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Tackling The Cholera Scourge

Ebonyi State has been in the news recently on account of the cholera outbreak in some of its communities. The state’s Director of Public Health and Disease Control in the Ministry of Health, Dr Chris Achi, confirmed last month that about 256 people had been affected by the disease since its outbreak in February. About 30 cholera deaths were also recorded in seven of the 13 local government areas of the state within three months.

We consider this development very disturbing because the disease has earlier ravaged many states across the country. From mid last year to date, the epidemic has been reported in more than 20 states including Abuja. Within some weeks following its outbreak in Bayelsa State last December, the disease killed 30 people while Anambra State recorded eight deaths from the 25 reported cases in January this year. The epidemic berthed in Borno State last September with Maiduguri, the state capital recording about 4,500 cases and 70 deaths in one month. Cholera has also killed about 20 people out of the 171 reported incidents in Rivers State since an outbreak of the disease was reported on January 5, 2015. Statistics from the Ministry of Health indicate that the number of cholera cases rose sharply from 1,623 in 2013 to 35,000 in 2014.

Cholera is an infectious disease transmitted through direct or indirect ingestion of contaminated food or water and it has a very high mortality rate if untreated. But despite being a killer disease, cholera is easy to prevent and curable. It is therefore puzzling that such disease has continued to pose a serious public health challenge in the country. What this shows is that Nigeria is low on the social development ladder.

About 50 million Nigerians are said to practice open defecation while only 58 per cent of her population has access to clean water and sanitation as indicated by figures from the Federal Ministry of Water Resources. These factors have been linked to mass cholera and diarrhoea deaths in the country. The Ebonyi outbreak confirms this fact. In the communities where the disease was reported, Dr Achi said the ponds where the citizens access drinking water were in very poor condition. He also noted that most of the houses do not have toilet facilities and people defecate around the surroundings of their homes thus exposing themselves to the outbreak of cholera.

The time has come for Nigeria to take a cue from the developed countries which have been able to eliminate the disease mainly through modern sanitation and the treatment and provision of drinking water. A study conducted by the World Health Organisation (WHO) recently indicates that the provision of safe water supply can decrease cholera by 73   per cent and that where both water supply and toilet facilities are provided the incidence can be reduced by as much as 76 per cent. Unfortunately, many parts of the country lack potable water and people get their drinking water from bacteria-infested sources. Toilet facilities and good sewage system are also lacking in most communities in the country thus putting the people at the risk of contracting cholera.

In view of this, we urge government to urgently consider intervention programmes that would address the root causes of poor sanitation and unsafe water supply in the country. It must show commitment to providing potable water in urban and rural communities and enforcing environmental and sanitation laws, among other measures. Beyond these, there is need to improve the standard of living of the people, particularly through the provision of affordable housing to avoid open defecation and overcrowding which have been linked to cholera outbreak. That cholera epidemic targets the lower strata of society suggests that if government could put in place and execute policies that will enhance the standard of living of the people, the cholera scourge could become history.

However, we should be reminded that the task of eradicating cholera does not lie with government alone. Individuals and families should endeavour to maintain clean environment and observe the simple rules of personal hygiene like hand washing after using the toilet and before preparing or eating food. People should also wash fruits and vegetables very well before eating. Boiling water before drinking is also advised. Nigerians should desist from defecating indiscriminately around their environment or waterways as contaminated faeces could get into the water source and cause cholera outbreak.

We advocate that government and concerned organisations, especially non-governmental organisations, should embark on massive public enlightenment campaign on the causes and prevention of cholera. Nigerians need to be educated on the use of oral rehydration therapy to replace lost body fluids, a consequence of diarrhoea. It is instructive to know that dehydration is the major cause of death in cholera patients. The public campaign should also address the problem of self-medication, another major cause of death in cholera patients. Nigerians need to understand the danger in resorting to self-medication when one exhibits symptoms of cholera such as diarrhoea and vomiting. As the government and people of Ebonyi strive to contain the disease, it behoves on all the three tiers of government across the country to devise strategies to chick cholera out of the country, for good.

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