Celine Lafoucrier: How Government, Community Can Curtail Cholera Outbreak

With 65 confirmed cases of Cholera and 30 deaths across 96 local government areas in Nigeria, according to the Nigeria Centre for Disease Control, and Prevention (NCDC) report, there is certainly every need for urgent action. In an interview with Ayodeji Ake, the Chief of United Nations Children’s Fund (UNICEF), Lagos field Office, Celine Lafoucrier, while fielding  question on the Cholera outbreak, highlighted important things the government and community must put in place to combat the scourge 

Can you speak on the children and young people affected by the cholera outbreak in Lagos and other parts of the country? 

Recurrent Cholera outbreaks critically affect children and populations at large. These vulnerable groups face substantial health risks, particularly those under five who are prone to severe dehydration and higher mortality rates. 

Educational disruption is yet another critical consequence of cholera outbreaks, as illness and the need to care for sick family members lead to school closures and reduced attendance, hindering children’s learning and development.

Similarly, post-recovery issues in children can include malnutrition, stunted growth, and weakened immune systems, increasing susceptibility to other diseases. These outbreaks underscore the urgent need for improved access to clean water and sanitation in many areas.

Despite the state government’s efforts to provide water to its population, the current outbreak demonstrates the need for an urgent government focus on ensuring the water supplied to the population is clean and risk-free.

Addressing the challenges of cholera outbreaks requires a deliberate focus on state policies to provide high-standard water and sanitation facilities, as well as strengthened healthcare systems capable of responding to the demand during outbreaks, and state-led educational campaigns on cholera prevention to protect children and the population at large. 

How can this situation be alleviated? 

To alleviate cholera outbreaks, a comprehensive approach is essential. Sustainable WASH infrastructure and strengthened health systems capable of anticipating epidemics as well as, effective community engagement strategies are crucial to halt transmission. 

This includes enhancing water, sanitation, and hygiene (WASH) infrastructure, implementing rapid surveillance, promoting social mobilization, administering treatment, and utilizing oral cholera vaccines (OCV). Ultimately, preventing cholera centres on good sanitation and hygiene practices.

Key actions include proper disposal of faeces, eliminating open defecation, and ensuring access to potable water. Regular handwashing with clean, running water and soap is vital. Additionally, avoiding the consumption of uncooked vegetables, unwashed fruits, raw or undercooked seafood, and food from street vendors is important to reduce the risk of cholera infection. 

What role does good water and sanitation infrastructure play in reducing incidences of disease outbreaks? 

Good water and sanitation infrastructure play a crucial role in reducing disease outbreaks, such as cholera, which causes an estimated 100,000 deaths annually.

Water, sanitation, and hygiene (WASH) interventions are fundamental in preventing and responding to cholera epidemics. Safe water supplies, hygienic sanitation, and effective water management are key elements in this effort. 

Increasing access to safe drinking water, improving sanitation and hygiene, and better water management can prevent almost one-tenth of the global disease burden.

Community access to sanitation, like simple latrines, prevents drinking water contamination from human waste, reducing infections. Regular handwashing with soap and safe drinking water storage are also high-impact practices.

Investing in drinking water, sanitation, hygiene, and water resource management systems is economically beneficial. Each dollar invested yields up to eight dollars in benefits. Safer water could annually prevent 1.4 million child deaths from diarrhoea, 500,000 deaths from malaria, and 860,000 child deaths from malnutrition, and protect 10 million people from serious illnesses like lymphatic filariasis and trachoma. 

How do disease outbreaks impact Nigeria’s progress in achieving the SDG goals on health? 

Disease outbreaks ultimately hinder Nigeria’s progress in achieving health-related Sustainable Development Goals (SDGs), particularly SDG 3, which focuses on ensuring healthy lives and well-being for all.

These outbreaks strain Nigeria’s health system, diverting limited resources from essential services like routine immunizations and maternal and childcare, undermining universal health coverage. 

Outbreaks disrupt health programs, leading to resurgences of vaccine-preventable diseases such as measles and diphtheria, which hinder efforts to reduce child mortality and control epidemics. 

Economically, outbreaks shift funds from primary healthcare to emergency response, causing economic downturns that reduce health budgets and government revenues, further straining health services. 

However, outbreaks also present opportunities to strengthen Nigeria’s health system. A robust response is needed to improve health infrastructure, enhance economic resilience, and ensure equitable access to health services.

This is essential for mitigating the impact of outbreaks and progressing towards sustainable health outcomes. 

Is there a role for communities in creating sustainable solutions to these outbreaks? 

Cholera outbreaks originate and spread within communities, making community-led and participatory approaches essential for sustainable prevention.

Communities and local governments can play crucial roles by leveraging communication channels to educate and protect public health. Prevention is more cost-effective than cure; thus, communities should establish systems that promote key hygiene practices, transforming them into a cultural norm.

Community-led surveillance can enforce sanitation practices, with empowered local monitors ensuring compliance. Ultimately, access to clean water and sanitation is critical in preventing outbreaks.

Communities must take collective action to ensure clean water access and maintain good hygiene. Identifying and empowering positive role models within the community can encourage the widespread adoption of healthy practices.