We must stop cholera from killing more children

With utmost sense of responsibility, government at all levels and other stakeholders should urgently take extensive measures to stop the deadly cholera that broke out in Lagos State and has spread to over 30 other states from killing more Nigerian children and young adults. Already, some parents and guardians, who are seriously concerned about the health of their children, are preventing them from going to school as primary and secondary schools in Lagos State resumed after the Sallah festivities. Also for fear of more fatalities, the Nigeria Centre for Disease Control and Prevention (NCDC) has declared an emergency on cholera as data gathered by all partners in the current fight against the disease indicate that the situation has gone beyond a particular threshold. There is a need for swift and potent action to save the lives of Nigerian children and prevent disruption of their educational pursuit.
 

Cholera is a deadly infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. According to experts, a person may get cholera by drinking water or eating food contaminated with the cholera bacterium, and the source of the contamination is usually the faeces of an infected person. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. Symptoms can include diarrhoea, which comes on suddenly and can quickly cause dangerous fluid loss by the infected person; vomiting which occurs, especially in the early stages of the disease, and can last for hours; and dehydration. Experts say people who have mild to moderate cases usually get better within a week, and even people with severe cases of cholera recover fully in a week or so if they get medical care, but the disease can kill an infected person within hours if left untreated.
  
In frightening reports, the NCDC, on June 13, 2024, revealed that from January 1 to June 11, 2024, over 1141 suspected cases and over 65 confirmed cases of cholera had been reported in 96 local governments in 30 states. The agency listed Lagos, Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, and Nasarawa as bearing 90 per cent of the disease’s burden in the country. Earlier, Lagos State said 350 suspected cases of the disease had been recorded in 29 wards across some of its local governments. Out of the 350 cases, 17 had been confirmed and 15 fatalities attributed to severe dehydration caused by delay in the presentation of those cases had been recorded.

The Commissioner for Health, Prof. Akin Abayomi, who made the disclosures, said Lagos Island was the epicentre of the outbreak with 106 out of the 350 cases recorded in the state coming from that area. Subsequent reports indicated that the situation was getting worse in Lagos, which has recorded 401 suspected cases and over 20 deaths, while the toll had risen to 53 nationwide by last weekend. Special Adviser to the Lagos State Governor on Health, Dr Kemi Ogunyemi, said the scenario was expected because of the Sallah celebration that drew large gatherings.
  
In an update on the cholera epidemiological situation in the country on Tuesday, the Director-General of NCDC, Dr Jide Idris, who announced the activation of the National Cholera Multi-Sectoral Emergency Operation Centre (EOC) in the country, said 53 deaths and 1,528 suspected cases had been recorded across 31 states and 107 local governments with a case fatality rate of 3.5 per cent since the beginning of 2024. The Lagos State government also announced that the cholera death toll had risen from 24 to 29.
  
One of the reasons for the current apprehension is that large gatherings similar to what was observed during Sallah are expected to happen, particularly among children and young adults, when schools resume after the festivities, which may make a lot of the kids more vulnerable to the cholera infection.
 

Some relevant global institutions, including the World Health Organisation (WHO), United Nations Children Fund (UNICEF) and International Organisation for Migration (IOM), that understand the danger cholera poses to the life of a child have met in Lagos to discuss on joint support for the government. As a warning, the Chief of UNICEF Lagos Field, Celine Lafoucrier, said the cholera was critically affecting children and young population who are prone to severe dehydration and a high mortality rate.
 
We call for swift action not only to defeat the disease but also to ensure that no life is further lost to it in the country. Nigerians must be adequately enlightened on the causes, symptoms and prevention of cholera. Basically, being hygienic and drinking clean water is the way to go. In a public health advisory, the NCDC claims that it is leading a multi-sectoral National Cholera Technical Working Group comprising relevant federal ministries and agencies, WHO, UNICEF and other partners, and now an emergency operation, to provide support for the affected states. The operational strategy should not be to sit in Abuja and be sending errands to the affected states, members of the group should visit those places to see what is really happening and know how to quickly intervene to prevent loss of life. State governments must also take practical and urgent steps to contain the spread of the disease and promptly provide medical care for affected persons.
 
We urge focus on other places where there is likely to be a large gathering of people for a period of time, like the three-week long orientation exercise of the National Youth Service Scheme (NYSC) that is scheduled to begin at 37 permanent camps of the agency nationwide before the end of this month. NYSC should ensure that the camps are clean and suitable for stay before the coming of the prospective corps members who should be mandated to observe all rules regarding hygiene during their stay in the camps.
 

There is also the need to take serious action against open defecation, which is rampant around the country because it is a major source of contamination of the sources of water, which some Nigerians, especially in the local communities, drink. It was learnt that cholera is now being found in seemingly clean places, including affluent neighbourhoods, hotels and restaurants with poor hygiene practices such as handling food with dirty hands and using contaminated water to wash utensils and prepare food. For this reason, the enlightenment should be extended to small and big restaurants, including food sellers around schools and other public places.
 
Besides the crucial need to stop the avoidable death of children from cholera infection, we say nothing should be allowed to compound the woes of the parents and guardians, who are already being suffocated by the unprecedented and unbearable high cost of living, astronomical increase in the cost of medical care, insecurity of life and property, unemployment, skyrocketing electricity tariff, poor wages and more.