By Victor Okeke
This year’s tail-end rains in Nigeria have been marked by devastating floods- at least 600 people have died and 1.3 million displaced from their homes. Heavy rains combined with poor urban planning have made parts of Nigeria more susceptible to flooding. Evidence has shown that women, the poor, and uneducated are most vulnerable to floods. Gender, poverty, and education are interrelated and they have indirect effects on vulnerability in flood disasters. Around the River Niger bridge which joins Lagos to Onitsha and the rest of eastern Nigeria, sizable portions of surrounding communities have been submerged under water, crippling economic activity for many small traders and farmers. The situation has been so dire that Sadiya Umar Farouq, Nigeria’s minister of humanitarian affairs, has asked five state governments to prepare to evacuate residents living along flood plains. In Anambra, one of those states, 76 people died trying to flee the flood after an escape boat capsized.
The last major flood emergency in Nigeria was between July and October in 2012, when the Niger and Benue rivers overflowed their banks. The reported death toll at the time was under 500, but it displaced a similar number of people as this year’s. But in addition to state governments failing to prepare early for seasonal floods, this year’s events have also been blamed on the release of excess water from Cameroon’s Lagdo dam in the middle of September. Nigeria does not have a buffer dam to prevent this flow though this need has existed since 1982 when the Lagdo dam was completed. From disease to healthcare disruption, flooding events affect people’s health through various direct and indirect ways. In fact, flood disasters result in five categories of health risks. In the most severe cases, it is drowning and trauma. People with chronic health conditions may not be able to access health services or take the medication they need. It also damages or disrupts healthcare infrastructure and systems. In other cases, affected persons may experience anxiety, depression and post-traumatic stress disorder. The displacement of people and overcrowding that often results from flooding provides optimal conditions for outbreaks of respiratory and gastrointestinal illness. Contributing factors in such settings include poor standards of hygiene, close contact among people, poor sanitation, poor nutrition, and poor food safety. People who come into direct contact with flood water (for example, by swimming or wading) that is contaminated with the urine of infected animals are at high risk of being infected. Symptoms include fever, headaches, muscle aches, chills, red eyes, abdominal pain, jaundice, vomiting, diarrhoea and sometimes a rash.
Malaria is caused by Plasmodium spp. parasites transmitted to humans through the bites of infected female Anophelesmosquitoes. Common symptoms include fever, sweats, cold shivers, headache, muscle or joint aches, malaise, loss of appetite, nausea and vomiting. Urgent diagnosis and treatment are important to prevent complications and death. Flooding can cause widespread damage to crops and livestock, affecting both the quantity and quality of food available. For instance, some big agricultural businesses are feeling the heat of the floods and that could increase food prices in the coming months. Olam Nigeria, which produces a quarter of Nigeria’s rice, says 10,000 acres of its farmland have been submerged, leading to a shortfall that could raise prices. Some have also lost livestock to diseases caused by the animals grazing on flooded fields and many have resorted to foraging for wild foods such as water lilies. Undernutrition or malnutrition remain major threats to health. Although it may not be as deadly, the emotional impact of losing one’s home, belongings or livelihood lingers long after the floodwaters recede. There’s also the economic stress associated with rebuilding, which adds to this psychological toll. Mental health problems in the aftermath of floods are often overlooked and are not as well studied as the immediate health impacts of flooding. According to research conducted in the UK in the aftermath of widespread flooding during the winter of 2013/14, the prevalence of depression, anxiety and post-traumatic stress disorder (PTSD) remained elevated for at least two years after exposure to flooding. “Our research suggests that support to deal with the extended damage to homes, sanitation and utilities caused by flooding might be needed to reduce mental health risks,” the authors wrote. As the flood water recedes, it is critical that the affected communities have access to safe drinking water. Uninterrupted safe water supply, safe wastewater disposal and solid waste handling are key to preventing large outbreaks of waterborne disease. Health education is an important preventive measure. Messaging should focus on safe water, hand hygiene, and food safety. Water can be made safe for drinking and cooking by boiling it for a minute in a clean container. Another way is to mix a teaspoon of household bleach (containing 5% chlorine) into 20-25 litres of water and leave it to stand for at least 30 minutes before use.
It’s important to wash hands with soap and safe water before, during, and after preparing food, and before and after eating. Also wash hands before and after caring for a sick person, after using the toilet and after cleaning up a child. There is a need to overcome households’ flood and health vulnerability through capacity building, training and sustainable mitigation efforts. At the governmental level, a comprehensive and realistic stakeholder analysis is needed to ensure the active involvement of all stakeholders, to generate their commitment and support and to identify what actions are most needed. Any actions to minimize household health risks will require an integrated, multi-sector, approach which would increase efficiency through pooling resources and skills.
Okeke writes from Centre for Social Justice (CSJ) Nigeria