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‘We are tired of burying our loved ones’

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Relatives and friends of victims of the ravaging cholera outbreak in the country have called on the Nigeria Centre for Disease Control (NCDC) and state governments to take urgent steps to contain the spread of the disease, saying they were tired of burying their loved ones.

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The NCDC recently said that the disease had spread to 18 of the 36 states of the federation and the Federal Capital Territory (FCT), with a total of 22, 130 suspected cases, including 526 deaths as of July 22, 2021.

Narrating their ordeals since the outbreak of the disease, the affected Nigerians urged the state governments to deploy officials of the relevant ministries and agencies to ensure proper sanitation and save the citizens from further deaths.

The Director-General of NCDC, Dr. Chikwe Ihekweazu, yesterday, told The Guardian that following the detection of a spike in cases of the disease five weeks ago, the agency activated a National Emergency Operations Centre to coordinate response activities in states. This is even as many state governments declared that the disease was being put under control.

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Lamenting the loss of his son to Cholera, Mallam Ahmed Ibn Abdulkarim, a resident of Corner Shagari in Ali Kazaure Ward of Jos North Local Council of Plateau State, said he was still going through pain.

“My son died from cholera in our community recently. The cause of cholera in the community is indiscriminate dumping of refuse by residents. They litter everywhere with the feces of humans due to the lack of a toilet. Pigs, goats, cows, and rams also live and go about within human settlement. “During the rainy season, the dirt is washed into the wells and rivers which we use for domestic purposes, including drinking. After drinking the contaminated water, you contract this cholera disease. Even unwashed vegetables, fruits such as mangoes, guava, and carrot cause cholera.”

Abdulkarim, who is a teacher, said his son contracted the disease and started experiencing stooling and vomiting. “He was quickly rushed to the hospital where he died after 10 hours”. 

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He said he expected the government to direct the Ministry of Environment to collect refuse, enforce the law on open defecation and control the free movement of domestic animals within communities.

In Kano State, four-year-old Auwab Mahdi of Sani Mainagge Quaters in the metropolis also died of the disease.

According to his father, Dr. Mahdi Ayyuba, the death of Auwab on the day after Sallah left the family in agony.

“On Sallah day, I received an emergency call that my wife was vomiting. I rushed back home and took her to the Infectious Disease Hospital (IDH) where she was administered cholera drugs. 

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“While in the hospital, I received another call that my four-year-old boy, Auwab, was also vomiting. We came back home and took him to the same hospital where he was equally treated. But the following day, Auwab died after taking pap and some drugs,” he lamented.  

A similar fate also befell a 44-year-old widow in Darmanawa Local Council of the state, who contracted cholera and could not receive medical help.

Her friend, Sumaiya Alkassim, said the deceased was left alone and got dehydrated after vomiting and emitting watery stool. 

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“I ran to our family house and brought food and water, which I served her. I also made sure I cleaned her up before going back to our house. Unfortunately, the next day when I went back to see her, I found her body lying motionless. When I informed her neighbours, they told me that they overheard her groaning and snoring throughout the night but none of them cared to know what was happening to her. I just want the government to do whatever it can to curb this disease,” she appealed.

No fewer than 173 people have lost their lives to the disease in Kano with at least 215 active cases in 41 local government areas.

The State Epidemiologist and Deputy Director of Public Health and Disease Control, Dr. Bashir Lawan Muhammad, told The Guardian that from March to July 2021, the state recorded 5,316 active cases of the disease, while 4,932 had already been treated and discharged from various hospitals.

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He said: “The outbreak started in March this year when we started recording cases in only one local government. But as I speak to you now, the problem has escalated to 41 local government areas.

“We have been doing the needful through our emergency and response units as well as chlorination of hundreds of houses and wells across the affected local government areas.” 

He revealed that apart from sending drugs and health personnel to the affected areas, the state government had launched a robust campaign through the ministry on the need to observe personal and environmental hygiene to avoid contracting the disease.

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According to Muhammad, a cholera outbreak is seasonal and could be transmitted through flies or human stool, which some farmers use as manure in their farms.

In Plateau State, the disease has killed 24 persons while the number of those infected and are still undergoing treatment was put at 1,315.

The Commissioner for Health, Dr. Nimkong Lar, told The Guardian on phone yesterday that the state government was leaving no stone unturned to make sure the disease is controlled.

He lamented that as the government was trying to stop the spread, some residents were not helping matters by always indulging in open defecation.

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In Benue, even though the state is yet to record any outbreak of the disease, many residents called on the government to adopt measures to prevent it.

Responding to the call, the Commissioner for Health and Human Services, Dr. Joseph Ngbea, stated that the government was awake to its responsibility of ensuring that the epidemic did not ravage the people.

Ngbea advised residents of the state to always observe healthy ways of living, especially by drinking purified water.

He added that the government was already working in collaboration with development partners such as the World Health Organisation (WHO) and Doctors Without Borders to ensure that more boreholes are drilled in strategic locations to supply potable water to the nooks and crannies of the state.

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In Bauchi State, the government has commenced vaccination of residents with 1.5 million doses of vaccines donated by the WHO.

Governor Bala Mohammed had after taking his dose last Wednesday said he had directed that the oral vaccines be administered free of charge. He urged the people residing where the epidemic is more severe to avail themselves of the opportunity provided by the vaccination and ensure success of the exercise.

Mohammed appreciated the Federal Government and other development partners for their efforts in securing the cholera vaccines.

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According to the State Primary Health Care Development Agency, 2,800 people contracted the disease with 42 deaths recorded between the middle of May and June 17, 2021.

The Executive Chairman, Bauchi State Primary Health Care Development Agency (BASPHCDA), Dr. Rilwanu Mohammed, also said that the disease had spread to 19 of the 20 local councils of the state.

He explained that the Primary Healthcare Development Agency had been working in collaboration with local government authorities to control the outbreak in the state.

Mohammed added that to curb the further spread, the government created a Cholera Treatment Centre (CTC) at the Bauchi State Specialist Hospital to isolate those infected. He advised residents of the state to maintain a high level of hygiene and continue to wash their hands frequently, drink clean water as well properly dispose of their refuse.

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In Enugu State, the Commissioner for health, Dr. Ikechukwu Obi, told The Guardian that the disease, which killed eight persons at the congested New Artisan Market area on the Enugu-Port Harcourt Highway and led to the hospitalisation of 20 others, had been brought under control.

He explained that the Ministry of Health had commenced surveillance, contact tracing, and risk assessment at the market and its environs. He said that Health Emergency Operation Centre for Cholera outbreak had been activated in the state to stop further spread. He also said that some of the cases had been treated and discharged, adding that awareness had improved on the disease.

“Cholera is an infection caused by some strains of the bacterium Vibrio cholera. Risk factors are poor sanitation and contaminated drinking water. The classic symptom is large amounts of watery diarrhea that lasts a few days. Vomiting and muscle cramps may also occur. Symptoms range from none to mild, to severe. Diarrhea can be so severe that it leads within hours to severe dehydration, electrolyte imbalance, and even death. Symptoms start two hours to five days after exposure.

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“It is prevented by improvement in sanitation, use of clean water, hand washing, and vaccines. Treatment involves the replacement of lost body fluids orally or intravenously, zinc supplementation, and antibiotics.

“We enjoin the general public to keep safe as the situation is under control and the Enugu State Ministry of Health will keep the public informed on future developments,” he said.

A medical expert, Nnamdi Uzoma, tasked the government to embark on a deliberate clean-up of the environment to save lives.

He said: “Look at that new artisan market, you will discover that the place is not fit for human habitation. The people there live on the waste being generated by them. They are so congested that it becomes difficult for anyone to get fresh air. That is why any disease could easily spread among the inhabitants.

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“I should think that government has a duty in that environment to save the lives of those living there. Let there be regular and deliberate clean-up exercise to improve healthy living,” he said.

The NCDC boss, Ihekweazu, in an interview with The Guardian, confirmed that there is usually a spike in cholera cases in Nigeria during the rainy season, especially between April and July.

His words: “Cholera is a waterborne disease, and the risk of transmission is higher when there is flooding which is associated with poor sanitation and disruption of clean water supply.

“The provision of safe water and sanitation is critical to prevent and control the transmission of cholera. In the absence of this, we will continue to record cases of the disease. 

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“Cholera is preventable and predictable; however, it can be fatal without proper and timely response. Following the detection of a spike in cases five weeks ago, the Nigeria Centre for Disease Control activated a National Emergency Operations Centre to coordinate response activities in states. We have deployed Rapid Response Teams, provided case management and laboratory supplies to support states with the response. We have also been working with the National Primary Health Care Development Agency to access the global stockpile of oral cholera vaccines for reactive vaccination campaigns in affected LGAs. 

“The risk of death from cholera is high when people do not access care immediately. We continue to scale up our risk communications to ensure that Nigerians are aware of the symptoms of cholera, how to prevent transmission, and the need to visit a hospital if they have cholera symptoms. 

We urge Nigerians to keep their environments clean, only drink or use water that is boiled and stored safely, ensure food is cooked and stored in a clean and safe environment, avoid open defecation and wash their hands regularly.”  

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He noted that the long-term solution for cholera control lies in access to safe drinking water and adequate sanitation. “We continue to advocate the Federal Ministries of Water Resources and Environment as well as state governments for solutions that ensure access to and use of safe water, basic sanitation, and good hygiene practices in communities,” he added.

Ihekweazu stated that the surge in the cases of Cholera at a time the country was trying to deal with the third wave of COVID-19 pandemic was placing a strain on the health system.

“The response to a pandemic and other disease outbreaks places a strain on the health system, as well as other aspects of the economy. Our health workers are working hard to manage infectious disease cases, carry out contact tracing, risk communications, and other response activities. The resources developed through the COVID-19 response, such as treatment centres across states, are being used in response to other outbreaks. However, we must remain conscious that these multiple outbreaks can further strain our health system. 

“We continue to appeal to Nigerians to take responsibility while remaining aware of the risk of spread of COVID-19, cholera, and other disease outbreaks. The existing measures such as handwashing with soap and running water can prevent these diseases,” he added.

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