CHOLERA EPIDEMIC RECENTLY RAVAGED COMMUNITIES IN KANO STATE, KILLING ABOUT 71 PERSONS. IT CAME AT THE HEELS OF SIMILAR OCCURENCE IN LAGOS STATE WHERE SOME PEOPLE LOST THEIR LIVES. EXPERTS AND INTERNATIONAL HEALTH ORGANISATIONS HAVE SAID THAT THE EPIDEMIC IN KANO IS A REFLECTION OF THE HEALTH INADEQUACIES OF THE COUNTRY, WRITE ROLAND OGBONNAYA AND IBRAHIM SHUAIBU
Health officials and international health organisations were overwhelmed at the recent cholera outbreak that ravaged some communities in Kano State leaving about 71 people dead and scores of others still receiving medication in health institutions. The cholera outbreak in Kano, experts said, was caused by consumption of unhygienic foods by the residents, especially with the high dependency on fruits by the residents.
In the last three month, 2165 cases of cholera were recorded in 22 local government areas of the state, while Fagge Local Government Area recorded the highest number of deaths with 12 lives lost. The Project Director of the Nigerian Centre for Disease Control (NCDC) in the Federal Ministry of Health, Professor AbdulSalam Nasidi confirmed that 71 people died since the first cases of the outbreak were reported in Kano last November.
Prof. Nasidi said: ?The first cases were reported on November 6, 2013 with 22 local government affected. Also, 344 wards were affected while 713 settlements were ravaged by the disease. A total number of 71 deaths were recorded in 17 local government areas, representing 3.3 percent case fatality rate.?
He explained that most of the affected persons were from the metropolitan local government areas, adding that the federal government?s donation was to support the Kano State government to address the scourge of the cholera. He assured that teams of health experts have been deployed to the state by the Federal Ministry of Health to fight the bacteria.
Malam Inuwa Adamu of Shirawa Quarters in Dala Local Government Area who lost his father to the disease, said: ?It was a sad story for us, because we are less privileged and relied on our father to look after us, but we lost him to this Cholera. He was a hardworking person. He contacted the bacteria after the family ate the salad he bought from the market. He died, but we were lucky to survive.?
Another victim, Malam Mamuda Kabiru of Fagge Quarters said: ?I lost my 24 year-old son, a student at the College of Education, Kano, after he ate a local food called ?Zogale.? He died on our way to IDH Hospital in Kano. We have learnt our lesson and the entire family will no longer eat Moringa unless it was properly washed and boiled so as to avoid contacting the disease again.?
In an interview, the Kano State Commissioner for Health, Dr. Abubakar Labaran Yusuf said the state government had spent over N76 million to provide necessary drugs to combat the disease in the local government areas of the state, while additional beds were also provided at various hospitals where the cholera were affected.
?We were happy to receive the delegation today, which shows government concern for the outbreak of the Cholera in the state. Cholera epidemic has been in the country since September last year, though at the initial stage, Kano was not affected,? Labaran said while receiving a Federal Government delegation. He attributed the success so far recorded in the battle against the epidemic to the effort of the government in educating the public on the need to take adequate care of their health as well as necessary logistic provided by the government.?
He said that more medical experts were being given necessary training to educate various communities on how to guide against the re-occurrence of the diseases.
The Commissioner stated that Kano State Government had spent a lot in making potable water available in the state to check the incidents of Cholera.
?When the outbreak started, we were recording about 97 cases. As I am talking to you, we have less than 40 cases in all the eight centres,? he said. He called on the public to be very careful about what they eat. ?People should understand that while fruits and vegetables are good for health, but taking unhealthy ones could as well be dangerous to life,? he admonished.
While thanking professionals, individuals and international agencies for the cooperation given to the state government during the outbreak, Yusuf assured that government would do everything possible to see that such occurrence would not happen in the future.
On his part, the Commissioner of Water Resources, Dr. Yunusa Adamu Dangwani assured that government would continue to supply the people with clean and healthy water. He called on the public to also help the government by reporting any broken water pipes in their localities. He said that poor pipe borne water was also part of the things that were responsible for the spread of the disease.
Alhaji Jafaru Ahmad Gwarzo, who is the Sarkin Tsaftar Kano (Chief Sanitary Inspector), also said that members of the public were cooperating with his men in their effort to see to the exit of the disease. Gwarzo advised that people should form more associations to look after the environmental sanitation of the state, while urging individuals and groups in all the 44 local government areas of the state to complement government efforts in that direction.
Some of the victims that were admitted in the hospital claimed that the disease was as devastating as HIV/AIDS, considering the way it was ravaging its victims. ?I was just lucky to survive from being killed by the disease,? said Balarabe Shehu, who was admitted in hospital for five days.
When THISDAY correspondent in Kano visited the Infectious Diseases Hospital, Kano, many of the cholera victims confirmed that they were affected because of their negligence regarding environmental sanitation, adding that, they could have avoided contacting the disease if they took good care of their environment.
Yunusa Sallari, who was in the hospital for seven days, told THISDAY that government should train vegetable and fruit dealers on how to handle their products in order to remain hygienic. He further called on consumers to always ascertain the health of fruits and vegetables before buying them.
A source close to the leadership of the Kano State Association of Fruits and Vegetables Dealers revealed that the association plans to see that marketers of their products who do not adhere to the principles of good hygiene are sanctioned. In addition to that, the source hinted that arrangements were in the pipeline to partner the state ministry of commerce and industry and ministry of environment to ensure that fruits are marketed in a healthier environment.
A body called the Coalition Against Infectious also challenged the government do something about marketing of fruits and vegetables in the state in other to avert re-occurrence of the Cholera outbreak that claimed the lives of over 71 people in the state. Mudassir Bashiru, the secretary of the association disclosed that the body was organising a workshop for marketers in conjunction with the state?s Ministry of Health to make sure that bad fruits and vegetables were not sold in the state.
Apart from the recent outbreak of cholera in Kano State that killed over 71 people, the epidemic had earlier killed scores of people in Lagos and Zamfara, bringing the number of people killed by the disease in a space of three months to about 352 people. Also, more than 6,400 cases were reported majorly in the North. Currently, doctors are monitoring the outbreaks in 12 of Nigeria?s 36 states.
Nigeria had the first series of cholera outbreak between 1970- 1990. According to a health spe...t, Mr. Tolulope Ojo, despite Nigeria?s long experience with Cholera, an understanding of the epidemiology of the disease aiding its persistence in outbreak situations is still lacking. ?We therefore hope that this review provides the knowledge gaps of the infection with the hope that it will help to develop targeted approaches to controlling the infection.
?Developed countries have an almost zero incidence of cholera because they have widespread water treatment plants; food-preparation facilities that usually practice sanitation protocols and most people have access to toilets and hand-washing facilities. A lot of responsibilities in curbing this epidemic lie with the government. But cholera is not a governmental disease. In fact, it is killing more of the average citizens of Nigeria. As Nigerians, we should contribute our own quota to battling and finally subduing cholera. Individuals can prevent or reduce their chances of contacting cholera by thorough hand-washing, drinking treated water and eating clean and well prepared food,? Ojo said in one of his research report on Cholera epidemic.
According to research, Cholera is an acute infectious disease caused by a bacterium, Vibrio Cholerae (V. Cholerae), which results in painless diarrhea (the main symptoms are watery stool and vomiting). Most people who contact this disease get it primarily from drinking water or eating food that has been contaminated by faeces (waste product) of an infected person, including one with no apparent symptoms.
?Ways to prevent Cholera is by washing the hands frequently with soap and water for at least 15 seconds especially before handling food and after using the toilet. Use alcohol-based hand sanitizers if soap and water are not readily available. People are advised to drink and cook with safe water that has been boiled and disinfected. It is ideal that one cleans the mouth of the bottle before opening them when drinking bottled water.
?Avoid eating raw food, take food that is completely cooked and hot, avoid improperly cooked seafood or meat. If you have to buy food from a street vendor, make sure that the food is cooked in a clean environment and served hot. Consume fruits and vegetables that are peeled by the consumer such as oranges, bananas and avocados. People are further advised to properly wash foods that do not have to be peeled such as apples, berries and grapes as well as avoiding dairy products like ice cream as they may be made from unpasteurised milk.?
Experts warned that infected sewage facilities and drainage systems must be treated, while infected materials must be properly disposed. ?Most importantly, it is necessary to introduce intervention measures that address the root problems of poor sanitation and unsafe water supplies in order to fully solve the problem of cholera,? Ojo said.
United Nations figures indicate that half of Nigeria?s 160 million population do not have safe water and a third do not have proper sanitation. Cholera affects both children and adults and it manifests symptoms include profuse diarrhea, vomiting of clear fluids, rapid heart rate, loss of skin elasticity, low blood pressure, dry mucous membrane, thirst, muscle cramps, restlessness and irritability (especially in children), extreme sleepiness, coma, convulsion, tiredness and dizziness, severe dehydration which if left untreated can rapidly lead to acute renal failure, severe electrolyte imbalance, shock and death.
According to experts, although symptoms may be mild, approximately five to 10 per cent of previously healthy people will develop copious diarrhea within about one to five days after ingesting the bacteria. It is important that one receives immediate medical treatment because cholera can cause death within just a few hours.
Above all, the World health Organisation (WHO) recommends that immunisation with currently available cholera vaccines be used in conjunction with the usually recommended control measures in cholera-endemic areas as well as areas of risk outbreak. Also, proper sanitation and drinking of clean and boiled water prevents cholera infection.
For many, the report of outbreak of Cholera pandemic in some states is startling. This is despite futile efforts by some governments to downplay the enormity of the affliction in their territories. A release by Minister of Health, Prof. Onyebuchi Chukwu shows the seriousness and spread of the disease across the country. At the last count, the centre government reportedly put the casualty rate of cholera victims in some parts of the country at 86 out of 1,623 reported cases. No state has challenged this assertion.
The breakdown of the plague that is blighting Ogun, Oyo, Plateau, Zamfara, Nasarawa and Lagos states is: Zamfara State-1,110 cases with 51 recorded deaths; Nasarawa State ? 105 cases with 9 deaths; Lagos State ? 134 cases with 4 deaths; Plateau State- 130 cases with 11 deaths; Oyo State ? 29 cases with six deaths and Ogun State ? 115 cases with five deaths.
The report took cognisance of the fact that the details could still be higher since there is the possibility of new cases and mortalities, especially among those currently bedridden by the ailment in hospitals across the country. Only reported and certified cases that are proven in laboratories to have been caused by vibiro cholerae serotypes 10 and 0139 are purportedly included in the ministry?s released statistics.
The intra-state nature of cholera outbreaks shows that the disease should not be handled with levity. It is good that the Federal Government has directed the Nigeria Centre for Disease Control to forthwith swing into action and come up with daily reports to be submitted to the Federal Ministry of Health, showing the degree of progress so far recorded across board.
Such reports should be made public. It is equally cheering that all federal health facilities in the country have been directed to provide free services to cholera patients. ?We recognise that this is of course without prejudice to the concerted efforts made by governments of the affected states to put a halt to the spread of the deadly disease,? the press release from the Federal Ministry of Health said.
The minister further made a valid point by stating that ?every Nigerian must commit to certain things. Can we stop going into the bush to defecate? Every Nigerian must know that it is unhealthy??
He further stated that every Nigerian should have access to clean and potable water.
However, the minister did not say what the contribution of the centre government had been in transforming the rural areas and the ghettos in towns and cities across the nation so as to forestall the outbreak of cholera.
For others, despite government?s failure to provide these amenities, the people should also not take this as an excuse to engage in unhygienic practices as cholera is an infection of the small intestine that occurs primarily by drinking water or eating food that has been contaminated by waste product of an infected person.