We are a team of researchers, teachers, students, and community members from Ghana and the United States examining Buruli ulcer outbreaks in central Ghana. We believe land disturbance—gold mining and deforestation in particular—combine with flooding events to create ideal environmental conditions for Mycobacterium ulcerans (the bacteria that cause the disease). Yet, we hypothesize that the degree to which people in rural communities are exposed to the bacteria varies according to individual participation in everyday activities like swimming, collecting water, and farming. Our approach thus attempts to understand the relationships between the environmental characteristics of Buruli ulcer landscapes (e.g. land-cover change and water quality) and individuals' everyday activities.
We employ mixed methods to unravel these complex relationships. At the regional scale, we use remote sensing of satellite imagery to detect land-cover change and flooding events over space and time. Community-level mapping is done with focus groups to identify not only the spatial distribution of landmarks and water bodies, but also perceptions of contamination and land disturbance. These maps help us identify possible Mycobacterium ulcerans habitat and risk areas. They also serve as the basis from which we develop sampling plans to test water and soil quality. At household and individual scales, we conduct surveys with people who have Buruli ulcer to understand what they do and where they go, and how their activity patterns and spaces differ from familial match cases.
We hope this information will help us make concrete recommendations for how human-ecosystem health might be enhanced. We are committed to working closely with community members, mining operations, and health officials to better understand this complicated disease and the human-environmental conditions under which it is found.