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Drinking themselves full of diseases

Investigation reveals FCT community’s water source has 6,000 bacteria colonies per litre

River Eku is the most reliable water source in Paikon Kore. The women and children who visit it are unwittingly exposed to the third deadliest disease in the world as the river is home to 6,000 bacteria colonies per litre of water. The river also contains faecal matter and other waste but in this FCT community, it is the only source of life laden with instruments of death.

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Jummai Iliya, 26, was with her two daughters at the bank of River Eku doing laundry and washing utensils, after which they would take a bath in the river. Further down, her five-year-old son, Majid, was splashing in the river and drinking the water. What Majid did not know was that a few meters away, a woman was squatting in the river to defecate, lumps of excreta carried downstream towards him.

“Majid, you will eat shit! Get out quickly,” one of his sisters cried.

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Majid might have escaped this woman’s shit, but there is no telling how much more he had already ingested. In reality there is hardly any escape for Majid and the 10, 000 other people of Paikon Kore, in Gwagwalada Area Council of the Federal Capital Territory who rely on River Eku as the only water source in the community.

“I don’t know how we would have managed in this community but for this river,” Jummai, said. “We have boreholes in Paikon, but only one is reliable and even that one is pumped only once a day, at the most twice.”

While they count and enjoy the blessings of the river, they are oblivious to the dangers they are exposed to through frequent contact with it.

Layered within this river are health threats, some of which are bloody diarrhoea, intestinal cramps, acidosis, malaria and the deadly neglected tropical disease – schistosomiasis – the third deadliest tropical disease behind only malaria and intestinal helminthiasis. Schistosomiasis is a major source of morbidity and mortality for countries in Africa.

River Eku, alluringly dangerous

Brownish green, River Eku sluggishly flows past Paikon Kore to four other communities, carrying cow dung and human waste, exuding a repulsive stench that visitors will find disturbing.  But for the inhabitants, they are used to this, or perhaps because they have no other choice, they don’t mind as the women do their laundry and dishes in the river. Or as most of the adults said, “God is the one who protects.” Beside them, their children splash happily in the river. This is also the same water they drink and use for domestic purposes.

A cross-sectional study on 385 randomly selected participants from the community about their knowledge and practice towards Urinary Schistosomiasis was conducted by Rabi Adelaiye and Mustapha Jamda of the School of Medicine University of Abuja Teaching hospital.

“Despite some level of knowledge of urinary schistosomiasis, poor attitudes and practices that enhanced transmission of the disease were widespread. Thus, there is need to provide alternatives to the stream if the community is to be kept away from potential source of infection,” the study showed.

According to the World Health Organisation Nigeria has the greatest number of cases of this second most socioeconomically devastating parasitic disease, after malaria.

Mr. Michael Ayeni, certified by the Institute of Public Analysis of Nigeria (IPAN) is a laboratory analyst and Head of Lab at the Waste Water Management department of the Abuja Environmental Protection Board. He analysed the chemical, physical, microbiological characteristics of the water sample from River Eku from March 9 to 26, 2018.

He did so against the standard for surface water as prescribed by the WHO, the African Forum for Utilisation and Regulation (AFUR) and the Standard Organisation of Nigeria (SON) in 2007.

Safe and Unsafe Levels

Ayeni said, “The pH is 7.04 which is within the permissible level of 6.5 to 8.5. The ambient temperature as at the time the sample was brought was okay.

“The total coliform colony permissible  must not be more than 100 per litre, but the analysis of the result shows that it is 6,000 colony forming unit per litre. This is extremely high.”

The standard for faecal coliform in water purposed for use as it is in Paikon Kore, is nil. But the water sample analysis revealed that it is greater than 1,600 per 100ml of water.

The analysis showed that there are 3,000 colony forming units of E.coli per litre  as against the standard of nil.

It also showed three schistosoma haematobium larvae – the major agent of schistosomiasis – per 100ml of water.

Ayeni commented that, “The analysis result of the parameters analysed shows clearly that the river where this sample was collected is heavily polluted with faecal matter.”

Sick of schistosomiasis

For three years, Sadiya Mali, 20, after first noticing blood in her urine self-medicated without seeing any improvements. It was the increasing severity of her abdominal pain that forced her to go hospital.

The expectant mother said, against the doctor’s advice, upon tracing her illness to River Eku, she can’t stop. “We don’t have water in our community. That’s where we all go.

“I take the medicines he prescribed. The bleeding has stopped but I’m still afraid because he warned me that if I continued going to the river, it would return.”

Ten-year-old Mariam Musa for as long as she remembers has always seen blood in her urine. “My parents have given me medicines, which I took twice daily.

“We all play in the river and some of us see blood in our urine,” she and her brothers chorused, big smiles on their faces.

Around and About Paikon Kore

Head of the community, Alhaji Yusuf Barawa complained that the community’s primary health centre doesn’t function optimally.

He said, “Although the staff at the centre try their best, there are no medicines. We usually have to go out to buy.”

Where as Saidu Nda who runs the PHC insisted that the community didn’t have any water problem and there were enough boreholes catering to its needs, the reality is an outright contradiction.

There are four overhead water tanks and no less than 11 taps but there is hardly any water running out of them with weary villagers lining with buckets and containers hoping they will flow with water.

Mr. Abu Shanabo a member of the community who conducted our reporter around said, the one tap that works is one of the least used because it is close to road and far away from the heart of the community.

He said, most women found it easier to go down to the river instead. The most centrally located overhead tank is the one that works. There were containers beneath it where villagers were waiting for it to be pumped. It is the only one constructed by the area council that works.

In the 2017 FCT budget for water supply, “The Water Treatment Plant at the Lower Usman Dam (LUD) is completed and has the capacity to supply 30 million cubic metres of water to FCT residents. The only water project approved for the sum of N1,920,000,000 was  to fund ongoing water projects within the metropolis and satellite towns of which Paikon Kore is one.

But in the community and its neighbours who depend on the same water source, there were only two overhead tanks were constructed with only one currently working.

WaterAid Nigeria, a not-for-profit organisation recently called for a state of emergency to be declared in the water and sanitation sector and a presidential taskforce set up and empowered to deliver on providing water and sanitation for all Nigerians.

Diseases, terminal illnesses lurking

Dr. Mukhtar Adeiza, a Senior lecturer and Consultant Physician, Infectious Disease Unit of the Ahmadu Bello University Teaching Hospital. Zaria  explained the health implications of the disease.

He said, “The coliform or E.coli content in the water which shouldn’t be there in the first place is a measure of how safe it is for that community. The higher the content the more the contamination, and the more at risk they are to waterborne infectious diseases. There is what we call diarrhea diseases or acute watery diarrhea.

“The watery diarrhea is what called gastroenteritis. The one that comes with blood and mucus is what we call dysentery. If people drink this water,  get infected and defecate into the water, the cycle continues. The transmission is water-borne and they could get sick by drinking it.

“Schistosomiasis (bilharziasis) – a trematode infection is also acquired from the water usually when the motile cercariae burrow into the skin when it comes in contact with fresh water habitat infested with snails which are the secondary hosts.”

The initial symptom is called swimmers itch. Other symptoms include haematobium or urinary schstosomiasis which presents with blood in urine and the other is S. mansoni which presents with bloody diarrhea.

Adeiza said, “Katayama fever can occur after a few weeks but on the long run after so many years they can develop what we call hepatosplenic schistosomiasis where they develop liver fibrosis and portal hypertension. It can also cause bladder fibrosis and some kind of bladder cancer or upper urinary tract obstruction and kidney damage.”

Schistosomiasis could worsen anemia in pregnancy and in children it is a cause of malnutrition and stunting of the child’s growth.

He explained that, “For the acute diahrreal disease, the treatment is very cheap, available and affordable with oral rehydration solution. It is one of the most affordable remedies. In some cases where you have fever with mucus and blood in stools, you may add a short course of antibiotics.”

The treatment of schstosomiasis is chemotherapy with medication.

In prevention of waterborne diseases, Adeiza advises that, “the most important thing is to reduce contamination of the water they use. Some may be ill and not know they are ill. These asymptomatic carriers are a danger to the danger in Public Health. It is the asympstomatic people that actually carry the infection. So health education and sanitation are very, very important to reduce water contamination. The water can be boiled and filtered.

“The other thing they can do for schistosomiasis is to break the transmission by interrupting the life cycle of the pararsite at different stages and the options available involve – avoiding contact with parasite and snail infested or wearing protective gear for occupations related to water. Drugs or chemicals called moliuscicides can also be used to destroy the snails.

“For acute diarrhoeal diseases, prevention of potable drinking water can control outbreaks.”

Majid stands on the river bank, disgusted by the obvious bullet he had just dodged. In reality it is only a temporary relief. In Paikon Kore, the River Eku is life – a life that comes bearing poison, and if nothing happens, it will eventually catch up with Majid, as it has done already with so many people in this forsaken place.

The story was done with support from Code for Africa.


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