Despite his tight schedule, Dr R. Ganiyu Jamiyu who is in faraway Republic of Togo on official assignment could find the time to grant an interview on public health concerns. The Chief Epidemiologist at the Federal Ministry of Health, Abuja, Nigeria, Dr. Jamiyu, also a Consultant Public Health Physician, squeezed out time because of his passion for soundness of health for the people.
A Public Health expert, Jamiyu brings his hands-on to bear while speaking with John Nwokocha, Editor, on the alarming situation of the Maiduguri floods.
Due to the recent flood disaster, vegetables from flooded areas are seriously contaminated with harmful substances, including sewage, dead, chemicals, and bacteria.
What should the public do at this point in time to stay alive in the face of epidemic threat? (Recall that the Borno State Government raised the alarm that dead bodies have mixed with vegetables in the event of the Maiduguri flood.
“Consuming these contaminated vegetables can lead to serious health risks, including waterborne diseases, food poisoning, and other health complications…
“To protect your health and safety, we urge you to avoid buying vegetables from flooded areas; only purchase vegetables from trusted sources and reputable markets; ensure that all vegetables are properly washed and cleaned before consumption.”)
Evacuate the dead bodies as soon as they are found and sensitize the general public on the need to cook the vegetables well before eating. Where there is obvious contamination by human remains, such vegetables should not be eaten but disposed of.
How can the government manage the situation to avoid it resulting in serious implications?
The crisis can be managed using the guiding principles of disaster management. At this stage especially response through evacuation of those affected to safe places (IDP camps or shelter). At the camps, Emergency Medical Team would need to be instituted to render emergency medical services. This also includes triage of those wounded and attending to patients based on seriousness of their conditions. Burying the dead after identification and if not possible tag them and take them to the morgue. Provision of food, portable water and institute WASH in the camps including mosquito nets and basic health services with provision for referrals to secondary or tertiary health facilities within or outside the states using the ambulance system. There will also be a need to strengthen the surveillance system so as to detect water related outbreaks such as Cholera and gastro-enteritis.
What is the cost of managing the crisis?
The cost of managing the situation will require conducting quick situation analysis/need analysis to identify the extent of problem/gaps (Quantitative, qualitative and observational). This will cover all the sectors including losses by citizens). From this, a quick costed work plan and implementation plan should be developed to address all identified problems and gaps.
Do you think the development can result in epidemic if urgent actions are not taken to manage it well?
If not probably managed, it can lead to epidemics as especially Cholera and other water related outbreaks (Acute gastro-enteritis, Enteric fever, upper respiratory tract infections, Scabies and other skin infections from water shortage.
Implementation of the development include the possibility of Cholera outbreak or gastroenteritis, hunger and malnutrition mostly among children, food insecurity, loss of income leading to increased poverty, damage of infrastructure which may affect electricity and water supply requiring limited resources to restore, increase morbidity and mortality from both communicable diseases and NCDs due limited access to healthcare services, more deaths, increased crime rates, worsen insecurity. Huge financial cost to the government for rehabilitation and recovery.
What should government do to forestall emergencies such as this?
What can be done to forestall emergencies include strengthening Emergency Prepared and Response in the State (Proper planning and preparedness including early warning and alert system, mitigation of possible risks through community engagement and participation as well as good maintenance culture, having a well-organized response team SEMA, SMOH, military and others), instituting a rehabilitative and resilience system for recovery from any emergencies.
Risk communication via media on the like hood of a possible outbreak and need to cook food stuffs and vegetables properly before eating. Also, sources of water especially underground need to boil before drinking. Government through the ministry of environment may help with chlorination of wells at ward levels as well as planned fumigation of the environment.
Does the country have the capacity to handle Public Health crisis arising from a disaster like this?
The country has the capacity to handle imminent public health challenges as evidenced by our success stories regarding our ability to curtail the Highly Pathogenic Avian Influenza, Ebola outbreaks and COVID-19 pandemic. The lessons from these have led to capacity building of many health workers on surveillance, IPC, case management, logistics, research; strengthening our laboratory networks in terms of capacity and ability; strengthening our integrated surveillance system at HFs and Point of Entry as well as Event-Based Surveillance (EBS). Our biggest strength is the ‘One Health’ approach for emergency preparedness and response, which means a multi-sectoral, multi-disciplinary coordinated and collaborative approach to responding to emergencies using the multi- hazard emergency response plan developed in-country.
What immediate actions would you recommend averting diseases spreading beyond Maiduguri?
Immediate actions to prevent diseases spread beyond Maiduguri include intensifying disease surveillance in all states including Event Based Surveillance, public awareness about symptoms and Signs of Cholera and other epidemic prone diseases and the need to visit health facilities or alert appropriate authorities at the state or NCDC using the 112 too free line. There is a need to carry out targeted fumigation. Provision of good water is very important as well as instituting WASH principles.
Did the country learn any lessons from the disaster?
The lessons from the Maiduguri flood include:
- Need to institute mitigation measures that involved the communities (proper drainage system, good urban planning, avoid indiscriminate dumping of waste in drainages, regular maintenance of government infrastructure like the damaged Alao dam, collapse prison wall)
- Strengthening the Early Warning and Alert System in the state and responding appropriately
- Regular capacity building for emergency responders (SEMA, SMOH etc ) on emergency readiness and response
- Proper risk communication on likely consequences of the flood and the appropriate measures to be taken by the citizens
- Provision of emergency equipment transport and ambulance for easy evacuation of victims such as boats, helicopter in addition to vehicles
- Provision of alternate water sources for drinking to affected population ( bottles water) or advise citizens to boil or chlorinate all water sources by providing water guards
- Provision of temporary shelter to victims as well as strict implementation of WASH
- Need to strengthen surveillance so as to pick early cases of Cholera and institute appropriate measures such as early referral to isolation centres for prompt treatment
- Mass vaccination of people’ in affected areas with Oral Cholera Vaccine
About Jamiyu: He has Masters in Public (Field Epidemiology) and Doctor of Medicine in Public Health, as well as a fellow of National Postgraduate Medical College Nigeria and West Africa College of Physicians. He has worked in different components of Nigeria National AIDS, Viral Hepatitis and STIs Control Programme (NASCP) such as Strategic Information; Quality Improvement (HIV-QUAL); Treatment, Care and Support; Infection Prevention and Control, and Programme Development and Administration.
While he was the Deputy Director-and Head of Viral Hepatitis Control Desk, he coordinated the development of Nigeria National Strategic Framework for Viral Hepatitis (2022-2026), the latest versions of the National Guidelines, Training Manual, Slides and SOPs on Viral Hepatitis Prevention. Also, Dr. Ganiyu Jamiyu has facilitated and participated in the conduct of national surveys on Viral Hepatitis, HIV/AIDS and routine immunization such as Routine Immunization Survey, first National Viral Hepatitis Survey, Integrated Bio-Behavioural Surveillance Survey (IBBSS) and HIV/AIDS Sero-Prevalence Survey, feasibility, acceptability and cost-effectiveness of Hepatitis C Virus-Self Testing (HCV-ST) in Nigeria and Hepatitis Elimination to Amplify Testing (HEAT).Since he assumed his current position as Chief Consultant Epidemiologist 7 months ago, he has initiated smooth collaboration among stakeholders on capacity and effective communication on emergency preparedness and response. Dr. Ganiyu Jamiyu has published a few journal articles and currently working on other manuscripts for publication. Dr. Ganiyu Jamiyu Deputy Director/Chief Consultant Epidemiologist Federal Ministry of Health, Nigeria.