By Fred Ezeh, Abuja
Last week, about half of Maiduguri, Borno State capital, was submerged by overflowing water from Alau Dam, Konduga Local Government. The incident threw thousands of families out of their homes to different Internally Displaced Persons (IDP) camps and caused l severe humanitarian crisis.
Few weeks ago, a similar incident happened as predicted by the Nigeria Meteorological Agency (NiMet). Many communities in Kebbi, Sokoto and other states were flooded.
In July, another incident was recorded in Lagos where parts of the city was submerged as a result of long hours of rain. The overflow of the incident was experienced in neighbouring states.
NiMet and other agencies also predicted that more rain is expected in the coming days, alerting communities in the riverine areas to vacate to safe locations.
However, there are indications that water level has already risen beyond normal in Kogi, Benue and some other states. That could result in flooding, hence the early warnings and the need for proactive measures to forestall the devastating effects of the imminent flooding.
In all these happenings, there are strong predictions that some public health dangers lie ahead. The Nigeria Centre for Disease Control (NCDC), recently raised the alarm that cases of cholera and other water-borne diseases could spike beyond the expected threshold.
Also, the NCDC confirmed that its bi-weekly epidemiology report indicated that more cases or cholera and other water-borne diseases are being reported from the states, perhaps, as a result of the increasing flood which has, obviously, contaminated several sources of drinking water for the people, in addition to the economic hardship that had affected people’s standard of living.
Health workers also confirmed a rise in cases of diarrhea, typhoid, cholera, and other water-borne diseases, perhaps, as a result of the rise in the patronage of unclean sources of water for consumption and other household use by Nigerians.
Cholera alarm
NCDC, last week, amplified the campaign for proactive measures to be put in place to avoid disease outbreaks in Borno State, which, from all indications seem inevitable due to the devastating flood that has led to the loss of lives and properties.
Its Director General, Dr. Jide Idris, recalled that flooding usually comes with grave health implications, stressing possible disease outbreaks to include: diarrhoea, cholera, dengue fever, typhoid and hepatitis.
He said: “The flooding in Borno has huge health implications, hence it’s important that we prepare the minds of state officials and that of other states experiencing flooding on the consequences of the flood.
“Undoubtedly, it can lead to an increase or emergence of several health cases. In the case of Maiduguri, the flood might have spread pollutants that are dangerous to the health of the people. The flood might have also carried industrial wastes, sewage and other pollutants detrimental to the health of the people.
“Undoubtedly, we are currently dealing with MPox but that should not be allowed to overshadow other public health threats which are claiming more lives. So, there’s need to heighten surveillance at all points of entry especially in the South South that’s bordering Cameroon, to avert the import of the Clade 1b strain of MPox, which is more deadly.”
Nevertheless, he gave assurances of the NCDC’s readiness to provide support wherever and whenever it’s needed to ensure the safety of those affected by the flood.
Other possible factors
Aside from the challenges highlighted by NCDC, there are several other factors, particularly economic hardship, that could predispose many people to several water-borne diseases.
Few months ago, the Abuja chapter of the Association of Table Water Producers (ATWAP), embarked on strike, and upon return from the strike, announced a hike in the price of sachet water by about 200 per cent, citing the significant rise in inflation and cost of production.
Within the same period, a video trended on social media where a particular woman was selling water in a nylon bag that was obviously packaged in an unhealthy environment, as a substitute to the sachet water that has risen in price.
This, perhaps, resulted in a sudden rise in the patronage of unclean sources of water for consumption and other household use by Nigerians, thus exposing the people to the risk of water-borne diseases.
Communicable diseases update
NCDC, last week, released a report that highlighted the state of communicable diseases in Nigeria. It stated that about 1,056 lives were lost to Cholera, Lassa fever and some other communicable diseases in the last eight months of this year (January to September, 2024).
Breakdown of the figure indicated that 216 people died of cholera, Lassa fever claimed 168 lives, 309 people died of Diphtheria, and Yellow fever claimed two lives, while Cerebrospinal Meningitis (CSM) claimed 361 lives. But no death has been recorded so far from Mpox, even though 67 cases have been confirmed in 23 states and FCT, amidst plans to commence Mpox vaccination in October.
It also highlighted that Antimicrobial Resistance (AMR) is becoming a major health challenge in Nigeria, stressing that the AMR pandemic has surpassed the big three challenges (Malaria, HIV & TB). For instance, 64,500 deaths were attributed to AMR, while 263,400 deaths were associated with AMR in the period under review.
NCDC highlighted that major causes/drivers of AMR are poor levels of awareness among health workers, policy makers, and the public; overuse and misuse of antibiotics in human and animal health; unnecessary use of antibiotics; using antibiotics without a prescription; using too many antibiotics in farming; poor hygiene and sanitation in community, health facilities, farms, abattoirs; as well as limited surveillance systems for tracking AMR trends.
It, however, confirmed that it is working with relevant stakeholders to ensure that Nigeria’s response to the diseases is both strong and effective, working hand-in-hand with counterparts from human health, animal health, and environmental sectors under the One Health approach.
NCDC further stated that it has engaged in raising AMR awareness, education, understanding, and behaviourial change among all relevant stakeholders, and also incorporated AMR education into health worker training programmes.
It added that several programmes are in place to help Doctors and Nurses prescribe antibiotics only when necessary, reducing the chance of resistance developing,” he said.
Regarding other communicable diseases, the NCDC encouraged regular and adequate hygiene as well as other preventive measures to reduce the chances of contracting the diseases.
Experts’ reactions
Meanwhile, some medical experts asked the federal and state governments health officials to be aware of the pending public health challenges, and brace up for a quick and effective response to the imminent upsurge in cholera cases and several other water-borne diseases across some states.
A public health physician, Dr. Laz Ude Eze, in his submission, said the prediction that cholera cases might rise in the coming weeks is expected considering several factors that support the claim:
“The recent flooding in Lagos, Maiduguri and other states, is a pointer that the outbreak of cholera epidemic and other water-borne diseases might worsen if necessary steps are not taken to contain the spread. Undoubtedly, the flooding in several states might have caused widespread contamination of water bodies, thus exposing the people to the risk of cholera and other water-borne diseases.
“To this end, the government is expected to step up public health messaging on prevention measures, while individuals should ensure they drink safe water, cook properly and practice hand hygiene regularly. I may not have good knowledge of NCDC responses against the epidemic, but whatever the case maybe, they should strengthen their responses.
Former chairman, Association Resident Doctors (ARD), FCT, Dr. Roland Aigbovo, raised the alarm that there might be increased hospitalization as a result of the development:
“However, Nigerians are resilient people. No matter what lies ahead, they always create an avenue to get going. Due to the present precarious economic crisis that has bedeviled our country with so much uncertainty and class widening in terms of wealth and living standards, many people, especially the downtrodden have resorted to alternatives to meet their daily needs and hence, quality and safety will be thrown to the wind.
“The dangers of such practices will be sales and consumption of unwholesome products that would endanger the lives of citizens vis-a-vis their health. For instance, there are already reports of sales of water in polythene bags that are obviously packaged in an unhealthy environment, and without standards. This will, definitely, lead to increase in water-borne diseases and increased hospitalization, resulting in loss of valuable manpower/work hours due to the poor hygienic conditions of packaging and untreated water from any source.”
Dr. Ken Ozoilo, former president, Medical and Dental Consultants Association of Nigeria (MDCAN), described the situation as catastrophic, and a pending public health challenge, considering the fact that water is central to the issue of public health management in Nigeria and beyond.
The campaign for Water, Sanitation and Hygiene (WASH) which was championed by UNICEF, local and international donor partners, and other State governments has been intensified for a long time with visible positive results being recorded.
“Fortunately, many Nigerians have picked and imbibed the message of hand washing for healthy living. But the situation in Nigeria today is scary and could affect the gains achieved over the years. Undoubtedly, a public health challenge is looming if something urgent is not done to salvage the situation.
“We are currently battling with the outbreak of several communicable diseases as being reported from different states in Nigeria. Soon, it will be the turn of meningitis. So, there’s a need to take precautionary measures to avoid additional public health issues that could overwhelm our system and manpower.
“Sadly, governments prefer reactionary measures/interventions which are more costly and often result in avoidable loss of lives, than proactive measures which are cheaper and affordable. But that should change if we want to achieve the desired gains.”
Abuja residents react
Nana Khadijat Musa, a resident of Jikwoyi, Abuja, told Daily Sun, that the state of affairs in Nigeria vis-a-vis standard of living, are terrible.
She lamented the rising cost of basic items including water. “A bag of sachet water in Jikwoyi (20 pieces) that hitherto cost N200 has risen to N400 and above. “Retail price for a sachet of water is now N50 up from N20. This has forced so many people to change their taste. I recently observed that many people now use “unclean” water, and that has exposed them to several water-borne diseases.
“Similarly, a pet bottle of water is now N300 and above depending on place of purchase, from hitherto N100. Soon, the producers would hike the price and they would use the recent fuel price hike as an excuse. Life and living has become too expensive for people at the lower cadre.”
Similarly, Onyeka Mmesomma, a resident of Kabusa, Abuja, confirmed that some of her neighbours have resorted to drinking “unclean” water sourced from nearby boreholes and wells. “But I don’t blame them because the cost of water has gone up alongside other essential commodities.
“I bought a bag of sachet water at N500. But for a particular neighbour of mine who has four teenage children, in addition to his house girl, how many bags of water do you expect him to buy at that cost to be enough for the family? People’s income is dropping significantly, while the costs of basic items are skyrocketing. That’s a recipe for impoverishment.
“I recently suggested to his wife to get WaterGuard, which is a dilute sodium hypochlorite solution used as a point-of-use treatment for household drinking water to purify the water so the children don’t come down with water-borne ailments that could cost huge financial resources to treat.”
She also confirmed that, in her neighborhood, some people have also resorted to drinking of “unclean” water sourced from wells. “These are evidently unhealthy water for families, but I have no solution to their problem because the cost of sachet they hitherto consume has gone beyond their reach.”
She challenged the government, particularly the local government, to intervene in the situation to avoid catastrophic public health challenges that might overwhelm the already overstretched public health care facilities in the FCT.
