Cholera Outbreak: Feedback from Nigerians living in penury
By Uji A. ILIYASU
Recently, most of the 36 states of the federation and Federal Capital Territory (FCT) have been grappling with cholera epidemic.
The recent scourge was first reported in Lagos State before spreading to Ogun and other states, according to reports.
Uji A. Iliyasu brings to the fore the kind of lifestyles that can give rise to cholera outbreak, moreso under the current socioeconomic realities and advises that residents in the affected states take crucial measures to contain the spread by observing personal hygiene and ensuring safer environment.
Also, it is important for communities in which the case has not yet been reported to take proactive measures to check the spread of the epidemic.
Background
Cholera outbreak in Nigeria is no longer endemic in one state or in one geographical zone. It is spreading across the 36 states and FCT, with cases and death toll rising on daily basis.
Cholera is an acute diarrheal disease that can lead to death if it is not treated early.
It is a disease mainly caused by poverty, as it usually affects people with inadequate access to clean water and basic sanitation in the homes and places of livelihood.
The scourge is transmitted through the ingestion of contaminated food or water. The outbreak is usually severe in rural areas and overcrowded city suburbs which lack safe drinking water while residents live in dirty and unsafe environments and defecate in open air.
Nigeria has been having cholera outbreaks since 1972, but the intensity of cases varies in years the scourge reappears.
The later part of 2010 was marked with a severe case that started from the northern part of Nigeria and spread to other parts, involving approximately 3,000 cases and 781 deaths.
The 2024 epidemic started in Lagos and Ogun states and is now spreading fast across the 36 states of the federation, and unfortunately, to Nigeria Correctional Service facilities.
Top 10 states hard hit
The Nigeria Centre for Disease Control (NCDC) said 2,102 suspected cases of cholera resulting in 63 deaths has been so far recorded across the 33 states and 122 LGAs in the country.
Director-General of NCDC, Dr Jide Idris, who disclosed this at a media conference on the update of the scourge recently in Abuja, said Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers and Delta states, were among the top 10 states that reported about 90 per cent of the cases.
Dr Idris said inadequate toilet facilities, poor sanitation and inadequate safe water are factors militating against cholera eradication in the country.
“Only 123 (16%) of 774 LGAs in Nigeria are open defecation-free. With Jigawa as the only open defecation-free state in Nigeria. More than 48 million Nigerians practise open defecation.
“Inadequate toilet facilities and existing ones even in many government facilities are not well maintained. Eleven per cent of schools, six per cent of health facilities, four per cent of motor parks and markets, have access to basic water, sanitation and hygiene services,” he said.
He also listed poor waste management practices, poor food, environmental and personal hygiene practices, capacity gap among healthcare workers at the state and LGA levels as part of the challenges.
However, he said the national cholera multi-sectoral Emergency Operation Centre (EOC) activated recently was providing strategic coordination to fight the scourge.
First reported case
The 2024 cholera outbreak in Nigeria started in Lagos state. Health authorities in Lagos state declared the outbreak on 15 June 2024, with 436 suspected cases. Later, on 23 June, suspected cases in Lagos rose to 500. The outbreak spread to Ogun state and moved to about 33 states.
Unregulated street beverages
The 2024 cholera outbreak, medical experts said, was caused by unregulated street beverages and contaminated water supply.
They said samples taken from popular street beverages in the area were found to have new cholera-related deaths have been reported in the last 72 hours, and the government is taking steps to eliminate the transmission of the disease.
Spread in correctional centres
Nigeria Correctional Service centres have been plagued by overcrowding, poor sanitation and inadequate facilities. These conditions lead to unsafe environments that aid the spread of diseases such as cholera.
According to reports, many correctional centres in Nigeria operate at over 200 per cent capacity, with some facilities holding triple their intended population. This overcrowding, combined with unsafe water and inadequate sanitation facilities, has led to numerous cholera outbreaks in correctional centres across the country.
Fortunately, the Nigerian government has acknowledged the issue and has taken measures to address it.
The construction of new correctional facilities and the implementation of rehabilitation programmes to decongest the centres are points to focus on.
Lagos State Commissioner for Health announced that there were 25 cases of gastroenteritis caused by cholera at the Kirikiri Medium Security Prison.
The World Health Organisation (WHO) has donated 10,000 doses of medicine to help the prison, which houses about 3,200 inmates.
WHO’s response
The World Health Organisation (WHO) has not sent vaccines to Nigeria, but instead, Federal Government has provided test kits and other materials, including Personal Protection Equipment (PPE) to 22 states.
The states that have received test kits, consumables and other materials from the federal government include:
Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa and Ondo. Others are Osun, Niger, Kano, Lagos,
Akwa Ibom, Benue, Kwara,
Anambra, Sokoto, Plateau, Ebonyi and Ekiti states.
FG criticised
Nigerians have criticised FG’s measures taken to halt the spread of the scourge.
Some medical experts believe that government’s response to the cholera outbreak is slow and not proactive.
They blame government at federal and state levels of not providing adequate healthcare infrastructure caused by corruption and mismanagement of healthcare resources
On this premise, many Nigerians have taken to social media to express their frustration and disappointment with the government’s handling of the outbreak, some have even called for FG to declare a state of emergency in the healthcare sector.
READ ALSO: Nigeria records 2,102 cholera cases, 63 deaths, in 33 states
Here are some prominent Nigerians who have something to say about the cholera outbreak.
Dr Jide Idris, Director General of Nigeria Centre for Disease Control (NCDC), addressing the media in Abuja, stated that the country faced another public health emergency after coming out of the Lassa fever and Meningitis outbreaks.
Dr Tomi Coker, Commissioner for Health, Ogun State, stated that efforts were in top gear to establish the actual status of the 16 cases still under close monitoring.
Professor Akin Abayomi, Lagos State Commissioner for Health stated that collaboration with the Ministry of Environment and coordination with partners are helping to bolster community sanitation efforts and outbreak control.
Dr Walter Kazadi Mulombo, WHO Representative in Nigeria, said controlling a cholera outbreak requires a multifaceted approach, using surveillance, water, sanitation, and hygiene measures, risk communication/social mobilisation, timely treatment, and oral cholera vaccines.
Reactions from NASS
The House of Representatives called on the federal government to take action to stop the spread of cholera.
Kingsley Chinda, House Minority Leader, moved a motion to adopt “urgent need to check the outbreak of cholera in Lagos and other parts of the country”.
James Faleke, lawmaker representing the Ikeja Federal Constituency in the House of Representatives, called on Nigerians to take the cholera outbreak as seriously as the COVID-19 pandemic.
President Tinubu reacts
President Bola Ahmed Tinubu directed the establishment of a cabinet committee to oversee the emergency operations centre led by the National Centre for Disease Control (NCDC) in response to the cholera outbreak in Nigeria.
The committee will comprise members from the Ministries of Health, Finance, Water Resources, Environment, Youth, Aviation, and Education.
President Tinubu has emphasised the need for improved WASH (Water, Sanitation, and Hygiene) practices, including addressing open defecation and ensuring access to clean water and sanitation facilities.
Conclusion
Raising people’s living standards can help provide a clean environment and food.
When people have a higher income, they are more likely to afford clean water and sanitation facilities;
eat healthy and nutritious food; live in better housing conditions, which helps in reducing the risk of disease transmission.
Governments at all levels must ensure citižens have access to education and information on proper hygiene practices;
improved waste management and disposal practices and lastly,
reduce poverty and inequality, which are underlying factors in many health issues.
Also, more needs to be done to address the systemic issues of unsafe drinking water.
Moreover, NAFDAC should do more to regulate street beverages in rural areas and in city suburbs like villages in Karu local government area of Nasarawa State, which holds a substantial number of Abuja population, especially now that the case has been reported in Kokona and Nasarawa Eggon LGAs.
Uji A.ILIYASU is Features Editor at Neptune Prime
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