RESUMO
Although dams have beneficial effects, they are also acknowledged as having serious environmental repercussions if they are not properly managed. The objective of this work was to examine the impact of the Barekese Dam in Ghana on the health status of three riparian communities downstream against a control. The environmental health status of the communities was analysed with reference to traditional endemic communicable water-related diseases in the catchment area, which were identified as malaria, urinary schistosomiasis, infectious hepatitis, diarrhoeal diseases and scabies. Case-control study was then conducted in the three phases of the dam (pre-construction, at the end of the construction and in the late operational phases) to analyse the health status of the communities as a function of the phases of the dam. The results showed that the control community consistently had a much better health status than two of the riparian communities, which were closer to the dam in all the three phases. However, it had a better health status than the third riparian community, which was farthest downstream, only in the first two phases. This community maintained a fairly constant health status retrospectively and did not appear to have been affected by the presence of the dam. On contrary, the health status of the two communities in close proximity to the dam deteriorated in the late operational phase. The study therefore showed that there was a strong association between the presence of the dam and poorer health status of the downstream communities in close proximity to it.
