Unclean water, dumpsites, stinky abattoirs fuel Bauchi cholera outbreaks
When 51-year-old Sa’adatu Abdullahi was rushed to the Misau General Hospital on August 4, 2021, her sister, Jamila Abdullahi, accompanied her to the Cholera Ward with a sample of the well water in a four-litre gallon. She looked pale and couldn’t say much about her condition. A doctor in the hospital, who craved anonymity, said Sa’adatu was passing stool that could be described as “pure water.”
“But her stool has changed to something like water from boiled rice. You can see that she is trying to speak,” he said.
Like other patients, Sa’adatu lied on a makeshift hospital bed, holding on to her abdomen to prevent the outflow of fluid. The hospital’s management had removed mattresses from the beds to allow free flow of stool into buckets placed under them and to prevent the spread of diseases among patients.
Sa’adatu was brought in by a commercial vehicle from Gwaram Village, located about one hour 14 minutes drive away from Misau. Three of her neighbours had also contracted the diseases, she told the doctors, adding, “I feel so empty. I can’t stand on my feet and my stomach is hurting. I came here yesterday.”
Hundred of kilometres away in Bauchi, Khadija Umar was rushed to the Trauma Section of the Abubakar Tafawa Balewa University Teaching Hospital, on June 24, after losing lots of fluid. The nursing mother vomited and stooled for more than a week before her husband took her to the hospital.
She said: “I asked them to discharge me when I started feeling a bit better. I was taking Oral Rehydration Salt (ORS). Unknowingly, I took an overdose. I took four ORS daily. After about two days, I was unconscious and my neighbours rushed me to the hospital. There, the doctor told me that my blood pressure was over 200mmHg, which he said was too high for my age and could lead to stroke. One side of me was not functioning anymore; it was about to get paralysed. I could not recognise anybody; I could not breastfeed my six-month-old baby. I thought I would die because my blood pressure was so high. I was not among those taken to the Cholera camp. I think it was because of my condition.”
The Chief Medical Director, Misau General Hospital, Dr. Mohammed Sani, said this year’s outbreak has overstretched the hospital’s services.
“Many of our doctors and other personnel were made to work overtime to treat the increasing number of patients. Some of them could not go home to celebrate Eid-il Kabir. Also, they had to put in place extra preventive measures to keep safe,” he explained.
Bauchi, like many states in Nigeria, especially in the North, has been experiencing seasonal outbreaks of cholera. And though the government has been making efforts to prevent it, the disease has become a recurring threat to both government and residents. Over the years, many Bauchi residents have died of this preventable disease, while thousands have had near-death experiences.
Cholera, described by the World Health Organisation (WHO) as a disease of the poor, remains a global threat to public health and an indicator of inequity and lack of social development. The WHO also said about four million cases are reported yearly, while 21, 000 to about 143,000 deaths are recorded globally. An investigation has shown that poverty and poor access to water, sanitation and hygiene (WASH) have exacerbated outbreaks of the disease over the years.
In 2014, a total of 16, 923 cases were recorded in Bauchi, while 143 people died across the 20 local councils of the state, according to the 2020 WaterAid Nigeria report. It stated that more of the cases were recorded in the state capital, with 87.3 per cent. The report, however, said there was no outbreak of the disease in 2015, 2016 and 2017.
In 2018, the WaterAid report revealed that Bauchi recorded 9, 725 cases of cholera, with 28 deaths. Children under the age of five constituted about half of the victims, amounting to 4, 751 of the total cases.
In their 2020 joint report, Development Exchange Centre (DEC), WODASS, NEWSAN, BASNEC, and FAcE-PaM, in collaboration with WaterAid Nigeria said: “… This current outbreak of cholera in Bauchi State is largely attributed to the indiscriminate disposal of waste (solid and liquid), inadequate clean water supply within Bauchi metropolis and its environs, and poor hygiene practices. Provision of safe water and sanitation, among other things, is critical to controlling the transmission of cholera, ending the epidemic and other waterborne diseases.”
In 2021, data provided by the Executive Chairman of Bauchi State Primary Health Care Development Agency, Dr. Rilwanu Mohammed, revealed that between May and June 2021, a total of 2, 874 residents were hospitalised in the state, with 42 deaths recorded. Bauchi Local Council has the highest number of victims with about 77 per cent of the cases, representing 2,185. Toro Local Council is another hotbed, as it recorded 212 cases within the period. Dass and Tafawa local councils recorded about 100 cases each in June 2021.
By August 9, the number of cases rose to 7, 043, while the death toll was 96, according to Nigeria Centre for Disease Control (NCDC).
The contributory factors, The Guardian gathered, include dirty abattoirs, poor handling of meat, non-observance of proper spacing of water wells and sewage networks, and indiscriminate dumping of refuse in the state, among others.
For instance, in Bauchi Local Council, where a majority of the cases were recorded, an investigation revealed that Bauchi meat vendors do not cover, or protect their wares in the markets.
The practice at Inkil Abattoir, Bauchi, where 20 to 30 cows are slaughtered daily, leaves much to be desired, as all activities at the facility are carried out in a foul environment.
Not only are cows slaughtered under a big shade, with shabby corrugated roof sheets, but the facility is also surrounded by stinking cow dungs that had been deposited for weeks. And though butchers could access clean water from an overhead tank to wash meat, the polluted environment overshadowed everything.
Also, the process of treating and transporting meat around the metropolis is simply unwholesome. The uncovered meat is conveyed to the two main markets – Muda Lawal and Wunti in open vans, tricycles and bicycles, while the vendors appear unperturbed by the hordes of flies that perch on the displayed meat upon arrival. They only make half-hearted attempts to chase away stubborn flies with some objects.
Across the metropolis, visitors are greeted by heaps of refuse that dot different junctions and compounds. School-age children are at work scavenging at refuse dumps, including the one beside Doya Primary Health Care Centre, along Gombe Road.
Many houses in the state capital are built haphazardly and in breach of the state urban development plan. At Yakubu Wanka area, along Gombe Road, most of the hilltop slums have no proper waste management system. Bathwater from 90 per cent of the houses in the neighbourhood cascades downhill, contributing to health risk factors, including outbreaks of cholera.
Ibrahim Umar, a resident said: “Those of us living under the hill suffer from the waste passed by those living on top. Their smelly water and the waste sometimes flow down here because of the topography of where our houses are located.”
The buildings in these areas do not comply with the United Nations Habitat guidelines, which stipulate that the standard spacing of residential houses “should not be more than 32-50 metres, and can be as low as 16-19 metres in residential areas. Short blocks (300’-500’) increase the walkability of a neighbourhood.”
An environmental expert at Abubakar Tatari Ali Polytechnic, Dr. Abubakar Sulaiman, said the government’s failure to enforce relevant laws is worsening the indiscriminate disposal of waste in the state.
“How can a government employ staff to monitor and regulate activities at abattoirs, only for those saddled with such responsibilities to leave the job undone, while the government continues to pay them? In a standard abattoir, there should be health experts, veterinary doctors and environmental officials, who must certify the health status of animals, and the butchers. Unfortunately, this is not obtainable in our abattoirs.”
“Sadly, taxpayers have not been holding government officials accountable. It is the government’s responsibility to ensure that waste is properly managed. It is so sad that at this stage, people are still dying of these preventable diseases. Where standard town planning rules apply, people should not build water facilities/structures close to close to the sewage. They must observe the standard of six-metre spacing. Unfortunately, the government has failed to educate the people on why they should maintain proper hygiene.”
Sulaiman, however, blamed residents of the state for being generally allergic to doing the right thing, saying: People generally do not like obeying laws, while some public officials tend to relax and ignore their duties…This contributes to the environment and many other problems. Most residents dump refuse indiscriminately. This is where all the contributing factors grow.”
He noted that formalising scavenging to boost recycling would tackle environmental abuse, adding that people should be enlightened on how to sort their waste, and how to even make wealth from doing so.
In a 2018 report, WaterAid said 65 per cent of Bauchi residents did not have access to clean water. The majority of these residents rely on wells as their source of water.
The Assistant Director, Water, Sanitation and Hygiene at the Rural Water Supply and Sanitation Agency (RUWASSA), Comrade Umar Sabo, said: “Generally, we don’t consider well water as a good source of water. We don’t go for testing of such a source unless it is on-demand by private owners. No matter how the construction is made, we only conduct testing on hand pumps and other sources of water.”
Only 15 per cent of households in Bauchi treat their water, while 84. 7 per cent of them don’t.
Experts have warned that drinking well water, which houses microorganisms, can cause diarrhoea, dysenteries, salmonellosis and hepatitis, among others. Symptoms of these include vomiting, cramps, nausea, headaches, fever, fatigue, and even death sometimes. Infants, children, elderly people, and people with weakened immune systems are more likely to get sick or die from disease-causing microorganisms in drinking water.
To fill the vacuum, the state’s multi-million dollar World Bank-assisted urban water project is providing clean water to some areas in Bauchi. But this also faces the challenges of occasional water treatment and breakdown, which leaves residents without water for days.
The state government, through its agency, the Bauchi State Environmental Protection Agency (BASEPA) has said 12 firms have been certified to ensure cleanliness in all the 20 local councils.
The agency’s director, Dr. Ibrahim Kabir, said he met with the head of the Primary Health Care Development Agency to strategise on ways of curbing the outbreak of cholera.
He said: “We have met as relevant agencies, particularly we at the curative agencies. Aside from that, our agency has also acquired equipment to evacuate waste on our streets. But one of the factors that are contributing to the Cholera outbreak is the creation of a habitable environment for all kinds of diseases to escalate. We also have the responsibility of doing house-to-house inspections. There are over 125 community inspectors at the agency.”
Kabir explained that about four agencies, of which BASEPA is one, are responsible for the management of abattoirs. “We were there about two weeks ago, along with the veterinary council and the Bauchi Local Council officials to inspect the facility. As a professional agency, we were able to identify some things that should be done at Inkil Abattoir.
“…There is a part they call lairage, where animals should be screened and certified for consumption. At this point, BASEPA and veterinary officials should be there to certify the animal’s health. But when we got to this place, we realised that the lairage and slaughtering ground have combined. We are in the process of separating them. When you go to the place, you are confronted with an unwholesome environment reeking of foul stench…”
The DG said the agency has won the Federal Government’s right to construct two abattoirs, and that soon, the facility would be ready.
• This report is supported by Civic Media Lab and WikkiTimes