RNN * rn (7\ (Y\\oHAo{ ,oEI .A ,+,hdA4 .6 ro o roEl :o. EIdx;o, @ oq0 dA .{ .d C' EI aco t4!to o 'r o +) d F{d o dod 6l +, oo ,.o(H (, o+ o o Fl oo D o u) dl atq -1 or{ Tl Q) '{! o +{ .dElsd1Ug o tr aa o + h o +,Ct{OG'rlA do ,r{ F{d-tsrto-co otrr{oo= daHoo r{hOJJ .H .r{ d -{cddctooE+)oc5Or{ AOo o-q,D+ra 6trOOt{L\ud -o .1 EF-F{oo\dir > ,!4d>rtIH doJdo .-< tfdu .O lh a ?J) R -€ o IN r-fi(\rol.r\ o\ '@ Ln, o A,o ..t Uo t{ ,5 {, oI .l 'F{:d {J ,o iC{ .-. *j---..- a oo @ I N+(\\Oc)6l-R 5: XSEE+(Do\o(nN o <f\o o6\0 (n(nf- t\ (nrFF-N hri\oo\c^n+tl\ot\-\cuaF-r\ rn <tN @ ^ \oo N \o N s,R aac'l e . -6 I -+t.-t.-N@ NNFNF 6INFFN tl ?A o aodo() r.1 a >,;+trE r{OJi@oCt{oodQ." e..P*- co T{ +,dFttq o O{ o o +{ '.1OP Tt od;qo o o r5I E p .: s t-l tn E](, ;1JH Ho la E{OHEF.aH a El H d cdE{a HaHEA >r aq =o e Eld EA <i U o@c'\asaI YV f t.- 3{ o ,o Ea N o6l N t.-o o\ $.<' lr\st - s as - -A eC1 ht.Qdro'lrrO =:EP:8ts8 o &, r(o (D 6N $o o (}\ lf\ c^N(Drnl.\ 6l O rJ\ t--C\r\+[r\ UOONOOc.{rCO(AoF @ O rn C'-t tn O\t\ ;-; ; i '*'. +\OOe-i@O(D(\lc\tf.' O(1 lJ\@6lFO\\o (\t < tr\ G O o\ O.\ F <F - O t: N .+ Lr\ F;;:S co F - or N rA E- - nsltno\ONCO(nq\lJ.\N@ r O (l- r TflSXfFFHgtsgF 6Oc.\iiO\\OtAr@Ne.l5 ++c-c-$u\lJ\U\o\6r'\a odElH;-3o'ddE{EtrCEldotYlddNalriPgt: { r{rldF6fd6cl.lr{e *upg Bf'd E o6todtJa cqaalaErEao dtbdo& PTorlFTd.G ,1 <) Eo EIEodd (l=atulEdoIk'.1;{dodl .{boEtta@adrr<, "EE5E5 =ESrF@ ?1d o {J! att7 - - o --a; F N O w O ? N s'\6b;;6r-\ (f\(n <r+Ln l'nlr\q\a56bbcoo co@ 6@@co@@oFoOeN<\O-NOF-(f;NNNc..lCn(fl(n!tsF F i- t-- t'- c- tr-. r F- 6.- c-. c- otda @to .-s?, VVYV rNslF tr-@F-r+@(nF r <t F \O S C'\ .+ f-h N rn tJ\ rtF o('\(DFoo '*-:. 60?@N\O OeCO \o\o t- C'- @ <t \o tr- s\6(\rtlrslt'-@6nFO\fC-?96 E{ a-trno\o l\. N or t.- cl\ @ t\(\t o\o \o+ !C .:-- N r+ o @ \o c-N tr -+- @ otr. o(J\ : t II I t I I I I i i I I I il gn n n a o.\C'-@ @ O\N N trr- \o 6l : -.-,; o'N c\ gr d F-cq c- <n-IHRSe'eS.sxY5€ (lc tn N(\+ ri\O c\ r d\t o <t N Ut\C-nt\C'\ o+(7.l Nr(D ol6lrer Oft ua\ 6oF-@d\Or+o+(nd\No\6INN Ed Jrl ot.<r o LJ\ +,A6(\-('\sltf\tr-CORFRXSR'ORO'H\otn.\ \oo\ r{ H6dp{ -qpco6t0t{PgsE 50(JS L e o>o d-i E0b0 ._{ b0gf"iii".,gg.iESI o ii dI.o dd,4 o d o o ql HEfiE',EE;EE3E EIorluo& uoIScU rcddorroT8eu rrJ.q+roN ,-.--*-J. ' -- : I I I .t I I I I _24_ GI{ATA: DISTRIBUIIOII BY RI\rrlR BASIN S 0F VI],l GtrS EVA-IU/ITED* Table II * I\no rillages are not included in [ab1e: VilJ.age of 'Iarriqa (ff4) Village of Akanya^lcora (fZO) ILLver Upper Region fiorthene Region $Lap1c eva-luation Detalled eva1uation Sirrplc evaluation Detalled evaluation Black VoLta Red Volta Morago Slssi]-i- Whlte Volta IGmba Ifulpamo Daka IiTasia 0ti !lole K:.].da e (rog, rro) I (ogr t agz J I29t 094 1 (096 t (ogt IOI r04 r (ro5 t@5 ) , J ) 099 T02 , , II oo o1 , , r (roe) r (ogo) r (o9r) r (oge) z (tz+, rzr) 7 (to7, ttz, tt1) r (rra) e (tzz, r21) (rzo, rer) (rre, rrl) r (rzz) r (rze) z (toa, r:s) r (rrz) 7 Total T7 1 I4 20 I7 IIX. frrrtrilr r ftr fi9IILq $qr?IW E-gIIII9IIJIIALUIIF toltm t tQo,t ro& to+ a'rof e tol @lrffi ut .rr ffi] Itot zl ?teo fl It o;IrS rr?. ?,tt It t?6 ler)t t0r r&t a It!t tot a Es.g"l Li*-i-l t9't IL I rril a Itrt:i, .( rl* o 0l ra3 T00 C 'tt 5 l!.2, a Epl ilh rl? 0 I^f:$Emt. Brlo 6n1 i10 It1 r R f/,1 8Ju Bi? il0 ,.J I Hitl ftlr n\? $t; ] I:13:J&:iit-!:iiryi1 !lrru'.t iltf, l+:r { }ifSg,ilLc*JJfP } frtfnf lrn{rrf Lrrf errolJ l,rtarry lll !ir'rq* rr r'$uhI i i Xrrlerl!-Ptaa I lse*I Couacll Lr,rhulrir,.Ilpdcl Lorel Corrnr.tl l,ai:tntrl ia*Ittnd<'qr tonql Cnuntll trur l-tatl Courr*11 .q&ftdntil l.rcrl r-iounr-I l. lltrron[r:. i.or *1 Cou',t i] {:U lrn$*Pnfirt l'14r'l t'Pri1e { ! Botgnl nr;a-Tongx [l-l'an fiotrtlr:: I 8r:rqt.r-l!*lrrlnn l,r,!'ql !'ri1'n': { ! (rrrrnllna*?t'trf ! ll 1t't'rrl t"o'rcLi l f*n;rtttr*+lrrtr I,.r:r:eI Ccrr'tr-i ! BSu tlrhen Colnrll Purl*r+Prlll.n*tsrt Loorl Covne l ! r Ylltrli fll'el'd frr ;irplr rtdrrtlr'r O lttl''{t rilnrttlt llr ilrlel}rrt rrrlurllra r,,lr lr,q i.,*t} {'r 'l 'r) a{) ,) l t ?,''l 7 r') ? i' 'r,l r ' t $r n m -26- ggANA; IILLAGES E)GHINED: LOCATI0N, ADMIIIISTRATM UNIT, ilAIN ETIINIC GROUP Table IV Vlllage i LI T Sfu\ ' KPANFA Geograpbical coordirates , @45 r 0o14 101 I 1019 10m 0"58 0058 Adnlnistrative unitiI I i I I L I I I ilaln ethnlc group iCode{ Nane Code no. of locality ln 1970 csBauS -T I Code I t090 091 092 093 q4 095 w6 q7 098 099 100 101 r102 103 104 105 .1 06 107 108 '1 0g 110 111 112 '11 3 114 '1 15 116 '1 17 1118 '119 120 1d .122 123 124 16 126 I I --t I N;}J 10049 | ? ,50 10"53 10r)48 10057 10043 10055 10044 1@56 10059 1 0048 1 0050 1003, 1@21 1@N 10o36 i 10036 I 0002 9051 1@43 10019 9048 1 0005 100 26 1 0030 9053 10g^26 10014 801 8 9017 9"36 1001 2 1 0004 9004 9005 9006 8q56 801 6 Loca1 Council I.AUBUS.3IE-NA}IDOU KUSANABA-ZEBILLA BONGO-.II].BD'M KUSANT\BA-ZEBILI,A KUS.{NAU.-ZEBILLA BONOLNABDAII TEI'TPANE4ARU CHIANA-PAGA CEIANA-PAGA CHIANA-PAGA CEIANA-PAGA SANDET{A SANDEIIA SANDEI.,IA SAI{DEMA NAVRONGO I,iALE1IALE SAYELI]OU ; I,AWRAJIMPA , ITAVDALI.FI'NSI 1 HA (URBAN CoUNcrr) i }IAI.IDALI-tr'i]NSI I WALE1IALE 1,IALEI{ALE uA (URBAN CouNcIt) IIALEWALE WALHTIALE SALAOA SABOBA-ZABZUOU SABOBA-ZABZUGU GUSflTEOU-CIIEREPONI OU$IIEGU.4HEHEPONI BIilBII,A BIIBIIA BOLE BOtE WENCHI I DAMONGO I GoREBA-SoUUr{ D.tllrKu LAWRA BAWKU BOICATINGA Bi,llKU BAWKU BOLGATANGA BAWKI' IL\YRONGO l.IAvRONGO NAVRONGO r{ivR0M}0 M\NOIrcO N^VRoNOo MYRO}EO NAVRONGO l\]AVRONGO GAUBAGA TAMALE IAWRA i{A WA WA GAUBAGA GAMMGA WA GAUBAGA GAUBAGA SATAGA YENDI TTII{DI IENDI IENDI YENDI IENDI DAUoI&0 DAMONGO IIIEI.ICHI D1 e trlct Councll n-- I i I t I I I I I I I I i I OE]IGENKPE TILI SKOTI I,IIDIIlABA aPgDABgcg AqEBgOA DAT{I'GU IIURI'NIA EAIIS LAIoIG=ATIgrA }IAKOMLSABORO BECHAUNSI IfIASI NNBISI iGDEUA sgA- -{AUoA SUGU oo34 o"3,1 oo34 oo27 10 24 1027 1020 1020 101 3 1 002 81 10D01 85001 I 841 006 850C?,6 85o63o 841 045 851 01 1 ol 8]26400o q27$oo 832001 832002 83oo79 830002 830007 830020 831 030 74060000 '13004602 81 0?9000 801 031 800000 2 801 041 14oo9 740041 800033 74Oo3401 74oo07 71 001 7ol 7X ol 801 721o31 723045 ?23035 ?20050 '120050 70004501 70003701 63ooa9 U.R. u.R. U.R. U.R. u.R. U.R. u.R. I].R. I].R. u.R. U.R. U.R. u.R. U.R. I'.R. II.R. N.R. N.R. 050 026 406 026 402 402 407 o23 023 o23 o2) 408 408 408 o24 o24 401 rsrl 050 050 053 o27 401 401 410 401 401- 411 4q 414 414 415 416 416 051 417 6831 416 418 402 DAGARI KUSJ\SE NABDAH KUSASE PRA-TBA FRA-T'BA BIUOBA KASEM KASEM KASEM KASM BI'LSA BI'LSA BIITSA MNKANA NANKAM MAUPI'RSI EWE &}TA}trURSI 2043 P4? ?p441 . 1o54t 0053 @59' 2F.^28 1 003 1016', @17 001 6E oo22E" 001 7 001 gE 001 1 001 1 ,,.36 . 2o)2 I 2o16 DAOARI DAOARI LOBI SISAI.II MAI,trIIRSI }.IAT{PURSI }TALA }IAUPURSI I,TAfiPURSI CEI'ItsURII DAGOI'IBA KOI'IKOUBA KONKOilBA CHAKOSI NANINGA NANUMBA BIAITOR SATAI,AGA EWE & DAGARI OONDJA TAf,PIILUA FRA-FM N.R. U.R. U.R. I'.R. N.R. N.R. U.R. KITLLUi{ MBARI guu LAUTEA_ KPASEIIKPE IAGABII SABOI{4IDA -$!sBr- LENOga_ znlmuA TUA0 YAPAUI YAPAI,A.BAGCTO .E$!E_ BI'ANI'O AIGNYAXROI.{ IUGURU '.R. .R. .8. '.R. .R. .R. .R. .R. ',R. .R. .R. .R. .R. .R. I 127 1 28 : SOttUN 12e . lugry, Notes : (21 9019 ' 1041 )o4j r 1oZ1 t 1@43 oo3, , 701 00801 7010101 84066000 DAI'IONGO DA.UONGO BOICI.TANGA- TONGO N }I u (1 ) An asterlsk denotes vll1agea of rrhlch only s part ras sel€cted for emluation (") Unbroken unilerllalng lndlcates villages rhere onchocerclasi!, is hyperendenic (prevalence rate over f0fi)(b) Broken ur:derllaing indicates thet oachocerclasis 1s nesoendenlc (betreen a6 afi, 69.9f1(") In thoss aot underlined onohocerclasis ia bypoeudenic (betreen 1fi artd, 9.9fi1 the village of Tanl.ra refuled onaluation. The portion chere a oengu! ras taken (part of ohlefts aelShbourhood) navlng ao bonogeoelty, the saople has no stetlstical \relue and tlre flguree for that villa€e are deducted fron the totals ln thle Table. (3) i Regioal I -27- GH.ll[A: PERCENTiGES OF TI4 TtlO SEES IN TI{E IELIAGES EVALU"'TED EPI census Total l,Iea Wonen Table V Code Nane 090 091 092 093 c94 095 096 097 098 099 100 'l 01 102 103 104 105 105 107 10a 109 110 111 112 113 114 115 115 117 118 119 120 1n 122 123 124 125 1N 127 128 1D 373 343 102 270 259 168 871 428 361 134 21 0 331 365 3n 35',l 1',14 4'.15 213 769 2',11 414 n5 456 195 (1 07) 316 322 340 333 3'.lo y4 443 y6 263 261 188 346 262 266 r85 162 563 154 12',1 95 431 230 184 '10 102 165 187 148 185 90 245 122 405 136 246 136 222 qa 184 161 169 193 182 1',l2 A1 17'.1 49,6fi 47,2n !1 ,1 tt q4 nl/ l r- 49 rO" 56 15" 50 12" 53,7" 51,1" 52r2" 48,6r 49 r8" 51 r2u 45r 0n 51 r8' 51 ,7n 51 ,6" 57 13' 52r7" 50 12" 55.4n 49 t5n 48 '7'l5or8' 188 181 59 116 132 13 434 198 177 6+ 108 166 1'.lB 181 172 84 230 92 354 135 198 1n 234 qA riz 161 171 140 188 162 232 189 13',7 132 8',1 158 130 133 50 r4fr 52r9n 48rgn 43rO' 51,0" 4315" 49 r8" 46 r3'l 49, ott 4'l ,8n 51 ,4" 50,2" 48,8rr 55,0" 48 rzn 48r3tl 48r4rt 43r2u 47 13" 49 r8" 44 r6n 5015" 51 13' 49 12" 51 ,1n 50r 0' 50,3n 42r0n 5or8' 48 r51' 52r4n 51 ,6" 52,1n 50 16' 46 13" 45 r7" 49,6n 5or ou GE}IGENKPE TILI SEKOTI l,IIDINAB.I .iPODABOGO ]ISEBUGA DAIruGU WURmILT B;LIU NAK0NG-'.TIIIIA NAK0NG-SrrBORO BECHAI'NSI WLi$I T'I]MB]SI KADEI,Il JANG.i 51]GU LISA ilut KPAIII.A KULLUN MB!-U DW TAN]NA KPASENIEE YAO B.\ SI\BOIiI4IDA S.lBARI KENGUA ZTNDUA fin{B0 YAPTIUT T,IPAL{.U'GGYO B,ILE BUhNFO AKTNIAKROI{ I,iURUGU SOMIJ}I iln Ku 126 1D 101 188 132 133 48 '9n 5o, ot' 49,7,1 58,0n 49,2" 51 ,5' +7,6n 48r4n 4'l ,9n 49 r4n 53,7" 54 r3'l 50 r4n 5oi o, 'l- hilr ilrrlr lrt0l|Jiltt rrfit r| ilt ltrilltt |f,$|ttlf ,lrt ,i,-t &L lrl *o crl o'J t l17 q6 EtIo I$F s sEEr fl SdEEEE EEIst $S EEiErstrSggf'gS ir 'l f-u,v oL+ fi,Yq9 fr'05t 6r-{( rrro6 6'.hJ Itt-(^t tt -ur 6r-Q, ;t-l]i 6 trSl eI-ot d-q ,-rJ IJ\ ao(J ti at (O .J rt, {'} ."'lt rrat a)|/|ra itir ffiill lli[l atr iluttr (r? It7,' xrl 'lro Jro {r6 d14 t-ttI ,,t7 fr,r I 'l t1 ftr ? l "r8 tE rg 1]r 9 -fi- +Jti.ffit llllrr rlt rrrr[t r !ar& t;lorrtr fltlil u ill ffiln ltrlrtt(rmlrrr.r ullnln. r{ uol rJl.ofittt r ffrrfl: ir t !et& tlt tat lltr r r lfllr I t alllt t I ffil1| + CITS orl oo? lrl ,,1 Irt lrl lr1 6rc 6$ lr? trl ltl 1lr, 1619 lar) 694, fr4t ,wr iH, aO-.la y-n ,0,?t 15-19 Ft-?a rt-rt 1o-14 {-9 0-.1 I I t) U.? lltlrjt 0ro t0 l, ,t-6 l0 ,lltrr 09? I 0 ,.,tt Il-5 t0 rrll.|r 09. 5 IE ?T 5 0 0 rt r0 5 0 tt-a turl|t w T I il tt I I F I I I {r l, lk, fO flltqr t06 q t, lrr) l0flltrjr tt, 5 0 0 t, r0 r, 0 rrr rri,ilrrrtrlllrttr 9ttl9a 6Y +folt tg 5. ,, 64 ,. t, 7a r, tI r lc 1a 2g t-3 o)1 ,H at ,,fi Vtura. 0 rl ll ,.-2 Ylllqr 0 $5 m 10 x-1 rfllqr o 1t, l0 l0 I t 1e r Itt E ! Ig IE nl H: Fie T -2I I t R + o\ Yr,\\a$ .,\Itttu\tITtB{*AF$&d !\ ra ,A !tt c,l{ I J,I t\ \o rnrnLn(r\ f\ (r\ (n Solo.+ 6\ o\ t'- .E\\o \o \oO\olFl o\ E- F- RR RR +Fl tt,\O\F nht\NN6l 6+ I r\a\.+$ \O\OCD@OINN I o\(rrr\ @ooO\trE I arN!t\t Ln tf (n c\ o\+-E I N r+ + co (n o\ \o \o NN FI +<t\o\o s: s&.lFl E..- N Ado = ot.- + o\ T r-a\ : Yo\o o\ TIJ\ rl\ h Jlr\ o\$ Irn s To : R ILl\ Io(n &. I$ 6J JN o\ Itn .i o ? TJ\ l Hx o ?1p 6l E-. I I a tltt tt etdF. D FI r.I b EIt = F] H tsl EIEr >i Fl doh tn H It:6 E El E Fqo H C< & tslo .: tH ci, f.ro Etd GNl*HHa s ct oU <i x o <n = E F. E r\r\N O G@ F @ F sl O r hAt\$ Ln r\(I\F <fF.- e o F- n\o c-- N \o (h r c.\\o N n E- N r \o ts- <cr\ (.re N 6r - co * (f\F N C\ €\ F\ 41- <i N F-N <+ @ r 6\c) N c\ar @ t--+ CD \O @ - 6r $ O 6l $ 6co@ @ fi e (.\ F: c1 O\ t-\O O \O E- @ D- @ a\ O\\O (n m rFt\Frr*-rN<r\-r U\ N (n $ t.- u\t\O + O N u\ E.-@ rn O Ll\r h\O s@ \O\O Ln N O\ (n r\@ t'-O \O co <t CO o|\ r+ N O (f\ +FFtnFF$NrNFS-C{ LJ\- N r1d+ o F< o b0q, a 00d Fori .-loq< o!{J d o o o a H .r{{, c oo ortp d{J o dt tr- + I (Y\ H HIH os d E< = i fq, E: NN N-NA\tfr- Nee :-- tf\ 6l ta O\ IJ\ FN sfqo\\o ItJ\\OE = H o\ ?rn rn = H ?orJ\ = cne<tFFNNcl fq i c\ - (n e N <f, r\ - N $ (n tr- (f\\o - c\ ar n @ e to Fs.+ tn c\r \o rr c\ t-.+ @ * N.t e (n\O + e\F N N.+ \o Io\o rO - O N 6 6\F \O F \O r+ Ln <l r+ g\ f\sf r t'- N A\ tn tt:(5 .:iE e.ozH frlE{o -7&Jti!)O.Aordo.>Hlr? EEE:=ol, E) l!:sl ofEo.o:) ox&B? tdF(5rq< AF{2Z 'i [r1ErHtsFqOHEO(, .II(, <Ln l?:E(544ElE >1 2I r'trd e,>EH ts:hpr >u)@.1 2abrdooaaVEI4,d HErq E{ rn .. i4<oZH <E(,o & & A. .+ F- N r Or G O o\ O\ N (n Ln O rn .+ N (n r\\O * rf\ O <i N * C'-(n-\O 6r+ O O\ O\(D + N (hr @ N t- o\\o @ NOt.-Cr\q@ t--F\ONNO Noscn(no Ncl g\(nFuan$ o'lrFN Gl+\or++o Nts F..(.\6+C--OF6lN c) u\q\O ha\N u\u.\(n(f\U\s r\O o|\(n@ N F F o\ Itr\q J$ h IlJ\ Fq F{ t H = H f- N !> CD tr-\O N - f- a\ C\ O (n D.- O \O t-- Or N (f\rNc! tf\.o Ei N dl C\P q- C{ \o o\ o tn c\ t- N \o co co \o F N F\ C) (\ O \D\O \O Cl\O O @ C O\ if + \O $ O\ S u\ e-* IoC\= E &, I$E \o o o c- @ o\ \o e-N @ Lf\ \o o$ rn @ \o e- @ (D o\ @ r+ N &. a tf\ oN o ol \o o\ IJ\ t\ \o F- \o LA \o @ o \o @ t- (D co @ o @ (D @ @co Nr +6 tr. C\ @O r@ a\o s<t o\r o\ \o O\ \O r r N a\O \o !:cO .+ r O N rno O C\rn O tr\(D O FF$FFNFFTeA\N rtjN I N o\ Iti J Tlr\ 1o h E E E Fq t4 H E \O F O\\O slorr\O cc| u\@ N ol\O (!\O <' Sl $ NF o\\\O .1. N - F N N F (nF N $ o\ c- Ln F Ln @ ry N \o @ cO 6 F F N o cl\ @ a\\o$erNNrNN-N Q N trrO * e c.\F F -.O - O tr-\O F-O rr\- - ;Ne$r-fi--+;;' V n Ln C- ri ts- n !i \O \O (o r @ or\ r+ Or @ r \O c^ o.\FFtr\(\NF;F+F;- r\o\o FN$ \o\o6(nNc\ o (.\ (7\N(\6\ 6(nhNNO rond\N\o \ocoF- FF\O GN eN Nc-(nN C- <fN€\ !+ \o(f\ N o@ NF <i \oNN C* rn tr- (n+\o o\N\O -N r\-\O rrN (DC-(/\ N rf\ o v) :- 6@NF (f\ s- $6NC\ O- s{ (n NG\ o(.\N? Nef\ h\D g\N-h co t-- @ hE\(D @ 60NA\ N\o\oNr(fr r+ coNN @e e{* F- F.- FGI R* sthNN $o\ (r\F\(\\O FF!t\ O<tFO\NFN\O r\o (D i+NF@ C!N<t!+NFFO\ F<tN\O FFr\O r+o(no '-: _ F' (o co N N N oN rf\(n IJ\F-- N rn o rn sl tnr+ O r C{ a\!+ r\\0 tr-CD (}\O\ O\ O\ 6. O\ O\ (,\ CI\ O\ CF\oooooooooo O r N c\ $ ln \O a\ d) ^ Ooooooooooo- :*--:- oo o o\ .+ tn @ o \f,\o FO 6.f\o5s NO6JO\5s S'r-^o-OUNO\ co €o\ rn o -\o c-@tr- o I @ + rt \o $ @ \o rf\ \o \o UU<)o \o \o Od\Otf(n\O<tre@\ON\Q3_3ERS B xHPsxI6\0 n \oA-hG t\.N sf e- C\ or\.+\O Nr\(no\ o\ FN 9NG* r\NG@ FN E.. Fq E Eq E ,4 o o o o N o\o\ o.\ trr o\ \o o\ c\ o-r(D rn CO @ o @ r'-NF-@O(r\(7\ (-\@ g\fr(n FFF \o 6F @ c{ (nN(\lo6(n(\ -O@NNF+O$c\ rF.F:N O\(nNNF\o6@rr err-N d\*r\ r1$o E{ o\(D c--tr- (, o5Itr -\n oIO H Hx o4p d N N h { N N N c\ N <+ r\ o\ rr\ t+ rn * \o tt\ N (\l rc N c{ N t.- t\ \o N N N E-- \o N s \o n tr- @ N + F- N N (\ o\ r N o\ @ N N N (f\ \o N N \o \o tf\ tn o-tr- + a NN.+ o \o \ON \+ @oN tf\ C-$ oN &. o\o\@+o ot rr\ N --tr\ o\or.\N G't'-N C! \O r+ o\ Y rr\NON\o= SH YO\OE o\ }. ^= ofntn = rco o\ Fq ILr\CAE k E Gb.N1-nN- E ho\ 5 h$Nf\ E @ N \t $ o c*. Nht'- coN @ N @ @ o\ @ @ rr\ \o t\- F. \o F-' O c\ t,'- C-. N E- .f N r \O d\\O (f\ C'{ rc \O \O N $ r \O u\\0 C-\O t.- co \o \o \OrO-l.r\t-.tr-tn \o@\o \O-O\d\<iU:\\.o \o (.\ (\ F\Otr-o.\@6'+ st--6NC\@@ C- tf\ a\ 6 Io rf\E h o\ T n$z 14 1 *E oCN rn rtr- \' t.-Ln f\F ('"\@ +(7\r\\Fr\Al Tl-tr\LnN.+tr\ <)+r+rl\t.-{ \- L]\(nF-e-q -<i(n(r.\u\N t.\U\UNCOO@ ts OF^OOFO\GIFFFF- (nN trt FLr\C\OOF-- +u\tJ\NNr.* (n o\ f\ \o <l ct\ \Oo\+ Ln Oo\O -* o-- Lr\@@tr\O{O\tn rr\tr\N E-n.+ eNr oNIr\ c^J*F @@o\ \OeF- @O\@ co r-.. \o co\o \o rr\ t.- @ o\ \o N \o t.\ @ t'' o\(\ tn a\ON on No OsF- rN+O<.t(\n rN-NNNN rn \o @ N N@rl-o\o AOhhc\N --N Ln .+ N (.- \O \O scOC\rF-@NN-NNT @ rn + @ r,\F*$ I N IoN t.\NNOF(\ --NNe $O\('\@sF\()ANNNFFF C'-.+OcoF@ A\O $ o.+ IJ\NrNolF- a\ <t 6F - Or\O(r\Nrr(n-N hrh@rNNNETi'\NN <ihN6t.\co w (.\- N -o-Jo o r\r\e(nN $ c\N (n+ o n o\ N 6A.{cod6>+rA.d oo+r+, TR r{ x $o.ooo@+ra \R \R oFldd a+,EO()+ + h\O F-@ 6rNNNNNNrN(\$h\OC-@O\0r --rNN h o\ r \o \o \o N @ o\t'-c\ (r\Nt-o+tr-o o sN 6 b +N CA (A CDN (nF rr\ co s N6e N- (f\N n'+ <.N NN E\nNN h@ oN *-;;NeN 6 E-(n -NN o66G\N N -i tt\ Nd\N rn no o\Ner(Y\ OE\ @c-- o @ @ocoo u\ +o(n E- \Oo -c\(n6 e- C! \o nt-. 6O\(n$ _O\T @o\\oO\ f\ @ oN s s N oN @N N tr- Fq :E fq = H = I Trn (\t (7\ clN 1o o\ N --: t- GILINA: P0PUI,ATI0II 0F YILLAGES E)LIMINED: RESIDENTS PRESE}IT llD RESIDENTS AtsSENT. ATTENDANCE -36- Table XIII 96 15 88, 2 82r6 97,4 91 ,8 81 ,3 93ra 94 11 9or o 86,2 87 13 90r3 87 15 90rB 9319 95,2 9311 91 ,9 97 r7 9814 89 19 91 ,5 96 r3 96,7 93ro 99,2 95,2 oory//tl 98r3 94 r7 g8,7 98r6 99 15 1ooro 99 12 96,8 98r3 9'.1 ,3 1o0r0 99 12 94t2 rThls co1"..ls reproduceil fron Dr Brinkuannrs document (cp. cit.) to drav attention to the divergence between the rates of presence arrd attendance. Note that, since sone ilata were obtaineal fron the conputer after that docuoent ras finalized, there are alifferences between the figures glven in the present Crde an 91 92 93 94 95 96 9'.l 98 99 100 101 102 103 104 105 105 10'l 108 109 110 111 11 2 113 114 115 116 1't7 118 119 120 121 122 123 124 16 126 127 12A 1D Nane Census popu- lation Re sidents exe.ained c.de 1 Pre sent but not exanlned codes 213 n 9 182 16 20 26 80 20 17 1, )u 41 2a 19 8 10 18 16 4 43 23 18 6 1 ) 1 tr 4 o 2 A 3 9 4 2 Re sidents absent and/or eulgrated codes 4rf n 19 92 m l4 2' 139 51 20 5 ,1 30 3'1 26 45 o 85 3 117 20 51 6 23 14 14 13 11 9 38 33 19 5 2 13 1rl I 4 3 Rate .f Pr€senc€ codes 1 r213 Rate of atteDdaace c.de 1 c.des 1 ,2r3r4' GEI{GEJ.IIPE TILI SEKOT] 1rIDI}L"8.}. i.PODABOGO ASEBUGA DANUGU WIIRI'TTIA BALTU I.IAKONG-ATINLt N,II(ONG-SABORO BECEIIUNSI WIASI FU}fBISI I(ADEIfu N,"GA JANGA SUGU LISA JJUT KPA]MA 8:IILLUN NAB.\RI DIru T^NIM KPTISNKPE TANGABA SABON.GIDA SABARI KENGUi ZiiNDUh TU}iBO YAPALT YAPALA.BAOGYO BALE BUINFO ltKrlNYAKR0M HURUGU s0Mur{ D,A-TUKII 5n 343 1102 no b9 168 871 428 361 134 210 331 365 3D 35',l 174 475 x3 769 2'11 444 vl5 456 195 10'1 376 322 340 333 370 334 443 366 63 261 188 346 262 266 1 3906 421 285 828 2b 2b 118 652 351 D9 112 144 2v m7 45 D3 158 3e0 192 635 24',l fio 246 415 175 93 360 D6 330 Do 33',1 311 423 351 69 240 168 3D 68 261 85ro 95,5 91 ,'l 89 r3 94 16 85 ,1 84,o 8513 94 15 96r3 '15r7 90 '989 19 92r1 87 14 95,4 8211 9s 16 84 r't 9216 88r5 9',1 ,+ 95,0 92rB 86 13 9615 96 16 97 ro 88,6 91 ,1 g4,3 95 19 96r4 99,2 95,o 91 ,o g7,7 98t5 9819 11 899 809 11ge 92ro5 Table and ln the said docunent. B N 8.--tr\O N l.-C{ N !'-or\C, t.-u\cO N (1 cO Ln O O \O N $ N Ln L'\<t l-rr\ C) r rAO * I tr- \o tr- B. fi e' P $ l{:'= 9P K's E L^ s}r : r\o '^N \o tr- oo ooOO \O @ rr\.+ N N N A+ U\ N F-tr\ er I I $tr\r ! I II H qlr\ N N o<io oF-.oCNO - r a\r\ o rf\- N rn (^ q)9 \o N (\J N<tNrco+---NNroN (\o6 r\ o\o\o ONN O rFt OIJ\ + h I r -- r r r I - I I I -- I I I U\N o o(\ o tr\ N \o O l'- $ tr\NQ 6l ttt1r\llNNtlllNll H trtlllllllllllll I $N<! or c\ o+oN f\N@ -o\= l--lF<?\lFl<.tllll o NCNN OD- L!"\ rJ\ o\ os oo<t erO o C{r o ()n o (n o\ o o \o Lr\ qc\N clrrF- N ol I I I I I I r t I I I I I I -F I I I lN(\rr\llll I I I t I I r l- I I I l- I I I t I - t I NNCD I I I I lN.+(^lt-tlllcntllf @\Or- 6lC\ I N f\ I -f <| c I r I N lNlnra1lltnl---Nttll F-6 r\r(. S r I - $- t-d\r I \O I f\ I N I <-'.+ I I I (n | (f\0 s Eq lz H Fq = -F V rn C'\ I h @ tn o\ -o\ o NNLr\ -r @ & Inc! O\NFC- \o oN N sc\ IoN k h€\ I orrr I (r\ FF I (r\N I I I I o\ F-, \O O Lr\ \o @F \o N c\N - F @ N r F I rO tt-N s Nro r e @rI.- sr o\ T rf\ H NF-$tltlltllt-NFO tr-oN tr\Nsh @ FN N \o -t\I I I r\ I N\o l6 lr\.Orrr\et- s\o ol{5 I Eq q)rrNCnrl-eo\rNlltl{ @ nNo.l t" 6N - C- t'- oLnr\ N 6r \O - I I - a\ I N N t - I Lr\N C-N o bod Fl r{ '.1 o d @oo <tro Hd q<!t{a 44A)U)H cdd4l-lZ(,E=gEE-9gEHS< 'd4E !l a id z &,a M !4 o 4 a Z @ < < cq rD H E g 3 ! 6 ZAB E fl 3 5 A g d d (\l C'\ LAS F O d O F N <t \O @ c|\ O tr" CO6adid\ 6\o\ oio o o o o o o - r -,JOOOOOC-- o rrg 0tr+'dotr+,Ytdd {J f{ F{d b!, r{'df oEOl.oq dd \q dc d N d s o ET .{trd ./ {r otR+q{ odoEi+ trdo d.d rO+JO 'dda0d+ddd d r-{{rdp.d o@o.dE< t g> rH t.-g\o r1l.o dH Ad +, o F. o\ t rn +s Io <f Io - Ir\F l,\ + r!+ rr\rr\l- F{d -P oFr q oo So"&o.N'CNOF-A tr-o ..r ei o F. t @(f\ >x I o r{ ,D ad €< d c tsg riC2cC a t r c c oc r'I C, J ,.t H r. H x @ rq c? o 01 G4E a C zo ts F o A E-Ce c F F o ,fl + ._{ aEotrPi .A Flir (ddi) e{o ,Pg90 t lJ Elod+, tiboq .do E.do+, d @r{ .co+t{ aH()d ogot00.dddrJ +dd d tr-lg.i o,dr.d&o+ sxod9. o O.Flor+r .{ 9.c >,d o d .o+0.t{oto -ar + dOHE oodobo.q hd+oOo rJa{.qgo'lp IDP Oo$rl{troooo,tr@Ad + - @+roo0td+{oddioa0+ldodcl.-ooo>rO oEoPt{;{.iQro , d rO{boo adohoot{ b0.o i0 >dd.dd d -{' +dtr@trddo.{orl&ocro,oi<+t&E >oao,OAts'Oro E ot0d .-{ ,A E@ o oo0 .cd +, .-{ r-tq{ 'r{o>@ ogobo o-c d .d+t +?id q{ '.1do>t aCooo.cp.'d + ddqrddo+,o cLc+oo ft.do+ .q r{ rd{rd.l +,tHoA o{ro o-qr{ o0+ dd+ q{o rro+ trdooo-cx q0+odqarqr troXo .oo l{o -@o@ AQOodsddtria{)dp o@ooot{ !0o@do0Ad ld-lHddoal{oOLo>oooatrC>oa0,o > .d a{ odOdrJIdd!a ,+Eto,otso Io o \l C 6 C c c c ooc ( oc o c oc u I c € c c d ct I 2 c FNor+{ vvvvv re{(n fa @ <f I I o @ tr- N LN o N rn r\0\o$o60 N^O \oo\o F\()r\o Fc o IJ\ + E rr\N\O or 'c oF- r.-c\o o(r\ o o t'.O O o@@f\ o\ Ho\$ Itn € E I o\ o\@ o .+N.+ rar or\F- EY c\ \o E To = NF o @(n N(NN c)rcO r+ si @ OrnO rt\ t.-- E o\ Ih N OJ @ N \o$ c\ s tr\ n O', o\or\ 0-\ o d\ \o Fq r+ Io \o F- o N o\t.- \o\o \o @- NT oo+ -ro\o Lr\ fq & I $, @ c'. NT -R.a o\ tr- o\\oN rn t'- \o sc\ (\.+ S FFn O\F N Fq N I N CDF\O \oGo \o (l rs r@ r\o\ A tr-\O O @Fra N k< o\ I rn Oo\g\ rr\ C- r\ Nc- O\6 r\co \o\o + tr'- o Lr\N+ FN lld-lid l.do.> E 6ao+O.$. k HaadA.ckd H a o o0++tao'd.dq{a,r M.cl E oH{rdlod lq N E @ N \o <t rr\NN FNF\+tr\ tr o +.dH+ddt{ '-{q0, .r{ aEOfrl fi FA n\o \o 6\O t.'- Ln ra -ll* otr'I ltt {fi,ttAs Ee|F&XAftrg mI F?'rfitIS8 0l fli ttll0lr;t P0Ftrtltl0l lfI fi[ fttrs frtrst$tj[rr It fst Brll{m* rul| IIIff trtlmtt8 lst tmfal. Itsl.flltfirilr Hr ]?dd; rr 1161f tr 'llp E*l"SXtlr ?AFfllrIOIr f,r frll !3 ittl ?r trl l tti*l lrt,ft*rrt lf,tirlrilfi ri+rbtr talrl Frrulltrrl f* '1 ptitvt; stl {t! Grl l*|} fiI trt l+r tr I Ert fr$ 4r3 !rd 6rl *$ ilr{ frl Itr{ lor 7 {r6 l, ! 7rl ?rl 7tl ?,8 ti llra orl a)rg {nJr 35* re 1lI" I { t5.lfr I0. tl 9-tr orl 0, I ort 0r? lrl or/ l rl lr $-11L"l 1r$ Xt3 *rl Grl lir * #Iro t9r& ttr$ I lfh r"1 +$s 1\i-T) l0*1. fS*!g ttL?{ !$-19 0-uL,J 1rl 0r? lrl lrl ?r5 16r t f,r{ 16, r fttT Itt-g Grftmrt ]+ilrrlm I t I t I GtuIilA: FREAUENCY 0F MAIN PLACES 0f' II'IIIIGRATI0II Places .f iruigration -40- Table XIEI Yl11age Code Distrlct oouncll Bo1gp - Bawku 4 14 a ) a ?anale Kuoasi Accra Suyani 0thers Total 092 093 095 096 097 098 099 100 101 102 104 105 108 109 110 117 118 Bongo-Nabdan Kusanata-ZebilIa Bongo-Nabdan Tenyaue-Oaru Chiana-Paga Chiana-Paga ChianaJaga Chiana-Paga Sandena Sandena Sandena Walenale Larrra^lirapa Nadawli-tr'unsl Wa SaIaga Saboba-Zabzugu 1 1 1 6 4 8 1 33 24 16 120 45 6 I 7 19 10 17 21 )z 3 23 1 17 2 I ? 2 b 3 1 38 2 4 1 2 3 1 5 ,) 4 3 5 11 57 D 18 19 52 17 a 11 19 18 6 27 81 5 23 1 16 Total 6 22 378 79 1 35 541 f sanple population (541 ) 416 4 ,1 69 19 1416 or2 615 1oor0 fi to+at population of the 13 viuages (|zn) 013 0r3 5r2 111 0r5 715 .{ d o F, hsPqfl:-=9PK'F5^S-P +Lr\ o oo H I l-+r\@tr\\ONl-l-Ln+F-nc\tf\- [,\ r\ o tnN E 6l - (\(\0 F-N r O <n- Q\O N r\- N +N-@$reN\ON \o o rnc- tlr ,r Lr\ H t I l- I I I I I I I I I I I I I o\ N f\O o:{ I I l'+'+- lF I lcJ. ls I I t I co I t l- I r I I I I I I t I I I I N o \o Ln O C-- o\= I I I t I I l- I I I I Ilrl N o o ti >, f+ tttlrllllllllllll I I E I t I I I t I I I l- I I I I I t I o t{hN H I r I -- I r I r I I I I I t I I N o\ o @or c.. o\ = ltlllNlNlllllllN F- @l| >r 14 I I tr I I r I r I t I t r I r I + c! o @N orr\ o\I I lr I ll t I I I l- I I I I \o(., o Lo Eq I I t- I I I I I r I I I I I I I o\ N o rr\$ o\tN-sl-lell[-r. llll @ o F, o\ h I I t l- I I I I I I t I I r I I N o F- O\ rO o\E c{ I N c\F I I I I I t e r I I I I o L'\ q F, co H l-NN I I I I lN I I I 1l I @ o\ LN g\N (7.\o\ @E I N a\N I I I N I I I F I I I I oN @ F, t.- h I - l\o I I I I I t-- I I I I I o\ N D* -r- @ N s I Ln- - I I r I I - - I I I I $ N q t \o h I I $- I I I I I s- I I I I I c! o N O\ \o rn o\F.-:E (r\ lrrn-r I l-Nr I l.f I I t I N o\(r\ o trh Lf\ H I N I t-- ( I I I t - - I I I I I N \o N N u\ t'\ @r\t.-u:l$-\o-rll-Nl$F-trFl \o o trFr st Fq ratlllllNtllllr\N N N rt t\N O\ (n\oE 11-NO\L51c\ I lr- I c1- I I I I s $6 a F, 14 tN-tttttI -\o N I I I tn o rn N NU\ O\Lr\n+ Lf\(\\O tr\ 1 I N I - I a\.+ I N I I L.\ tr\s @ t{ >r N Eq tNtlltco F r o\F I t I I t CAN \o o\ ,i @r\ tr- \OE O9r$Orr\l-l(n\'N@l6lFol t- : q a1 f\ I \o t I _ I I I _ (^_ q I I _ N \t rn o\ lr\ LI\ Lc\ @@NN= - @ t\N r^- + N + N N r\ I FNNN$l NN \o c.lN Cro /od;d{rd olzItat oqtr -t .{o . .-to .40P>o <oHd F{<HAd4</1AH(ti<.il12(5 E :a llrJzDZz4Ht<H2&o Hco D!, Hoo lr @trl (,< zo 4sl o trr 2 e A M k cJ < a Z @ < < rA CqBEESEf;EEBEE*5498f, N (n 6\0 t-- @ 0l\ o - N $ \o @ cr\ o c-' coO\6O\ O\O\ O\ O\O O O O O O O r - r oOoOOOOrr .{dD o +, r{ F{d ,. o o I lH H EX o r-{p dFI q F,$ \o tr ol\ l=l 5 I 6 tr- o. & rilE g HA EEI Ho aFH TA H aH A A t:doo trld r_a .)H E< d H frl &o Eq H €{&4 o" rrla trlO H@ a trl@A ,t F] H H e. 4i= (5 or{Jd o ol{ 0, lx HNX <l olF{ .o .d e. \o o\ co Lr\ o\ \or e o o ZI EI EI EI st EI EI 3l EI HI E AEI 3l J EIHbI6l .,l EI EI EI EI EI j N s Ntf\ tr- +\o I D.- L'\ F-. C) @ \o o\ $o\ o oOo tn t.- o + t-- (D 6 o N o\a tr- r o\ N \o \o tr\ o o N o I o\ Ad+ o e. o\ rn o\o (,\ R. t-- D-N N IJ\ I \o @o .+ LA \o I I I N n I I t I I o\ t*- r+ o oo I t t I I I I I I I I t I I I I (f\ I I I I I I I I I I I I I N o fr N I N I I c.l I I I I I rn l'- o\ o\ I I I N I I I I I I N N o\ e- N \o N N t I I N \o @ (D n @ @ o\ I N I I N I I I I \o o\ tr- o\r @ t <t c't t N t I I I I I s $ t'- tr- E- N N \o I I t \ot.. Nr s N o tr- I N I t.- I I t Ns o e- s rn @ I N N I I I I , nN \o S+6 E- o N n I N I N I I I \o co @ @ o N N N I $ N \D t I I N rn o rn o\ N o\ D- \o + N I I I \o\o N \o o\ coN F-. \o o\ I c- I I I I C.lIJ\ c.- N r c.l tro d +dtiAA1:t< a +, o& N tf\ v, D- @ cI\ H sg rn \RN a-43- GHAI{A: EIIIGRATION AilD 0NCHOCERCIASIS PERCENTAGI OF E}1IGRANT FOPULATIOJ'I II,I RELATIO]' TO ?OTAL P0PULATI0N AliD PREVALEI'{'CE 0F ONCiIOCIRCIASIS Tabfe XX % out of total population Code t 25 27 18 5 139 z) 17 16 ) 18 57 D 52 11 1g 81 Village EndenicltyEnigrantpopulation Naue Recent totaL population 11'l 104 106 09, 109 096 110 098 118 099 102 092 093 097 100 101 108 4315 53r2 53,3 56 14 60rB 64 16 67,7 6811 6811 69,5 69 19 7o 19 72'8 7316 75rz 76r3 SorB SABOII.GIDA KADEMA JI.NGA ASEBUGA SAA DAi,'IUGU KPANtr'A BALIU SABARI NAKO}IG-ATII.EA WIASI SEKOTI I,IIDINABA I,IURUNIA }IAKONG-SABORO BECI]AUNSI LISA 340 351 475 168 711 871 444 361 333 134 365 102 270 4m 210 331 769 013 'l r0 5 r'l 1o r'J 1rg 16,o 5r2 4r7 4rB 1r a 419 EO 10,'l 1Zr2 5r2 5r7 1o 15 -44- GHAIIA: SIATUS 0F SOCIAL, EDUCATIOIIAL AI{D HEAL'III FACILITIIIS IIi 'IIE VILLhGES EVILUATED niddle school river se11 borohole facility exists facility lackirg doubtful: infornatlon not obtained Table XE MS. I,j = BH. ?- Vl1lage Fopulation School CIinlc Maternity lJater Boreholes Code Naue 09t) c91 092 093 094 095 096 097 098 noo 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 111 117 118 119 1N 121 122 123 124 125 126 12'l 1m 1D GI'NGENI{PE TIL] SEKOTl IJIDINABA ,IPCDABOGO TiSEBUGA D/ri{UGU WIIRUI]IA BALIU NAKONG-ATINlA NIKONG-SABORO BECHAi]NSI wtASa r''UMBISI i!.,DEI'IA NAGA J,[IIGA SUGU LISA SAll IPANFA KULLIIN NABARI DW T,1.NIlIA KPASENIT,PE YAGABA ST\BON-GIDA S,\DARI ]GNGUA ZTiNDUA TI,t{80 YAPALA ) YAPALA.BAC,GYO) Bl'rl,E BI]ANFO AKAI'TTAKROI,I IiIIJRUGU s0MlrN D,{TUI$ 3?3 343 102 270 259 158 8',11 4m 361 134 n0 331 365 3D 357 174 +12 213 759 2',11 444 275 $6 376 aDo 340 333 370 334 443 366 263 261 188 346 262 266 ? 1 rith J classes 1 w-ith I classes 1 with I classes 1 ldth J classes ? 1 rrlth I with 1 rrtth 1 wlth ? ? ? 1 rr.ith 1 wlth 5 classes + MS I classes 3 olasses J classes 6 clqsses + MS j classes 1 rl'ith I classes 1 nith I cJ.asses + MS 1 vith 3 classes + MS 1 with J classes + MS 1 ll-lth J classes 1 vith 6 classes 1 with 6 classes I rith 4 classes Cfosed uith 3 classes wlth 3 classes vlth 3 classes uith 3 c]ass€s 1 with I classes + + + + ? ? ? ? + + 1 closed ? ? ? i.I&R 1^I&R BH ? li&R R R i,I&R 1^I 1^I t,&R \I&R I,I&R R I1I&R 1.I }I&R w&R td&R R R R Lake Dau+R BH 1.I&R R }J R 1^I&R KEY: -46' TABLE FOR DEIERI'{INING CHILDREN'S AGE F'ROII lTiE DE]'ITAL FORI4IILA (after TREBAUL) IV I .1r,1rI. r V. v. 6 Annex I v o 5-7yrs 8 yrs 9 yts 'l 0 yrs 11 yrs 12 yrs 6 4 6 The Ronan figures lndicate uilk teeth and the Arabic figures pernanent teeth. Unless otherwise sholrn in this Tab1e, the four half jaws are sylrrletrical. Variations in the a€es of appearance given range fron two months for mill: teeth to one lrear for pernanent teeth. Milk teeth Permanent teeth I I OX (= fron 6 months to 1 yr) IIt III 1 yr' I I v 2-5yrs -47- ETHIiIC CODE (new eclition OU77) Any addition rrill be notified to R.5. S.\I,IADOGO or C. P:'.IRtULT Annex II 000 l,lcsi 001 Yaana (Yans6) and Zaos6 002 Yarga (tarrd) 00J Silni-nosi 00zi Fuls6 or Kurumba 00! Deforo 006 Ban6;r6 010 Gurnantch6 01 1 Sariba 01 2 iloba 01! Bozoro or Bouzoura 020 Gurunsl 021 Kfla or Lila 022 liuna or Nunuma 021 l.,as6na 024 Nankana 025 Ko 026 Kusas6 02f Sisala 028 Pugu1i 0D Pana 0J0 Bisa nr Busansd 031 SaDo (northern) 040 Bobo not otherwise spe c ified 041 Bobrfing 042 Bobo-ou16 or Bwa or Ni6ni6gu6 or Bobo-Iila 041 Boron 044 Sarnbla 010 Dagari 0!1 Birifor 052 l.Ii,l6 0ll Lobi 054 D)'an 0!! Gan 0!6 Dorisi6 or Dcgsb, Iionono 0!f vigu6 018 Tunl, T6gissi6, Loron, Bodoro 0l! Kulango 060 S6nuf^ 061 ,\lnlranka 062 Taguana 06J Nanorgu6 064 Karaboro 05! Toussians 066 hrrka 067 Gouin 068 Tiefo 069 0uara 110 Agnl 111 Abron 112 AbE 201 Malink6 202 Baaana 400 Barda 401 l,ianpursi 402 Fra-tr'ra 401 Deleted cl. 02O 404 Ew6 401 Deleted cf. 02) and 026 406 },labdan 40f Binoba 408 Bulsa 40! Dagonba 41 0 I'Iala 411 Chunburu 41 2 Ashanti 41J Deleted ct. O55 414 ](onkonba 415 Chakosi 416 Goqja or Zebaka 41 J Safalaba 418 Tanpulua 419 I'lanumba 420 Kabsagna 421 Talensl !01 f'abyl (ex kabr6) 102 Losso !01 Kotokoli !04 Laurba !0! Bassar !06 Narlgo 507 l,iarba 508 Wen€ara 501 Baaende 502 Busa 070 071 072 0'13 o75 016 o77 078 o79 080 081 Banbara Diula Bobo-DluLa I'iarlca or Dafing Saroogho Dogon or Habb6 Bozo Natioro Kalans6 or Nongon Siauou 816 0!0 Sonrhal 0!1 }iaranod 0t2 Haoussa 0!l Djerna 0!4 Peul or Fou-l-b6 0t! Rinalb6 O!6 Folnongani 101 Djtuinl 102 Bantl6 !Ol Sarakole 999 0thers -48- OUTLINE GUIDE FOR A 1rILLNGE CARD (new edltion replaclr:g previous ones) To help in fl1Iing in the trviflag€ cardtt that has to be nade out after each visit ( sltrple or detailed evaluation), the Eain ltems are enunerated bel-ow. Please take then in the order given so that the presentation of the cartls w111 be standardized. ilhethcr sunoary or detailed, every card nust be signed by its author(s). Armex IfI Top right:Top left: irlane of State (folloved by relevant code) Nane of village (fo[or.-ed by its oode No.) Latitude and longltude Canton Council District r?egion 1. Date and No. of visit 2. Purpose of vlsit: glnplc and/or detailed evaluation (uith justification zhere necessary). 3. Focus of onchocerciasis; I'lame of river. llearest cltor.rologlcel mpture polnt (with code No.). 4. Access: Itlnerary, state of track. 5. I^Iorki:r* conditions: installations. 6. Naoe of villaee chlef 7. EthnJc eroup(s) and subgroups lf app1lcab1e. B. popul-atioa: Available census data (iudicate source and date) EPI census data (Lrith any coucuts) Note: As far as possible, present all these data in ono Table. 9. Historv ard structure of vilIa^se (arrnex nap lf necessary) 9.1 0rigin of inhabitants, stages ln population settlelent, period of set'l,Ieaent and reasons therefore, contacts rrith indlgenous fuhabltants and/or nodalities of occupation of the area, najor events. Conflguration of dwelling area, division of village into neighbourhoods. Social facil-lties: sehool, cIlnic, youth centre, etc. Soclopolitical profile: social units (fanily, lineage, clan) and political organlzation(traditional authoritier, Ilodern poruer structure). Econonic actlvities. resources apd problens 10.1 Agriculture: land-holding systerx, location of fields, orga.nisation of work (men, wonep, children), extension or pronotion agencies (governnental or nongovernnental), crops harvested. 10.2 0ther activities: stock raising (ireraing, grazing at a distance fro:1 dwellings ), crafts, fishing, etc. 10.3 Connercial exchange irrfrastructure and structures: roads, narkets, sales agencies, etc. Current niprati.ons 11.1 Inralgration; Since when? 0rigins and notivations, nodalities of settleuent, aunerical voluoe, age:grouPs aad s€r ooncerned, period of residence envisaged, activities of l:aulgrants. 11.2 Enigration: Slnce when? Numerical volune, a€eigroups and sex concerned, destination, notivations, dluration envisaged. Note: As far as possible, enter aII theso data in a single Tab1e. Specific oroblens 12.1 water. What nater ls used (for uhat purposes?) ln the different seasons of the yoar? Lined wel]s? Relatlonship to the rlver and to watering places (nen, woaen, chiJ-dren). 12.2 Schoolchilalren. The young in goneral. 12.3 0ther specific problens: health, hygiene (tatrines?)1 nutrltion, clothing, recreations, etc. Illscellaneous noles: Questions unsettled concerni.ng the survey, epldcniology, etc. Cartoeraphlcal docu-Eents' Give preclse references, in particul..-t on 1/2oo 000 scale Annexes: sketoh-naps, photographs (aerial or other), translations of recorded interviews, age pyrauid, etc, Q.) 9.3 9,4 10. 11. 12. 13. 14. 15. Claude Pairault and Ran C. 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