How drinking untreated, unsafe water aid cholera outbreak in Nigeria

…High cost of clearing chlorine hampering water treatment

Nigeria, Africa’s most populous nation, is presently battling the outbreak of cholera, a food and water-borne disease that is ravaging the country.

Cholera is an acute diarrhoea infection caused by drinking contaminated water or eating contaminated food.

The recent outbreak of the disease in Nigeria, experts say, is partly due to the increasing rate of drinking untreated and unsafe water.

Today, many Nigerian families take drinking water from unsafe water sources and reservoirs that are not properly treated with chlorine or water guards.

The outbreak comes at a time, when the prices of sachet water, Nigeria’s most common and cheapest source of safe drinking water, went out of the reach of the masses.
Prices of sachet water recently hit the rooftop with retailers selling a bag for between N300 and N400 and one or two sachets for N50 depending on the location and temperature of the water bag.

This forced many to depend on boreholes and other unsafe sources of water to meet their drinking water needs.

According to the Nigeria Centre for Disease Control and Prevention (NCDC), water is usually contaminated by the faeces of infected individuals and the contamination of drinking water can occur at the source, during transportation or storage at home.

Also, beverages prepared with contaminated water, cooked vegetables and fruits freshened with untreated wastewater are other means of transmitting the infection.

NCDC reported a total of 1,141 suspected cases, 65 confirmed cases of cholera and 30 deaths from 96 local government areas in 30 states of the Federation from the 1st of January to the 11th of June 2024.

Read also: Cholera outbreak in Ogun, Lagos claims lives, leaves many fighting for survival

The Centre revealed that 10 states contributed 90 percent to the burden of cholera including Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa and Lagos States.

In Nigeria’s commercial city of Lagos, health authorities declared a cholera outbreak on 15 June 2024 when 436 suspected were reported.

Six days later, there were more than 500 suspected and 43 confirmed cases, with a 5.4 percent case fatality rate among the suspected cases reported.

Costs of clearing chlorine hampering water treatment

BusinessDay Sunday’s findings show that many Nigerians no longer treat their boreholes, water reservoirs and other water sources owing to the skyrocketing prices of imported chlorine and water guards used in treating drinking water.

For instance, Tony Anakebe, a clearing and forwarding expert, told BusinessDay Sunday that Customs changes the foreign exchange rate for calculating import duties at the port daily.

According to him, fluctuating Customs exchange rates for clearing goods frustrate businesses that depend on importation to bring in critical production input.

He said that at the exchange rate of N1,‪513.235‬ used for calculating import duties as of June 28, an importer 20-foot container of chlorine would pay as much as N20 million as levy while an importer of a 40-foot container would pay as much as N26 million.

“This is even though an importer of chlorine enjoys payment of zero percent duties and 20 percent levy. The issue is that Customs gives the pre-arrival assessment report (PAAR) on any import using the current FX, which is N1,‪513.235‬. The same fate awaits importers of pharmaceutical products, and they pay as much as N26 million per 40-foot container,” Anakebe said.

Experts’ views on preventing cholera

Health specialists believe that drinking and cooking with unsafe and contaminated water can lead to the outbreak of cholera.

Hope Orivri, Ph.D, a Water, Sanitation and Hygiene (WaSH) specialist told BusinessDay Sunday that drinking contaminated water or food can result in cholera infection.

According to her, cholera can be prevented by drinking clean water and good hygiene.

She said people need to get their drinking water from safe water sources such as piped water to avoid cholera infection.

“In cases where people can’t access piped water, they must treat home water by adding a small amount of chlorine to the water. If you get water from water vendors supplying tankers, ensure to store the water safely by cleaning the container and cover with a lid. Again, chlorine can be added or a capful of ‘water guard’ as prescribed,” she said in a phone interview.

She said drinking water must be clean and kept safe, and that sanitation and hand hygiene must be observed because water, sanitation and hygiene (WASH) are inseparable.

Orivri advised parents to always ensure that children don’t dip a scoop into a drinking water container.

The WaSH specialist said that water containers used for storing drinking water at homes are better with a tap or one that requires pouring the water out.

For other hygiene practices that can reduce the spread of cholera, Orivri said there must be improved sanitation, people must avoid open defecation to prevent contact with faeces and hand washing at critical times is very important.

Hand washing is also very important as she said that hands should be washed with soap and clean water during the following times: “after using the toilet, before preparing food for the family, before eating, after cleaning baby’s poo, after tending to an animal, after cleaning a wound and after touching surfaces.”

Open defecation is also seen as a major factor that contributes to the outbreak of diseases in Nigeria particularly cholera.

According to findings from the 2021 WASH NORM report, approximately 48 million Nigerians still engage in open defecation and only 8 percent of the population practice clean handwashing.

Olumuyiwa Odusanya, a professor of Public and Community Health and vice Chancellor of Lagos State University of Science and Technology, told Punch that there is a need to build more toilets in every house and community to stop cholera.

He said licensed markets should have a place to eat, drink, and pass out waste products. He called on the government to legislate that people get new toilets of their own and that communities build toilets in public places.

According to him, part of the problem is that there is no active water supply in the whole of Lagos anymore.

“Give people pipe-borne water, which is usually purified and when there’s a cholera outbreak, people should hyperchlorinate their water, wash their hands, and make sure their source of water is safe. Chlorinate if cholera comes into your water supply,” he said.

Prevent the spread of cholera

Alert Roberts, associate professor of public health at the University of Lagos, said during a recent television conversation that people should rush to the hospital at the first or at least second episode of cholera cases because the disease attacks the lining of the intestine.

“When the intestine loses its integrity, everything in the body rushes to the intestine and fills it, and everything rushes out either upwards or downward effortlessly.

“The minute you see one episode before it gets to the second or third, which can come in rapid succession, start rushing to a health centre that has the capacity because the second danger is that the patient can get so dehydrated that can result in the collapse of the vine,” she said.

Roberts said that people should ensure that the faeces and the vomit are covered up or buried properly while they use a hypochlorite solution to wash everything clean to avoid flies from perching on it and carrying it to food or cooking utensils.

She encourages Nigerians to clean their environment because flies and open defecation are people’s enemy at a time of cholera outbreak.