Thursday, June 13, 2013

Why are they against Environmental health practice?

By Sani Garba Mohammed

Environmental Health remains at the periphery of sustainable development, because it is inadequately defined, rarely quantified, and institutionally fragmented. Failing to address environmental health amplifies the burden of diseases, which impinges on Sub-Saharan Africa's overall economic performance and wellbeing of the population especially the poor.

---James A Listorti et al
The dearth of Environmental health practitioners better known as Environmental Health Officers [EHO] in Nigeria is a great set back to the healthcare delivery which is making not only primary health care services off target, but equally other health services.
This is because "to a greater extent" said Aniefiok Moses, Journal of Environmental Health June 2006, "the development of environmental health in Nigeria has been retarded due to the dominant influence of the medical profession, which assumed superiority and erroneously annexed everything health into medical practice.....”

This strange marriage existed for so long that it was near impossible to established or convince anyone that Environmental health was a profession. Whereas, World Health Organization has recognized Environmental Health as a profession, it was totally impossible to say so among policy makers in the health sector in Nigeria, more so, even in Britain, where the development of Environmental Health started in 1877, it was not recognized and regarded as profession until 1956. Here in Nigeria it is in 2002 that environmental health was recognized as a profession by act no 11 of 2002.

In a country which has taken enthusiastically to the curative idea of modern medicine, it is difficult to genuinely emphasize the environment as the critical factor in health.
“Can the sanitary landfill or sewers be really as important as specialist hospital? Safety of food in the restaurant for instance, does not appear to get the same attention as the case of a food poisoning admitted to the intensive care unit of the hospital.

Nigeria is caught in a style of thinking largely in favour of generating more support for curative institutions and professionals for the fight against diseases in hospitals rather than prevent them in the environment. But we all know that, the environment exerts more profound effects on all stages of life than do the curative services which are not always promising.

“We all know that” said Dan Rikichi Kajang  “in the nineteenth century the major influences on personal health came when sewers and clean water supplies were established. In particular cholera and typhoid were prevented by sanitary measures, but public opinion and medical opinion were initially hostile to the environmental strategies. Yet these environmental engineering efforts did more for the cholera and typhoid than all the medical practitioners put together”.

The environment is diametrically attached to human health, illness and mortality. Some estimates put that 40% of world deaths are related to environment. Exposure to potentially hazardous agents such as microbes, toxic chemicals and metals, pesticides, and ionizing radiation, account for many form of environmentally related morbidity and mortality.

 But now that the profession is coming of age under the amiable and indefatigable Registar-Augustine Ebesike, and doing everything possible to place it in its appropriate domain in the scheme of national health issues, those feel threatened are fighting back and making sure all available channels are blocked so that the profession stagnate.
These saboteurs and co have been the one rendering the profession irrelevant in health interventions by hijacking most of its area of scope under them, by using all covert and overt means to frustrate its effort of retrieving its lost place in the scheme of health service in the nation.

At primary health care, which is the base of Nigeria health system, where 70% of environmental health services are, it has been downplayed in favour of curative health services. Also from federal ministry of health, National Primary Health Care Development Agency to the state own, environmental health services are given only superficial role, notwithstanding its central role in the delivery of all the other health services.
Because of their stance against proper environmental health practice, Nigeria could not tame its environment so as to reduce disease burden and make the environment safe for sustainable development and for future generation. Also, it is glaring that Nigeria could not likely achieve the Millennium Development Goals in key health areas-[under five mortality, maternal mortality and malaria prevalence] and environment [clean drinking water and sanitation].

It is an open secret that over 70% of Nigeria’s health problems are environmentally related, sadly, in spite of this glaring evidence and conviction that prevention is better than cure, they make sure greater emphasis is still being placed on curative health services, while simple and effective strategies like personal hygiene, food hygiene, and environmental sanitation are relegated to the background.

Those against or feel threaten of full environmental health practice feel that they may be render irrelevant, or the offices they are holding sway may be taken over, or the money they are making could be stop, are doing these for their selfish and pecuniary interest not for the development and progress of the nation health sector.
Globally, environmental health control is accepted as a major health component whether in public health or primary health care. If it is properly organized and implemented, it will improves longer survival, less disability, more efficient personal and social performance, and socio economic development. Why should Nigeria pay lip service to it in favour of costly and unpromising venture?

There is no valid reason[s] to be afraid of environmental health practice, for, the time has come for it recognition as inroad to public health intervention in Nigeria.

Environmental health practice is not a one man work; it is a multi-professional which includes the like of agriculturist, biochemists, disaster preparedness specialist, environmental biologist, toxicologist, environmental health officer, fire safety officers, geographers, hydro geologist, occupational health nurse, occupational health physician, sanitary engineer, etc. Therefore, environmental health must be planted on our national consciousness, discussed at major fora and placed on the national agenda,  this is the only way public health and safety can be guaranteed in this and the next generation.