Combating diarrhea in Nigeria

At Dalori camp in Maiduguri, the capital city of Borno State, women with long faces were seated outside a two-room clinic that serve about 19,000 Internally Displaced People (IDP), holding their dying children tenaciously. The children looked weak from severe diarrhea triggered by cholera epidemic in the camp.  That was in August last year.

By September, 16 people have died of diarrhea and vomiting at three camps in the city while 172 were left in critical condition, according to Medecins Sans Frontieres (MSF).

Cholera is a fast-developing, highly contagious infection that causes diarrhea, leading to severe dehydration and possible death.
The disease remains a leading cause of death among children in Sub-Saharan Africa, where proper sanitation is a serious issue.
According to the United Nations Children Education Fund, UNICEF, the diarrhea prevalence rate in Nigeria is 18.8 percent and is one of the worst in sub-Sahara Africa and above the average of 16 percent.

In Nigeria, diarrhea accounts for an estimated 150,000 deaths every year mainly amongst children under five due to unsafe water, poor sanitation and hygiene practice, UNICEF report stated.

The loss, according to UNICEF, is equivalent to the number of people lost by a big passenger aircraft crashing every day.
According to the Director of Project, Pharmaceutical Society of Nigeria –Partnership for Advocacy in Child and Family Health,  Remi Adeseun, no fewer than 195,000 children died of pneumonia while 120,000 of them lost their lives as result  of diarrhea in Nigeria annually.

Expressing concern over the high incident of diarrhea in Nigeria, Chief Water, Sanitation and Hygiene (WASH) UNICEF Nigeria, Kannan Nadar, noted that the deaths could be prevented if more   basic sanitation facilities are established and awareness on proper hygiene and sanitation practices are improved. Nadar particularly emphasized the importance of good hygiene practices such as hand washing.

Sub-Saharan Africa, the region with the highest child mortality rates globally, also has particularly low levels of hand washing, according to UNICEF and WHO report. Recall that the UN General Assembly declared the year 2008 the International Year of Sanitation.

In Nigeria, diarrhea accounts for an estimated 150,000 deaths every year mainly amongst children under five due to unsafe water, poor sanitation and hygiene practice, UNICEF report stated

Here in Nigeria, the Hand Washing Campaign is one of three targets outlined in the Action Plan developed by stakeholders for commemoration of the 2008 International Year of Sanitation (IYS).

The two other targets are creating enabling environments to sustainably expand sanitation and hygiene programmes and construction of one million latrines.

There are a lot of scientific evidences showing the significance of hand washing at critical moments to reduction in diarrhea, which is the second leading cause of death amongst Nigerian Children (after malaria). A report published in the Journal of the American Medical Association (JAMA) shows that improved hand washing likely played an important role in reducing the incidence of diarrhea.

A recent study indicates that hand washing can reduce diarrhea episodes by about 30 percent and up to 47 percent reduction has been achieved in some cases.

Globally, UNICEF is supporting 50 countries including Nigeria to implement Community Approaches to Total Sanitation (CATS) such as Community Led Total Sanitation. This is aimed at empowering communities to identify their sanitation challenges and take necessary actions to end open defecation

Likewise, the Nigerian government and several corporate bodies are also collaborating to fight the epidemic.
Recently, Reckitt Benckiser, RB, the world’s leading consumer health and hygiene company upped its commitment to the eradication of diarrhea among Nigerian children. During a visit to Nigeria on Tuesday 19th January, RB announced a multi-billion partnership with federal government to fight the scourge of diarrhea among Nigerian children.

This fact was revealed when officials of the company paid a courtesy visit to the Vice President, Professor Yemi Osinbajo where they presented the ‘Save a Child a Minute’ N7.2bn program to him. Under the programme, Nigeria will receive N1.2bn towards creating what the company called, a “Healthier and Prosperous Nation.”

The RB delegation included Managing Director, RB West Africa, Rahul Murgai; Deputy Head of Political Section, British High Commissioner, Andrew Fleming and RB Global Head of External Communications & Affairs, Patty O’ Hayer.
Others are Chairman RB Nigeria Chief Olu Falomo; Marketing Director RB West Africa, Oguzhan Silivrili and Chief Financial Officer RB West Africa Alasdair Peach; Deputy Country Director, Save the Children, Kwame S. Boate, Ph D, and Director of Advocacy and Media, Save the Children, Dr. David Olayemi.

Murgai said the RB’s global vision is to provide their consumers with innovative solutions for healthier lives and happier homes.
He said RB which has been operating in Nigeria for over 50 years is working to create a culture of health and hygiene, and is present in the country with its portfolio of trusted brands like Dettol, Nurofen, Strepsils, Gaviscon, Durex, Harpic, Mortein and Air Wick.

He said the company is not looking at Nigerian opportunity over short term but see a longer term potential and that Nigeria will remain the epicenter for African growth and plays an important strategic role in serving and developing other key markets in West Africa.

According to him, Dettol, a trusted brand name among Nigerian households and mothers has been partnering with Ministry of Health, Nigerian Medical Association, Save The Children and other NGOs to create awareness around good health and hygiene. The company has already reached 5 million mothers and 3.9 million school children over last 6 years to improve maternal health and reduced infant mortality in line with Nigeria commitments to the Sustainable Development Goals.

He said the interventions however need much greater participation and scale from other corporate organisations, NGOs and government, if they must build a truly healthier and prosperous nation.
We believe that the implementation of National Health Act, Rota-Virus and Wash Policy will all contribute to making Nigeria healthier, Murgai said.

The impact, according to the RB boss, is startling in human terms- as ‘one child dies every minute’ under the age of 5 from preventable diseases, specifically diarrhea.

He disclosed that RB would soon launch ‘Save a Child a Minute’ programme in partnership with Save The Children, and the pilot scheme will commence in Shomolu LGA where they plan to reduce prevalence and incidence of diarrhea by 50 percent and mortality by 80 percent.

“What makes the program ground-breaking is that for the first time, a holistic approach on the WHO Seven point plan is being implemented in Africa. The knowledge is being shared with the Federal government in anticipation of creating a national movement to fast scale the program,” Murgai added.

Speaking specifically on Dettol’s commitment to increase awareness around the importance of adopting healthy hand washing habits among children, Murgai revealed that the Dettol School Hygiene Programme (SHP), which was launched in 2009, has reached more than 3.9 million children since inception with various education materials and school visits to enlighten the pupils on the importance of personal hygiene.

“Every year Dettol reaches over 1million new moms in hospitals and 1million school children through hand washing programmes in schools to reduce infant deaths and improve maternal health through its Dettol grassroots hygiene programmes,” he said.
The joint interventions appear more crucial as the Water and Sanitation Programme Research reports that Nigeria loses N455bn annually which is 1.3 percent of the Nigeria’s GDP to poor sanitation and hygiene, a condition that increases the risk of disease and malnutrition.