June 25, 2024

Cholera: Nigeria off track to meet sanitation target


…As experts link open defecation to outbreak

 By Sola Ogundipe

As Nigeria faces a critical sanitation challenge with the cholera outbreak, health experts have called for a multi-pronged approach, by prioritising sanitation and enforcing regulations against open defecation.

The experts who say that the persistence of open defecation is jeopardizing the nation’s commitment to ending it by 2025, harped on promoting behaviour change for the country to get back on track to meet its sanitation targets and ultimately save lives.

They acknowledged the need for a shift in strategy, emphasizing the importance of creating demand for toilets alongside construction efforts.

Nigeria currently ranks No. 1 globally among countries with the highest number of people defecating in the open space and is widely off track to meet the target, set by the Sustainable Development Goals, SDGs, and is crucial to prevent waterborne diseases like cholera.

As of June 24, 2024, the National Centre for Disease Control and Prevention, NCDC, reported 1,528 suspected cases of cholera and 53 deaths across 31 states and 107 LGAs in Nigeria since the beginning of the year. The case fatality rate is 3.5 percent. The NCDC has also placed Nigeria on high risk for increased cholera transmission and impact due to the rainy season.

Open defecation, or the act of defecating in open-air locations instead of in covered ones, is a widespread practice in Nigeria, creating a perfect storm for cholera outbreaks.

In 2021, the Water, Sanitation, and Hygiene National Outcome Routine Mapping, WASH-NORM report estimated that 48 million Nigerians, or 23 percent of the population, still practiced open defecation, while only 8 percent practiced hand washing.

According to a public health expert, Dr Casmier Ifeanyi, Nigeria has continued to pay lip service to water, sanitation, and hygiene (WASH).

Ifeanyi stated, “I challenge you to go and dig it up. Of the 30 states already reported to have the outbreak, how many of them have a public potable water supply in place? I can categorically tell you none. So, we do know that cholera is a disease that thrives where water, sanitation, and hygiene are at its low rate,” he stated.

Calling for the country to speak to issues he emphasised the need for improved WASH practices including addressing open defecation and ensuring access to clean water which are essential for preventing future outbreaks.

“Most public places lack toilet facilities, and individuals who perpetrate this act of open defecation, lack knowledge of the health implication. If you also take a critical look at the practice of open defecation, it is a crescendo in all the states so far. Of course, it is an endemic and is unhealthy. I think Nigeria is among the leading nations across the globe in open defecation. So why wouldn’t cholera find its place here?

Also speaking, another public health specialist Dr. Isaac Egboja,  blamed the outbreak of cholera on open defecation in almost all the affected states in Nigeria.

“There is open defecation in nearly all the states that are affected, and during this time of the year, when rain falls, the feces are carried to streams, ponds, open wells, and other water sources, and these are means of contamination.

“This isn’t just about deadlines; it’s about protecting the health and well-being of millions of Nigerians. The fight against cholera and other waterborne diseases hinges on winning the battle against open defecation. It’s a fight Nigeria must win for a healthier future.”