KANESHIE, Accra — Gyamfua arrives at the footbridge here by 5:00 a.m. every day. Long rows of passengers board buses spewing black exhaust fumes into the air as she prepares her fruit stand. Throughout the day, vehicles stream through the busy route. By sunset, thick layers of dust have settled on her table and her fruit, and have been drawn into her lungs and bloodstream.
Over 12 years here, the 39-year-old has paid a heavy price. She has had frequent flu-like illnesses, coughs, headaches, sore throats, sinus problems and mild fevers. Doctors say these could well be symptoms of something worse, but she has not sought their advice. She knows the pollution is bad for her. But she has no choice.
“I have nowhere else to go. This is what feeds my family, so I will keep managing,” she tells this reporter in Twi.
Gyamfua’s dilemma is shared by thousands of Ghanaians who work in polluted outdoor settings — street hawkers, food vendors, traders, market women and commercial drivers — where earning a living often means spending long hours in toxic air that is almost certainly making them sick.
Experts say government needs to work harder to reduce the sources of pollution in Ghana, particularly transport emissions. However, with other sources, such as the annual harmattan, beyond government control, they are pointing people to practical steps they can take to protect themselves.
Beyond the obvious use of nose masks and reducing time spent exposed to polluted air, they are pointing to another surprising source of protection: diet.
A new study has found that diets rich in antioxidant and anti-inflammatory compounds — foods rich in vitamins C, E and selenium, including fruits, vegetables, eggs, peanuts, sardines and sunflower oil — could reduce some of the respiratory and cardiovascular effects associated with air pollution exposure.
The lead researcher, Prof. Kofi Amegah, Associate Professor of Environmental and Nutritional Epidemiology at the University of Cape Coast, says the most dangerous particles, known as PM2.5, can penetrate deep into the lungs and enter the bloodstream, where they trigger stress and inflammation, weakening the immune system and increasing the risk of diseases.
“What these antioxidant-rich foods do is mop up the free radicals so that they cannot cause diseases in the individual,” Amegah says.
Air pollution is taking a heavy toll on Ghanaians’ health.
The 2025 State of Global Air report ranks Ghana 14th among the world’s most polluted countries. The report links air pollution to at least one-third of the country’s disease burden, including stroke, lung cancer, lower respiratory infections, chronic obstructive pulmonary disease and neonatal deaths.
More than 32,000 people die prematurely from air pollution-related causes in Ghana each year, accounting for nearly 14 per cent of all deaths nationwide.
Experts say concentrations of the most dangerous pollutants, known as PM2.5, in major cities such as Accra are about seven times higher than the World Health Organisation’s recommended annual average.
Between 2013 and 2023, Ghana’s pollution levels increased by 17 per cent, according to the State of Global Air report, showing the problem is getting worse even as awareness of the problem grows.
Ghanaian authorities have made progress in passing laws to curb air pollution in recent years. In 2025, Parliament passed the Environmental Protection (Air Quality Management) Regulations, which let the Environmental Protection Authority enforce national limits on pollution from factories, vehicles and other sources.
The EPA says it is working with the Driver and Vehicle Licensing Authority to add an emissions test to the roadworthy check that vehicles must pass. The Authority has begun to act, shutting down polluting companies in the last few months.
But the new research shows that vulnerable groups can do more to protect themselves.
The research focused on 307 street vendors divided into two groups: one group received a weekly supply of antioxidant-rich foods, while the control group maintained their usual dietary patterns.
The participants were monitored for 12 months, with lung function assessed at the beginning and end of the study. The group that ate the antioxidant-rich diet recorded improved lung function and lower odds of symptoms, including cough, difficulty breathing and irregular heartbeat, as well as fewer hospital visits, compared with the control group.
Prof. Amegah says the findings should compel government to raise awareness and include public messaging about the importance of diet as part of the air pollution strategy.
“This is local evidence which must be taken up by policymakers and integrated as one of the key interventions to reduce the impact of air pollution on the populace,” says Prof. Amegah.
Felicia Mawuli, a plantain seller at the Opeibea-Airport traffic light intersection in Accra, was a participant in Prof. Amegah’s research. She says the diet made a big difference to her health.
“They brought us fruits and other food items every Monday and checked on us each month until the duration was over,” she said, speaking in Twi.
“Personally, I used to experience persistent coughing due to the smoke from the vehicles, but after being on the project and consistently taking oranges and the other foods they recommended, I feel a lot better.”
Felicia has continued her new diet, in addition to wearing masks daily, and continues to see an improvement.
Experts say traffic hubs like Kaneshie are particularly dangerous for hawkers, traders and drivers who spend all day breathing in pollutants.
That does not surprise Charlotte Brookman-Amissah, a retired nutritionist.
She describes antioxidant- and anti-inflammatory-rich foods as vital to “help the body put out fire” and counter some of the effects of prolonged exposure to polluted air.
She recommends locally available foods, including chicken, fatty fish such as salmon and sardines, beans, kontomire, garden eggs, carrots, cabbage, yam, cocoyam, sweet potatoes, brown rice, groundnuts and cashew nuts.
Brookman-Amissah also points to oils such as palm kernel, olive and avocado oils, alongside local spices, including ginger, turmeric, cinnamon and garlic, which she says offer “excellent protection at little cost”.
The Ghana Health Service is already well aware of the importance of diet, according to Eunice Joan Teah Dzagli, Head of Health Promotion at the Greater Accra Regional Health Directorate of the Ghana Health Service.
She says nutrition education is already an important part of the Service’s health promotion to help patients suffering from hypertension, diabetes, cardiovascular disease and other chronic illnesses. She says that, with these findings, the education will be intensified, particularly among vulnerable populations.
But getting healthy fresh food to Ghanaians presents another range of challenges. Poor roads, lack of storage facilities, harmful farming methods and dietary traditions devoted to less nutrient-rich foods like cassava are also stopping good food from appearing on Ghana’s plates.
Cost is also a factor, a fact known well to fruit seller Gyamfua.
“I know the benefits of consuming fruits because I sell some, but I can’t eat it all the time. That will mean running down my business,” Gyamfua says.
Dzagli called for collective efforts across all government agencies, including agriculture, roads and education, to ensure that foods arriving at markets are diverse, safe and retain their nutritional value.
Brookman-Amissah, however, warns that diet alone cannot completely counteract heavy exposure.
“A nutritious diet reduces some of the harm; it does not cancel it,” she says. “Diet is our shield. Clean air remains the real solution.”
Experts say that, for outdoor workers like Gyamfua, telling them to eat more fruits and vegetables without addressing the polluted environments in which they work places the burden of protection on individuals who can only do so much.
Some street vendors say they need support to sustain initiatives that provide healthier diets to exposed workers, but, more importantly, they want opportunities to leave the streets altogether.
“We can educate the vendors about the dangers of air pollution, but many of us may not be able to continue it,” says Lina Nyarko, a founding member of the Traffic Hawkers Association. “We appeal to stakeholders to support us with some vocational skills or small capital to enable us to leave the streets.”
For now, Gyamfua loads her pan with pawpaw, which is currently in season. Experts say she and other traders should consume more fruits and other nutritious foods while government works to provide cleaner air and safeguard their health.
BY ABIGAIL ANNOH
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