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‘Cholera dealt with us like Boko Haram’

Binta Mohammed is an internally displaced person at the Muna Garage camp in Maiduguri, Borno State. She narrowly missed being added to the death statistics about a year ago, when cholera ravaged the camp and killed about 23 people within one week.

Although she is alive to tell her story, she mourns her unborn child who succumbed to the pressures of the deadly disease.

Still visibly tormented by the experience, the 24-year-old said, “It was a terrible period for me. I was sick to my bones. The fear of death was the same when they [Boko Haram] attacked our village, Marte [Borno State]. The same way I lost hope that I would escape their rain of bullets is the same way I lost hope of recovering from cholera. Then God healed me and was also there for us when we escaped from Marte. Cholera dealt with us without mercy like Boko Haram.

The story is no different in Balori, the biggest camp for no less than 35, 000 people displaced by the insurgency.

Mustapha Abdullahi from Bama, Borno State almost lost his life to the disease after he got infected in September 2017. 

“It started one night with severe stomach pains,” the father of five said. “I had never felt anything like it in my life. In no time, I started vomiting and stooling. Luckily, the ‘doctor’ was on the camp and was able to attend to me. But it took me almost one week to recover.”

While Binta and Mustapha count their blessings of survival, 140 others who had similar experiences as theirs, were not as lucky. They died from cholera.

Dr. Mukhtar Adeiza a Consultant Pulmunologist and Immunologist at the Ahmadu Bello University Teaching Hospital, Zaria explained that cholera is an infectious bacterial disease caused by consuming infected food and water supplies.

 

He said, “It causes severe diarrhoea, vomiting, dehydration and can be fatal if not treated early.” 

 

Responding to the menace

Nongovernmental organizations along with government agencies swung into action in response to the disease.

The Borno State Ministry of Health lead partners including World Health Organization (WHO), in the response to the outbreak in Muna Garage. They established a cholera treatment centre, increased risk communications and assessed the need for an oral cholera vaccination campaign in affected areas. 

A child recoverying from cholera. PHOTO by: MSF
A child recoverying from cholera. PHOTO by: MSF

Médecins Sans Frontières (MSF) set up an oral rehydration point in Muna Garage camp and an initial 40-bed cholera treatment centre in Dala community, with patients coming mostly from Muna Garage. They also set up rehydration points in places where new cases were being reported and trained state health workers and those of the WHO in prevention and control methods.

To curb the spread of the disease in Balori, the IDPs now treat their water source with chlorine.

Ahmed Ali a primary health worker said, “A few of us were trained by the Rural Water Supply & Sanitation Agency, on the process of using the chlorine and applying it to the water. But we decided to designate one person to be responsible for it.”

According to the WHO, “Borno State has reported 26 new cases with zero deaths between 25 June and 1 July 2018.”

 

Cholera gone, but still more worries

While cholera fatalities have been curbed in the camps, diarrhoea has become the new threat for the IDPs.

Ahmed who is referred to as the ‘doctor,’ on camp, said, “At some point we discovered that our water was infected and people were falling ill. They complained of stomach pains and watery stool. We were not sure if it was cholera again or something else.

“It started first with one child but in time, I was treating thirteen children. The spread was quite fast to other children and even their adult caregivers. We were dealing with gastroenteritis, vomiting and diarrhea.”

The treatment ward for these cases, were two mats on the bare un-cemented floor on which two women – Maryam and Zulaihatu- oblivious to the flies and filth around them, calmly laid down as they were administered saline fluid. They shared the room with a one foot high refuse bin oozing a pungent odour with discarded bandages, syringes and other such items sprawling around.

Ahmed, anticipating the reaction of our reporter upon inhaling a whiff of the pungent odour oozing from the dustbin, said, “My sister, this is where we are especially when the cases come in at night. The other facilities on the camp are usually closed so this is where their families bring them.”

With the coming of the rains and worry over the spread of the disease, they fear that the facility will be further stretched and grossly inadequate to cater to their needs. 

Maryam and Zulaihatu being treated in a room they share with the one foot high refuse bin on the right.
The main water source for IDPs in Balori now treated with chlorine.

While Binta and Mustapha praise the response they got and the fact that most of it came free of charge, Maryam and Zulaihatu don’t feel so lucky. They each had had to pay about N5,000 for their treatment from out of pocket and were expecting that there would be more charges for the medicines they would require to ensure their health were fully restored. This was money they had mostly received from goodwill of visitors to the camp.

To cater to the needs of internally displaced people and avert out of pocket payment for treatment, the Nigerian Ministry of Health had in 2016 began plans to register 480 IDPs as part of the first phase of the National Health Insurance Scheme (NHIS) for them.

The acting federal commissioner of the National Commission for Refugees, Migrants and Internally Displaced (NCFRMI), Margarette Essie, had told journalists during the flag off of the scheme at the Sabon Kuchingoro IDP camp, in Abuja, that the initiative was in line with the government’s resolve to integrate them into the society.

So far, no IDP in the Sabon Kuchigoro or Gongola camps which are of the biggest in Nigeria’s capital, are have yet to benefit from the scheme. Calls, messages and attempts to reach the NHIS on the matter were unsuccessful. 

Offiong is a 2018 HSG Media fellow.

This story was done with support from Code for Africa. 

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