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Cholera outbreak: When water becomes an enemy

Patients in the hospital

PERHAPS the late Afro -musician, Fela Anikulapo Kuti was right when he sang that water has no enemy. To him, whoever that dares the might of water, may be keeping a date with death.

True to his words, the abuse of water in Nigeria is currently giving many sleepless nights-no thanks to the failure of governments across the country to treat water sources. From the North to West, the wrath of water has resulted to harvest of deaths. And it seems that this death that is caused by cholera and gastroenteritis is not looking back, following its subsequent spread to South West of the country.

According to reports, the water borne disease first broke out in northern Nigeria.

This unrestricted death toll has created tension across the country.
It was gathered that the affected states are Jigawa, with 86 confirmed cases and six deaths; Bauchi, 1725 cases and 53 deaths; Gombe, 1188, 59; Yobe with 456 46; Borno has 1090 cases and 80 deaths; while Adamawa has about 986 cases with 56 dead.

Others are Taraba with 277 cases with 16 deaths; FCT has about 137 cases with two deaths; Cross River has 557 cases with 24 deaths; Kaduna has 12 cases with two deaths while Rivers has 81 confirmed cases with three deaths.

Although, this disease is not new to Nigerians, that it is spreading to other parts of the country has unsettled many.

Vanguard Features,VF, gathered that no fewer than 70 persons were hospitalised in Ile-Ife last week Friday following the outbreak of the disease.

Sadly, the reported case of the epidemic in Ile-Ife now add to the growing number of states that have been affected by the cholera scourge and is the first reported case in the southern part of Nigeria since the disease broke out recently in northern Nigeria.

“We are paying the price of government neglect,” opined an health expert.

Further VF checks revealed that though the disease is a natural occurrence, a lot of people are blaming the Federal government for its perennial spread.

This is hinged on the believe that Nigerians are yet to have access to clean water, which is a basic human need. According to reports, about 61percent of the country’s population is denied this basic need.

“It is a shame that despite the simplicity of the cure, hundreds and sometimes thousands of people in Nigeria die every year from this disease. The worst is that they are usually slow and ineffective in responding to this epidemic,” a community health worker, Sheun Ademola told VF.

Instructively, it was gathered that Cholera is an acute intestinal infection that causes severe vomiting and diarrhoea, leading to serious dehydration and can be fatal if not properly treated. However, if an infected person is given the proper fluids as soon as the first symptoms appear, the disease can be completely cured.

A mixture of sugar and certain essential salts must be mixed with clean water and be taken in large quantities to replace what the body has lost. If the patient is rehydrated as soon as possible, the death rate is less than one percent.

Public enlightenment as a major weapon of control

Corroborating this finding, Chief Medical Director of Lagos University Teaching Hospital,LUTH, Prof. Akin Osibogun said, “it is a disease caused by a small microbe called Vibrio cholerae of which there are three main subtypes.

The organism is food and water borne i.e it is transmitted through food and water. One very sure way of preventing transmission is by making sure we boil our water before drinking, maintain good personal hygiene practices including washing our hands after using the toilet. Cholera epidemics often occur whenever safe water supplies are compromised.

“ It also occurs when flooding may result in contaminated water mixing with sources of drinking water. Public enlightenment is a major weapon in the control of cholera outbreaks. The Cholera vaccine can also be useful in providing protection although this lasts for only about six months.

Mortality in Cholera patients is usually due to the fluid and electrolyte losses arising from excessive diarrhoea and vomiting. Early and adequate medical attention incorporating fluid and electrolyte replacement and the use of potent antibiotics can help reduce mortality significantly,” Prof. Osibogun explained at length.
We are in control

Despite the public indictment of the Federal Government, government said it was in total control of the outbreak.

A statement signed by Mrs. Rekia Zubairu, Special Assistant to the Minister of Health, Prof. Onyebuchi Chukwu, said the Ministry’s Public Health Department was convinced that the country has turned the table around noting that the efforts of the department could be seen as not a single fatality had been recorded in close monitoring of the situation in the last 48 hours.

The statement said: “The Federal Ministry of Health has worked very hard with all stakeholders, including the media, to bring this epidemic to an end.”

It appealed to Nigerians to observe simple rules of hygiene in their daily activities, stressing that the relevant authorities would provide infrastructures to ensure that the people have access to information, potable water and adequate sanitation.

The statement said that “adopting common policies regarding disease surveillance, development of follow-up mechanisms to ensure implementation of jointly agreed action and activities, will be of tremendous benefit to the countries.”

It added that the expected outcomes of the meeting would include a concrete policy and implementation framework on the trans-border of diseases, including surveillance and monitoring.

The statement explained that the meeting was President Goodluck Jonathan’s directive to the Health Minister to meet with his counterparts in neighbouring countries to address the issue of trans- border transfer of polio and other diseases during Bill Gates’ visit to Nigeria three months ago.

Gates is funding development activities worldwide, through his Bill Gates Foundation.

On its part, the Lagos State Government also urged members of the public to be vigilant and observe a high standard of personal and environmental hygiene following outbreak of cholera in some states of the country.

Commissioner for Health, Dr. Jide Idris who made the call in Lagos at the weekend, said it became pertinent for residents to be vigilant because the disease, which is easily communicable is contacted through the ingestion of contaminated food and water.

He advised members of the public to report any suspected case to the nearest health facility and the directorate of disease control in the state Ministry of Health.

His words: “Health workers are advised to be on the alert and report suspected outbreak of more than fives cases in their facilities to the state Ministry of Health. People can also call the following numbers: 08023228573 or 0802321333 for assistance.

“Cholera is a disease spread through the drinking of contaminated water and eating of contaminated food. It is very dangerous and kills within a very short period of time if not treated promptly.”

Idris noted that cholera should be suspected in any person who develops diarrhoea with or without vomiting, weakness, leg cramps, excessive loss of body fluids (dehydration) or dies from frequent stooling hence he urged them to take adequate measures in order to reduce the risk of contacting the disease.

He listed measures to be taken as including washing of hands with soaps and water frequently and thoroughly; boiling of water before drinking if the source of the water is in doubts; washing of fruits and vegetables thoroughly before eating; cooking of food thoroughly before eating; disposing of waste material properly; and keeping of water containers clean.

The commissioner pointed out that in the case of suspected cholera, members of the public should prepare oral dehydration solution (10 level teaspoonful of sugar and one level teaspoonful of salt in two 35cl bottles); give the suspect a lot of fluids to drink; keep giving the suspect food as soon as it can be tolerated; and thereafter visit the nearest hospital whether the condition of the suspect improves or not.


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