In 2017 there was a severe cholera outbreak in several camps in Borno State. The initial response that
everybody has to an outbreak is often to give information and more information and more information
about what to do. There is an outsized focus on information to make people change their behaviour or
take a desired course of action. That information alone makes one do something has been proven to be
a fallacy. We see the symptoms of this every day in our society.
When the weather forecasting organisation, the Nigerian Meteorological Agency, finds that there’s
going to be a flood, all they do is announce, “There’s going to be a flood”. The National Emergency
Management Agency picks up the chorus, announcing, “Those of you living by the coastlines and flood
plains, move to higher grounds.” See? That’s easy. Say that, and people would move from their current
locations and go to higher grounds and live happily ever after until they see the rainbow in the sky. The
owners of the higher grounds would be so accommodating; they would provide three square meals and
share bedrooms with the new visitors. What a wonderful world!
So there’s just information. Often, nothing is supplied about providing alternative locations for people to
relocate to. Most of those living in flood plains or by coastlines make a living on those environments as
fishers or farmers. When we are told that there will be flooding, nothing is done about the implications
for livelihoods, conflicts, and all. Nationally, what is the implication for fuel supplies or other deliveries
to different parts of the country? No need to think about these and so we stop there. Information alone
was enough, the people who feel pangs of large family sizes would have stopped doing that because
they have low income, but police families are usually the largest despite the poor pay they receive.
When we experienced that outbreak, especially at the Gubio IDP camp in Konduga LGA, the immediate
reaction was to deliver information on washing jerrycans, toilets, hands and everything washable. It
seemed like they were preparing for an august visitor. But despite the heavy campaigns, and increased
awareness, the need for the displaced persons to have soaps, detergents and antiseptics was not given
as much priority in the planning. That is not a sustainable way of ensuring that people continue with the
right behaviours after the campaigns are done.
Currently, there are reports of a rise in cholera cases in Nigeria. From January to July, nearly 4000 cases
were recorded and 91 persons died, according to the Nigeria Centre for Disease Control, NCDC.
(Anytime I write the acronym, I imagine the guys in navy blue colours who are consistently trying to
outstare the police, who wear a lighter blue. You know those guys.) Of course, the number of cases in
Nigeria at global figures should not be terrifying. According to some studies, cholera infects between 1.3
million to 4 million people in a year and can lead to between 21000 to 443,000 deaths. Thus, one could
say the cases in Nigeria being 4,000 shouldn’t be scary. However, we know that deaths from anything
are usually higher in developing countries. And Nigeria is a spectacular case in such situations. Last
week, someone had a plane crash in the United States, and the two people on board didn’t die despite
that this helicopter crashed into a place in the community. The people on the ground did not die, the
people on board did not die for some reason. We in developing countries just have a way of dying faster
than the people in the developed world. You might attribute it to them observing safety precautions
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more than we do here; or you might also attribute it to the fact that we have a more dense population
than some other places. Therefore, while we have under 4,000 cases of cholera in Nigeria, those 4,000
cases can easily spiral to 500 deaths, while somewhere else, you would require a million cases to deliver
such a number of fatalities.
Why is cholera something of concern at this point? It is because cholera is transmitted through unsafe
drinking water or food; this is directly linked to the kind of floods that we are experiencing right now
where people are being displaced from their homes, and access to potable drinking water is going to be
very little or non-existent. People are often very poor, so they don’t also have the resources to buy
bottled water, and because of our power supply system (as well as lack of value for life), this flood will
even stop access to the supplies, and you won’t even have the bottled water. People will defecate in the
open or even in those same contaminated waters, thereby increasing the level of contamination.
Children will play in those waters, and the cycle continues. A good power source is absent, so boiling
water will not be possible. Getting chlorine to treat the water will not be easy; poor, displaced people
must buy those things. The opportunities for people to wash their hands with soap and safe water after
using the toilet or cleaning their children’s poo is also limited. We can see precisely why current cholera
can easily spiral into epidemic proportions in Nigeria within the coming days. Already, the proactive
Borno government has declared it an emergency. They are right to have done so.
Well, I have done is give information here too, right? What can we do beyond information? But I ask
myself, “Why should I say what we should do? Because everybody actually knows what we should do!”
For those who need reminders, we know we have to cook our food very well, stop eating things such as
fruits or vegetables if we don’t cook or peel them. I don’t know if any of you remember the World
Health Organisation’s dictum “Cook it peel it or leave it”; it applies very well today to the current cases
of cholera. If you don’t have a good place to use the loo please do not defecate inside the water where
people fetch water to drink or have their bath; go somewhere about 30 m (or the equivalent of four
houses) away from that water source and defecate there. Ensure you bury your faeces; the chances of
rainwater taking the faeces into the water that you drink is less likely. If you are digging a latrine, please
dig about the length of your arm all the way into the ground. You are making sure that nothing digs up
the poo, or water does not rain water doesn’t come to carry it into your source of drinking water.
Finally, please use soap and water to wash your hands very well. Scrub it with soap for about 20
seconds. Some people say if you can sing “Happy birthday to you, you know, happy birthday to you;
Happy birthday, happy birthday, happy birthday to you” while washing your hands, you’re most likely to
have spent about 20 seconds. If you don’t do that, the chances of you being available to sing another
Happy birthday will be made slimmer by cholera.
