The Federal Government has warned that the increasing level of flooding and continuous rainfall may worsen the spread of cholera in the country.

The Minister of Water Resources and Sanitation Joseph Terlumum raised the concern while addressing a press conference on Thursday.

According to him, a total of 63 deaths and 2,102 suspected cases have already been recorded as of Wednesday, July 3, 2024, since the outbreak of the epidemic.

Recent incessant rains have resulted in floods in some states and the Federal Capital Territory (FCT), a situation that prompted the minister to call on state governments across the country to intensify efforts in clearing drainages.

He said, “We are calling on states and local government councils, to intensify and step up efforts to avert flood-related disasters in their domains as we approach the peak of the flooding season.

“At the national, some states have started experiencing some level of flooding and its associated disaster as of April this year. So far, more than three states such as FCT have experienced high levels of flooding, with several casualties recorded, including displacement of people and loss of properties.”

According to the minister, there has been no release of water yet from any of the dams within and outside Nigeria.

For Kainji and Jebba Dams on River Niger, he said water is still impounded into their reservoirs.

Flood-Prone States

He said river flooding is expected beginning this month, and states likely to be impacted are; Akwa Ibom, Anambra, Adamawa, Benue, Bayelsa, Cross River, Delta, Edo, Jigawa, Kogi, Kebbi, Kaduna, Niger, Nasarawa, Ondo, Ogun, Rivers, Taraba and the FCT.

“Clearing of blocked drainage systems and canals, replications of people living along waterways and states and local governments, are encouraged to desilt river channels and canals in their respective constituents, to collect runoff water is part of the recommendation file for flood motifs,” he advised.

His call came days after the Director General of the Nigeria Centre for Disease Control (NCDC) Jide Idris confirmed that the death toll from the rampaging cholera outbreak had risen to 63, and 2,102 suspected cases.

He said cases have now been recorded across 122 local government areas in 33 states of the country’s 36 and the FCT.

Idris added that about 90 per cent of the cases were recorded in 10 states with seven of them in the southern region.

“Of the top 10 states, Lagos, Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers, and Delta that contribute about 90 per cent of the cases, seven of them are southern states,” Mr Idris said.

He attributed the outbreak to the ingestion of contaminated food and water, even as he expressed the country’s capacity to curtail further spread despite the challenges posed by the culture of open defecation.

Emergency Response

Earlier, Idris said the agency had activated the National Cholera Multi-Sectoral Emergency Operations Centre (EOC) to coordinate what he described as a robust response to nationwide cholera cases.

He said the NCDC activated the EOC after conducting a dynamic risk assessment.

“In response to the rapidly increasing cholera cases, a dynamic risk assessment was conducted by subject matter experts on the cholera outbreak situation in Nigeria last week,” the NCDC boss said.

“The subject matter experts were drawn from relevant Ministries (Health, Environment, Agriculture, Water Resources, etc.), Departments, Agencies, stakeholders, and major partners. The outcome of the risk assessment placed the country at “High Risk” of increased risk of cholera transmission and impact”.

Identified Challenges

While addressing the president, the DG highlighted some of the challenges faced in the fight against cholera, including open defecation, inadequate toilet facilities, and poor sanitation.

He said the government has demonstrated strong political will to control the outbreak despite these challenges, with an inter-ministerial cabinet committee established to support the response efforts.

The minister said, “Only 123 (16 per cent) of 774 LGAs in Nigeria are open defecation free, with Jigawa being Nigeria’s only open defecation-free state—more than 48 million Nigerians practice open defecation. Inadequate and existing toilet facilities are not well maintained, even in many government facilities.

“Inadequate safe water and poor sanitation: 11 per cent of schools, six per cent of health facilities, four per cent of motor parks and markets, have access to basic water, sanitation and hygiene services.”

He also listed other challenges, including waste management practices, food, environmental and personal hygiene practices, and the capacity gap among healthcare workers at the state and LGA levels.

“Weak regulation on the construction of soak-away and boreholes (some sunk close to a water source and boreholes sunk in the wrong location). Inadequate implementation and enforcement of public nuisance law and other relevant public health laws are some other challenges,” he added.

Idris further noted that the inadequate state-level capacity leads to delayed disease reporting and response at state and local levels.

“Additionally, poor regulation of food vendors and commercial water supply compromises hygiene standards, while weak regulation allows boreholes and wells to be situated near sewage or toilet pathways,” he added.

He emphasised that low knowledge and practice of basic hygiene practices, such as hand washing and the exacerbating effects of climate change and flooding, are hindering efforts to contain the outbreak.

Global Re-Emergence of Cholera

In June, the World Health Organisation (WHO) announced the re-emergence of cholera cases across countries in Africa, East Asia, America, Europe, and the Eastern Mediterranean region.

Data made available by the organisation showed that about 195,00 cholera cases have been reported in the five regions between January and May.

Africa was ranked the region with the second-highest cholera cases, with 92,789 cases from 14 countries. It closely followed the Eastern Mediterranean region, with the highest number of cases, more than 98,000 cases from seven countries.

For deaths recorded, Africa ranks highest with 1,698 deaths. The Eastern Mediterranean region, on the other hand, had 256 deaths.

This data, WHO said, combines both suspected and confirmed cases of the disease.