Water Quality in Nigeria: Experts tackle persistent waterborne disease outbreaks with Scalable Solutions

Tosin Clegg

Cholera continues to pose a significant public health challenge in Nigeria, with 10,837 cases and 359 deaths reported across 35 states and the Federal Capital Territory as of September 29, 2024. This marks a staggering 239% year-on-year increase in fatalities, emphasizing the critical link between environmental factors and the disease’s persistence. The root causes—poor drinking water quality, increased flooding, and inadequate wastewater management—create a perfect storm for cholera outbreaks, threatening public health on an alarming scale.

As of 14 October, the global stockpile of Oral Cholera Vaccine was depleted, with no remaining doses available. Although more doses were expected, this shortage poses significant challenges to outbreak response efforts and hampers efforts to control the spread of the disease. Beyond the administration of drugs and vaccines, maintaining a clean source of drinking water is directly related to public health and safety and it serves as a means of curbing the spread of waterborne diseases within the nation.

Contaminated drinking water remains a primary driver of cholera, as unsafe water sources often harbor the Vibrio cholerae bacteria. In many communities, insufficient access to clean water forces communities to rely on untreated rivers, wells, or stored rainwater, all of which are susceptible to contamination from human and animal waste. The growth and spread of these waterborne pathogens amplify the risk of infection, particularly in rural and underserved areas. The impact of flooding has further worsened the cholera crisis in Nigeria. Rising floodwaters, fueled by climate change and poor urban planning, overwhelm sanitation infrastructure and spread contaminants into water supplies. The stagnant pools left behind serve as breeding grounds for bacteria, compounding the risk of cholera transmission in affected communities. Inadequate wastewater management also plays a pivotal role. The improper disposal of human waste, often due to a lack of functioning sewage systems, results in direct contamination of water sources. Open defecation and untreated wastewater discharge perpetuate a cycle of contamination, exposing millions to cholera outbreaks.

Addressing Nigeria’s persistent waterborne disease challenges requires a comprehensive and integrated approach that prioritizes access to clean water, robust wastewater treatment systems, and proactive flood management. Without targeted interventions, cholera and other waterborne diseases will continue to pose severe public health threats, especially to vulnerable populations.
Since 2017, a team of researchers led by Dr. Imokhai Tenebe has been investigating drinking water quality in Ekpoma, uncovering significant risks and proposing potential interventions. The team, which includes over ten water quality professionals such as E.O. Babatunde, J.B. Neris, C. Mikano, O.B. Ezeudu, and O.C. Edo, has been instrumental in shedding light on the extent of the crisis. In Ekpoma, Nigeria, the situation is particularly dire. This community relies heavily on rivers and roof-harvested rainwater for drinking, as accessible groundwater sources are virtually nonexistent. These water sources leave the population extremely vulnerable to diseases caused by ingesting contaminated surface water.

“Our studies have revealed alarming levels of contamination in various water sources in the community, posing serious health risks to the local population,” said Dr. Tenebe. One landmark study published in the Journal of Water and Health in 2023 assessed the quality of stored river water in Ekpoma. Researchers collected 123 water samples from 41 locations, analyzing physical properties such as pH, salinity, and electrical conductivity, as well as concentrations of potentially toxic metals like aluminum, chromium, copper, lead, and zinc. Shockingly, only 25% of the samples met regulatory standards. Lead contamination was particularly concerning, contributing to 98.8% of the cumulative carcinogenic risks associated with oral ingestion.

The study identified several contributors to water quality degradation, including agricultural runoff, crude oil exploration, and the naturally high levels of certain metals in regional soil compositions. In addition to chemical contaminants, the team investigated bacterial content in both rainwater and river-sourced water. Their findings, published in studies from 2020 and 2024, revealed the presence of ten different pathogenic bacteria in all samples tested. These pathogens pose significant threats to public health, exacerbating the already dire situation.

The challenges faced by Ekpoma are a microcosm of the broader water quality issues plaguing Nigeria. Across the nation, inadequate access to clean drinking water leaves communities highly vulnerable to outbreaks of waterborne diseases such as cholera. Extending their research beyond Ekpoma, Dr. Tenebe’s team has also investigated the quality of sachet water—a common source of drinking water in high-demand areas like Ota, Ogun State. Their findings revealed significant bacterial contamination in supposedly treated sachet water sold to the public, raising serious concerns about the safety of this widely consumed product.

The work of Dr. Tenebe’s team underscores the urgent need for scalable solutions to Nigeria’s water quality crisis. Key interventions include implementing advanced water treatment systems, educating the public on safe water practices, and strengthening enforcement of environmental and water quality regulations. These measures are essential to breaking the cycle of water contamination and protecting public health in communities like Ekpoma and beyond.

Moreover, the establishment of localized, government-owned water treatment facilities can play a transformative role in improving water quality across the country. By decentralizing water treatment and ensuring affordability and accessibility, such facilities can provide a sustainable and equitable path to safe drinking water for millions of Nigerians.