Has cholera returned to claim the North?

Like Pwapwadi, Ahmadu Jauro, 19, a student of the community school in Gurin Villge in Fufore local government area of the state suffers from like symptoms which villagers have come to term as a “strange disease”. But there is nothing strange about the disease which has so far claimed over a thousand lives than the […]

Like Pwapwadi, Ahmadu Jauro, 19, a student of the community school in Gurin Villge in Fufore local government area of the state suffers from like symptoms which villagers have come to term as a “strange disease”.

But there is nothing strange about the disease which has so far claimed over a thousand lives than the fact that it is a fresh outbreak of cholera, which like measles, polio and meningitis breaks out with an alarming regularity over the vast swathes of Northern Nigeria and other regions in the country.

Pwapwadi and Ahmadu are among hundreds of children living in Adamawa State, suffering from attacks of cholera caused chiefly by drinking contaminated waters and from poor sanitation. Many young people have died here within the last few weeks from the cholera epidemic not only devastating the health of the people but creating a general disquiet among a rural and largely illiterate community trying to come to grips with this “strange killer”.

 Hints of this silent epidemic, which has not been largely covered by health officials, first seeped out from the remote areas of Gurin.  But by now, the depth of the tragedy and the staggering toll it has wrought has spread to many places like Mubi, Maiha and other areas in the state, with still more emerging cases, forcing villagers to break their silence and begin to speak out.

It is hard to know the exact number of children and adults that are being ravaged by this disease in the state. Families of affected persons were faced with the problem of transporting victims to the private hospitals in the next local government, which means a journey of 60 kilometres under difficult terrains and barely effective transport systems. The villagers have to make the journey across because the long strike by health workers in the state means the government health centres in the villages lack health workers to attend to the sick and dying.

The culprit of this “strange disease” is a stagnant and dirty stream, which is the source of water for the Gurin community. They do their washing, cleaning and bathing here. It is also the water that they drink and use for cooking.

The economic toll of the outbreak to the community is also as devastating. It has seriously hampered the ability of the people of the affected areas to make a living from either farming or trading, which is their chief occupations. The lost of strength for their livelihood is better appreciated when one realize that these people are very poor. Only a handful of children in the community are able to go to school. Even for those, learning isn’t that easy and straightforward. Too many school days are lost to this disease and other days are not that fruitful as the children struggle with learning disabilities brought on by damaged or slow cognitive development. Often times, women rely on pools of stagnant rain water or rain water trapped in earthen pots and basin as an alternative change for fresh water.

Most of the state’s 7,000 health workers, including nurses, specialists and administrators but not general doctors, in local government areas began an indefinite strike on 25 June to protest the suspension of an improved salary structure by the state government

The death toll from cholera ravaging some parts of Adamawa State have continued to increase with the state health workers union confirming that the death toll has doubled beyond the figures given by the government as. More deaths are expected to occur.

The state chairman of the Medical and Health Workers Union comrade Jerimaya Nyekwor while speaking to Weekly Trust explained that the drugs the Adamawa State government procured for the victims of the outbreak of the disease cannot be administered properly if not by qualified and trained health personnel.

 “Let me be frank with you, the number given by the state commissioner of information is an understatement,” says Comrade Nyekwor. “People are dying in their hundreds while thousands are getting infected by the disease suspected to be cholera. It’s unfortunate that the government is unmindful about the deadly situation because it’s being shrouded by people with selfish interest. Deaths in the recent cholera outbreak could have been avoided were health workers not on strike.”

A spreading epidemic

The blame game is unnecessary. The cholera devastation may have spread from Adamawa to the neighbouring Borno State as reported by the News Agency of Nigeria. In Borno State, the epidemic is believed to have broken out in Biu where so far no fewer than 52 lives were lost. Dr Abubakar Sadiq, the Medical Director in charge of the treatment camp set up by the Borno Government in Biu disclosed this on Thursday when the Borno Deputy Governor, Alhaji Adamu Dibal, visited the camp. Dr. Sadiq told the Deputy Governor that the medical team had treated 1,355 people who were victims of the killer disease.

“We received about 1,355 patients in the camp for treatment but unfortunately about 52 of them could not make it as they died from the disease,” said Dr. Sadiq. “An average of about 100 patients were brought in from villages on a daily basis at the peak of the epidemic, but we thank God that we have been able to contain the situation for now.’’

The effects of the devastation of the epidemic in Borno is lower than in Adamawa because of the availability and quick deployment of medical personnel, about 131 of them according to state officials, which have helped stave off the attack of the epidemic. Just like Adamawa, the major culprit in Borno is poor sanitation and drinking contaminated waters.

Earlier on Thursday, The Water Supply And Sanitation Sector Reform Programme (WSS-RP) had said that more than 1,300 children in Yobe, a neighbouring state to Adamawa and Borno States, had died from diarrhea-related complications in the last two years, tracing the cause of the epidemic to poor water and sanitation.

The Programme Coordinator of WSSS-RP, Malam Kabiru Abass, said a study revealed that only 40 per cent of Yobe people lived under good sanitary conditions, while the remaining 60 per cent engaged in open defecation near houses, on farms and by streams.

“Provision of latrines and hand washing with soap or ash after toilet would reduce the risks of contracting diarrhoea in the state,’’ he said.

Still more…

By the last count, in Jalingo, the Taraba State capital, which is on the north eastern axis with Adamawa, Borno and Yobe States, no fewer than thirty deaths were reported following the outbreak of cholera a fortnight ago.

Although the state government through the Ministry of Health claimed that only ten deaths were recorded during the outbreak, hospital sources confirmed thrice that number of death occured while several others patients were said to be undergoing treatment at different health centres in Jalingo.

Areas that were badly affected in Jalingo in the wake of the cholera outbreak are Turaki, Sarkin Dawaki, Barade and Lamurde wards where residents live under unhygienic and poor sanitary conditions.

Mohammed Bose, the Commissioner for Health first confirmed the outbreak to the AFP news agency who quoted him as saying: “We have recorded cases of cholera outbreak in Jalingo in which nine people have died.”

But findings by Weekly Trust at the State Specialist hospital as well as other health facilities in Jalingo revealed more deaths from the outbreak even as more cases were being recorded on daily basis. Among the victims were some patients who reportedly died in their homes because they could not afford the cost of hospital medication.

At the Turaki model primary health clinic, a community health extension worker, Bashir Tukur, confirmed to Weekly Trust that no fewer than five deaths were recorded at the clinic since the outbreak. Tukur added that the clinic had admitted about 45 patients, among them women and children, some of whom were treated and later discharged.

Tracing death to its lair

Several causes have been attributed to the recent cholera outbreak in Jalingo. Apart from poor environmental sanitation coupled with poor hygiene, experts have also traced the cholera outbreak to the poor water supply in the state capital.

Isiaka Bashir, programme manager of the State Rural Water Supply Agency, who went out with a team to identify the causes of the outbreak said: “Poor environmental sanitation and hygiene as well as poor water supply in the state capital are responsible for the cholera outbreak.”

Usman Zubairu, the officer in charge of the Mafindi Urban Health Centre also traced the root cause of the cholera outbreak in Jalingo to what he called inappropriate sanitation and unhygienic practices by residents of the state capital.

 Apart from water vendors, most residents of Jalingo derive their sources of drinking water from ponds, streams and rivers. One of these is the River Lamurde where residents living by its banks were said to be worst hit by the cholera outbreak. The water from the river which is used for drinking and other domestic purposes is said to be heavily contaminated by sewage deposits from residents along its bank.

Weekly Trust checks also show that the old abattoir located right in the heart of Jalingo as well as the Jalingo prison located at a sprawling settlement called Angwan Gaadi, have also contributed to the recent cholera outbreak.

The environment around Sabon Gari where the abattoir, which is yearning for relocation, is situated is in a sorry sanitary state. It is heavily polluted by stench of blood and faeces of slaughtered animals which put the health of residents and visitors in jeopardy.

Similarly experts say those living within the neighbourhood of the Jalingo Prison are also vulnerable to air and water borne diseases such as cholera. Sewage from the prison yard is said to be indiscriminately disposed into drainages that are in turn washed into rivers and streams from which the locals derive their water source.

Taraba state government, according to the Health commissioner, Mohammed Bose, is on top of the situation. Bose said his ministry had deployed a team of experts to the field to assess the situation so as to determine government’s next line of action.

Experts say to stem future occurrence of cholera outbreak in the state a deliberate policy must be put in place to delineate the role of the various stakeholders from the federal, state local government and community level.

“First and foremost, there must be improved environmental sanitation as well as provision of potable water in the state through the rural and urban water supply scheme,” said Isiaka Bashir, programme manager of the state rural water supply agency.

A civil society worker, Ahmed Koson who personally volunteered to convey some patients to the hospitals in the wake of the cholera outbreak called for the relocation of the old Jalingo Abattoir which is currently located right in the heart of the state capital. Koson also called for improvement in water supply as well as the poor sanitary conditions in the state capital.

The big question though is when will the country bid a final goodbye to diseases that are not really strange but have well known causes and methods of cure? This is a question whose answer the confused villagers of Gurin in Adamawa State will be yearning to know.