Date Archives February 2013

Water Board Blues

This is the Transcript for a post written for The ScoopNG. Read the original post here.

Depending on where you live in this country of ours and/or how old you are at the moment, there’s a pretty good chance you’ve never had the opportunity of having drank tap water.

Yes, there used to be a time when “tap water” wasn’t a subtle euphemism for the water you got at your kitchen sink via the water pump engine in your apartment. And it didn’t come in plastic bottles either. Tap water, back when I was little, came via a long labyrinth of pipes buried in the ground linking to the water reservoirs operated by the government’s Urban Water Board.

Boreholes were a very rare source of water fifteen years ago. Water flowed in our homes; our showers worked. Of course there was the occasional incident of burst pipes that had to be tied or replaced. And just like it was/is with PHCN, when the workers at the Water Board went on strike, scarcity ensued and all roads led to the rivers. Those who weren’t close to any water body sought for the nearest compound with a water borehole facility. Life wasn’t always grand in this country, I tell you. Oh wait…

As the years rolled by, finding water dripping down the street became a rarity. Then the streets became permanently dry. It’s not that all the burst pipes had finally been fixed; water just wasn’t coming through them anymore. The taps stopped flowing. More water boreholes sprang up in various homes and instead of paying the water rate to the government, people started to pay other people for access to water. A new industry – the potable water industry kicked off soon afterwards and never looked back since.

You’d think there couldn’t possibly still be such a thing as an Urban Water Board around these days. Much to my dismay, while driving across town recently, I stumbled across a building whose sign post bore the four words: State Urban Water Board.

Questions automatically cropped up in my head. Did people still leave their homes in the mornings and go to work a job at the water board? How does the government justify floating a ministry of water works and still pay salaries when tap water has since become an issue of folklore?

Is it a settled matter that we can’t have tap water back in our homes? It doesn’t seem to be a big issue – at least it doesn’t get the level of discourse that power attracts, even at election campaigns. Are we resigned to the fact that, as the general population grows richer (if they ever do), people are going to have to sink their own boreholes to get water?

Truly, there are a few places that still get water from the water board. For most of these areas, the water is anything but potable. Smelling, unclean water often comes up through the pipes, rendering the water almost completely unusable. This is as a result of the pollution of the water bodies from which the water is gotten – very likely a direct product of the rapid rise in population and urbanization. The water board is handicapped by old equipments (for purification, pumping, etc), understaffing or a dearth of properly trained employees and, among a myriad other problems, low prioritizing by the government.

The federal government needs to rethink its stand on the issue of people having water flowing in their houses again. The Federal Ministry of Water Resources and the various state arms across the country need a revamping. The potable water industry is booming and people are gradually paying more for water. The cost of bottled water is a bit ridiculous. And there have been instances where we’ve had reasons to question the quality of some of these brands of water on sale.

The increasing number of boreholes may pose an environmental risk yet. Poking all that many holes in an area may yet compromise the safety of the area from the effect of environmental/climatic hazards like faults and/or earth quakes with time. Whatever rationalizations we muster up for why things are the way they are, they just won’t hold water in the face of the plunge we’re headed for if things don’t change soon enough.

It’ll take a responsible government to give people water in their homes again. Only such a government can make the painstaking effort required to revamp the water industry, staff the Water Boards with well trained civil engineers, purchase standard purification and storage equipments all in a bid to provide potable water. And should the day ever come when tap water flows in our homes again, we shouldn’t have to be afraid to drink it. Any government that can get that right would have done right by us all. It’ll have passed a responsibility test.

On Grading Governance

This is the transcript of a post written for The ScoopNG. Read the original post here.

As I make my ten-minute walk to work every morning, I usually pass by a couple of kids en route to school. Nothing particularly horrifying about a bunch of kids walking to school though. Except that some of these ones I pass by juggle various contraptions like stools and chairs along with their school bags.

The first time I noticed it, I quickly assumed that there was some sort of event at their school. Or that it was probably Arts and Crafts Day at school. Then I saw a repeat of the same scenario the next day. When it became apparent that it was a routine event, I decided to go and check out the school with my friend on our way back from work.

The school wasn’t far off – only a street away. The site was humbling and depressing.

Buildings in various stages of completion (and varying degrees of quick retrogression) sprawled across a dusty and forlorn landscape passed off as the citadel of learning for these kids. There are no chairs for the pupils to seat on and there are no black (or any other type) boards in the class rooms. The rooms offer almost no protection from the elements and grossly fall short as a place fit for disseminating and assimilating knowledge.

One thing was plain: these pupils didn’t stand any chance at getting the required level of education to make them stand out in life. If that doesn’t startle you just yet, maybe this next bit would help put things in perspective: the location in question is not a village; it’s a capital city — Abakiliki, the Ebonyi state capital.

A few weeks ago, the Good Governance team led by the Minister of Information, Mr. Labaran Maku, visited this city and conducted scheduled tours of various government establishments, while commissioning a few projects with a view to assessing the score card of the present government administration in the state. Preparations to receive the minister were top notch stuff.

Two days before the team was scheduled to visit my company, a flat screen TV appeared in the lobby, faulty ACs were fixed, the sidewalk was painted and polishing was done on various areas in a bid to impress. Dancers were hired and a reception party was thrown to receive the team.

While the fanfare lasted, I couldn’t keep my mind from those school kids – most of them sitting on dirty floors in a dingy, unkempt room that passed off as their classrooms. They were only about 1000 yards away and their plight wasn’t even going to be factored into the parameters used to assess the government saddled with the responsibility of ensuring they had befitting schools to attend.

The ritual involved in assessing a government’s administration without factoring in the input/opinions of the governed is practically a charade at best. This is not to say we shouldn’t have such a thing as a tour of the States by a set aside Good Governance team. Just that there ought to be a mechanism in place to check how well the projects embarked upon by various state governments affect their citizens. It should be much more than the perfunctory commissioning of facilities/projects and the luncheons. There’s got to be a way to get feelers from the people on how well the government is impacting their lives.

When teachers grade students in school, they don’t just grade them on their favourite subjects but on the entire work load for the session. And no matter how great a student fares in their favourite subjects, they don’t get to move to the next level if they lose points on the other required subjects.

Maybe the Good Governance team could do one better by also having to check, besides the projects brought to its attention, that other vital amenities/services are being taken care of by the governments they’re assessing.

After the scheduled tour of my company was done, the Minister and his team left and headed right on to the next state on the schedule. Obviously, the assessment of the government of this state would be nothing short of a pass mark. As I walked the path back home later that day I saw a couple of school kids returning from school. I couldn’t help but think that they’d been ripped off and that they, along with the many other citizens of their state who don’t get a fair deal from their government, would never be heard.

Lassa fever is the not-so-new super bug

This is the transcript for a post written for The ScoopNG. Read the original post here.

Tuesday morning, December 23, 2008, was like any other morning. Ezeugo* was preparing to have breakfast before heading out to work. He had heated some water and made tea. He planned to take it with the bread he’d brought with him the previous day from Owerri, Imo State, his home town, to Afikpo, Ebonyi state where he resided and ran a shop.

On observation, he discovered that the seal of the bread had been broken and it seemed like some rodent had managed to pilfer some crumbs off of the loaf. He did what the average Nigerian would do: he chopped off the parts nearest to the area the rodent had bitten off and proceeded to have his breakfast. After that he went out to work. It was holiday season and business was good.

At dusk on Christmas day, after sufficient partying and merry making, he headed home to rest. That’s when he noticed his body temperature had started to rise and that he felt rather exhausted. He figured it could be either one of two things: he either was fatigued from all the ensuing stress of the holiday season or he was coming up with malaria fever. The fever was more likely, he thought. He proceeded to purchase Paracetamol from the Pharmacy down the street to help relieve him. He wasn’t better by the next morning; he was weaker and hotter. That’s when he proceeded to the nearby clinic. Two nurses tended to him and, when his condition continued to deteriorate quickly, they referred him to the General Hospital, Afikpo. The General Hospital was being manned at the time by a doctor undergoing his National Youth Service.

The moment Ezeugo entered the General Hospital and the doctor took one quick look at him, he knew whatever it was that ailed this patient, the hospital didn’t have the required personnel and/or equipments to handle it. He had a hunch it was something more sinister than malaria fever and thus dispatched him to the General Hospital, Abakaliki, where he was certain the patient would get better care.

At the General Hospital, Abakaliki, Ezeugo was admitted and his attending physician administered treatments to help keep him stable. Nobody knew what it was exactly that ailed him. Some very bad strain of fever was at the top of the guess list though.

A few days later, while Ezeugo was fighting to cling on to life, his doctor started to get sick. Another doctor had to pitch in to watch over them both. Not long after that, the second doctor got sick too. Because the patient was the priority (and probably because doctors are wont to delay their own treatment when they get sick), he got more attention and thus, better treatment. It was after the first attending suddenly died and the second was in the throes of death that it became clear that there was an epidemic in the hospital. Whatever Ezeugo had, it was not a fever they’d handled before. They filed a report to the Federal Ministry of Health (F.M.O.H.), Abuja and asked for help.

When the FMOH team arrived from Abuja, they quickly checked the patient’s charts and proceeded to get an accurate history by doing a back trace through every stop the patient had made enroute to Abakaliki. Shocking discoveries were made during the investigations. The two nurses at the clinic and the Pharmacist Ezeugo had initially contacted at Afikpo had mysteriously passed away.

Meanwhile, Ezeugo had been transferred to The Irrua Specialist Teaching Hospital, Irrua, Edo State, where they had a Human Virology centre. Tests revealed that he had Lassa fever and after a series of questioning, the patient revealed the story about the bread he’d eaten. The connection was made: Lassa fever from rat pee. It was a cool diagnosis but one made after two doctors, two nurses and a local pharmacist had paid a steep price.

Lassa fever was first observed in 1969 in the Nigerian town of Lassa in Borno State. Its primary [animal] host is the Natal Multimammate Mouse (Mastomys natalensis), which exists in abundance in most of Sub-Saharan Africa. The rodents are usually hunted and cooked by the locals and serves as a protein source. The virus is usually transmitted via the urine or feces of the animal when they access stored food in peoples’ houses or even in store houses.

According to a statement by the World Health Organization on the prevalence of the disease in Nigeria, “… Person-to-person transmission occurs through direct contact with sick patients in both community and health care settings. Those at greatest risk are those living in rural areas where Mastomys are found. Health care workers are at risk if adequate infection control practices are not maintained.” In the first quarter of 2012 alone, 623 suspected cases, including 70 deaths in 19 of the 36 states were reported by the Nigerian F.M.O.H to the W.H.O. as of March 22. That is nothing short of an epidemic, if you ask me.

The cases are likely to have increased towards the latter part of the year as various states experienced flooding issues. This would have resulted in the mouse in question, along with other animals of course, being displaced. Some would probably have found their way into people’s homes in search of food and shelter thereby increasing the risk of infection for the human occupants.

The diagnosis for Lassa fever isn’t much different from that of the regular malaria fever. The symptoms include diarrhoea, vomiting, cough, headache, sore throat, nausea, etc – very much like the ones associated with malaria fever, (although other more markedly different symptoms occur in some few cases) except that it’ll refuse to be tamed by the usual drugs that are used to combat malaria. Many doctors are likely to miss it – and that fact isn’t as much a slight on their competence as it is on the general awareness level regarding the infection. The most efficient way to combat the disease at the moment is early administration of the Ribavarin injection or tablets. The drug is relatively expensive and not readily accessible.

The problem with Lassa is that you can hardly do anything about the pathogen carrier (eliminating the rats is practically impossible). And unlike aids, the slightest contact with an infected person increases your chances of contracting it, as the virus is present in all body fluids.

The F.M.O.H. is currently carrying out an awareness campaign regarding an outbreak of the disease and is supplying Ribavarin drugs and injections to the General Hospitals across the states. However, the problem of relative ignorance still persists in rural communities where the risk factors are higher. The awareness campaign has to be intensified and taken deep into the hinterlands as most of our foods are cultivated, stored and comes from there. Let’s say, for example, an infected bag of garri is bought at Oba Market in Benin, Edo State (which may have come from any village in the state) and transported to Lagos. Okay, you already know where I’m going with this.

If we’re to stem the tide of this epidemic, all hands are going to have to be on deck. People will have to store their foods better, and report immediately to the hospitals for treatment as soon as they notice feverish symptoms, instead of self medicating, as the majority of us are prone to do. The government, through the F.M.O.H., should ensure that efforts are increased to ensure that Ribavarin is supplied to more hospitals and maybe work out a partnership with corporations in the health sector to help leverage on the price of the drug. Most importantly, the awareness campaign is everyone’s responsibility. If you know about the disease and how to prevent it and your neighbor doesn’t, it’s your duty to educate them. It just might save your life.

*name has been changed for confidentiality sake.