Hadiza Mohammed and Onyinye Oranezi (Lead Writers)
It is generally accepted that water is life, yet basic access to water resources, especially in rural communities is a luxury. Water scarcity means poor access to water for drinking and basic hygiene practices such as hand washing, which may lead to disease outbreaks. Currently, many sections of Nigeria, particularly Kano, Sokoto and Zamfara in the northwest region and Gombe in the northeast are facing limited access to potable water which has become a significant challenge.
Most of the time, water shortage is attributed to vandalised infrastructure, conflict, and climate change, which has resulted in droughts and desertification. On Monday, May 5th 2024, the global community observed World Hand Hygiene Day to raise awareness about the importance of knowledge and learning about hand hygiene to prevent infectious diseases.
Impact on health systems
Lack of access to water and sanitation has severe consequences on the spread of waterborne diseases such as cholera, typhoid, and diarrhoea. According to the World Health Organisation (WHO), contaminated drinking water is estimated to cause approximately 505,000 diarrhoeal deaths each year.
In April 2024, the Nigeria Centre for Disease Control and Prevention (NCDC) reported an outbreak of an unknown illness in Sokoto, Kaduna and Zamfara states. As of 18th April 2024, 196 suspected cases have been reported presenting symptoms of fever, abdominal swelling and pain, vomiting, and weight loss. Although the source of this outbreak is yet to be confirmed, contaminated water is often a source of outbreaks, especially in areas where water quality and sanitation infrastructure may be inadequate.
Aside from the risks of waterborne illnesses, water shortage can lead to severe dehydration, particularly in northern Nigeria, where extreme heatwaves are becoming increasingly common. This may lead to heat exhaustion, cardiovascular diseases, and skin defects.
Health workers also bear one of the biggest burdens of poor water supply, which undermines hand hygiene practices among healthcare providers, increases the risk of Healthcare-Associated Infections (HAIs) in hospitals and clinics, and jeopardises patients’ safety. This is made worse when an outbreak occurs, as the demand for stringent sanitation and infection control measures intensifies, putting additional pressure on already strained water resources and healthcare infrastructure.
According to a study, infections acquired from unhygienic health facilities are a leading cause of morbidity and mortality among hospitalised patients in Nigeria, resulting in longer hospital stays and increased healthcare costs. The study also found a high overall frequency of HAIs (20.2%), with surgical site infections, urinary tract infections, and bloodstream infections being the most common types.
Climate change as a catalyst
While Nigeria’s progress toward attaining Sustainable Development Goal SDG 6, clean water and sanitation is often viewed as a goal that can be achieved through the provision of adequate WASH infrastructure, such as boreholes and water pumps, the impact of climate cannot be overlooked. Climate shocks such as droughts, desert encroachment, and floods contribute significantly to the depletion of water sources and compromises water quality, even when access is available.
To achieve the dual goals of universal access to clean water and improved hand hygiene, climate change must be considered and addressed. Government authorities and relevant stakeholders may develop a water conservation resource while investing in water shortage solutions such as reservoirs, and water recycling facilities. In line with the current administration’s National Health Strategic Implementation Plan II (NHSRII), which emphasises the importance of an efficient, equitable, and quality health system, it’s imperative to approach health promotion, including hand hygiene, through a multi-sectoral lens. Without addressing underlying issues like water shortages in Nigerian communities, the sustainability of hand hygiene practices can be compromised, undermining broader health initiatives.
Although the purpose of this year’s World Hand Hygiene Day is to promote awareness about the importance of hand hygiene, it is also important to remember that to ensure that the practice of hand hygiene is maintained, there needs to be an adequate supply of basic water resources.