In recent times, Nigeria has recorded 86 deaths resulting from outbreak of cholera in six states. JOYCE REMI-BABAYEJU looks at why cholera is endemic in the country and what can be done to prevent it.
Presently, some states in the country are under the siege of cholera epidemic resulting in the deaths of no fewer than 86 people in affected states.
In the wake of this epidemic in the country, the minister of Health, Professor Onyebuchi Chukwu, gave an update on cholera outbreak in Nigeria. According to the minister, states so far affected include Ogun, Oyo, Plateau, Zamfara, Nasarawa and Lagos states and still counting.
The minister said there were a total of 1,623 cases out of which 86 deaths occurred. The distribution per state is Zamfara State: 1,110 cases, 51 deaths; Nasarawa State: 105 cases and 9 deaths; Lagos State: 134 cases, 4 deaths; Plateau State: 130 cases, 11 deaths; Oyo State: 29 cases, 6 deaths and Ogun State: 115 cases and 5 deaths.
He said that laboratory examination has confirmed the outbreak to be caused by Vibiro cholera serotypes 01 and 0139.
When there is an epidemic the most affected are vulnerable children whose immunity is weaker than those of adults. Children are known to be the most casualties whenever there are health challenges in communities.
Cholera is a viral infection which occurs when people consume contaminated water and food, and often it spreads as a result of poor sanitation and hygiene. The minister reiterated a well know fact that the cholera epidemic was caused by poor hygiene and sanitation, including open defecation, and surface water contamination in most of the affected states.
Presently, it is reported that 100,000 Nigerian children die from cholera related diseases annually. This is as a result of lack of portable water in most communities.
UNICEF report of 2012 says that at least 67, 000 cholera cases were reported mainly around Lake Chad Basin in Nigeria, Cameroon and Chad with 2,153 deaths and at an average fatality rate of 3.2 %.
A former UNICEF Nigeria Representative, Dr. Suomi Sakai, said, “Cholera is a deadly disease that kills quickly but it is preventable, if one can imbibe and practice simple life-saving behaviours like boiling water before drinking; hand washing; and personal and environmental hygiene.”
According to the Nigeria’s National Demographic Health Survey, NDHS, of 2008, only 45% of Nigeria’s population have access to safe drinking water and it has been reported that cholera is caused by consuming contaminated water and food and spreads as a result of poor sanitation and unhygienic practices.
In a recent paper, ‘The Global Burden of Cholera,’ there are estimates that there are between 1.4 to 4.3 million cholera cases every year worldwide, resulting in 28,000 to 142,000 deaths per year among the 1.4 billion people who are exposed to the risk in countries in which the disease is endemic. In epidemic countries, children under age five accounts for about half of the global incidence and deaths caused by cholera.
WaterAid Nigeria reported during the recent World Toilet Day celebration in Nigeria that an estimated 100,000 children under the age of five die of diarrhea every year as result of poor access to sanitation and clean water.
The country representative of WaterAid Nigeria, Dr. Michael Ojo, states that as a result of poor hygiene and sanitation, especially when it comes to hand washing, about 1400 children in Nigeria contract hand to mouth diseases resulting in Diarrhoea which kills about 157 children in every 1000 live births in Nigeria.
According to other reported figures, about 70,000 Nigerians lose their lives yearly due to poor hygiene and sanitation, including children below the age of five. And that “every hour, Nigeria loses eight children due to lack of access to clean water and sanitation and only one in six adults indulge in hand washing at critical times.”
A UNICEF Principle Adviser Child Survival and Development for West and Central Africa, Dr. Guido Borghese once said, “cholera shows us how closely linked malnutrition is to unsafe water, poor sanitation, and hygiene. A child below the age of five who has recovered from severe and acute malnutrition will be back for treatment in a matter of days or weeks if he or she is drinking contaminated water.’’
Borghese said that hand washing campaigns, treatment of drinking water and awareness raising radio programmes must be a continuous exercise throughout the year as simple and effective ways of prevention and containing the spread of this infectious deadly disease.’’
According to figures released by UNICEF in 2013, lack of safe water, sanitation and hygiene is a leading cause of deaths from diarrhea in children under five, with approximately 16,000 children dying each day worldwide. Also, UNICEF states, about 194,000 Nigerian children under five die annually due to diarrhea and in addition, respiratory infections kill another 240,000. This could be particularly in children if there is an improvement in water, sanitation and hygiene.
According to figures released during the recent World Toilet Day, in Nigeria, over 100 million people do not have access to improved toilet facilities out of which over 45 million defecate in the open particularly in urban slums and rural communities. Lack of toilets pose a great danger to public health and general well-being as evidenced during the recent cholera outbreak in several parts of the country.
In most low income and middle income economies people still lack toilet facilities. Owing to the lack of this essential human facility, people are forced to defecate indiscriminately. It is reported that toilets are still out of the reach of more than one-third of the world’s population with “devastating consequences to the health and development of children.”
Lack of toilet facilities in homes and indiscriminate disposal of feces in environments pose great danger to the health of adults and children, this accounts for the major cause of the recent outbreak of cholera in most parts of the country.
It has been medically proven that sanitation is essential for the promotion of human health, and it also promotes economic benefits, contributes to dignity and social development and the well being of human beings.
To eradicate cholera epidemic, the minister of health has advocated some preventive measures and hygiene practices like, hand-washing with soap after visiting the toilet and also before eating, cultivation of the habit of regular and intermittent hand-washing with soap and water, desisting from open defecation, boiling of water before drinking, protection of food from house flies, Thorough washing of fruits and vegetables before eating them and environmental cleanliness.
Basic sanitation and hygiene should be the collective responsibility of everybody, governments and all stakeholders to ensure that the health of children is safe- guarded and for the reduction of child mortality by the 2015 MDG target year.