?Fix sanitation; fix diseases is? how experts have summed up? the need for a clean environment and good personal hygiene so as to stop the transmission of communicable diseases, writes WINIFRED OGBEBO.
The cliché that cleanliness is next to Godliness has still not found expression in our society, nay environment.
Yet, scientists hold the view that most sicknesses and deaths could be prevented or kept at bay if our environments were clean.
According to a Water and Sanitation Specialist with the United Nations Children Education Fund (UNICEF), Dr Bisi Agberemi, if you fix sanitation, you can fix some of these child-killer diseases like malaria, cholera and polio on a sustainable basis.
He argued that cholera is high because of poor sanitation and access to improved sanitation facilities in Nigeria, saying, “The brother of cholera is diarrhea. That one kills so fast. If you look at the last survey, the infant mortality rate is about 25 to 1,000 live births and under -five is about 115 to 1,000 live births. These are direct consequences of direct access to poor sanitation facilities and, of course, most of the people affected we can see are children.
There are some records that even say that we might be having about 200,000 deaths annually due to diarrhea diseases. That is a lot and equivalent to a child dying somewhere in Nigeria every three or four minutes. It’s like, you pack a jumbo jet filled with about 550 children and it’s crashing on a daily basis. We don’t place any importance on it because we are not seeing it. As we sit here, every four minutes, a child is dying due to diarrhea. It’s as bad as that, so when you look at it from that perspective, you can see that addressing and fixing the problem of sanitation will actually resolve a lot of these things.”
“We also have the issue of polio. You get polio in very poor sanitation areas. You don’t get polio where you have good sanitation; you get people living with polio when they are living under very poor sanitation conditions.”
Despite repeated calls for improved sanitation and personal hygiene, the sanitation situation in the country is still very poor. According to the National Demographic Health Survey of 2010, only about 31.2 per cent of Nigeria’s population has access to improved sanitation, while the rest use all manner of sanitation.?
?? Nigeria is not doing well in the areas of access to improved sanitation, the UNICEF specialist says, “Again, when we say improved sanitation facilities, there are delineations for it because, globally, sanitation has been classified to either improved facility or unimproved sanitation facility, shared facility for open defecation. So when you take improved sanitation facilities, these are facilities that ensure that human beings do not have contact or hygienic separation from human excreta. So, we say its improved sanitation facility. Of course, if it’s otherwise, it’s unimproved and if it’s open defecation, there are times you do it either in the field or onto the surface water. When you talk about access to improved sanitation, we are just concentrating on the people in Nigeria, who have access to improved sanitation facilities.
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According to the UNICEF specialist, sanitation is a very broad term. But within the context which he works, he says, “When you address sanitation, it refers essentially to human excreta disposal and management, but that is not to say that there are no other components. There are several other components like food sanitation. There are a lot of issues that have to do with sanitation in very broad terms but for the purpose of impact on intervention and monitoring, when you talk of sanitation, you’re, in most cases, referring to safe excreta disposal and management.”
? Furthermore, he says, “in Nigeria, when you use the data we have, like the NDHS of 2010, about 31.2 per cent of Nigeria’s population have access to improved sanitation while the rest use all manner of sanitation. This tells you that the situation is not really good. Again, when you look at it from the urban and rural dichotomy, of course, you have more problems in the rural communities than in the urban”
In the view of Dr. Ignatius Adeh, a researcher, Centre for European Environmental Law and Research, Faculty of Law, University of Bremen, Germany, the country needs to adopt a holistic and integrated approach.
He explained, “look, what we have here is malaria pandemic. If you look at the statistics on malaria related deaths which I believe you have yourself, every thirty seconds, a child dies in Africa, killed by malaria. An estimated 300 to 500 million cases each year cause 1.5 to 2.7 million deaths, more than 90% are children under 5 years of age in Africa. The countries where they have reduce malaria sickness are those countries that enjoy relatively clean environment, Eritrea, Komoros Island, and some Southern African countries. These are countries that have very low malaria deaths because they have relatively stable policy on environmental sanitation and malaria prevention. I’m not saying mosquito net is not a good idea but we must combine it with a good sanitation and fumigation systems.”
“That means not just adopting measures at combating the mosquitoes alone, but also integrating techniques to deal with their habitation. The only way to do that is through a combination of environmental sanitation and malaria prevention measures. Anything short of this approach would be like pursuing one’s own shadow. Look, you need to ensure their inability to procreate by eliminating their habitation through better sanitation for those areas particularly slum areas and poor neighbourhoods that need them.”
According to him, it is senseless setting targets without putting in place relevant strategies to meet set objectives and that if the country is serious about reducing/eliminating malaria deaths,it? must adopt adequate and achievable measures.
“So far, the mistake that`s been made again and again is the idea of thinking that one can fight malaria by making a cocoon of net around oneself without taking care of the environment.
In Nigeria, the mass number of people particularly the high-risk group (pregnant women and children) are right now as we speak in market places/schools/health centres/play grounds. Go to markets in places like Kubwa, Nyannyan, Maraba, Karu, Gwagwalada, Jikoyi, etc, these places are without mosquito nets. Even those of us who can afford mosquito nets around our windows and doors still battle with it because these flying tiny things gain entrance through open doors and sometimes through the so-called mosquito nets into the house.”
He noted that policy makers are aggressively? advocating the use of mosquito nets, yet, adopting preventive measures is better than curative. Nevertheless, he says, “They go about pursuing smokescreen systems that have obvious limitations. Prevention through environmental fumigation and promoting better sanitation in high risk areas is the answer. You can kill the mosquito itself, what about the eggs, larvae and pupae?”
“I think the best way to fighting malaria in the country is to adopt a holistic and integrated approach: environmental sanitation and fumigation. The idea of promoting mosquito net and malaria drugs when we know that children who go to school do not wear mosquito net, adult who go to work and public places do not wear mosquito net, when you are relaxing outside your home, you don’t wear mosquito net. Mosquito nets are only a bedtime story which lasts only six to eight hours.”