Environmental Health in Nigeria and the way forward

By Abiodun  Peter Bamigboye [Now late]

Introduction

Environmental factors play an important role in health and disease among the population of particular concern are young children and other high risk population group. Scientists have long worked to understand the environmental and humanity’s place in it. The search for this knowledge grows in importance as rapid increase in human populations and economic development intensify the stresses human beings place on the biosphere and ecosystems. People want to be warned of major environmental changes and, if the environment is under threat, want to know how to respond. Fortunately, rapid increases in scientific capability-such as recent advances in computing power and molecular biology and new techniques for sensing biological, physical, and chemical phenomena below, on, and above the Earth’s surface – together with the rediscovery that the human-environment relationship is a critical topic for the human sciences, are making it possible for science to provide much of this knowledge. The scientific excitement and challenge of understanding the complex environmental systems humans depend on, making the environmental sciences centrally important as humankind attempts a transition to a more sustainable relationship with the Earth and its natural resources.

The influence of the environment on health are varied and complex. Diarrhea, caused by unsafe water, inadequate sanitation and poor hygiene, accounts for 15 to 18 percent of child deaths annually. Malaria is responsible for 2.5 million deaths each year, mostly among young children. Acute lower respiratory infections (ART), mainly pneumonia – which has been closely associated with exposure to indoor smoke from cooking with biomass fuels, are the leading cause of death for children under five years of age.

A great deal of the underlying causes of disease, injury, and death in developing countries lie beyond the purview of the health care system. They cover a range of physical factors (inadequate sanitation, water, drainage, waste removal, housing, and household energy) and behavioral factors (personal hygiene, sexual behavior, driving habits, alcoholism, and tobacco smoking). Many of these environment- and occupation-related health problems turn into public health problems when they become widespread, a factor aggravated by inadequate public health infrastructure. Yet, policies in the sectors responsible for these negative health impacts are often not based on health criteria. The health sector itself tends to focus its interventions within the health care delivery system, not necessarily in other sectors that are the source of the problem^2,3. Similarly naturally occurring ecological factors that can exert negative impacts on all sectors (mosquito-borne diseases, arsenic in the water, floods, droughts, and so on) are seldom addressed systematically by any of the sectors at risk, even though some sectors may be exacerbating their effects (spreading mosquito habitats, consuming great quantities of water, or producing greenhouse gases that may worsen climate change). As a result, the enormity of health benefits possible through interventions outside the health sector is not being tapped. Environmental Health interventions are one of the important of those neglected areas.

The subject of Environmental Health (EH) is undoubtedly one that has generated a lot of debates both locally and internationally. It is a sector or sub-sector that is largely talked about but receiving little or no attention in many places particularly in developing countries of the world. The WHO’s concept of health brought in focus the ecological as well as the sociological paradigms of health with a view to holistically addressing issues relating to health and wellbeing. If health is seen not just as the absence of disease but also as a central goal of human development, then the protection of the environment and the protection and improvement of health are mutually supportive. It is against this background of increasing international focus on environmental sanitation, that the Committee on Environmental Sanitation was established by the first World Health Assembly in l948. The Committee’s first, groundbreaking report, published in 1949, concluded that physical development, health and survival, depended on the management of environmental factors which included excreta and community waste disposal; safe drinking water; food safety; healthy personal habits; understanding the causes of diseases; and, the control of disease vectors. It was decided to focus action on the reduction of infectious diseases by monitoring how they respond to environmental management, and that the lessons learned in public health engineering from the sanitary revolution in Europe and the Americas would be of particular value. Changes from old patterns of life were an essential precondition for the achievement of better environmental health. The historical account of the contribution of EH in 19th and 20th Century United Kingdom in ensuring good health and its adoption by the WHO as a fundamental approach to addressing global health situation underscores the relevance of this sub-sector.

During the 1 990s, a series of reports from think tank agencies, the World Health Organization (WHO), and the Centers for Disease Control and Prevention (CDC) rated environmental concerns among the most important health issues and global threats. They also ranked environmental public health and sanitation accomplishments among public health’s greatest accomplishments. The 30-year increase in life expectancy to 76.7 years from 1900 to 1998 has been attributed to environmental public health monitoring and regulation of the water supply, sewage systems, and food quality, as well as to immunizations and primary preventive care. As a result of proper sanitation, more than 80% of human disease has been eliminated The strong tradition of environmental public health and sanitary services was maintained through the middle 1 960s, when new environmental problems gathered attention: globalization of the food supply; contamination of drinking water; air and noise pollution; ionizing radiation; proliferation of solid and hazardous waste, disease vectors, and wastewater; and degradation of housing, institutional services, and environmental conditions in child-care facilities.

What is EH?

Environmental Health has been defined as the science which study the biological, chemical or physical agents introduced into the environment or occurring naturally and their effects on human health and ecological systems. The field also includes the study of human activities, a vital component in our complex ecosystem 6 (UGA, 2005). In another sense, ER is understood as the science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. Toxicology and occupational health are also included in this category.

Environmental health as used by the WHO Regional Office for Europe, includes both the direct pathological effects of chemicals, radiation and some biological agents, and the effects (often indirect) on health and wellbeing of the broad physical, psychological, social and aesthetic environment which includes housing, urban development, land use and transport. In general term, EH comprises those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations. It would be seen from the foregoing that the scope of this field is wide and varied. These areas in which EH should focus include but may not be limited to those in table 1 below.

Table 1: Typical Responsibilities of Environmental Health and Protection Programs

• Ambient air quality
• Indoor air quality
• Water pollution control
• Safe drinking water
• Noise pollution
• Radiation
• Food safety
• Industrial hygiene
• Childhood lead poisoning
• Acid deposition
• Disaster planning and response
• Cross-connection elimination
• Healthy housing
• Institutional environmental control
• Recreational area environmental control
• Solid waste management
• Vector control
• Pesticide control
• Toxic chemical control
• On-site liquid waste disposal
• Unintentional injury control
• Bioterrorism
• Global environmental issues.

These services are provided by various cadres of trained personnel generally referred to as environmental health personnel who serve the general welfare by safeguarding and improving the quality of food, shelter, air, water and other natural resources. The role of EH in health and disease cannot be underestimated. One is quick to refer to the great sanitary reforms which follows the historic cholera outbreak in UK and the various feat achieved in the control and/eradication of some other diseases. The contributions of EH to the global burden of disease is also very significant (see table 2 below).

Table 2: Environmental Factors and the Global Burden of Disease: Proportion of Global DALYs Associated with Environmental Exposures (1990)

Diseases	Global DALYs 1000)	% attributable to envtal. factors	Envtal DALYs (1000)	% of all DALYs (all age group)
ARI	116,696	60	70,017	5.0
Diarrheal diseases	99,631	90	89,670	6.5
Vaccine preventable infections	71,173	10	9,117	0.5
T.B	38,426	10	3,843	0.3
Malaria	31,706	90	28,535	2.1
Injuries Unintended	152,188	30	45,656
Intended	56,459	NE*	NE	3.3
Mental health	144,950	10	14,495	1.1
Cardio vascular disease	133,236	10	13,324	1.0
Cancer	70,513	25	17,628	1.3
Chronic respiratory diseases	60,370	50	30,189	2.2
Total these diseases	975,350	33	320,470	23.0
Other diseases	403,858	NE	NE
Total all diseases	1,379,238	23	320,470

Source: WHO (1999). NE-Not Estimated

Failure to address peculiar EH problems has very grievous and economic implications with serious development implications. For instance, it is one record that the global neglect of EH sub-sector has the following development implications:

• 2.4 billion people lack access to basic sanitation
• 2 million people die every year from diarrheal diseases (including cholera) associated with inadequate water supply, sanitation and hygiene
• The majority are children in developing countries
• Water, hygiene and sanitation interventions reduce diarrhea incidence by 26% and mortality by 65%
• 200 million people, in 74 countries, are infected with schistosomiasis and soil-transmitted helminthes and 20 million suffer severe consequences
• Basic sanitation reduces schistosomiasis by up to 77%
• 500 million people are at risk from trachoma and 146 million are threatened by blindness
• Trachoma can be prevented by improving sanitary conditions and hygiene practices.

The need to reverse this ugly trend became necessary globally and WHO had many years ago realized this necessity. To spearhead these changes WHO was asked to develop/refine international sanitary standards and guidelines for national health services to involve them in priority environmental health programs, and to educate the public. Specifically the organization undertook to:

• Link environmental sanitation with other health-related activities
• Cooperate with other UN bodies
• Undertake demonstration projects, especially for rural sanitation
• Promote research and disseminate information
• Cooperate with governments in strengthening national health services in environmental matters, and develop human resources.

Since its inception in 1948, WHO has had to define how it would pursue the achievement of “The improvement of EH as called for in Article 2(1) of the Constitution. “The First World Health Assembly gave environmental sanitation the same priority as malaria, maternal and child health, tuberculosis, veneral diseases and nutrition and these priorities became known as ‘the big six’. It is a known fact that while some most developed countries have accorded such priority to EH, many of the countries in the South had not.

WHO has always maintained that EH and particularly sanitation is literally the foundation on which a sound public health structure must be built. The organization has also maintained that over 75% of all communicable diseases affecting humans are environmentally related. Over the last 50 years WHO has generated, evaluated and Shared new knowledge on safe disposal of excreta, sewage and community waste and has also been at the forefront of exploring the linkages between environmental pollution and change, and people’s health and livelihoods. There is no doubt that people, especially poor people living in countries where basic infrastructure is lacking, are seriously affected by environmental degradation. In addition, the ongoing and deteriorating situation of sewage causing environmental pollution needs urgent and serious attention.

The Millennium Development Goals (MDGs), adopted at the Millennium Summit of the United Nations in September 2000, call for a dramatic reduction in poverty and marked improvement in health h of t he poor. Access to safe water and sanitation is fundamental for better health, poverty alleviation and development; and improving water and sanitation services has been recognized as a crucially important strategy towards meeting the MDGs . Such an achievement is feasible, but given the scale of the problem, especially for sanitation facilities, far from assured.

Experience shows that while the importance of sanitation is recognized, progress is lagging far behind compared to the provision of safe water. The toll on human health is high, resulting in about 2 million deaths per year from diarrheal diseases and approximately 2 billion people infected with schistosommiasis and soil-transmitted helminth infections globally. A host of other diseases are related to poor disposal of human excreta, poorly constructed or managed latrines, and poor solid waste management and drainage. If the toll on human health and human life of all of these sanitation-related conditions could be effectively added up, it would truly reveal a tragedy of grave proportions. Therefore something has to he done.

The Challenges EH

Efforts at improving El-I services must address specific problems and challenges so as to accelerate service delivery for greater effectiveness. Globally, EH challenges operate within the context of the following issues

• Increasing urbanization

• Ageing physical infrastructure coupled with lack of preventive maintenance

• Sharpening inequalities, polarization of society and choices

• Decaying family and community fabric

• An ageing population

• Increasing stress

• Centralization of decision making and power – but local nationalism

• Extremism/fundamentalism/terrorism

• Environmental degradation

• Diminishing natural resources

• Need for sustainable environments and sustainable lifestyles

These challenges are also manifesting in an environment whereby specific issues likely to hinder effectiveness arc apparent. These constitute serious threat to El I services in many places in the world. As a matter of fact, predictions for specific future of EH services should bear in mind:

• Emerging & re-emerging pathogens

• Resistant and virulent strains

• Bio-terrorism

• Global warming – related health problems & natural disasters

• Population movements

• Water shortages. & related conflicts

• Energy shortages

• Infrastructure failures

• Social polarization

• Globalization of markets and products

• Greater awareness of Genetic susceptibility of individuals and groups

• Improved toxicological techniques

• Better informed public; class actions

In Nigeria, efforts directed at improving EH services are challenged by the following factors:

1. Weak Governmental policy and legislations.

Many people had argued that policies are non-existent but the fact is that no nation exists without one form of policy or the other. Policies directed towards improving EH services in Nigeria are weak and ineffective. There also seem to be some constitutional defects in the role definition as regards responsibility for ER matters. While it is generally believed that ER services are largely the responsibility of LGAs. It is a known fact that LGAs as presently constituted, financed and managed would be unable to ensure a healthy environment. The need for a reappraisal may be necessary. The National Policy of Environmental Sanitation championed by the Federal Ministry of Environment is a right step towards addressing this problem. However, its implementation must be devoid of sentiments, and unnecessary bureaucracies.

In addition to this is the fact that most EN legislations are either obsolete, inconsistent or had failed to take cognisance of the cultural settings in which they are supposed to operate. The need for suitable legislations to address specific EH issues is urgent.

2. High level of ignorance.

To a large extent, many people including many of those expected to provide EH services have not fully appreciate the significance of the environmental dimensions of health and the correct issues involved. Specifically many people particularly mothers have not fully understood the link between personal/public hygiene, health and disease as well as the ways to break the link. In addition to these, many policy makers and professionals still hold on to the restrictive bio-medical approach to health and disease.

Where knowledge is low, incomplete or incorrect, there is the tendency that people’s ability to make informed decision about their health would be limited and their exposure to risks aggravated.

3. Poor political will and commitment.

In many places, there is poor political will and commitment. This lack of will also include the lack of will to make realistic plans and the poor will to implement plans. EH services required commitment on the part of all stakeholders towards the realization of program goals. It must be appreciated that mobilization in favor of improved ER has been poor, non-specific and sometimes misdirected. There is need to increase the commitment of all. This is particularly required at the LGA level.

4. Poor funding of EH Services.

Funding for ER services have been poor over the years compared with other sub-sector. Though it is difficult to obtain how much had been spent by each tier of government on ER , it is generally believed that the sector had not been favoured in the allocation of needed resources. In many states of the federation, many LGAs are without a functional refuse van while other implements required are either insufficient or non available. The success of most EH programme is directly dependent on the amount of resource inputs and this has to be appreciated. In addition to this, lack of resourcefulness is another factor that has bedevilled the sector. In most cases, the little resources allocated are really not available to prosecute ER services due to undue corruption. In many places, EH services are seen as one of the main conduit pipes through which funds are siphoned. The need to be more resourceful is considered very important.

5. Training and Human resources Development.

By an large the training of most ER personnel takes place at the state government-owned Schools of Health Technology/Hygiene which are expected to be of the status of a Monotechnic . There are about 35 of such schools in Nigeria. The standard of many of these schools leaves much to be desired. Coupled with this is the fact that the country used to be the pioneer of a University-based ER training programme in Africa. The then UNIFE (Now Obafemi Awolowo University, Ile-Ife) B.Sc EH programme was famous during its years of existence as the only one in Africa. Today the story is different as the programme was rationalized under questionable circumstances around 1990. Training and human resources development must be seen as an important aspect of evidence- based ER service delivery. The Council’s effort in this direction is welcomed and its expected to be complemented by training institutions so that more competent professional could be trained.

The way forward

Moving ER service forward in Nigeria requires a radical approach towards the provision of improved services. The services are expected to be universally accessible to people irrespective of where they live. It should also be culturally, economically and socially adapted to each local setting and directed towards addressing specific health and development problems.

To make environmental health a really potent force in the 21st century, important changes are needed. To some extent, these changes are a problem of money and resources and pose a political question: what priority should be given to environmental health within the full array of social needs and wants? But they also raise problems in communication, in education and in technology development itself

Reflecting WHO’s corporate strategy, EH activities should focus on six strategic areas of work which are:

• Ethical and evidence-based policy.

• Stimulating research and development, testing new technologies and comparing performance.

• Technical and policy support for sustainable capacity building.

• Setting. validating, monitoring and guiding the implementation of norms and standards.

• Assessing status and trends.

• Developing tools and guidelines for disease control and risk reduction.

Revitalization of environmental public health services in the country is important for four reasons:

1. Many environmentally related conditions affect the health and lives of millions of citizens at significant cost,
2. Many emerging and re-emerging public health problems require innovative enviromnental public health services interventions,
3. Environmental public health is an important part of the public health response to terrorism and other emergencies, and
4. Environmental public health services issues are becoming more complex.

Specifically, the following has to be addressed as a way forward for effective ER in

Nigeria:

1. EH policy and Regulation.

There is need for Government at all levels to ensure that policies are directed towards addressing environmental health problems. Policies must clearly indicate what is to be done, by who and also include system for monitoring and evaluation of activities. In addition to this, there is need for appropriate legislations to address specific issues. The obsolete Public Health Laws (1958/59) as applicable in different parts of the country must be reviewed. EHOAN/EHORECON’s initiative to get a suitable legislation should be supported by all. If there are grey areas that need to be addressed, this should be sorted out.

2. Advocacy.

In a system where both government and individual priorities are misplaced in disfavour of ER, the need for a planned advocacy strategy becomes very needful to sensitize all stakeholders towards improved services. There is need for both policy advocacy as well as personal advocacy in favour of ER. To ensure service sustainability requires indigenous advocacy. In this wise everyone must be involved. Everyone who cares can be an effective policy advocates. The media has a unique role in this strategy particularly in providing correct information to members of the public, in letting the government know what they should be doing, and in advocating for good practices.

3. Intensifying Hygiene Education

ER professionals must take leading responsibility in modifying their approach to providing ER services. It must be clear to all that most traditional approaches towards service delivery are no longer fashionable. Efforts must be geared towards achieving positive behavioral changes in matters relating to El-I. This might require a review of the present curriculum of instruction in the training schools as well as a re-orientation of all stakeholders.

4. Inspiring a Shared vision.

Application of the concept of shared vision is important for improved EH services. Efforts directed at improvement as well as the strategies to be adopted must be shared among all stakeholders. Shared vision demands partnership and collaboration which is expected to have multiplier effects towards realization of targets. Coupled with this is the need for team work among all stakeholders. Levels of government must see the joint responsibility in ensuring a safe environment for health.

5. Fostering Leadership

This is important so as to ensure that the goal of ER services is enhanced by environmental public health services and also develop strong working relationships among the stakeholders in EH services and to assist state, tribal, territorial, and local health entities and other stakeholders to improve the practice of EH This goal requires development of a National programme to create a cadre of well-trained specialists who will become leaders at all levels of ER service delivery. The professional association in collaboration with the Council would be expected to champion this course.

6. Communication and Social Marketing

The intent of this goal is to improve communication and information sharing among EH professionals and other public health agencies, communities, policy makers, and others and enhance the significance and understanding of environmental public health. Achieving the goal also will define the structure of an effective system for sharing EH information. This goal will be accomplished by promoting and disseminating strategies. Education approaches, and models of best practices to engage communities and policy makers in discussions about EH issues.

7. Developing the Workforce

This strategy is expected to promote the development of a competent and effective EH workforce to deliver contemporary services and address emerging needs. Implementation of this approach includes defining the scope of work as well as the size, composition, performance standards, and competencies of the ER workforce and its current leadership. Accomplishing this goal will include activities that outline ways to develop an EH workforce training stem. Development of the National Environmental Health Service Corps or a fellowship program is also a critical component. In addition, these activities will support programs to increase the number and elevate the status of ER practitioners who engage in competency-driven continuing education and training.

Conclusion

In today’s world, efforts to ensue or maintain high levels of EH status in addition to traditional concerns need to take account of the broad development agenda as well as a number of often complex processes or phenomenal. In doing this, it is time governments at all levels stop paying lip service to ER matters. It must be appreciated by all that no nation can ache desirable level of development without proper EH delivery Government the people, the professionals and all other stakeholders must champion a course in ensuring a healthy environment in Nigeria and for Nigerians.

References

1. USAID (2003). Environmental Health in USAID. USAID, Publications.
2. Osaki Carl (2003). Community Environmental Health Assessment: Challenges and Successes in WA State. WA State Board of Health, Seatle, WA.
3. Anderson Henry (2000). Environmental Health in Wisconsin-Challenges for 21^st Century. Wisconsin Medical Journal, vol.
4. WHO (2003). Five Decades of Challenges and Achievements in Environmental Sanitation and Health. WHO Geneva, 2003.
5. NAP (2001). Grand Challenges in Environmental Sciences. National Academies Press.
6. UGA (2005). Environmental Health Science. College of Public Health University of Georgia in Athens
7. Healthweb (2005). Environmental Health. University of Michigan
8. Environmental Health Competency Project: Recommendations for core competencies for Local Environmental Health Practitioners, Appendix C, Page 16.
9. Robinson, P (2001) EHOs: A Species Under Threat. Environmental Health News, Vol: 16, No: 24. London, UK.
10.  Faertein Brain (2004). Resurrecting Equity Protection, challenges to environmental inequity: A deliberately indifferent opportunistic approach. Jnl. of constitutional Law. No. 561:7.2.

PRIVASTISATION OF WASTE DISPOSAL: ISSUES AND PROSPECTS

BY Abiodun Peter Bamigboye [now late], presented at the Environmental Health Officers Association of Nigeria annual scientific conference in Lagos, 2003

1.0     Introduction

          The failure of succeeding governments at various levels of Nigeria to effectively manage Municipal solid wastes (MSW) has remained a national embarrassment and a cause of concern. Waste management deficiencies remain one of the major health and development problems in the country. It is also a major cause of mortality especially of vulnerable population groups in the country as it exposes people to disease causing organisms and various pollutants from water and the physical environment. A strong association has long been established between the spread of communicable diseases and poor refuse management system. A look at most of the urban towns and villages in the country pictured a grossly deficient system of waste collection management and disposal-a sharp departure from what obtains in most developed countries of the world. The problem has thus become a complex one in Nigeria which requires urgent attention at all levels of policy initiation and implementation. The lack of capacity on the part of government and/or its agency has largely been responsible for this ugly situation.

In recent times, there has been lots of speculation as regards the intention of government to privatize waste management in Nigeria. Experts and professionals have continue to wonder on the viability of the idea while would be contractors have started their lobby to get involved in the business of waste management although without having much knowledge of its workability. It must be said at this juncture that Private Sector Participation (PSP) in waste management is not stately that should be implemented in haste. There is need for extensive knowledge and capacity building of the part of governments, professionals and the operators so that the benefits would be realizable. The choice of this topic and its target audience is therefore considered timely for addressing a pressing problem confronting our nation.

2.0     WASTES AND WASTE MANAGEMENT

Waste has been defined as a resource in the wrong place (Adewumi, 2001). Waste refer to lack of use or value or useless remains. It is a by-product of human activities. Solid waste encompasses diverse nature and constituents. It is generally classified as household, market or commercial, industrial, medical, construction, etc. All these could either be wet or dry in nature. It has therefore being advocated that the best way to deal with wastes is to restore value to it (Adewumi, 2001) to the point at which it ceases to be a waste. The lack of value in many cases can be related to the mixed and in many cases unknown composition of wastes which also compound management problems. The provision of municipal solid waste services is a costly and vexing problem for local authorities everywhere.

Solid waste management involves distinct operations: storage, collection, transfer and transportation, resource recovery, recycling and final disposal. Effective management of waste therefore aims at ensuring that waste does not in any way constitute danger to health and safety or man and the environment at every stage of its handling. Waste management from time immemorial has become an essential part of Public Health service management which is expected to benefits all residents of the community. The service is no-exclusive (i.e. benefiting all sections of the society), and non-rivaled, meaning that any resident can enjoy the service without diminishing the benefits of others (Dillinger, 1988). As a result of these characteristics, Solid Waste Management (SWM) thus become a public good to which local metropolitan government is typically responsible. Constitutionally, responsibility for the disposal of waste in Nigeria rests on the Local governments. It is however clear that Local Government Areas (LGAs) presently seem to be incapable of handling the situation either due to:

1. Lack of expertise or resources
2. Poor planning
3. Lack of proper understanding of the various issues involved in the handling and management of municipal.

The need for other levels to play key role thus become inevitable. Various approaches have been explored in other countries to address the problems presented by poor waste management. One of the which is allowing private firms to be involved on all or selected aspects of waste management. Many countries have moved towards privatization in the last decade but only few have done it successfully.

2.1.1  Problems of SWM in Nigeria

The problems of SWM in Nigeria present a situation that is difficult in a way to clearly understand the complexes. This is because so many factors compound the problem from place to place. The factors include organizational, finance, climatic and ecological. Generally speaking, the followings are features of the SWM services in most places in Nigeria.

1. d.    Low Service Coverage: In some places the public financed system covers only a little section of the population and as such other places especially the rural areas have no organized form of waste disposal
2. e.      Substantial inefficiencies: This is most cases in characterized by high costs but low quality services and also labor intensive but low labor productivity giving  rise to mountains of refuse in many places
3. f.      Insufficient resources in which there is little or no cost recovery and a near total dependence on general revenues or transfers. Thus whenever money fail to come from the central sources no service is provided.
4. g.     Widespread uncontrolled dumping especially in market places of major towns and entirely in the rural areas.
5. Unorganized collection methods
6. i.       Inconsistent policy characterized by lack of commitment
7. j.       Problem posed by poor urban planning and poor road infrastructure complicating problems of collecting and transporting wastes to disposal sites
8. k.    Inadequate data on per capital waste generation making planning cumbersome and unrealistic
9. l.       Problem of waste segregation/sorting which increases the proportion that goes final disposal.

3.0     PRIVATE SECTOR PARTICIPATION IN SWM

          One proven ways of obtaining efficiency gains in solid waste management is through the involvement of the private sector-that is when key success factors of competition, transparency and accountability are present (Cointreau-Levine, 1994, Cointreau-Levine et al, 2000). As a matter of fact there is a growing interest in the participation of private companies in solid waste management. Most times this is driven from failures of municipal systems to provide adequate services, and some time by pressure from national governments and international agencies. It is a system that has recorded success in the US, Canada, Hong Kong, Morocco, Ecuador, Ghana and other places (Cointreau-Levine et al, 2000) and its being experimented in various places in Nigeria including, Lagos, Ibadan, Akure, Onitsha, and a few other places (Ogunwolere, 2000).

PSP in itself is not panacea but a possible opportunity in solid waste management. There are important questions which needs to be answered and these are: whether and how to involve the private sector in the provisions of municipal solid waste services. It should be looked at as a strategic management option where existing management options for services delivery are either too costly or inadequate. It should be seen as a means of enhancing efficiency thus lowering cost and mobilizing private investment thereby expanding the resources available for urban infrastructure. PSP like other business require planning and direction both in the long and short term otherwise it is bound to fail.

3.1.    Approaches to PSP in Nigeria

3.1.1  Contracting

Contracting has become a viable means of securing as long as it is possible to adequately described outputs anticipated from the contract. Of all the methods opened to PSP in waste management, contracting waste collection to private firms offers the greatest opportunity for effective management. It theoretically offers the opportunity for a less costly service than the public service which makes it well suited for discrete activities within the solid waste system. This opportunity is bet harnessed through solid waste collection.

An important issue in this regards is the absence of barriers to entry. This service involves low economies of scale, technological simplicity and moderate investment costs (Ogunwalere, 2000). This is feasible for local firms with modest financial resources to enter into the business. Findings from the Latin America showed that most of the firms were small-to-medium sized, indicating that there were no barriers to entry, (Bartone et al, 1991). Similar situation also exist in Korea. In most places in Nigeria, Particularly in Lagos, less than 10% of the contractors has 1 or 2 collection vehicles as most of them depend on government vehicles.

Competition play an important role in getting low cost solid waste service from private collectors. In 1984 after many years of private collection system, the San Jone city in California re-examined the prices they were paying and dedicated that they might lower their waste management costs by activity increasing competition. They thus focused on helping a competitive waste management firm develop a new landfill. This approach waste found to have resulted in saving lot of contract costs to the tune of between US$25-$31 million in five years (Leite, 1991).

Some form of contracting involve a mix of public and private service. This approach was implemented in Bangkok where competition between private and public contractors led to the streamlining of the roles of the public service by 30% (Cointraneau, 1992). In Minneapolis where the approach experienced initial high cost than those of the private contractors, the public costs dropped towards the level of private contractors after five years (Bartone, 1999). This approach has the natural tendency to make both types of providers more accountable while it motivates the public service to be more efficient and on the part of the contractors it makes them realize that the city cannot be held hostage of cartels, monopoliers or collusion. This kind of approach is not yet organized to a level where the gains of competition could be maximized in Nigeria. However some form of collaboration exists between the private and the public service providers. The Lagos State Waste Disposal Board in 1985 (now Lagos State Waste Management Authority-LAWMA, divided the city of Lagos into zones and awarded contracts of refuse collection to selected private contractors to collect industrial and commercial wastes from large generators. 60% of user charges being collected by LAWMA was paid to the contractors while 40% was retained to cover their own cost of administration, billing and disposal in this form of contracting that was introduced at that time (Ogunwalere 2000).

3.1.2  Franchise

This is the method in which local government that is in charge of waste collection and disposal or any other agency so charged with the responsibility givers exclusive right to a qualified private firm for the responsibility to provide service to customers within a zone. In return for the right, the private firm pays a license to the government. The firm subsequently charges her customers appropriate fees to cover the cost of the service. Ceiling fixed by the government agency through ordinance may regulate the fees charged monitoring of the performance of the private firm having franchise agreement with government rests on the government agency. It is also their responsibility to regulate user charges.

An important advantage of franchise over contracting for government is that the private firm bears the cost of billing and collection of user charges. However it has the disadvantage of not usually resulting into the same low cost as contracting because of the cost of billing due to non-payment and late-payment (Cointraneau, 1992). However, there is need to make for a guaranteed lower cost than the public service. In doing this it is important to have a well defined contract performance measures, initiate enforceable contract sanctions, arrange for vigilant contract monitoring and cost accountability. There is also the need for the government agency to arrange for a means of receiving and managing complaints from residents about solid waste service.

Franchise has become a popular method of PSP in most places in Nigeria. It is being implemented in Ibadan, Lagos, Onitsha, Kano among others. Franchise if properly managed has the potential to enhance better efficiency and control. One major compliant from residents of Ibadan is that they were not given free choice to select their designated company and indeed some of the companies turnout not to be reliable (Cointraeau, 1992).

3.1.3  Informal Sector Waste Collection

In many developing countries, the informal sector provides waste collection services to low-income neighbourhood. While the formal sector is based on basic activities, the informal sector consists of non-basic services. This is common to see wastes being carried in carts being pulled by donkeys or carts being pushed by people. A major feature of this practice is the indiscriminate dumping of refuse by these cart pushers resulting from their lack of necessary equipments to haul wastes to official landfills. This practice has been reported to be predominant in Colombia where more than 600 clandestine dumps exist which were created by the informal sector using mainly donkeys (Coaintraeau 1989). The need to organize these collectors into a cooperative and developing a franchise arrangement whereby the rights and responsibilities of the informal sector collectors are defined has been suggested (Cointraeu, 1989). Community participation could be a very necessary tools in this wise in which the people are involved in the section of such informal refuse collectors in their neighborhood and negotiate the means of disposing the refuse with them. A high level of community organization would be a useful tool in achieving this. In doing this, a local leader may be put in charge of collecting fees from residents to fully cover costs of and also initiate actions to keep the neighborhood system self-sustaining.

3.1.4  Micro-Enterprise

Apart from this direct involvement of the sector in waste management, another form of PSP is through the incorporation of micro-enterprises and informal waste recycling cooperatives in the municipal solid waste management system. Research has shown that the promotion of micro-enterprises has proven to be an effective way of extending services to poor urban communities (Arroyo et al, 1999). The promotion and development of recycling cooperatives also provides a way of upgrading the living and work standard of informal waste pickers, resulting higher incomes for them and greater self esteem (Haan et al, 1998). Formalising the activities of scavengers would help in better organization of their services.

3.1.5  Concession

This is an arrangement under which the private sector finances and owns solid waste management facilities. This ownership is usually for a period of time sufficient to depreciate investments and provide a reasonable return to the investors. Concession agreement could specify performance standard, methods of judging performance, penalties for delay or non-performance, risk assignment, insurance requirements, dispute resolution and standard for workers’ safety and health environmental protection.

Concession components include building, owning, operating and sometimes transferring of facilities through long-term contractual agreements. Some components that are commonly referred to are:

1. Built, Own, Operate and Transfer (BOOT): This involves the building, owning, operating and after a specified period the transfer of the infrastructures. It provides a means of having the private sector financed facilities whose ownership will eventually be transferred to government.
2. Built, Own and Operate (BOO): This involves building, owning and operating waste management through contracting by a private firm. Such facilities can provide solid waste services such as transfer, disposal or resource recovery. BOO is widely used in many developed countries like the USA, Germany and Canada (Cointraneau, 1989).

3.1.6  Private Subscription

This involves each household and commercial establishment hiring private collection firms and paying the user fee charged by the firm. This brings in opportunity for open competition. This methods has been known to have some disadvantages including:

1. Higher costs than those incurred by government contracting with private firms
2. Usually more costly than the public service.

Collusion has always being an issue when open competition is practiced. Association of private refuse collectors exist in a number of cities in Nigeria especially Lagos, Ibadan, Akure and other places.

4.0     KEY ISSUES

4.1.1  Factors Influencing Private Sector Participation in Solid Waste Disposal

Privatizing solid waste management in developing countries requires elaborative consideration of all the issues involved and arriving at realistic decision as to whether to privatize a specific aspect or portion or the entire aspect of the service. In deciding whether to have PSP, many factors needs to be analyzed such as cost recovery, efficiency, public accountability, management, finance, economies of scale, legislation, institution and cost (Cointraneau, 1994). For each situation therefore, governments needs to weigh the economic risks associated with the political manipulation including payment, environmental regulations, tariff regulation, inflation and other associated factors. Cost factors in particular should be analyzed separately for the different components of solid waste service collection, cleansing, disposal and transfer.

However, some factors are worth considering in making decision to involve private sector in the service. These include:

1. Efficiency: The need to know the political realities constraining government from providing efficient service is required. These realisties include, cost accountability, labour tenure, government wage scales, labour practices, personnel benefits, work arrangement, bureaucratic procurement procedures and hiring and firing procedures. Also important is the need to find answers to questions like.
2. Where these constraints could be removed
3. Where same constraints could characterized the involvement of the private sector
4. If there are economies of scale.
5. Capability: Certain questions need to be addressed as regards to capability. These are:
6. Does the government recognize that expertise is essential for competent and low-cost solid waste management?
7. What are the differences between government and the private sector in technical and financial resources required to build or buy, operate and maintain waste management facilities
8. Can performance be effectively monitored?
9. Costs: The cost of running the public service must be compared vis a vis the cost of maintaining PSP. There must exist an accounting information to determine whether PSP would offer solid waste services delivery at a lower cost. The need to have a strategic planning and good feasibility study as relates to efficiency of technology and equipments is very important.
10. Accountability: There is need to assess whether PSP will disportionately benefit an elite, wealthy class with control over private capital or whether market opportunities will be available to small and middle sized business which would eventually lead to some redistribution of income and power

aa. Competition: PSP as matter of necessity must allows for healthy competition among firms on the hand and between firms and government on the other hand. Government policy on PSP must be made in such a way to facilitate this and appropriate provisions made to ensure that at all time the required atmosphere is created to make it work.

1. Risk: There must be a regulatory framework to protect the private sector against risks due to environmental damage, currency adjustments and inflation, political changes etc, so that the prices of services are not unduly burdened with hidden costs for risk protection. Signing contract for a minimum length of time to allow for full investment depreciation and economic of scale would reduce risk.

4.1.2  Expectations from the Private Sectors (as part of their sector participation process)

1. Technological assessment studies
2. Public consultations
3. Environmental Impact Assessment
4. Design facilities and acquire permits.
5. Activities Expected from Government

4.1.3  Activities Expected from Government

1. Identification of the activities to be privatized and the development of a private sector policy strategy
2. Preparation of the privatization (including detailed cost analysis and potential restructuring) plan
3. An appraisal phase which basically consist of preparing the transaction itself
4. Implementation of the privatization policy
5. Maintaining a balance between private and public sectors to secure contestability (e.g. monitoring public provision over some waste collection zones).
6. Minimizing labour redundancy, health and safety risks
7. Monitoring performance based on well specified contracts
8. Considering willingness to pay in determining user charges
9. Defining equitable collection zones in order to minimize collusion and procurement irregularities
10. Defining clear contractual clauses and well-advertised, transparent, equitable and scheduled procurement
11. Ensuring that government has available financial means to comply with its constraining and to establish cost-recovery systems
12. Developing the capacity of public sector to regulate and monitor private service providers
13. Providing governmental support by changing national laws and policies and by providing guidance and setting norms.

4.1.3  General Issues

1. Extent of privatization-is government backing out?
2. How much planning has been made prior to privatization
3. How much waste is generated per capita, within different socio-economic group
4. Facilities available for disposal-location, capacity, efficiency etc
5. Making collection efficient-transportation, storage, transfer station etc
6. Capacity building (personnel for monitoring) in terms of training, retraining, research etc
7. Modifying the role or state environmental agencies
8. Recycling-strategies to minimize waste available for disposal
9. The software components-Health education, information, community organization, sorting at source etc.

5.0     PROSPECTS

Although PSP in solid waste management has failed in a number of few places, it has continued to gain prominence in many other places with recorded success. (STAT 2002). The private sector:

• Improves efficiency and lower costs by intruding commercial principles of:

-         Limited and well focused performance objectives

-         Financial and management autonomy

-         Hard budget constraint

-         Clear accountability to consumers and providers of capital.

• Has better financial and management autonomy, a hard budget constraints and clear accountability to both customers and providers of capital. This would help  in providing better equipment and services
• Provide new ideas, technologies and skills. The activities of scavengers has recently introduced into the Nigeria industrial sector re-cycliable materials that is already solving problem of supply of original raw materials.
• Mobiles needed investment funds especially for short-lived collection vehicles
• Job creation for various categories of staff
• Environmental beauty and protection
• Enhancement in health status and community hygiene

All which is expected to lead to lower cost and tariffs.

Ample evidence abounds from around the world to support these claims. Findings from the United State, Canada and the UK shows that in about 2000 cities surveyed, the services provided by public monopolies typically cost between 25-4% more than competitively contracted services (Bartone, 1999).

6.0     Conclusion

The problems of solid waste management in Nigeria demand a radical approach to finding effective solutions to address the various problems of confronting the sector. It is also very clear that with the abundant human and material resources and a vast enterprising market, PSP in solid waste management has a great potential in Nigeria. It cannot be out of place for government in Nigeria to explore the opportunity offered by a wide range of resources and to work out strategies to make PSP in waste management workable in Nigeria. In doing this there would be the need for a waste management sector reforms and a commitment on the part of governments to really address waste management problems. Effective planning is fundamental to its success and a commitment (both political and administrative) to implement plan if very central to PSP in solid waste disposal.

Public health not doctors' preserve

By Sani Garba Mohammed

Public health is a term that is eliciting concern from health professionals; for, as the name imply, it deals with the issues pertaining health be it preventive, curative, promotive or rehabilitative.

In Nigeria, the rivalry between health professionals is making the term to lose relevance as to what public health stand. It reaches a stage where by one profession corner the title and determines what goes in and out, leaving large chunk of other health professional onlookers.
This comment will look at what is public health, whether or not one profession should be alpha and omega, and the need of collaborative approach towards making public health better.

Permit me to quote WHO [1952] definition of public health which is “the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community efforts for the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene, the organization of medical and nursing services for early diagnosis and preventive treatment of disease, and the development of social machinery to ensure for every individual a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to release his birthright of health and longevity”.

Based on this, we can deduce that public health consist of environmental health services [it has 18 components], medical, nursing, laboratory, other health services, including other sectors relevant to health like agriculture, science and technology, power, communication, engineering, etc., that address the physical, mental and environmental health concerns of communities, and disease prevention technologies interventions designed to improve and enhance quality of life.
Considering the all-encompassing scope of public health, no any profession, be it medical, nursing, chemist, etc., can lay claim to be its only promoter, as it is obtainable in Nigeria where the mere mention of ‘public health’, direction will look at doctors only, not all health workers.

Doctors have now appropriates public health practice as their own only, and determine how it should be run, from federal ministry level down to local government level; and any attempt to do the right thing by the right professionals in what they have interest will not see the light of the day.

Nowadays it has become a norm that every minister of health is a doctor, the same with majority of states, also many position are now reserved for doctors only like headship of hospitals, national primary health care development agency, etc., which any health practitioner like pharmacist, medical scientist, environmental health officer, nurse can hold with the necessary managerial skills. These, give rise to a situation that very health policies, tend to be one-sided, from the prism of medical practice, with the exception of other sides which are equally important.

For instance, the effort to prevent/and or reduce the endemicity of malaria could not succeed, because the emphasis is based on curative approach that hinge on only provision of insecticide treated nets, provision of drugs, to the detriment of more effective control of environmental health management of our surroundings, which harbor the vector that causes it, because money is involved from donors.

Now doctors are penetrating in to many professions and forcing their thoughts on how to do or not do this and that; they are into radiography, laboratory science, pharmacy etc., but still want to usurp the role of those who start from degree level.
”Take a look at a scheme of service, from 2001” said Godwill Okara “ addressed to the minister for health, telling him of eleven schemes of service for professionals in the health sector, to be implemented. The then minister caused this letter to be circulated to all chief executives of hospitals for immediate implementation. Up till now, this scheme of service has not been implemented because doctors feel they are the ones to [lead]”, daily trust 3rd July, 2012.
He also added “There are laws: do your own, let me do my own. When people think that they are above the laws of the land, it is an open invitation to anarchy. And the kind of situation we see in the health sector, there could be no greater anarchy than it. Despite the immense human and material resources in Nigeria, the Nigerian health service is being rated 51 out of 53 in Africa. It’s a shame. Instead of facing these facts, they gang up, become partisan and want to protect the interest of their colleagues against all others”

The other area where other health professionals are being discriminated is their non-admission by many universities for Masters in Public health, which it seems is exclusive reserve of medical doctors; with the exception of few universities in the south-like federal university of technology, Owerri, University of Calabar, University of Port Hacourt, University of Uyo-all northern universities reject any non-doctor health practitioner from the programme, even if s/he has first class in his degree.

National Health Bill further creates another huge gap which if allows to be signed without the input of other health professionals, will do more harm than good, and public health services will suffer. “The new bill” according to Nigerian Health Watch “states that the "Executive Chairmanship of the proposed National Tertiary Hospitals Commission must be a Medical Director of the status of a Professor with a minimum of ten years working experience in a Teaching Hospital"

“This clause that limits the Executive Chairmanship to medical doctors in perpetuity has all the other health professions up in arms. Doctors argue that it is their traditional (read tribal) role to lead a medical team. The other health professions argue that they (their tribe) must also have a go at leading the commission.

“It is our contention at NHW, that this clause in the health bill is flawed, as it does not protect the best interests of Nigerians, and has placed tribal interests as belonging to a profession (a tribe of doctors), reaching an academic height (a tribe of professors) and having worked in teaching hospital (a tribe of public sector workers) - none of which ultimately guarantees a good leader and manager which the National Tertiary Hospitals Commission needs to fulfill its promise to the Nigerian people”.

I am not bringing this to castigate or blackmail my fellow practitioners, as I have many friend doctors, mentors, but just to highlight the issue at hand at its pertain the practice of public health, which are directly or indirectly affecting it delivery to the target beneficiaries, for no any profession is an island unto itself, as doctors needs pharmacist, radiographer, laboratory scientist, so also pharmacist need chemist, nurse, and other health practitioners. As a sanitarian [aka environmental health officers], I need police, lawyer, engineer, laboratory scientist, etc., to discharge my work accordingly, as such, public health services needs all of us to join hand and deliver, for, we own it up together.

So, for public health practice to prosper there should be no enmity, or feeling superiority of one over the other, we are all equal as all have undergone training of not less than 5 years. Let us join hands together if we are ever serious. Public health belongs to us not one of us. It is better late than never.

Sani Garba Mohammed, is of department of public health technology, federal university of technology, Owerri.

INTEGRATED PEST MANAGEMENT (IPM)

A LECTURE DELIVERED ON THEMATIC MODULE ON PPP IN VECTOR AND PEST MANAGEMENTFOR REGISTERED ENVIRONMENTAL HEALTH OFFICERS IN NIGERIA AT FILBON MOTEL, CHIME AVENUE, NEW HEAVEN, ENUGU, ENUGU STATE ON 7TH SEPTEMBER, 2012

BY
SAN. OLALEKAN ISHOLA JP (NIMS)

INTRODUCTION
Integrated pest management (IPM) this is a pest management/control strategy which utilize biological and ecological knowledge, pest monitoring, various material and techniques, together with natural pest population regulatory factors for the management of pest.
Integrated pest management (IPM) is an effective and environmentally sensitive approach to pest management that relies on a combination of common-sense practices. IPM programmes use current, comprehensive information on the life cycles of pest and their interactions with the environment.

The IPM approach can be applied to both agricultural and non agricultural settings such as the home, garden and workplace. IPM takes advantages of all appropriate pest management options including, but not limited to, the judicious use of pesticides. In contrast, organic food production from natural sources, as opposed to synthetic chemicals IPM is a board based ecological approach to structural and agricultural pest control that integrated pesticides / herbicides into a management system incorporating a range of practices for economic control of a pest in IPM one attempt to prevent infestation to observe patterns of infestation when they occur and to interferes (without poisons) when one deems necessary. IPM is the intelligent selection and use of pest control actions that will ensure favourable economic, ecological and sociological consequences.

IPM extended the concept of integrated control to all classes of pest and was expanded to include tactics other than just chemical and biological controls. Artificial controls such as pesticides were to be applied as in integrated control but these now had to be compatible with control tactics for all classed of pest. Other tactics such as hest-plants resistance and cultural manipulations, became post of the IPM arsenal.IPM added the multidisciplinary element, involving entomologists’ plant pathologist, wood scientists and environmentalists.
In 1972 in United States of America IPM was formulated into National Policy by, President Richard Nixon who directed federal Agencies to take steps to advance the concept and application of IPM in all relevant sectors.
In 1979, president primary carters established an integrity IPM co-coordinating committee to ensure development and implementation of IPM practices.


IPM COMPONENTS
I.P.M is designed around (4) four essential components while in some cases around (6) six basic components.
1. Acceptable pests level, this an understanding of the factors that regulate pest number or encourage their presence e.g. presence of breeding sites, filthy environment, poor waste disposal, indiscriminate piling up of unused material, favourable climate conditions etc.

2. MONITORING: Since insects are cold blooded, their physical development is dependent on the temperature of their environment. This is necessary to decide whether to apply control measures. It is also important in determine seasonal build up and dispersal, evaluating control or comparing different control measures.
Monitoring can be done by using:
a. Feeding activities
b. Visual observation on their number
c. Dropping
d. Disease development e.g. mosquito
e. Use of attractants

3. PREVENTIVE CULTURAL PRACTICES: Sanitation (Removal of disease causing agents on the source of growth/breeding sites). This cultural technique will prevent the spread of diseases; caused by pests.

4. MECHANICAL CONTROL: Should a pest reached an unacceptable level, mechanical methods are the first options consider. They include simple hand picking erecting insect barriers, using traps, vacuuming and tillage to distrust breeding.

5. BIOLOGICAL CONTROL: This is the use of living organisms to reduce pest populations. It is based on the knowledge that all living organisms have natural enemies unlike with agricultural pest, e.g. introduction of Tilapia and Gamdusia species used against mosquito larvae.

6. RESPONSIBLE PESTICIDES USE / CHEMICAL CONTROL: This is the application or use of natural or synthetic chemicals called pesticides to kill pests. The straight interpretation of pesticides is pest killers which is the original concept. In recent years many discoveries have been made of substances that influence insect behavious, for examples, chemicals which attract, repel car/or stenle pests without killing them. New concept of chemicals control is the judicious application or use of natural or synthetic chemicals that cause directly the death repulsion, attraction, deterrence, or in other ways influence pests for control purposes e.g. rodenticides inspecticides, fungicides e.t.c. examples of recent additions are the pyrehtroids and insect growth resulations (IGR) e.g Dimulan and Hydropene.

Constraints of IPM COMPONENTS
1. In some rural places, construction of houses may have to be altered so as to be able to screen at sites of our exchange.
2. Cost of chemicals which may not be affordable to some extent.
3. Sale of adulterated/fake chemicals.
4. Wrong application of selected chemicals.
5. Lack of modern techniques by spray men.
6. Inadequate bed nets.
7. Insects are still free to bite since bed nets are used mainly at night.
8. Heat may build up with in the net, making sleeping not enjoyable
Reasons for failure of the programme
1. Over reliance on a single approach to pest control especially pesticides, this has led to various ecological health and environmental problems.

2. Epidemiology of some diseases have been over-simplified for example may control measures that have worked in other areas are sometimes extrapolated to other areas and situations without taking into consideration the fact that the ecology of disease transmission is complex and could vary from place to place.

3. Many control programmes did not evolve within the context of occupational and social considerations of the target community.

4. Diseases transmitted are considered very important while the vectors are unimportant.
5. Emphasis is usually place on eradication of the pest species all costs.

SOLUTIONS
IPM can reduce human and environmental exposure to hazardous chemicals and potentially lower overall costs of pesticide application materials labour.
1. Public education programmes are vital to any vector control programme. It should be carefully planned and culturally sensitive and may be accompanied with incentives not threats. This enlightenment programme must be rich, and incentives may be financial, economic, informational, behavioural, regulatory and evaluation.
2. Effective maintenance of central measures, appropriate institutional arrangement must exist, spare parts, pesticides and other materials must be available all the time and monitoring programme should be supported.
3. Teams within disease control agency or vector control agency must be interdisciplinary. Anthropologist/sociologist, entomologists, medical personnel and environmentalist can learn together how to increase their contribution to vector management especially with the choice of appropriate management tactics.
4. Educational officers must be trained and re-trained to introduce them to current trends in vector management. Vector management is a dynamic exercise, every year new methods and technologies are developed for dealing with specific vectors.
5. Government must provide adequate funding for public education and other aspects of vector management programmes.



CONCLUSION
Implementing the IPM programme will completely reduce the chance of accidental exposure of pesticides to children, adult and the popular. This proactive, can control pests better in the long term than just pesticides alone. “Overtime” an IPM programme can cost less than conventional pest management practices by reducing dependence on pesticides.

HEALTH SAFETY IN PEST MANAGEMENT

HEBY SANITARIAN M.A. SOMOYE
A PAPER PRESENTED AT THEMATIC TRAINING ON PEST MANAGEMENT CONTROL HELD AT FILBON HOTEL, UPPER CHIME AVENUE ENUGU ON 6TH SEPTEMBER, 2012.

Several causes of overt poisoning by pesticides occur in workers applying these agents of disinfestation. Therefore, the importance of safe handling of insecticides cannot be over emphasized.

It must also be a way of life for spray men and persons applying insecticidal dusts, whether the materials used are highly toxic, moderate, or slightly toxic to human. Absence of accurate data in the country disenables to get the number of death recorded from accidental ingestion of solid and liquid toxic substances. We have observed a case whereby a spray man collapsed and die ignorantly for unknowingly habouring a particle of zinc phosphide under the finger nail which was not properly washed before going to observe prayers. He died putting water into his mouth containing the agent.

Respiratory exposure is most frequent among persons that handle dusts, which are not readily absorbed through the skin. Dermal exposure becomes much more hazardous when sprays are applied. The solvents such as organophosphorus used with many spray destroy the protective oily barrier of the skin and allow more intimate contact with the chemical toxicant.
Poisoning by ingestion is most critical among children under five years of age when pesticides are put especially in mineral bottles and kept in accessible places, such as the kitchen pantry, or sink cabinet.

Pest control services must be handled by a professional, who have been trained and licensed to handle such onerous task. A basic principle in choosing an insecticide for public health operations is to select a product that is moderately or slightly toxic to humans, and to observe meticulously the operational precautions that would be required with a more toxic material.

HOW DO ACCIDENTAL PESTICIDE POISONING OCCUR?

1. By Mouth –
- Dusts and sprays entering mouth during applications
- Drinking pesticides from unlabelled or contaminated container
- Using the mouth to start siphonage of liquid concentrates
- Eating contaminated food
- Transfer of chemical to mouth from contaminated cuffs or hands.
- Drinking from contaminated beverage container
- Answering or calling from phones while on operation of pest control services.
- Shaking hands with people while on duty
- Usage of hand to clean/rub the nose / mouth while on duty.

2. THROUGH THE SKIN

- Accidental spills on clothing or skin.
- Dusts and sprays setting on skin during application spraying in wind.
- Spraying in wind.
- Splash or spray in eyes and on skin during pouring and mixing
- Contact with treated surfaces as in too early Re-entry of treated fields, Hand Harvesting, Thinning, Cultivating, and Insect or pest scouting.
- Children playing – in discarded containers
- in pesticide mixing or spill areas.
- Maintenance – Repair work on contaminated equipment.

3. BY BREATHING
- Dust, mists, or fumes
- Smoking during application or contaminated smoking supplies
- Do not inhale concentrations which are immediately dangerous to life and health, are unknown or when concentration exceeds 10 times the permissible exposure limit (PEL).
- Failure to use mask containing respirator during all times of exposure may result in sickness or death.
- The air borne contaminants which can be dangerous to your health include those so small that you cannot see them.
- Leave the contaminated area immediately and contact your supervisor if you smell or taste contaminants or if dizziness, irritation, or other distress occurs.

WHAT TO DO

GENERAL

(a) Follow the instructions issued by the manufacturers and/or regulations issued by the authorities.
(b) Do not leave product unattended in the field while you are spraying.
(c) Always keep a bucket with clean water in the working area.
(d) Store insecticides in containers with the original labels. Keep the insecticide out of reach of children and animals, preferably in a locked box with a sign posted such as “DANGEROUS – CHEMICALS – KEEP AWAY”
(e) Mix insecticides in a well-ventilated area, preferably out of doors to avoid or minimize inhalation of dusts and fumes.
(f) When mixing and applying flammable chemicals, avoid the fire hazard associated with tobacco smoking, defective wiring, open flames and hot plates
(g) Do not eat or smoke when working with insecticides. This will reduce opportunities for accidental ingestion of toxic materials.
(h) Mix only as much insecticide as is needed for each application, thus reducing the problems of storing and disposing of excess insecticide. Dispose of excess insecticide carefully so that contamination will not affect man and wildlife.

ENVIRONMENT
(a) Do not contaminate any water sources
(b) Prevent livestock grazing or feeding on fresh sprayed plants
(c) Do not collect any food or feed from freshly sprayed areas.

STORAGE OF PRODUCTS:- Use only original well-labelled containers.
- Store products away from the sun and humidity in a place which must be locked. Key assigned only to authorized individuals.
- Do not smoke in the chemical store room.
- Adequate ventilation is essential and a washable floor desirable.
- Product should be dated upon receipt.

PRODUCT AND CONTANER DISPOSAL:
- Any left over product is to be poured back into its original container. Use a funnel and wear gloves.
- Empty containers completely, Emptied metal container are to be flattened, perforated and disposed of in a land fill approved for pesticides or buried in a safe place away from water supplies. Dispose of plastic containers in an incinerator of land fill. Treat steel drums with kerosene, diesel oil or solvent: rinse well. Ask the dealer about recycling: otherwise crush and bury.
- Do not re-use empty containers for any other purpose

HYGINE:
- Avoid exposure to spray
- Do not carry cigarettes or edibles in your pocket while handling or spraying pesticides – contamination danger
- Refrain from drinking, eating or smoking when handling pesticides.
- Wash face and hands with soap and clean water before drinking or eating
- Wash hands before going to the toilet.
- Avoid spillage of spray liquid on any part of the body
- Take off immediately any clothes contaminated with chemicals.
- Wash exposed parts of the body with soap and plenty of clean water
- Stand up – wind when handling or spraying pesticides.
- After work, thoroughly wash or take a shower, use soap, change into clean clothing.
- Do not call or receive from G. S. M phone while handling or spraying pesticides.
- Minimize or talk less while handling or spraying pesticide.
- Ensure that finger nails are well cut so as not to retain any dirt /dust while handling pesticides especially zinc phosphide.

PROTECTIVE CLOTHING
- Wear appropriate protection when refilling the spray tank and during product application.
- During preparation of spray mixture.
You must wear Overall, Rubber boots, Rubber gloves, Face shield or half –face respirator + goggels
- Put on Head protection
- The spray operator must equally put on Overall, Rubber boots, Rubber gloves, Half-face respirator and Head protection
- Respirator with filter must be replaced after about 8 hrs wear during application.
- Keep trouser – legs outside the boots in order to avoid drainage of pesticides into the boots.
- Wear long sleeves over the gloves in order to avoid drainage of pesticides into the glove.
- Wash gloves with water and detergent before removing
- Do not use cotton or leather gloves. These are more hazards than no protection. They absorb pesticides.
- Change into clean clothes after finishing spraying each day.
- Wash protective clothing daily with hot water and use detergent (soap)
- Wash protective clothes separately from family or personal clothes.
- Defective clothing provides inadequate protection, discard and replace defective clothing.

WHAT TO DO IF BREATHING CEASES
- Move the patient well away from any contaminated areas and from the vicinity of pesticides
- Wash exposed parts of the body with plenty of fresh clean water and soap. Put on clean clothing
- Put patient on his side; tilt the head back.
- Call a doctor as quickly as possible, but do not abandon false objects from the mouth (chewing gun, false teeth etc).
- Artificial respiration should take precedence over all other first aid measures if breathing ceases. Do not waste time.
- For an Adult:
(1) Open your mouth wide and take a deep breath
(2) Pinch the casualty’s nostrils together with your fingers to prevent air from escaping.
(3) Seal your lips round his mouth
(4) Blow into his lungs until the chest rises
(5) Then remove your mouth, and watch the chest fall
(6) Repeat and continue inflations at your natural rates of breathing.

COVULSIONS OCCUR
(1) Ensure that the patient can breathe adequately. If necessary pull the tongue forward to prevent it blocking the throat
(2) Do not give anything by mouth to an unconscious person
(3) Keep the patient warm and dry

PESTICIDE IS SPLASHED IN THE EYE
Wash the eye with clean water immediately. Speed is essential to prevent injury to the eye. Use large amounts of clean water to gently irrigate the eye for at least 15 mins. In addition, boracic acid solution may be beneficial.

PESTICIDE IS SPILLED ON THE SKIN
(1) Remove all contaminated clothing. Cover the patient with a clean blanket.
(2) Wash the skin thoroughly with plenty of soap and water immediately and repeat again
(3) Clean under finger and toe nails, and clean the hair.
(4) In addition wash contaminated skin with rubbing alcohol to remove any remaining pesticide.
(5) Put on complete clean clothing
(6) Decontaminate protective clothing with hot water and soap. Wash cap/hat, gloves and boots (both inside and outside).

EQUIPMENT SELECTION

A PAPER PRESENTED BY SANITARIAN M.A. SOMOYE AT THEMATIC TRAINING ON PEST MANAGEMENT CONTROL HELD AT FILBON HOTEL, UPPER CHIME AVENUE ENUGU ON 6TH SEPTEMBER, 2012.


Four key factors should be considered when selecting insecticide application equipment:
(1). Will it do the Job?
Each piece of equipment should be moderate to operate. It is good economy to buy the best equipment available. Simplicity of operation and ease of maintenance should be key factors in making a selection.

(2). Is it safe?
Safety should be a prime consideration in all insect control operations. Hazard to the equipment operator, the general public and the environment should be considered.
(3). Is it of good quality?
Poor quality equipment may do great harm to the public relations aspect of insect control programme.

(4). Is it expensive?
Purchase of low quality items may save initially, but the long-range expensive cost should be weighed against such factors as durability of equipment, availability of spare parts and repair facilities and degree of care that can be expected from workers who use it.

The equipments are sub-divided into four categories viz a viz:
(1). Hand Sprayers: which comprise of
(a). The Compressed air sprayers
(b). Aerosol Dispenser
(c). Hand pump atomizer
(d). Pistol sprayer
(e). Knapsack sprayer
(f). Trombone sprayer
(g). Hand duster
(h). Bulb duster

I will discuss on few of these machines especially the most pronounced among them.
THE COMPRESSED AIR SPRAYER:
This is the mainstay of most public health insect control projects. It is used particularly to apply residual sprays for mosquito, fly, and flea control, larvicides for mosquito and fly control, spot treatment for cockroaches, ants, ticks, bugs and many other types of household insects.
The compreseed air sprayer consists of a tank, air pump, outlet pipe, spray hose, valve, ward and nozzle.

THE AEROSOL DISPENSER OR “bug bomb”, is more widely used by the general public than any other type of insecticide applicator.
Insecticide aerosol dispensers are sold in two general types: (a). Small low pressure, disposable “bug bombs” used by the average householder, and (b) larger high-pressure, re-fill able aerosol dispensers used in some public health programme and by pest control operators.
The small low-pressure aerosol bomb consists of a can with a discharge valve and nozzle at the top, and a tube extending from the valve to the bottom of the can.
The insecticide in a concentrated oil solution is mixed with a propellant (usually the nontoxic gas Freon in liquid form) and placed in the can at the time it is assembled.
When the discharge valve is pressed, propellants gas within the can forces the insecticide – propelland mixture through the nozzle and it is atomized into spray.
One of the most common types of bug bombs for flies and mosquitoes contains prethrum, allenthrin, or synthetic pyrethrum for quick knockdown , a synergist such as piperonyl butoxide, and a synthetic insecticide such as methoxychlor or the kill.
THE HAND PUMP ATOMIZER or “flit gun” is a familiar household item. A piston pump forces s stream of air over the tip of the siphon tube. This creates a partial vacuum in the tube. The insecticide is sucked from the tank attached to the pump into the airstreams, which breaks the insecticide into spray.

There are two types of hand pump atomizers.
The intermittent hand sprayer produces a spray of insecticide only while the pump plunger is being pushed forward.
The continuous hand sprayer forces air into the tank to develop and maintain a constant pressure and deliver a continuous spray discharge. Pneumatic paint sprayers operate upon the same basic principle as the “flit gun” but are powered by an electric or gasoline motor. They are sometimes used for space spraying in larger buildings where hand equipment is inadequate.
THE PISTOL SPRAYER is very much like the “gun” used for oiling automobile springs. Pulling the trigger on the gun produces a fine, solid stream of insecticide. It is especially valuable when small amounts of solution or emulsion need to be applied to cracks and crevices in buildings for cockroach, bugs and ant control.
It has been used to apply small amounts of insecticide to collections of water in small containers, such as tin cans, saucers under flowerpots, old tyres or water drums.
They were used extensively on the Aedes aegypti eradication programme and may play a part in many urban mosquito control programs.

THE KNAPSACK SPRAYER is borne on the back of the operator, has shoulder straps so that it can be carried on both shoulders. A simple diaphragm or piston pump and a mechanical agitator are mounted inside the tank and actuated by a lever worked by the operator’s right hand.
The insecticide is under liquid pressure during each stroke of the pump. Knapsack sprayers are used chiefly in treatment of small garden, and to a lesser extent for mosquito larviciding in very swampy areas where it is difficult to pump up a compressed air sprayer.
THE BULB DUSTER is also designed for careful in door work. A 4” rubber bulb is filled with a screw cap containing a dust nozzle. After the bulb is filled with dust, and the cap replaced, hand pressure on the bulb disperses the dust.

2. POWER SPRAYERS
(a). Hydraulic power sprayers
(b). Boat mounted power duster
Hydraulic Power Sprayers, originally designed for use on field crops, orchard and shade trees and live stock, are frequently used by public health workers to apply insecticides as residual sprays to control adult mosquitoes and flies as laravicides to control mosquito and fly larva, and as area treatments to control fleas, ticks and chiggers. The spray liquid is pressurized by means of a power – driven hydraulic pump with suitable regulators provided to maintain the desired pressure.

BOAT MOUNTED POWER DUSTER is used in some mosquito control districts. These machines have several advantages: they can be used from the open water side of mosquito – breeding places, they have a wide effective swath over water with only floating or low surface vegetatio., and they do not require access roads in difficult, swampy terrain.

MIST AND FOG APPLICATORS
Mist and fog applications are used for space spraying with contact insecticides. Mist and fog machines control insects by he same principle as that utilized by hand sprayers and aerosol dispensers – contact killing.
Mists- are composed of droplets 50 – 100 microns in diameter, particles of sufficient size to settle 4o the earth fairly rapidly, but remain a 200 – 300 foot swath with only a light wind to promote distribution. This settling will occur despite the fact that there may be thermal air currents rising from the heated earth during the daytime.

Fogs - Are composed of much finer droplets, from 0.1 to 50 microns in diameter, that remain suspended for a long period of time, settling only in relatively still air. These particles are likely to rise in the daytime and produce little or no kill of insects during this period.
The above considerations indicate that the moist blowers are especially suitable for daytime operations such as fly control and that fog applicators are most effective during the evening, night and early morning hours, particularly for adult mosquito control.
The chief advantages of mist and fog applicators are (1) Economy of operation due to their low manpower requirements. (2) Ability to apply small amount of concentrated materials to a large area and (3) Large portions of a city may be treated in a short period of time during disasters and in period of high insect abundance.
The chief disadvantage in their use for treating urban are as is the fact cars and windows may be spotted by the insecticide and shrubbery may be burned by the oil if machines are not properly operated.

OTHER APPLICATION EQUIPMENT
Pouring of chemicals may be of value under certain conditions. Measured amounts of insecticide may be poured into fast – flowing streams for black fly control. A sprinkler can is useful for mosquito larviciding of catch basins.
DRAGGING bags of chemical through water, or laying the bags in moving water may serve to control black fly larvae or other water – dwelling forms. Calculations should be made to assure adequate control without damage to fish or other wild life, and also not pollute human water supplies.
DRIP CANS are superior to pouring or dragging for water treatment because insecticide dosage can be controlled more exactly. They are better to use in moving than in still water.

PAINT BRUSHES are very effective for applying controlled amounts of insecticides to areas where insects hide and run.
They are especially suited for controlling household insects such as cockroaches and termites. There is less change of damaging materials such as synthetic floor tiles or painted woodwork when applying insecticide with a paintbrush than with a sprayer.

POISON BAITS are used occasionally by public health workers. Chicken watering fountains containing sugar water and an organic phosphorus compound such as dichlovors are used to control flies in chicken houses. Shallow trays covered with hardware cloth containing granular fly baits may be placed in areas with high fly populations such as dairy barns.
GELATINOUS CAPSULES (“TOSSITS” containing mosquito larvicide are useful for immediate treatment of small bodies of water. Inspectors can easily use them, saving the expense of sending out a control crew.

PRESSURE INJECTORS to inject phosphide into egg, very useful in baiting snakes.
RESIN STRIPS containing dich (or DDVP) are used to control insects in buildings, such as cockroaches under sinks, silver fish, clothes moths and carpet beetles in closets. These strips are used at a rate of one strip per 1000 cubic feet. They are also used to control mosquito larvae in catch basins.
They are effective for 3 to 4 months dripping cotton cord in organic phosphorus insecticides such as parathion, diazinon, or ronnel. When installed in diary barns, loading docks, and similar situations at a rate of 30 linear feet per 100 square feet of floor space, fly cords often provide effective fly control for 3 months or longer.

CARE AND MAINTENANCE OF INSECTICIDAL EQUIPMENT
Manufacturer of insecticidal equipment usually provide information on the care and maintenance of each type of applicator. Follow these instructions for lubrication, operation, and maintenance.
All applicator equipment requires diligence if it is to be kept operating properly. Many complaints about equipment malfunction are traceable to improper maintenance.
HAND SPRAYERS are generally a greater maintenance problem than dusters. Several basic rules should be followed in the care of a sprayer.
1. Handle it carefully
2. Keep it clean
3. Strain formulations through cheesecloth to keep particles out of it.
4. Rinse it out thoroughly after every use
5. Every evening after use rinse it and then pump 1/3 gallon of clean water through it.
6. Do not let water freeze in it.
7. Every 3 months:
a. Disassemble it completely.
b. Put small metal parts into kerosene allow to set, then clean with a small bottlebrush.
c. Soak nozzles, wands, and tank with trisodium phosphate solution, then clean with a scrubbing brush, then rinse thoroughly.
d. Replace worn gaskets, broken parts etc.
e. Reassemble it.
f. Pump 2 changes of water (with 1 cup of vinegar per gallon of water) through it.
g. Pump clean water through it.
h. Oil certain parts, as in the spray gun.

POWER EQUIPMENT should be covered when not in use.
Have regular preventive maintenance on all motors.
Replace damaged parts immediately.
Allow only experienced personnel to operate power equipment.

CHEMICAL CONTROL
TYPES OF INSECTICIDES
An insecticide is a substance used for killing insects and their close relatives, ticks, mites and spiders. A perfect insecticide, would be: (1) highly toxic to harmful insects and related arthropods; (2) harmless to man and to beneficial animals, insects and plants; (3) attractive to insects and not unpleasant to humans; (4) inexpensive, easy to produce and readily available; (5) Chemically stable for residual applications, (6) Unstable for use in aerial applications that will not grossly contaminate the environment, killing insects rapidly and breaking down subsequently into harmless compounds, (7) nonflammable, (8) no corrosive (9) no staining and (10) easily prepared into any desired formulation.

Insecticides are classified traditionally according to the way they kill insects: as
(1). STOMACH POISONS must be swallowed to cause death. Poison baits are stomach poisons mixed with materials such as sugar to attract insects.

(2). CONTACT INSECTICIDES - Penetrate the body wall or the tarsi of arthropods. They include residual sprays applied to walls and ceilings of building to kill insects that rest on the treated surface, aerosols and space sprays that adhere to and kill flying insects, and larvicide’s that penetrate the tracheae and body walls to kill insect larvae.

FUMIGANTS - are volatile chemicals whose vapors enter insects bodies through the breathing pores (spiraclås) and through body surfaces.
Methyl bromide, for example, is a nonflammable, deeply penetrating fumigant used to kill insects in fabrics, foods and other stored products.

DESSICANTS – are sorptive dusts, which scratch or abrade the body wall, or absorb its fatty, or waxy, protective outer coating, causing the insect to loose body fluids and die by dehydration.
The insecticides used to kill arthropods of public health importance may be divided conveniently into six groups viz a viz:
1. The minerals – fuel oil, kerosene, sulfur and borax – contain some of the oldest insecticides still widely used.
2. The botanicals – pyrethrum and rotenone which were in use before 1900 still are favorites because they pose no problem of toxic residues. Synthetic pyrethroids play an important role because they can be manufactured and standardized in quantity.
3. The Chlorimated hydrocarbons - such as D.D.T, lindane, and chlordane, were the most widely used insecticides from the 1940’s through the 1960’s. however, problems of resistance and environmental contamination arose and the use of this group of toxicants is now limited.
4. The Organophosphates – such as malathion and diazinon, have generally replaced the chlorinated hydrocarbons because they control resistant insects they are biodegradable, and do not contaminate the environment.
5. The Carbamates – such as carbaryl and propoxur are a relatively new class of contact insecticides, which may supplement the organophosphates.
6. The Fumigants – include well known materials such as naphthalene and Para dichlorobenzene used by the general public, and other very toxic materials such as methyl bromide or hydrogen cyanide which are so dangerous that they should be used only by specially trained personnel.