Where are our sanitary inspectors?

BY GREG ODUGWU

SEPTEMBER 26, 2013 

Because of obvious reasons informed by its mode of operation, many people in Abuja do not recognize the Abuja Environmental Protection Board as the environmental watchdog of the Federal Capital Territory; rather, the impression many residents and visitors have is that this environmental outfit is just a disguised “local police” for the FCT. These dark-shirt-and-peak cap boys would rather arrest a lady who, by her manner of dressing – or gait, resembles a commercial sex worker, than pick up a waste bin that has blocked a gutter in a residential area. They are ready to chase hawkers, itinerant artisans, and other hapless petty traders into any bush in town, and overzealously apprehend them, than chase an eco-hazardous vehicle or a carbon emitting truck. An Abuja resident once described them as “policemen without boots”, because some of them wear bathroom slippers to engage the so-called “Abuja vagabonds”.

This was why I was taken aback when I read in the media, during the recent Lassa fever epidemic, that the AEPB had introduced sanitary measures to ensure that residents of the FCT would not fall victim of the virus that was transmitted by hairless tailed bush rats that abound in the country. It was sad to read that 40 lives including some medical personnel had been lost to the disease with over 400 others infected this year alone. Although Abuja was not among the 12 states of Edo, Taraba, Borno, Gombe, Yobe, Plateau, Nasarawa, Ebonyi, Ondo, Rivers, Anambra and Lagos, which harboured the acute viral disease which was first discovered in 1969 in Lassa Town in Borno State, the nation’s capital city needed to be quickly hemmed in by preventive measures against the outbreak.

The AEPB’s sanitary measures include the re-introduction of sanitary inspectors to carry out a citywide house-to-house inspection of premises to ensure that residents applied environmental health practices. According to the Assistant Director, Environmental Health and Safety of the AEPB, Kate Ogbonna, residents are advised to keep their homes and environments clean including their kitchen, pantries, cooking utensils and others. The campaign also kicks against rearing of animals, birds and fish within residential premises. It also stops the parking of abandoned cars and other household property, and enforces the clearing of blocked drainage and stagnant water within and around residential apartment in the territory. It was learnt that the sanitary inspectors commenced work immediately on February 25 and were moving from house to house to inspect and also serve defaulters with notice to comply with safety and cleanliness rules and regulations, failure of which they would be charged to court.

For Abuja to wake up from a deep environmental slumber and start doing what needed to be done, means that, perhaps, the Lassa fever outbreak has finally sounded the clarion call that this is the time for Nigeria to wake up to the reality that the direct consequence of poor environmental sanitation is high morbidity and mortality rates due to sanitation-related diseases like cholera, diarrhoea, dysentery and typhoid. The wise adage says, “A stitch in time saves nine” or, more colloquially, prevention is better than cure; but we live in a country where the government and the people’s body language says “cure is better than prevention”.

I wonder what made us forget where we are coming from as a country. Some of the best aspects of governance like sanitary inspection which used to be standard practice before, have been discarded, and now it is manifest that we are paying dearly for it. Can we count how many times we hear of individuals and families dropping dead after having a particular meal? Could it be that some of these incidents were just cases of contamination due to widespread poor environmental health situation in the country today? Those that lived in the colonial and post-colonial periods in Nigeria knew them as “Wole-Wole” among the Yoruba, “Nwa ole-ala” among the Igbo, and “Duba-Geri” in the Hausa-speaking parts of the country. They were the dreaded, respected and, yes, obeyed government workers in Nigeria who took preventive health to an enviable height.

It is interesting that the AEPB used the old nomenclature, instead of calling them Environmental Health Officers as is the modern practice. I therefore pray that the aura of service shall descend on these workers today as it was in the past, so that they will achieve a lot. Nigeria needs them today more than ever before. This is because as the adverse effects of climate change is visiting developing countries, the adaptation strategies must include environmental health. Sadly, in Nigeria today, the position of environmental health officers in Primary Health Care has been hijacked by medical health practitioners (most especially medical doctors) and it is not supposed to be so. The truth is that doctors have professional orientation that centres wholly on curative health, and not preventive health – the guiding practice of environmental health.

Environmental health officers, also known as public health inspectors, the world over have standard duties which include protection of water sources, waste water treatment, waste management, vector and pest control, prevention and control of land, air and water pollution, food hygiene and safety. Others are air quality management, occupational noise management, occupational health and safety, accommodation establishment, port health duties, accident prevention, environmental health aspect of public recreation and tourism, etc. In more developed countries, sanitary inspectors are actually the people who review the floor plans of new buildings and give approval for builders. Could it be that the absence of these officers is a fundamental contributor to the ubiquitous cases of building collapse in Nigeria in recent times?

Our government needs to sit up. Health delivery is not only about cure and care. There are a lot of diseases that are environmentally preventable. And there are a lot of environmental indices that set the template for the inevitable breeding of vectors, and then subsequent outbreak of epidemics, just as witnessed in the case of Lassa fever. Now is the time to be wholistic in planning for the safety of the Nigerian masses, rather than wait for emergencies. Let us take a look at the Roll Back Malaria programme for instance. There are four intervention strategies: Early diagnosis and prompt treatment; Use of insecticides treated bed nets and mosquito control; provision of malaria treatment for pregnant women to reduce impact of malaria infection on their health, and on the health and development of their children; and prevention and responses to epidemics. But the situation is that the last strategy is downplayed in favour of the first three; ironically, prevention and response to epidemic is the one Nigeria needs more to stem the tide of malaria permanently and this is where environmental health management is required.

What is more, the government needs to make it mandatory for all institutions to make provision for the office of environmental health officers. At the moment, many Federal Medical Centres, federal hospitals, state hospitals and other health institutions and ministries do not have such essential office. I believe that when the government fills this yawning gap, the nation’s institutions of higher learning will create courses and degrees for environmental health management where these officers will be trained, just as it is the practice in advanced nations. In Nigeria, there is a paucity of platforms for certification and capacity building for public health inspectors at the moment. Should the situation remain unchanged, even the brand new Abuja sanitary officers after a while will go back to chasing commercial sex workers and hawkers, and this too will become a chapter in our notorious national storybook aptly titled: “One step forward, two steps backwards”.