CHOLERA, DIARRHEA & DYSENTERY UPDATE (72): NIGERIA (EBONYI) FATAL
A ProMED-mail post
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International Society for Infectious Diseases
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Date: Sat 9 Nov 2024
Source: The Nation [edited]
https://thenationonlineng.net/how-burial-of-ebonyi-cholera-victim-provoked-epidemic-that-claimed-28-lives/
One of the challenges faced by communities in the remotest parts of
Ebonyi State is lack of adequate social amenities, especially potable
water.
Ebonyi State is said to be one of the states with poor underground
water, meaning that streams in most parts of the state are not
hygienic enough for drinking.
While inhabitants of urban centres can afford to sink boreholes or buy
sachet or bottled water imported into the state, poor folks in the
rural areas, due to their poor economic status, struggle to afford
clean water.
According to the World Health Organisation, safe drinking water,
sanitation, and hygiene (WASH) are crucial to human health and
well-being.
“Safe WASH is not only a prerequisite to health but contributes to
livelihoods, school attendance, and dignity, and helps to create
resilient communities living in healthy environments.
“Drinking unsafe water impairs health through illnesses such as
diarrhea, and untreated excreta contaminates ground waters and surface
waters used for drinking water, irrigation, bathing, and household
purposes.
“This creates a heavy burden on communities,” the organisation [WHO] says.
It estimates that poor WASH conditions still account for more than one
million diarrhea deaths every year and constrain effective prevention
and management of other diseases including malnutrition, NTDs
[neglected tropical diseases], and cholera.
Ebonyi State has, over the years, continued to record many deaths due
to poor WASH conditions, particularly diarrhea and cholera and
especially in the rural areas.
This year [2024], the state was hit with another outbreak of cholera
which the government said claimed 28 lives.
Worst hit is Ndibokote community where at least 14 persons died,
according to government estimates, though locals insist the death toll
from the community is around 25.
A visit to the community shows that it lacks clean drinking water, and
there is no public health facility available.
The outbreak, which occurred in September [2024], started when a woman
died after she took ill and was passing stool repeatedly.
Egodi Nwiboko, a health worker in the village who works at a chemist
shop in the area, noted that after the woman’s death, more people who
attended her burial died.
She called on government to sink boreholes for the villagers as lack
of potable water contributed to the high number of casualties recorded
in the outbreak of the virus.
Egodi said: “We have no water in the community. We drink anything we
see as water, which contributed to the spread of cholera in the
community.
“Government should drill boreholes in the community to save us from
the precarious situation.
“There was a day they came into our chemist shop and told us that a
woman was passing stool, and we went to see the woman. But the woman
died before we got to her. She was vomiting and passing stool.
“After the woman’s death, people started telling us that there was
cholera outbreak in the community. We had never experienced such a
thing, so we didn’t believe. The woman was buried, and many people
that attended her burial started passing stool while others were
vomiting.
“That was how the disease started spreading.
“As people were vomiting and passing stool, they were dying like
chicken. Some died within 5 minutes that they started passing stool.
Some were vomiting.”
The disease would later spread to some other parts of the local
government and other nearby local government areas [LGAs].
In nearby Oferekpe, a woman reportedly died of the disease while in
Okpuitimo; in Abakaliki LGA, 6 persons reportedly died while a further
17 persons were hospitalized.
Speaking to our reporter, residents blamed the outbreak on the absence
of clean source of water in the community.
A member of the community, [SN], said the outbreak was caused by
consumption of contaminated water. He noted that the disease spread
faster after the burial of a female victim in the community.
who went and ate a dog killed in the area. Those who went for the
burial and those who ate the dog meat were the first to fall sick.
“Those who went to the burial also ate a cow that was killed and
prepared in a very dirty environment. The community is located in the
remotest part of the state. In fact, it shares boundary with Benue
State.
“There is no good source of water in the area. The only borehole in
the area is no longer functional. The only source of water there now
are ponds and a stream, and they are very dirty.”
He noted that most people there practice open defecation, and these
may have contaminated the ponds and streams in the community.
“The situation is worsened by the heavy rainfall around this period,
which carries into the stream all the faeces and wastes and probably
contaminating it,” he said.
“This place is a very hard area to reach, as you can see on your way
coming that the road is nothing to write home about. The community is
a very large one and very well populated too. It has over 8000 to 9000
inhabitants.
“We have 2 polling units in this place. The thing is, the only
borehole we have is broken down, and the other one is completely
moribund.
“So, going by the genesis of this very incident, before the burial of
the woman in question, the rains stopped for a very long time.
“After some time, the rains came again, and by the time it started
again, there were already lots of defecation in the bushes. So the
rains washed all those to the streams, and our people are making use
of only stream and pond waters.
“Only people who have corrugated roofing make use of stream water, but
that was also not good at that time because the roofs were also very
dirty during the early rains. So this triggered this outbreak.
“Right now, we are helpless, and we have lost so many souls in this
struggle. People are dying –men, women, and children.”
A patient, Mrs [MN], said she started vomiting a day after the
burial.
“I was so sick that I found it hard to walk. I was passing out stool
regularly. They rushed me to the hospital in Iziogo where I was given
drugs and I got better. I was later discharged, and I am well now,”
she said.
A youth leader in the community, Mr [MN], re-echoed similar sentiment
about the outbreak and lack of adequate social amenities in the
community.
He said: “The outbreak started when one woman died. After the burial
of that woman, it escalated. We were suspecting that it is cholera,
but we have not had it before. The last time we had such a thing was
when we were kids. So we didn’t know the symptoms.
“So after the burial, people that went there started having the
symptoms and were dying. It killed about 3 persons on 22 September
[2024] and continued spreading and killing more people. We have
recorded many deaths, and many are still in the hospital.”
A visit to some of the ponds revealed very dirty water covered in
leaves and other debris floating on their tops, signifying that the
water is very dirty and not fit for human consumption.
Another member of the community, [AA], who served as guide to our
reporter on the visit, insisted that the ponds are the main source of
water for drinking and cooking in the area.
He said: “You can see the kind of bad water we drink here. We don’t
have good water to drink. This is the reason for the recent cholera
outbreak which led to the death of many persons. We lost many persons
because of it.
“We also don’t have good roads in this community. Neither do we have
any hospital,” he further lamented. “We don’t have a hospital or
health centre. If we had one, the death from this recent outbreak
wouldn’t have been this much, because the people infected would have
been rushed there, and they would have got adequate treatment on
time.
“The nearest health centre is in the next town of Iziogo. You will
pass about 2 villages before you get there. So it is very far. There
is no access road to that place. So before you would manage to pass
the difficult terrain to get there, the person might die.”
man-made.
Pointing to heaps of sand around the pond, he said: “We used to dig
deep inside the ground and heap the sand which came from the pond
around it to trap the water.”
He explained that this became necessary to ensure that enough water is
available for the community during the dry season.
“When the rains stop, if you come here in the dry season, you will see
that this large body of water will become very small, and we will even
be scraping it from the bottom.
“This is the water the whole village drinks. We don’t have a borehole,
pipe-borne water, or well. Both schoolchildren and adults in the
community all come here to get water. We don’t have any other water
source around this village. The pond is located in the centre of the
village. It is where we get the water we use in cooking and also the
one we drink.”
community to prevent a reoccurrence of the outbreak.
He said: “We are calling on government to come to our aid by giving us
good water.
“We also don’t have good roads. You can see the sand heaped around the
pond to show that it is man-made. We had to dig deep inside to ensure
that enough water is stored here during rainy season so that during
dry season we will still have water left to use.”
Government reacts