The Cholera Outbreak

THE current cases of cholera outbreak in parts of Bayelsa and Anambra states are very sad reminders of the endemic poverty of most Nigerians coupled with poor sanitary condition across the country. The cholera outbreak also advertises a certain poverty of ideas on the part of those who rule even in matters that are supposedly routine. Millions of Nigerians live in squalid conditions, without potable water or healthcare facilities, while the citizens are easily exposed to environmental diseases associated with unhygienic environmental condition. This is a shame to a nation that should have outgrown primary healthcare challenges. 

  Coming on the heels of an earlier cholera outbreak that ravaged Lagos, Ogun, Oyo, Plateau and Zamfara states last November, the frequency of occurrence is indicative of a huge shortfall in human development index and a failure of leadership in the country. 

  According to reports, cholera has ravaged many communities, with the death toll in Bayelsa State alone reaching 23, while no fewer than 25 people died in Anambra State. The worst affected communities in Bayelsa State include Otuan, Igbomotoru in Southern Ijaw, Isiama and Ekede. Innoma community in Anambra West Local Government Area is the epicenter of the disease in Anambra State and there is the fear that the disease might spread to other areas if unchecked. The nationwide strike embarked upon by health workers since last October, of course, seems to have compounded the problem. The on-going electioneering campaigns also seem to have overwhelmed the Federal Government to the extent that no attention is being paid to saving the nation from a potential disaster.

  It is heartening though that in Bayelsa State, for instance, the State Commissioner for Health led some medical personnel to the affected communities to distribute drugs. While expressing dismay over the outbreak, he promised to mobilise health officers to the localities to ensure that the epidemic did not spread further. Transportation over the riverine terrain of the state may, however, constitute a hindrance to quick intervention but the effort was commendable. 

  And in Anambra State, the State Commissioner for Health, Joe Akabuike, reportedly received drugs and hospital equipment from many donor agencies and indigenes of the state. A team of doctors and nurses was also immediately deployed to the area as soon as the outbreak was reported. This was good but more concerted intervention is needed from the Federal Government to stop the spread. 

 Cholera is an acute gastrointestinal disease caused by Vibrio cholerae. The bacterium generates a soluble toxin in the intestinal tract that activates watery diarrhea leading to extreme loss of fluid, dehydration and collapse. The fatality rate is usually very high if left untreated, especially among children and infants. Deaths can also occur in adults in a matter of hours after initial presentation.

  Since it was discovered in 1883 by the German bacteriologist, Robert Koch (1843-1910), cholera has wreaked havoc in different parts of the world, especially in poor countries. In 2010, it was reported that cholera has affected some 3-5 million people and caused as many as 100,00-130,00 deaths on a yearly basis worldwide.

  In Nigeria, cholera epidemic has been recurrent for decades due to poor hygiene and poor water supply and use. The country lacks progress in human development indices in this 21st century. People commonly urinate and defecate in the open while the wastes are washed into open filthy drains. Besides, the propensity for contamination is very high from roadside food vendors and people eating in unhygienic condition.

  The best way to combat cholera is through improved sanitation. The government can do more by providing the citizenry with potable water. There should also be regular public enlightenment on personal hygiene, washing of hands, especially, after visiting the toilet and keeping the surroundings clean. This presupposes availability of water. Unfortunately, only a few homes have potable public water supply. 

  The latest outbreak, once again, presents a challenge to the authorities to address basic social amenities that make for good hygiene and improved environmental condition. Anti-cholera interventions should necessarily be holistic, targeting short-term measures as well as long-term improvement in human development indices.