AVERTING CHOLERA OUTBREAK IN NIGERIA

BY: ABUBAKAR JIMOH

Cholera is  acute enteric infection caused by the ingestion of bacterium Vibrio cholerae present in faecally contaminated water or food, currently spreading across the Northern part Nigeria like a hurricane.

Cholera is an extremely virulent disease that affects both children and adults. Unlike other diarrhoeal diseases, it can kill healthy adults within hours. The epidemic is characterized by profuse watery diarrhea, vomiting, and leg cramps. Through these, an infected person, rapid losses body fluids which lead to dehydration and shock; and in absence of treatment or early awareness, death can occur within hours.

So far Cholera outbreak has claimed thousands of lives and renders hundreds hospitalized. For instance, about 150 lives were lost and over 1,300 others hospitalized in August, 2010 in Bauchi state; followed by another lost of 67 lives and 1,742 hospitalised in the same state in the year 2011; over 47 lives were lost while about 735 others were hospitalize in Gombe state in the year 2010 with more than 190 other cases were reported in the state in the same year; and generally about 4,600 lives were reportedly lost to cholera outbreaks between 2008 and 2010 in Nigeria. 

In a study conducted by the Federal Ministry of Health in collaboration with the World Health Organization (WHO) and National Emergency Management Agency (NEMA) several causes have been primarily attributed to Cholera outbreaks in the country, among these are insufficient access to safe water and proper sanitation, disruption of the exiting basic environmental infrastructures, massive displacement of Internal Displace Persons or refugees to overcrowded environments where the provision of potable water and sanitation is lacking.

Consequently, the National Emergency Management Agency (NEMA) apart from constant distribution of relief materials and drugs to the victims of Cholera outbreak, the Agency under the leadership of the Director-General, Alhaji Muhammed Sani-Sidi organizes regular campaigns and sentisations programs across the six geo-political zones in Nigeria purposely to educate and immune the public, especially those in the rural areas against avoidable deaths from the outbreak of disease such as Cholera.   

As more cases of Cholera outbreaks are reported annually, there is  very vital for the governments at all levels institute a regular reliable and accurate surveillance data as this would help to monitor the trend and evolution of the outbreak and enhance adequate intervention measures as it was successfully exploited in the United States Cholera Outbreaks in the 1800s.

The key to effective control of cholera is environmental sanitation. It has been argued those human beings are surrounded by thousands of harmful organisms. In the 2011 5 years survey of 4 different communities conducted by the WHO, it was obtained that the provision of sanitary facilities for human waste disposal can reduce the incidence of cholera by as much as 68%.

In several occasions NEMA has encourage communities to protect themselves against cholera by adhering to proper food safety practices as well as to good personal hygiene. Sanitation is so important to the health and well being of the people, as without good, clean sanitation systems leads to emergence and spread of epidemic.  Improper disposal and accumulation of rubbishes in our surrounding result to micro organisms that transform into Cholera epidemic that harms thousands. Poor sanitation results to blocked drainages and further damage to infrastructural facilities.

Personal hygiene is strictly required of individuals to help combat Cholera outbreak, it is advised that to prevent further spread of the epidemic, there is need for the members of public to wash their hands with soap and water before preparing food, eating or after visiting the toilet and latrines; wash plates, cups, cutlery and utensils with soap and water before use; boil drinking water and keep it in clean covered containers, or disinfect water with chlorine-food should be cooked before being eaten and it should be eaten hot; food; while all fruits should be washed thoroughly before being eaten.

Governments at all levels should ensure adequate provision of drinkable water supply, especially in the rural areas. For instance in a study conducted by WHO, it was discovered that provision of a safe water supply can decrease Cholera by 73%. Where both toilets and water supplies are provided, the incidence can be reduced by as much as 76%. Inadequate water supply and basic facilities expose several communities to dangers of Cholera outbreak. Interruptions to the water supplies, together with overcrowding, are aggravating factors causing Cholera epidemic.

There is a need for the provision of all healthcare stakeholders to NEMA to help strengthen its ongoing sensitization campaign against Cholera outbreak to enhance adequate public education and enlightenment. This would include massive public enlightenment campaigns on the need for clean environment, proper disposal of wastes, the washing of hands after using the conveniences, proper washing of foods especially vegetables before eating them, and the boiling and filtering of water before drinking are simple precautions that majority of the people need to be taught which can protect them from cholera and save their lives. All communities must be taught how Cholera can be prevented and cured, immediately it is noticed.

 abujimoh01@yahoo.com

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