BY W. D. AMAKIRI
Being a paper presented at the Thematic Training of Environmental health Officers on Health, Safety and Environment, in Benin-City, May, 2012
1. INTRODUCTION AND DEFINITION
HSE is an acronym which means Health, Safety and Environment. Conceptually, it refers, to a process tool that is used in managing the health, safety and environmental concerns of an organization. Health, safety and environmental concerns of an organization refer to how the work force of an organization can remain healthy, safe and work in an environment devoid of issues that will be harmful or prejudicial to health and well being; that is, work in an environment devoid of hazards.
What this means is that it is a management system, normally, deployed to scientifically handle the negative HSE issues and concerns of various work processes. Because it is used in the scientific management of those issues which would negatively impact the work force in the work processes at work and the environment, the EHO as a key expert in the environmental work team must be well grounded in its conception and application. The EHO stands to benefit from its application to the science of food hygiene inspection, so as to be able to identify and eliminate food safety hazards. It is, therefore, the aim of this paper to highlight the application of this concept in food inspection.
2. DEPLOYMENT OF HSE IN FOOD INSPECTION
The basic aspect of the HSE management process or system, is the identification of hazards and putting in place systems that work effectively to eliminate such hazards or reducing them to As Low As Reasonably Practicable (ALARP) where they cannot be eliminated. The sole aim is to make the work environment and work place safe to a standard that makes it harmless.
Similarly, the role of the EHO in food inspection is to identify and eliminate food safety hazards or hazards inherent in food so as to activate measures that can be put in place to render unwholesome food wholesome and safe for consumption.
3. HSE TOOLS AND THEIR APPLICATION IN FOOD INSPECTION
The basic HSE tools of hazard identification are unsafe acts and unsafe conditions audits, inspection of work processes, inspection of personnel during work, inspection of work methods and auditing and inspection of work tools and equipment.
Audit involves a purposeful inspection walk through of the work environment, taking a critical look at the work place touching all the significant areas mentioned above with the sole aim of identifying inherent hazards and recommending strategies for their elimination or reduction. It includes critically inspecting the various aspects and processes in the work area and environment with a view to uncovering inherent hazards. Such identified hazards are recorded and reported to the process owner(s) for correction and or re-engineering for the purpose of rectification and or remediation.
Unsafe act audits, unlike other HSSE audit tools which aim at identifying work processes, tools and equipment, rather aim at identifying the behavioural shortfalls of the worker that can result in creating a hazard or hazardous situation that may lead to an accident.
3.1. APPLICATION
Similarly, the EHO can apply these tools to inspect food, food handlers, food handling and preparation processes and food preparation premises to identify food safety hazards and recommend strategies for reducing or eliminating them to ALARP. In case of work processes and methods that cannot be corrected, a well documented change process, agreed by the parties, should be put in place to change the process and or method to a safe one.
3.2. AREAS TO APPLY THESE TOOLS (AREAS OF COVERAGE)
Areas of concern where these tools can be applied are:
i. The food transportation process;
ii. The food stores (cold and dry) and other storage facilities;
iii. The kitchen which includes cooking equipment and utensils, floors, service drains personnel i.e. all categories of food handlers and designated waste management tools and equipment.
4. HSE AND FOOD HANDLING PERSONNEL
The HSSE tool can also be used to assess some health parameters of food handling personnel in areas such their personal health, personal hygiene and the use of personal protection equipment (PPE) in food handling.
4.1. HEALTH OF FOOD HANDLERS: By health of food handlers we mean the state of fitness of the food handler. State of fitness refers to the physical, mental and social wellbeing of the food handler.
The current practice in determining the fitness of food handlers does not lie only in medical examination but rather on the implementation of a fitness to work (FTW) regime. This process involves the filling out of a questionnaire by the food handler stating his/her health status. This questionnaire is kept as the baseline data on the health of the food handler. It is used in assessing the health of the food handler in times of illness. A food handler is made to update the questionnaire each time he/she stays away from work due to ill health. The updating must include the type of ill health that kept the food handler away from work. This process thus gives facility owner and visiting EHO to make a good assessment of the health status personnel and gets some fall back data base during the investigation of a food poisoning incident.
4.2. PERSONAL HYGIENE: Personal hygiene of food handlers refers to the state of cleanness of the food handler and this is a function of the general maintenance of the body. The hair, the finger and toe nails, the armpits and pubic regions and all other enclosed parts and the entire body and clothes must be scrupulously cleaned and maintained at all times. It also involves proper bathing and wash ups and care of the private and enclosed parts of the earlier mentioned. Hairs must be on low cut or covered with appropriate head gear.
4.3. PERSONAL PROTECTION EQUIPMENT (PPE) Food handlers must always wear PPE when on duty. Apart from helping to protect the food handler during an accident, it also keeps him or her comfortable and gives a sense of pride thereby increasing productivity.
References
1. Clay’s handbook of Environmental Health, W. H. Basset and F.G. Davies; 1981 H. K. Lewis & Co Ltd, London.
2. FOOD Poisoning and Food Hygiene 2nd ed., Betty C. Hobbs; 1970 Spattishwoode, Ballantyne & Co Ltd, London and Golchester.
3. Coroner’s Practical Food Hygiene, Coroner Publications Ltd, London.
Friday, August 31, 2012
THE PLACE OF HSE IN FOOD INSPECTION
I am an environmental public health practitioner. Obtained first degree in public health [environmental health and safety] from Federal University of Technology, Owerri.
Tuesday, August 28, 2012
HEALTH, SAFETY AND ENVIRONMENT: CHALLENGES OF THE CURRENT DEMOCRATIC DISPENSATION
By Professor F. 0. OLA TUNJI
Department of Chemical Engineering
University of Lagos,
Akoka — Yaba,
LAGOS.
A paper presented at the 39th Environmental Health Officers Association of Nigeria, held in Lagos, 2003
1.0 INTRODUCTION
It gives me great pleasure and I feel highly honoured to be invited to deliver a plenary address at this your 39th Annual National Conference of the Nigerian Environmental Health Officers Association (NEHOA) taking place at the Banquet Hall, Lagos Airport Hotel, Lagos. I can see that I am to speak on the theme of this Conference, viz, “Health, Safety and Environment: Challenges of the Current Democratic Dispensation”. This theme cuts across many areas in the wide field of Health, Safety and Environment (HSE). We must immediately recognize that this Conference is for Environmental Health Officers and therefore we must emphasize aspects that relate to environmental health in this conference. It is well known that health, safety and environment are very much inter-related and any nation that believes in proper development of its people must consider this trio-based activity.
I wish to congratulate your organizers for choosing such a timely theme/topic at this time of our nation’s development in the present democratic dispensation.
2.0 WHAT IS “HEALTH, SAFETY AND ENVIRONMENT (HSE)?”
It is well known that man’s activities have impacted heavily on Mother Nature and those activities have caused deterioration in the quality of the environment and health, and poor safety conditions. Audu (1) had looked at the evolution of HSE management in the world as reported in a workshop in the year, 2000. The point has been made that the focus of man is predominantly exploitative involving unhealthy race/competition. Also, there was the wrong notion that the environment is ever assimilative, thus assuming that the Earth was inexhaustible in resources and characteristically discrete in behaviour. It was only in the area of safety that Man’s activities even in the olden days had slightly taken some precautions because of the direct impact on the people. This means that indirect impacts on man never receive as much attention for precautionary measures as direct impacts. It is interesting to note that, even in the olden days, safety was managed by instincts and not by scientific analysis or structured approach. Thus, “historical failures” determined how to prevent future occurrences of safety failures.
It is important to note Audu’s assertion in his paper that the Environmental and Occupational health aspects did not attract equivalent attention until much later historically largely because of their indirect impact on man’s wellbeing. We are told that with booming economy, various governments awoke to their responsibility of policy making and enforcing the regulations. We must mention here the establishment of the Federal Environmental Protection Agency (FEPA) IN 1988 which has served as an effective regulatory body in the control of quality of the environment.
Also it was interesting to note that increased public awareness (people standing up to their rights) has literally “cajoled” industries to taking a hard look at their processes in a bid to align the industries towards effective management of HSE aspects.
Because of their interrelationships, the HSE matters were elevated and structures of managing them put in place just like that for any process activity. It has since metamorphosed and given birth to the management system (MS) of HSE. Nigeria cannot afford to trail behind with her fast emerging and liberated economy. In any case, public awareness is ever Increasing and agitation is also becoming sophisticated. There now exists in the very developed companies HSE-Management System manual known as HSE-MS Manual. This manual is a documentation of systemic approach to management of HSE- critical aspect of our activities and an attestation of commitment to sustainable development.
Being a management tool the HSE-MS draws its existence from a Business Model (BM), Quality Management System (QMS) and Hazard and Effects Management Process (HEMP). It is hoped that Nigeria will soon adopt widely the concept of the development and use of the HSE-MS manual.
Let us at this juncture look at an example of HSE policy as enunciated by Mobil Producing Nigeria (MPN). In a paper written by Chief O.T. Olagbende, Manager, Environmental Affairs, MPN in year 2000 (2), HSE Policy for MPN states that “Mobil Producing Nigeria Unlimited is committed to safeguarding public health and protecting the physical environment of Nigeria” . The paper continues thus: “In recognition of this commitment, MPN complies with all applicable environmental laws and regulations and additionally strives to reduce overall emissions and encourage pollution prevention in Its operations wherever technically and economically feasible. In implementing its HSE Policy, MPN emphasizes among other measures, Pollution Prevention by encouraging techniques such as sources reduction, process modifications, reuse and improved housekeeping. Management of these techniques is achieved through procedure outlined in MPN Waste Management Programme. Also emphasized is participation in the Development and Transfer of Environmental Technology aimed at improving methods of storage, transportation, handling, treatment and disposal of wastes generated from its operations.”
3.0 OCCUPATIONAL HEALTH SERVICES IN NIGERIA.
For a Conference of Environmental Health Officers, the subject of occupational health services must be very important. In a paper presented at a Workshop in year 2000 (3), Chike Nwokike, Medical Adviser to Lever Brothers Plc looked at the Effective Organisation of Occupational Health Services in Nigeria. The summary of the paper is discussed here. The first thing to note is the WHO/ILO assertion that “every citizen of the world has a right to healthy and safe work, and to a work environment that enables him or her to live a socially and economically productive life. Nwokike’s paper reviewed the subject of occupational health and its practice In Nigeria and suggested strategies for improvement at the national level and within organizations, using modern management systems. We are told that Occupational Health is defined by the WHO and ILO as the promotion and maintenance of the highest degree of physical, mental and social well-being of workers of all occupations. Other aspects of the paper by Nwokikle are summarized below:
Occupational health is primarily concerned with health in its relation to work and the working environment and is largely preventive in nature. Occupational health seeks to protect workers from hazards at work and prevent work-related illness. In addition, occupational health is also concerned with preventing adverse effects on the work as a result of the health status of the worker. It is said that WHO declares that occupational health is an important strategy not only to ensure the health of workers, but also to contribute positively to productivity, quality of products, work motivation, job satisfaction and thereby to the overall quality of life of individuals and society.
You may wonder what is the result of inadequate occupational health and safety services. This is said to result in poor working environments with uncontrolled exposure of workers to hazardous conditions. This situation can be costly to the individual workers, the employers and the country at large as a whole in terms of human misery and financial losses.
The results of inadequate occupational health and safety services include the following:
i. Injuries and deaths from work-related accidents.
ii. Acute and chronic illness from work exposure.
iii. Increased sickness, absence and loss of man-hours.
iv. Low morale, low productivity.
v. High medical costs.
vi. Avoidable damage to machinery from accidents
vii. Poor quality products
viii. Poor public Image
ix. Higher costs, lower sales leading to lower profits.
It is worth noting that the development of adequate occupational health and safety services in Nigeria has been hampered by the following factors:
a. Insufficient knowledge and understanding of the critical issues involved in occupational health and safety on the part of the workers, management, employers and even government.
b. Many of the workers are illiterate and are not able to adequately understand the machinery and appreciate hazards of the industrial processes and chemicals.
c. High rate of unemployment means high reservoir of low cost manpower and consequently the value of labour is not appreciated.
d. Cultural factors — for example a fatalistic outlook that accepts accidents or occupational disease as inevitable..
e. Inadequate training facilities in occupational health and safety.
f. Inadequate and ineffective legislation-poorly enforced.
g. Non-reporting of accidents and occupational diseases resulting in inaccurate statistics.
h. Poorly focused Trade Unions who are more interested in wages etc than improvement in health and safety.
i. Lack of commitment and direction by government.
It must be mentioned here that many organizations and industries in Nigeria, instead of encouraging the provision of proper and core occupational health and safety services, have encouraged the provision of limited curative services usually through general practitioners on retainership basis. The exceptions are few of our multinational companies in Nigeria like Unilever Brothers, Cadbury, Nestle etc. as well as some Oil companies including the NNPC.
- Special e.g. drivers’ medical, food handlers
(iii) Supervision of the Working Environment
- Regular factory/work area visits
- Advice on industrial hygiene
- Hazard Identification
- Personal Protective Equipment/Clothing Supervision
- Environmental Monitoring
- Ergonomics Control.
(iv) Biological Monitoring e.g. Audiometry, Lung Function Test.
(v) Supervision of Food Hygiene
(vi) Advice to Management and Staff on Occupational Health
(vii) Health Education/Training e.g. in health, hygiene, first aid etc.
(viii) Health Promotion, Counselling
(ix) Supervision of Sanitary Conveniences and General Cleanliness
(x) Records/Health Statistics
(xi) Research/Teaching.
We need to take note of the final point made in Nwodike’s paper as to the need for establishing integrated occupational health, safety and environmental services unit, It is now a normal practice in many large organizations in the developed countries to have this type of integrated system. This helps In ensuring coordinated efforts in providing high standard and efficient servides.
It is important to develop an integrated Health, Safety and Environmental policy for a given company as advocated by Nwodike. This Health, Safety and Environment Unit would act as an indispensable advisory service to which all levels of management and production can systematically turn for advice whenever necessary.
4.0 HSE AUDIT AND ITS IMPORTANCE
The question we should ask ourselves at this point is why HSE Audit? In order to answer this question, we need to even know what HSE Audit is all about. Ndukwe (4), in a Workshop paper in the year 2000, took a look at Health, Safety and Environmental Audit. His paper defines auditing of health, safety, and environment as a process of monitoring an organization’s ongoing management of the various activities that can have an impact on human heal! h, safety or on the environment. Ndukwu asserts that a sure way of assuring a community that an organization’s operations do not pose unreasonable risks to human beings, or to the environment, is by having an audit conducted by skilled personnel using state-of-the-art-techniques. In addition, he says that it is advantageous to an organization if, from time to time, it does safety and environmental audit of its facilities especially when an audit ensures that an organization complies with all applicable regulatory and internal policies.
Ndukwe gives a brief account of what Health, Safety and Environmental audit is all about. This is as follows:
Audit Planning
At the audit planning stage, the auditors decided on the form of written document to guide them in the fieldwork portion of the audit. This document is usually known as audit protocol.
Understanding Internal Management Systems and Procedures
This is the first on-site activity of the auditors. The auditors must have accurate understanding of the facility’s management systems, standard practices and procedures, and be able to relate them to the scope of the audit. The auditors develop a working understanding of how the facility manages its activities, which can impact its Health, Safety and Environmental performance.
Assessing Strengths and Weakness of Internal Controls
In this step, the aim is to assess the facility’s environmental management systems and the engineered controls, whether if operating as intended will yield results that meet external regulatory requirements and any internal standards. The review and evaluation are intended to reveal the inadequacies in the facility’s health, safety and environmental management systems and to suggest ways of improving the management systems and/or engineered controls as the case may be.
Gathering Audit Evidence/Findings.
The first thing to do before gathering audit evidence is that the team develops a testing plan which includes verification strategies, sampling methods, and approximate time allocations for doing specific jobs. The audit team must ensure that evidence is gathered in accordance with testing plans to determine compliance with governmental and internal requirements and to verify that each of the environmental management systems included in the audit is working as designed and intended.
Evaluating Audit Results.
Prior to audit results being evaluated, each auditor should check his/her assigned protocol steps to ascertain that they have been completed and, if not, what additional information is needed. There is also a need to review the list of audit exceptions to ensure that they are all factually correct.
Audit results to be evaluated include audit findings (an overall statement of compliance with regulatory requirements or conformance with internal standards), exceptions (specific deficiencies with respect to applicable regulations or internal requirements), and observations (which may include exemplary practices, but more often may include specific deficiencies or areas of concern).
Reporting Audit Findings and Exceptions
This is the final step in the basic 6-step audit process. The report should accurately reflect the audit findings, exceptions, and observations.
Ndukwe’s conclusion is worth noting.
a. That the focus of audit report should be on compliance with regulations, policies and procedures, and good management practices (not on individuals or their mistakes).
b. That the main aim of an audit is to recognise good practices, update procedures, eliminate exceptions, and sensitise an organisation on issues which in future will be important to health, safety and environment.
5.0 CASE STUDIES OF RESEARCH WORK ON WASTE
MANAGEMENT IN THE PRESENT DEMOCRATIC DISPENSATION
This paper concludes with case studies of current research findings by graduates of the Postgraduate Diploma (PGD) programme in HSE at the College of Medicine, University of Lagos (CMUL). These researches have been carried out on present problems in our local environment and these are only a tip of the iceberg.
Case Study 1: Mushin Local Government Area of Lagos State.
a. Title of Project: “The Problem of Solid Waste Management and Its Effect on Community Health in Mushin Local Government”. Sanusi, A.K. PGD/HSE, College of Medicine Project, 2000.
b. Brief Comments from the Author’s Work
Waste Management in Mushin Local Government remains an environmental problem that is becoming more complex on daily basis. The current challenge calls for the government, private sectors, voluntary organization, to harmonise their activities to promote sustainable management of waste. The different methods of solid waste management in Mushin Local Government are listed as follows: Burning, Burying, House Collection, Incineration, Open Dumping, Twin Litter Bins’ Communal Refuse Depots, Cart Pushing and Land Fill Sites.
c. Recommendations from the Author’s Work (only a few given here)
i. There should be a statutory requirement that all solid waste emanating from home, offices and factories must be sorted and placed in labeled polythene bags for the private operators to collect.
ii. It is reasonable that sorting of waste begins at sources. Categories into which the waste can be sorted include plastics, metals, non-metals and organic paper.
iii. Indiscriminate dumping of waste or dropping of litter on roads or into gutter or public drains should be legislated against and should attract a minimum penalty to discourage people against it.
iv. Enforcement must be strict and should be handled by specially trained environmental health officers equipped with motor-cycles or vehicles for mobility and accessibility.
v. Lagos State Waste Management Authority should create fence and supervise dumping sites at suitable locations well away from building areas to which all those within the locality must take their waste.
vi. The local government councils should supplement the effort of the private sector participation (PSP) by a sort of mopping up exercises, for example, removing of waste from the public places, schools, hospitals, open places, public drains, roads, median and verge.
vii. The local government should commence the teaching of environmental health and safety subjects in the primary schools, as a means of catching them young and also of reaching out to their parents and getting them to develop environmentally-friendly habits.
viii. Licensing of private waste management operations should be done by the local government, using ward clusters as operating base units.
ix. These operators must, as a prerequisite for licencing, produce evidence of their ability to mobilize the resources, i.e. men, tippers, needed for their job
x. The environmental department of the local government should be adequately funded in order to enable the mopping up exercises to be successfully carried out and the environmental equipment to be purchased, such as rakes, hand-shovels, tippers and mechanical shovels.
xi. The environmental health officers of the local government need to be exposed to more management training exercises to enable them learn modern management concepts which will help them plan their work better and learn to think more critically and creatively about their work.
xii. Finally, there is need to employ more environmental health officers in the State. Presently, the number of environmental health officers in the State as at year 2000 is less than 800 which is just too small to cope with the challenges in the State.
Case Study 2: Epe Local Government Area of Lagos State.
a. Title of Project: “Environmental Impacts of Bush Burn/nc, and other Burning Activities in Epe Local Government Area of Lagos State.”. Amacho, T PGD/HSE, College of Medicine, Unilag Project 2000.
b. Brief Comments from the Author’s Work
Epe Local Government Area is a rural setting with a population of 219,891 by the National Population Commission data of 1990. It is bounded on the West by lkorodu Local Government Area and on the South by lbeju-Lekki Local Government Areas both of Lagos State. The boundary on the North is by Odogbolu Local Government Area of Ogun State and on the East by Iwopin Riverine Local Government area also of Ogun State. The main occupation of the people are farming, fishing and petty trading.
Bush burning is an activity that is mostly carried out by farmers in Epe LGA in order to prepare the land for farming which is one of the major occupations of the indigenes. Apart from bush burning, other burning activities considered and studied were domestic or household burning (also termed residential burning), industrial burning, and burning in public place.
c. Recommendations from the Author’s Work
i. Awareness should be created among the people on the dangers of burning activities especially through community involvement and participation.
ii. There should be provision of adequate ventilation in case of domestic burning.
iii. There should be promulgation of laws against indiscriminate burning activities relating to bush burning, refuse burning and burning of garden weeds.
iv. Community watchmen should be engaged in the monitoring of indiscriminate burning within the community.
v. There should also be regular monitoring of the state of the environment by the State Government through the activities of the advisory committee on environmental sanitation set up by the Ministry of Environment and Physical Planning.
vi. Attempt should be made to convert heat energy produced by incinerators, furnaces and burners into steam for treating and drying processes.
vii. There should be provision of Personal Protective Equipment (PPE), such as nose masks, for workers in the burning or incineration industry if air pollution cannot be controlled or reduced to a minimum.
viii. Environmental education should be introduced into School Curriculum especially at the primary and secondary levels.
Case Study 3: Ikeja Local Government Area of Lagos State.
a. Title Project: “Private Sector Participation in Domestic Refuse Collection and Disposal: A Viable Option in Solid Waste Management in Ike] a Local Government Area of Lagos State” lyoriobhe, V.E. PGD/HSE, College of Medicine Project, 2002.
b. Brief Comments from the Author’s Work
Ikeja Local Government is one of the twenty local governments in Lagos State. The Local Govenment area is bounded in the North by Agege and lfako-ljaye Local Governments, in the East by Kosofe and Sornolu Local Governments, in the South by the Mushin Local Government and in the West by Oshodi/Isolo and Alimosho Local Governments. lkeja Local Government area is a mini-Nigeria in setting, with almost all the tribes present, though the majority of the inhabitants are predominantly Yoruba speaking people. The population according to 1991 census figures is 281,530. The project focuses on the Involvement of private sector participation (PSP) in domestic refuse ‘collection and disposal in Ikeja Local Government Area. As at the time of the project in the year 2002, there were twenty-six (26) private sector refuse operators.
c. Recommendations from the Author’s Work
i. There are inadequate resources militating against effective solid waste management. These resources are pay loaders, bulldozers, tippers, compacting vehicles, dino chassis and bins, cleaning implements and funds. Adequate provision of these sources will enhance solid waste management.
ii. There is a need for private sector to be involved in solid waste management in all the urban local government areas in the country since they have similar problems in solid waste management. This is because the government cannot bear the burden of solid waste management alone as a result of the huge cost. More importantly, those who generate the refuse that pollute the environment should pay for its evacuation. The programme is working in Lagos State.
iii. There is a need for recruitment of skilled personnel such as Sanitary Engineers, Environmentalists, Geologists and Environmental Health Officer to take charge of solid waste management. These personnel should be able to plan and coordinate all the processes involved in solid waste management.
iv. There should be adequate and proper town planning for effective sold waste management. For example, there is a need to provide good access roads which should be properly linked to one another. Other needs are street lights and good drainage system. All these will ease the evacuation of refuse from all the nooks and crannies of the city.
v. There is also a need to put in place development and extension of Health Education Services.
There is no doubt that if every Nigerian has been duly and sufficiently exposed to Health Education, the environmental sanitation of Lagos state in general would change for the better. A well-planned and coordinated environmental health education programme for all the communities in the state should be given high priority.
vi. There should be comprehensive environmental legislation. The laws relating to environmental sanitation offences should be made comprehensive. The cases should be tried in courts especially set up for environmental sanitation and related matters. Stiff penalties should be meted out to offenders. The enforcement officers should ensure that the laws are enforced to its logical conclusion.
vii. Refuse waste should be sorted out at source of storage. The reusable materials should be bagged in bags with different colours. The items should be identified with the colour of the bags.
viii. The private sector operators in solid waste management should be strengthened in terms of acquisition of appropriate equipment such as tippers and compacting vehicles. The government should fashion out a way to grant them loans directly or guarantee the loans in financial institutions. To ensure repayment, a mechanism to recover the money should be put in place.
ix. There should be sanctions for the private operators who do not perform according to the law. Any Private Sector Operator with lapses should be removed from the proramme. However, prior to the removal, he/she should be warned in writing at least three times.
x. Finally, there should be a way to reward the best worker and/or the best private refuse operator company. This reward system will motivate the workers, while it will also create competition among the operators.
6.0 CONCLUSION
The paper takes a look at Health, Safety and Environment (HSE) as it affects the Nigerian polity. The paper focuses on occupational health services in Nigeria and the need for establishing integrated HSE service units in organizations. The importance of HSE audit was highlighted especially to ensure compliance with regulations, policies and procedures as well as good management practices. Finally, in order to bring out the challenges of the current democratic dispensation, case studies of current research work on waste management problems in Lagos State were given and discussed.
7.0 REFERENCES
1. AUDU, Y.B. (200) “Managing HSE as Core Business” Nig. Soc, of Chem. Engineers Proceedings, Nov pp. 161-1 70.
2. OLAGBENDE, O.T. (2000) “Waste Management Programme-Mobil Producing Nigeria’s Experience”. The Punch, June 5, 2002
3. NWOKIKE, C. (2000) “Effective Organization of Occupational Health Services in Nigeria.” Nig. Soc, of Chem. Engineers” Proceedings, Nov. Pp.11-28.
4. NDUKWE, O.C. (2000). “Another Look at Health, Safety and Environmental Audit”. Nig. Soc. Of Chem. Engineers’ Proceedings, Nov. Pp. 92-98.
Department of Chemical Engineering
University of Lagos,
Akoka — Yaba,
LAGOS.
A paper presented at the 39th Environmental Health Officers Association of Nigeria, held in Lagos, 2003
1.0 INTRODUCTION
It gives me great pleasure and I feel highly honoured to be invited to deliver a plenary address at this your 39th Annual National Conference of the Nigerian Environmental Health Officers Association (NEHOA) taking place at the Banquet Hall, Lagos Airport Hotel, Lagos. I can see that I am to speak on the theme of this Conference, viz, “Health, Safety and Environment: Challenges of the Current Democratic Dispensation”. This theme cuts across many areas in the wide field of Health, Safety and Environment (HSE). We must immediately recognize that this Conference is for Environmental Health Officers and therefore we must emphasize aspects that relate to environmental health in this conference. It is well known that health, safety and environment are very much inter-related and any nation that believes in proper development of its people must consider this trio-based activity.
I wish to congratulate your organizers for choosing such a timely theme/topic at this time of our nation’s development in the present democratic dispensation.
2.0 WHAT IS “HEALTH, SAFETY AND ENVIRONMENT (HSE)?”
It is well known that man’s activities have impacted heavily on Mother Nature and those activities have caused deterioration in the quality of the environment and health, and poor safety conditions. Audu (1) had looked at the evolution of HSE management in the world as reported in a workshop in the year, 2000. The point has been made that the focus of man is predominantly exploitative involving unhealthy race/competition. Also, there was the wrong notion that the environment is ever assimilative, thus assuming that the Earth was inexhaustible in resources and characteristically discrete in behaviour. It was only in the area of safety that Man’s activities even in the olden days had slightly taken some precautions because of the direct impact on the people. This means that indirect impacts on man never receive as much attention for precautionary measures as direct impacts. It is interesting to note that, even in the olden days, safety was managed by instincts and not by scientific analysis or structured approach. Thus, “historical failures” determined how to prevent future occurrences of safety failures.
It is important to note Audu’s assertion in his paper that the Environmental and Occupational health aspects did not attract equivalent attention until much later historically largely because of their indirect impact on man’s wellbeing. We are told that with booming economy, various governments awoke to their responsibility of policy making and enforcing the regulations. We must mention here the establishment of the Federal Environmental Protection Agency (FEPA) IN 1988 which has served as an effective regulatory body in the control of quality of the environment.
Also it was interesting to note that increased public awareness (people standing up to their rights) has literally “cajoled” industries to taking a hard look at their processes in a bid to align the industries towards effective management of HSE aspects.
Because of their interrelationships, the HSE matters were elevated and structures of managing them put in place just like that for any process activity. It has since metamorphosed and given birth to the management system (MS) of HSE. Nigeria cannot afford to trail behind with her fast emerging and liberated economy. In any case, public awareness is ever Increasing and agitation is also becoming sophisticated. There now exists in the very developed companies HSE-Management System manual known as HSE-MS Manual. This manual is a documentation of systemic approach to management of HSE- critical aspect of our activities and an attestation of commitment to sustainable development.
Being a management tool the HSE-MS draws its existence from a Business Model (BM), Quality Management System (QMS) and Hazard and Effects Management Process (HEMP). It is hoped that Nigeria will soon adopt widely the concept of the development and use of the HSE-MS manual.
Let us at this juncture look at an example of HSE policy as enunciated by Mobil Producing Nigeria (MPN). In a paper written by Chief O.T. Olagbende, Manager, Environmental Affairs, MPN in year 2000 (2), HSE Policy for MPN states that “Mobil Producing Nigeria Unlimited is committed to safeguarding public health and protecting the physical environment of Nigeria” . The paper continues thus: “In recognition of this commitment, MPN complies with all applicable environmental laws and regulations and additionally strives to reduce overall emissions and encourage pollution prevention in Its operations wherever technically and economically feasible. In implementing its HSE Policy, MPN emphasizes among other measures, Pollution Prevention by encouraging techniques such as sources reduction, process modifications, reuse and improved housekeeping. Management of these techniques is achieved through procedure outlined in MPN Waste Management Programme. Also emphasized is participation in the Development and Transfer of Environmental Technology aimed at improving methods of storage, transportation, handling, treatment and disposal of wastes generated from its operations.”
3.0 OCCUPATIONAL HEALTH SERVICES IN NIGERIA.
For a Conference of Environmental Health Officers, the subject of occupational health services must be very important. In a paper presented at a Workshop in year 2000 (3), Chike Nwokike, Medical Adviser to Lever Brothers Plc looked at the Effective Organisation of Occupational Health Services in Nigeria. The summary of the paper is discussed here. The first thing to note is the WHO/ILO assertion that “every citizen of the world has a right to healthy and safe work, and to a work environment that enables him or her to live a socially and economically productive life. Nwokike’s paper reviewed the subject of occupational health and its practice In Nigeria and suggested strategies for improvement at the national level and within organizations, using modern management systems. We are told that Occupational Health is defined by the WHO and ILO as the promotion and maintenance of the highest degree of physical, mental and social well-being of workers of all occupations. Other aspects of the paper by Nwokikle are summarized below:
Occupational health is primarily concerned with health in its relation to work and the working environment and is largely preventive in nature. Occupational health seeks to protect workers from hazards at work and prevent work-related illness. In addition, occupational health is also concerned with preventing adverse effects on the work as a result of the health status of the worker. It is said that WHO declares that occupational health is an important strategy not only to ensure the health of workers, but also to contribute positively to productivity, quality of products, work motivation, job satisfaction and thereby to the overall quality of life of individuals and society.
You may wonder what is the result of inadequate occupational health and safety services. This is said to result in poor working environments with uncontrolled exposure of workers to hazardous conditions. This situation can be costly to the individual workers, the employers and the country at large as a whole in terms of human misery and financial losses.
The results of inadequate occupational health and safety services include the following:
i. Injuries and deaths from work-related accidents.
ii. Acute and chronic illness from work exposure.
iii. Increased sickness, absence and loss of man-hours.
iv. Low morale, low productivity.
v. High medical costs.
vi. Avoidable damage to machinery from accidents
vii. Poor quality products
viii. Poor public Image
ix. Higher costs, lower sales leading to lower profits.
It is worth noting that the development of adequate occupational health and safety services in Nigeria has been hampered by the following factors:
a. Insufficient knowledge and understanding of the critical issues involved in occupational health and safety on the part of the workers, management, employers and even government.
b. Many of the workers are illiterate and are not able to adequately understand the machinery and appreciate hazards of the industrial processes and chemicals.
c. High rate of unemployment means high reservoir of low cost manpower and consequently the value of labour is not appreciated.
d. Cultural factors — for example a fatalistic outlook that accepts accidents or occupational disease as inevitable..
e. Inadequate training facilities in occupational health and safety.
f. Inadequate and ineffective legislation-poorly enforced.
g. Non-reporting of accidents and occupational diseases resulting in inaccurate statistics.
h. Poorly focused Trade Unions who are more interested in wages etc than improvement in health and safety.
i. Lack of commitment and direction by government.
It must be mentioned here that many organizations and industries in Nigeria, instead of encouraging the provision of proper and core occupational health and safety services, have encouraged the provision of limited curative services usually through general practitioners on retainership basis. The exceptions are few of our multinational companies in Nigeria like Unilever Brothers, Cadbury, Nestle etc. as well as some Oil companies including the NNPC.
- Special e.g. drivers’ medical, food handlers
(iii) Supervision of the Working Environment
- Regular factory/work area visits
- Advice on industrial hygiene
- Hazard Identification
- Personal Protective Equipment/Clothing Supervision
- Environmental Monitoring
- Ergonomics Control.
(iv) Biological Monitoring e.g. Audiometry, Lung Function Test.
(v) Supervision of Food Hygiene
(vi) Advice to Management and Staff on Occupational Health
(vii) Health Education/Training e.g. in health, hygiene, first aid etc.
(viii) Health Promotion, Counselling
(ix) Supervision of Sanitary Conveniences and General Cleanliness
(x) Records/Health Statistics
(xi) Research/Teaching.
We need to take note of the final point made in Nwodike’s paper as to the need for establishing integrated occupational health, safety and environmental services unit, It is now a normal practice in many large organizations in the developed countries to have this type of integrated system. This helps In ensuring coordinated efforts in providing high standard and efficient servides.
It is important to develop an integrated Health, Safety and Environmental policy for a given company as advocated by Nwodike. This Health, Safety and Environment Unit would act as an indispensable advisory service to which all levels of management and production can systematically turn for advice whenever necessary.
4.0 HSE AUDIT AND ITS IMPORTANCE
The question we should ask ourselves at this point is why HSE Audit? In order to answer this question, we need to even know what HSE Audit is all about. Ndukwe (4), in a Workshop paper in the year 2000, took a look at Health, Safety and Environmental Audit. His paper defines auditing of health, safety, and environment as a process of monitoring an organization’s ongoing management of the various activities that can have an impact on human heal! h, safety or on the environment. Ndukwu asserts that a sure way of assuring a community that an organization’s operations do not pose unreasonable risks to human beings, or to the environment, is by having an audit conducted by skilled personnel using state-of-the-art-techniques. In addition, he says that it is advantageous to an organization if, from time to time, it does safety and environmental audit of its facilities especially when an audit ensures that an organization complies with all applicable regulatory and internal policies.
Ndukwe gives a brief account of what Health, Safety and Environmental audit is all about. This is as follows:
Audit Planning
At the audit planning stage, the auditors decided on the form of written document to guide them in the fieldwork portion of the audit. This document is usually known as audit protocol.
Understanding Internal Management Systems and Procedures
This is the first on-site activity of the auditors. The auditors must have accurate understanding of the facility’s management systems, standard practices and procedures, and be able to relate them to the scope of the audit. The auditors develop a working understanding of how the facility manages its activities, which can impact its Health, Safety and Environmental performance.
Assessing Strengths and Weakness of Internal Controls
In this step, the aim is to assess the facility’s environmental management systems and the engineered controls, whether if operating as intended will yield results that meet external regulatory requirements and any internal standards. The review and evaluation are intended to reveal the inadequacies in the facility’s health, safety and environmental management systems and to suggest ways of improving the management systems and/or engineered controls as the case may be.
Gathering Audit Evidence/Findings.
The first thing to do before gathering audit evidence is that the team develops a testing plan which includes verification strategies, sampling methods, and approximate time allocations for doing specific jobs. The audit team must ensure that evidence is gathered in accordance with testing plans to determine compliance with governmental and internal requirements and to verify that each of the environmental management systems included in the audit is working as designed and intended.
Evaluating Audit Results.
Prior to audit results being evaluated, each auditor should check his/her assigned protocol steps to ascertain that they have been completed and, if not, what additional information is needed. There is also a need to review the list of audit exceptions to ensure that they are all factually correct.
Audit results to be evaluated include audit findings (an overall statement of compliance with regulatory requirements or conformance with internal standards), exceptions (specific deficiencies with respect to applicable regulations or internal requirements), and observations (which may include exemplary practices, but more often may include specific deficiencies or areas of concern).
Reporting Audit Findings and Exceptions
This is the final step in the basic 6-step audit process. The report should accurately reflect the audit findings, exceptions, and observations.
Ndukwe’s conclusion is worth noting.
a. That the focus of audit report should be on compliance with regulations, policies and procedures, and good management practices (not on individuals or their mistakes).
b. That the main aim of an audit is to recognise good practices, update procedures, eliminate exceptions, and sensitise an organisation on issues which in future will be important to health, safety and environment.
5.0 CASE STUDIES OF RESEARCH WORK ON WASTE
MANAGEMENT IN THE PRESENT DEMOCRATIC DISPENSATION
This paper concludes with case studies of current research findings by graduates of the Postgraduate Diploma (PGD) programme in HSE at the College of Medicine, University of Lagos (CMUL). These researches have been carried out on present problems in our local environment and these are only a tip of the iceberg.
Case Study 1: Mushin Local Government Area of Lagos State.
a. Title of Project: “The Problem of Solid Waste Management and Its Effect on Community Health in Mushin Local Government”. Sanusi, A.K. PGD/HSE, College of Medicine Project, 2000.
b. Brief Comments from the Author’s Work
Waste Management in Mushin Local Government remains an environmental problem that is becoming more complex on daily basis. The current challenge calls for the government, private sectors, voluntary organization, to harmonise their activities to promote sustainable management of waste. The different methods of solid waste management in Mushin Local Government are listed as follows: Burning, Burying, House Collection, Incineration, Open Dumping, Twin Litter Bins’ Communal Refuse Depots, Cart Pushing and Land Fill Sites.
c. Recommendations from the Author’s Work (only a few given here)
i. There should be a statutory requirement that all solid waste emanating from home, offices and factories must be sorted and placed in labeled polythene bags for the private operators to collect.
ii. It is reasonable that sorting of waste begins at sources. Categories into which the waste can be sorted include plastics, metals, non-metals and organic paper.
iii. Indiscriminate dumping of waste or dropping of litter on roads or into gutter or public drains should be legislated against and should attract a minimum penalty to discourage people against it.
iv. Enforcement must be strict and should be handled by specially trained environmental health officers equipped with motor-cycles or vehicles for mobility and accessibility.
v. Lagos State Waste Management Authority should create fence and supervise dumping sites at suitable locations well away from building areas to which all those within the locality must take their waste.
vi. The local government councils should supplement the effort of the private sector participation (PSP) by a sort of mopping up exercises, for example, removing of waste from the public places, schools, hospitals, open places, public drains, roads, median and verge.
vii. The local government should commence the teaching of environmental health and safety subjects in the primary schools, as a means of catching them young and also of reaching out to their parents and getting them to develop environmentally-friendly habits.
viii. Licensing of private waste management operations should be done by the local government, using ward clusters as operating base units.
ix. These operators must, as a prerequisite for licencing, produce evidence of their ability to mobilize the resources, i.e. men, tippers, needed for their job
x. The environmental department of the local government should be adequately funded in order to enable the mopping up exercises to be successfully carried out and the environmental equipment to be purchased, such as rakes, hand-shovels, tippers and mechanical shovels.
xi. The environmental health officers of the local government need to be exposed to more management training exercises to enable them learn modern management concepts which will help them plan their work better and learn to think more critically and creatively about their work.
xii. Finally, there is need to employ more environmental health officers in the State. Presently, the number of environmental health officers in the State as at year 2000 is less than 800 which is just too small to cope with the challenges in the State.
Case Study 2: Epe Local Government Area of Lagos State.
a. Title of Project: “Environmental Impacts of Bush Burn/nc, and other Burning Activities in Epe Local Government Area of Lagos State.”. Amacho, T PGD/HSE, College of Medicine, Unilag Project 2000.
b. Brief Comments from the Author’s Work
Epe Local Government Area is a rural setting with a population of 219,891 by the National Population Commission data of 1990. It is bounded on the West by lkorodu Local Government Area and on the South by lbeju-Lekki Local Government Areas both of Lagos State. The boundary on the North is by Odogbolu Local Government Area of Ogun State and on the East by Iwopin Riverine Local Government area also of Ogun State. The main occupation of the people are farming, fishing and petty trading.
Bush burning is an activity that is mostly carried out by farmers in Epe LGA in order to prepare the land for farming which is one of the major occupations of the indigenes. Apart from bush burning, other burning activities considered and studied were domestic or household burning (also termed residential burning), industrial burning, and burning in public place.
c. Recommendations from the Author’s Work
i. Awareness should be created among the people on the dangers of burning activities especially through community involvement and participation.
ii. There should be provision of adequate ventilation in case of domestic burning.
iii. There should be promulgation of laws against indiscriminate burning activities relating to bush burning, refuse burning and burning of garden weeds.
iv. Community watchmen should be engaged in the monitoring of indiscriminate burning within the community.
v. There should also be regular monitoring of the state of the environment by the State Government through the activities of the advisory committee on environmental sanitation set up by the Ministry of Environment and Physical Planning.
vi. Attempt should be made to convert heat energy produced by incinerators, furnaces and burners into steam for treating and drying processes.
vii. There should be provision of Personal Protective Equipment (PPE), such as nose masks, for workers in the burning or incineration industry if air pollution cannot be controlled or reduced to a minimum.
viii. Environmental education should be introduced into School Curriculum especially at the primary and secondary levels.
Case Study 3: Ikeja Local Government Area of Lagos State.
a. Title Project: “Private Sector Participation in Domestic Refuse Collection and Disposal: A Viable Option in Solid Waste Management in Ike] a Local Government Area of Lagos State” lyoriobhe, V.E. PGD/HSE, College of Medicine Project, 2002.
b. Brief Comments from the Author’s Work
Ikeja Local Government is one of the twenty local governments in Lagos State. The Local Govenment area is bounded in the North by Agege and lfako-ljaye Local Governments, in the East by Kosofe and Sornolu Local Governments, in the South by the Mushin Local Government and in the West by Oshodi/Isolo and Alimosho Local Governments. lkeja Local Government area is a mini-Nigeria in setting, with almost all the tribes present, though the majority of the inhabitants are predominantly Yoruba speaking people. The population according to 1991 census figures is 281,530. The project focuses on the Involvement of private sector participation (PSP) in domestic refuse ‘collection and disposal in Ikeja Local Government Area. As at the time of the project in the year 2002, there were twenty-six (26) private sector refuse operators.
c. Recommendations from the Author’s Work
i. There are inadequate resources militating against effective solid waste management. These resources are pay loaders, bulldozers, tippers, compacting vehicles, dino chassis and bins, cleaning implements and funds. Adequate provision of these sources will enhance solid waste management.
ii. There is a need for private sector to be involved in solid waste management in all the urban local government areas in the country since they have similar problems in solid waste management. This is because the government cannot bear the burden of solid waste management alone as a result of the huge cost. More importantly, those who generate the refuse that pollute the environment should pay for its evacuation. The programme is working in Lagos State.
iii. There is a need for recruitment of skilled personnel such as Sanitary Engineers, Environmentalists, Geologists and Environmental Health Officer to take charge of solid waste management. These personnel should be able to plan and coordinate all the processes involved in solid waste management.
iv. There should be adequate and proper town planning for effective sold waste management. For example, there is a need to provide good access roads which should be properly linked to one another. Other needs are street lights and good drainage system. All these will ease the evacuation of refuse from all the nooks and crannies of the city.
v. There is also a need to put in place development and extension of Health Education Services.
There is no doubt that if every Nigerian has been duly and sufficiently exposed to Health Education, the environmental sanitation of Lagos state in general would change for the better. A well-planned and coordinated environmental health education programme for all the communities in the state should be given high priority.
vi. There should be comprehensive environmental legislation. The laws relating to environmental sanitation offences should be made comprehensive. The cases should be tried in courts especially set up for environmental sanitation and related matters. Stiff penalties should be meted out to offenders. The enforcement officers should ensure that the laws are enforced to its logical conclusion.
vii. Refuse waste should be sorted out at source of storage. The reusable materials should be bagged in bags with different colours. The items should be identified with the colour of the bags.
viii. The private sector operators in solid waste management should be strengthened in terms of acquisition of appropriate equipment such as tippers and compacting vehicles. The government should fashion out a way to grant them loans directly or guarantee the loans in financial institutions. To ensure repayment, a mechanism to recover the money should be put in place.
ix. There should be sanctions for the private operators who do not perform according to the law. Any Private Sector Operator with lapses should be removed from the proramme. However, prior to the removal, he/she should be warned in writing at least three times.
x. Finally, there should be a way to reward the best worker and/or the best private refuse operator company. This reward system will motivate the workers, while it will also create competition among the operators.
6.0 CONCLUSION
The paper takes a look at Health, Safety and Environment (HSE) as it affects the Nigerian polity. The paper focuses on occupational health services in Nigeria and the need for establishing integrated HSE service units in organizations. The importance of HSE audit was highlighted especially to ensure compliance with regulations, policies and procedures as well as good management practices. Finally, in order to bring out the challenges of the current democratic dispensation, case studies of current research work on waste management problems in Lagos State were given and discussed.
7.0 REFERENCES
1. AUDU, Y.B. (200) “Managing HSE as Core Business” Nig. Soc, of Chem. Engineers Proceedings, Nov pp. 161-1 70.
2. OLAGBENDE, O.T. (2000) “Waste Management Programme-Mobil Producing Nigeria’s Experience”. The Punch, June 5, 2002
3. NWOKIKE, C. (2000) “Effective Organization of Occupational Health Services in Nigeria.” Nig. Soc, of Chem. Engineers” Proceedings, Nov. Pp.11-28.
4. NDUKWE, O.C. (2000). “Another Look at Health, Safety and Environmental Audit”. Nig. Soc. Of Chem. Engineers’ Proceedings, Nov. Pp. 92-98.
I am an environmental public health practitioner. Obtained first degree in public health [environmental health and safety] from Federal University of Technology, Owerri.
THE CHALLENGES OF ENVIRONMENTAL HEALTH OFFICERS IN PRIMARY HEALTH CARE IMPLEMENTATION
By S.A. Ojewale, being an invited paper presented at the 39th National conference/scientific workshop of the Environmental Health Officers Association of Nigeria [EHOAN], at the Banquet Hall, Lagos Airport Hotel, October, 2003
Abstract
Since 1977, when the World Health Assembling endorsed Primary Health Care [PHC] as the new model for building health systems, progress in establishing accessible, affordable and appropriate health care has been painfully slow.
Following this, in May 1978, an international conference was headed by WHO member states in a town in former USSR called Alma-Ata where 134 nations including Nigeria declared that PHC is the key to attaining ‘health for all in the year 2000’.
Many health professionals were involved in the policy formulation, planning & implementation of PHC in Nigeria; one of such health cadres is Environmental Health Officer [EHO]. Environmental Health Officers are always in the fore-front since the inception of PHC in Nigeria, diagnosing, sieving & coping with the challenges arising from the implementations of PHC. This paper therefore, discusses where and what these challenges are and how EHOs are coping with the challenges now and in the future.
Introduction
Primary Health Care is posing a lot of challenges to Environmental Health Officers, the challenges, which are implicit or embedded in the definition, concepts, and also in the components of PHC, are so overwhelming and inundating that it is only those Environmental Health Officers that are articulate, well abreast, scientific with adequate native intelligence that could meet and tackle the challenges, many of which have reached crisis or danger point, after all when things [challenges] are going tough only the tough can get going.
Definition of PHC
I would have preferred to define PHC as people oriented service built on the axiom of health of the people, by the people, and for the people [Bamigboye 2001] and not perceived as the exclusive prerogative of health professions as observed by Lambo [1995], but the challenges will not be so glaring as I would want them. Even then, Environmental Health Tutors Officers should have it at the back of their minds that PHC requires concerted efforts and there should not be any role or professional conflicts or wrangling among all the stakeholders.
More importantly, PHC as defined by Alma-Ata in 1978 is essential health care, based on practical, scientifically sound & socially acceptable methods and technology, made universally accessible to individuals and families in the community and country can afford to maintain at every stage of their development in the spirit of self-relevance and self-determination.
Any discerning listener will quickly realize that there is more to the issue of interpreting correctly the definition and concept of PHC than its implementation. There are underlying disagreements over how PHC problems are defined, their degree of seriousness, who is responsible for solving them, and how amenable they are to solution. These disagreements run deep, they are based on different professional training, moral principle, different values and different assumptions.
In Nigeria, every health worker including EHO talks about Primary Health Care (PHC) but if you ask them to define or explain the term, they often offer funny explanations. This shows that as important as the program,, is, it is still not well understood even by those who are expected to plain and implement the programme. We must assist each other in the process of interpretation by identifying the appropriate context, that is which the actions concerned make the most sense.
CONCEPTS OF PHC
The concepts of PHC are equally important in its implementation just as its definition is, of course, the concepts are entrenched in the definition because, it must be socially acceptable to the people, scientifically simple and at a minimal affordable cost.
One may be tempted to gloss over the issue of affordability but it is a serious and indicting challenge. For instance, since 1977, when the World Health Assembly endorsed Primary Health Care (PHC) as the new model for building health systems, progress in establishing accessible, affordable and appropriate health care has been painfully slow. While expanded coverage of preventive and curative services has saved millions of lives, many of these gains have proven to be short lived. In many cases, the benefits of investments continue for only as long as funding lasts. In the poorest countries, Nigeria inclusive, dependency on external support is increasing especially for PHC services. Thus, despite considerable efforts and enthusiasm for PHC, neither governments nor donors have been successful in fostering lasting change in local capacity to deal with health problems in the developing countries. At Local, State and Federal Government levels we have Environmental Health Officers as PHC coordinators, Expanded Programme on Immunization (EPI) or measurement and Evaluation Managers. The big question is how sustainable are these programmes are at local, state and federal levels?
It is reported that the Primary Health Care (PHC) agenda rested on two hidden assumptions. One was the expectation that the world economy would continue to grow as it had throughout the 1960s and 1970s. The Second presumed that the volume of external support for PHC would increase to enable the transitions of PHC in developing countries. Neither of these assumptions was ever realized because of recession and debt, the oil crisis and declining terms of trade began to cripple the economies of many countries, it has not improved to date. What is more challenging than this?
COMPONENTS OF PRIMARY HEALTH CARE (PHC)
I want to further illustrate the challenges of Environmental Health Officers in Primary Health Care (PHC) implementation by making reference to ten components of PHC. In this regard, I am completely ignoring the artificial but lose boundaries created between the components earmarking them for specific health cares. The obvious reason is that the Environment i.e. the sum total of the conditions within which organisms live directly or by implication embraces all the PHC components. It is therefore logical to assert that all the ten PHC components discussed here are sources of challenges to Environmental Health Officers.
MATERNAL AND CHILD HEALTH (MCH)
Maternal and Child Health (MCH) aims at promoting the health of mothers of child being age and their children, so that children have the opportunity for normal growth and development and so that the reproductive life of women does not constitute too much risk to their health and well-being. The situation of MCH is Nigeria today is not encouraging, Nigerian is one of the countries where maternal and infant mortality rates are very high, the condition become exaggerated and exacerbated by poor economic conditions and non-challant attitudes of males to reproductive health.
As long as MCH remains the exclusive reserve of Nurses and Midwives, many husbands and fathers of which Environmental Health Officers are, may not see the need to encourage family planning and exclusive breast feeding (Baby Friendly Initiative). Men should co-operate with women in reproductive health.
Early marriage leading t teenage pregnancy with a; its numerous complications and pregnancy in quick successions are inimical to the health of mothers. Environmental Health Officers should see and accept this as a challenge. They should not be alienated in what MCH or reproductive health is all about. Maternal and child health syllabus could be incorporated into the West African Health Examination Board (WAHEB) Curriculum.
PROVISION OF ESSENTIAL DRUGS AND APPROPRIATE TREATMENT OF COMMON DISEASES
Here Environmental Health Officers (EHOS) are rising up to met the challenges in the areas of Onchocerciasis, Guinea-worm, Tuberculosis and Leprosy (TBL) eradication control programmes. I am aware that many EHOS are TBL managers having undergone an intensive training in Kaduna. But for the Carter Foundation, Nigerians would have known that Dracontiasis is prevalent in our midst. The versatility of EHO training and the resilience of an average EHO are the hall mark which made it possible for the cadre to be actively involved in guinea-worm, Onchocerciasis (River blindness), tuberculosis and leprosy control and eradication programmes. The challenge to wipe out these diseases is not beyond human achievement. Environmental Health Officers (EHOS) played noble and major roles in the total eradication of smallpox in the early 70s.
PREVENTION AND CONTROL OF LOCALLY ENDEMIC DISEASES
In Nigeria, malaria fever, Schistosomiasis, meningitis etc. constitutes endemic diseases which contribute greatly to both morbidity and mortality of children and adults. All these diseases are preventable and can be controlled.
One of the prominent challenges of EHOS is PHC implementations is the problem of malaria fever. The scourge has been with us since and in the South West Region of Nigeria, it was comment in those days to see sanitary inspectors as they were called then holding a big ladle to sample stored water for mosquito larvae and pupae. Culprits were prosecuted and penalized. But this had gone with our colonial masters.
Malaria is a global crisis, which as a household world in the sub region is taken for granted. A Roll Back Malaria (RBM) survey shows that 1/5 of the world’s population is at risk of malaria. This proportion increases yearly as a result of climate change environmental degradation, breakdown in Health care and wars.
This survey also reveals that there are 400 million cases of malaria illness each and at least one million people die annually. Most of these deaths occur in African children and he number is growing. Malaria often in combination with other diseases kills a child every 30 second. The survey further states that among pregnant women malaria is wide spread causing low weight babies and stillbirths. Nearly 60% of miscarriages are due to malaria. It is a major killer of refugees in Africa. This background is necessary as stimulant so that we will know what we are facing.
Roll Back Malaria (RBM) founded by the government of malaria affected countries, WHO, UNDP, UNICEF and the World Bank met in Nigerians in year 2000 to see how they can half the burden of malaria for the world’s people by the year 2010.
Current WHO initiatives in malaria control such as Roll Back Malaria (RBM) emphasize the use of insecticide-treated nets (ITNS) as one of the key strategies for malaria prevention and control in sub-Saharan Africa. UNICEF and WHO have set the goal of providing 32 million nets and 320 million net treatment a year for the next decade to protect 80% of African households from malaria (West African Journal of Nursing Vol. II No. 2, November, 2002).
To start with, the sudden and astronomical rise in cases of malaria is a tacit indictment on our professional competency. We need to brace up and join the other stake holders, we cannot afford to be complacent and rely on past glory old fame, it is a matter of how do we stand now, not how we stood then small pox was eradicated.
It is clear from the information provided in many health education campaigns in sub-Sahara Africa that there is still confusion surrounding effective methods of individual and community malaria control. For instance, in many areas, it is suggested that people and communities should cut the grass and bushes in their premises as means of preventing malaria. However, it has been shown that this does not reduce the incidence of Anopheles (the genus of mosquito that transmits malaria). In sub-Sahara Africa female Anopheles mosquitoes predominantly feed late at night when most people are in bed, most frequently biting between 10:00 pm ad 4.00 am. Day-feeding culex mosquitoes do not carry the malaria parasites and therefore cannot transmit the disease. As of now insecticide treated nets (ITNs) is yielding positive result if field reports are anything to go by. Right now, the net has no contraindication but there are human barriers to the use of this net. This is an aspect of the work of EHOS, to create awareness of the safety and effectiveness of ITNs.
However, ITNs should be seen as a panacea or a fool proof approach to malaria control. Environmental, physical, biological and chemical control should be intensified more than ever before. Premium should be on Environmental, physical and biological control using community based and integrated approach.
FOOD AND NUTRITION AND DENTAL HEALTH
A hungry dog is an angry dog so says a proverb: This is true because except there is abundance supply of food items and at affordable means, the gospel of Primary Health Care will be falling on deaf ears. Environmental Health Officers are not agricultural officers but they can evolve an intersectoral collaboration to ensure food surplus. However, food adulteration, contamination due to poor handling or from dirty premises is quite challenging and common. We should closely work with National Agency for Food and Drug Administration (NAFDAC) in eradicating the use of poisonous chemicals as food additives, flavours enhancers and preservatives. Environmental Health Officers (EHOs) have been too silent and complacent on the war against the use of potassium bromated commonly used by bakers. Reports indicated that potassium bromated is carcinogenic.
Since the supported taking over of anti-mortem inspection of animals by the veterinarians, EHOs are not forthcoming in inspecting meat and meat products when such are display in markets. It is common nowadays to find uninspected meat and meat products being displayed for sale in markets. The gullible and innocent members of the public are paying dearly for this because many must have been infected with one food borne disease or the other especially bovine tuberculosis.
Wholesome food cannot come out from dirty surroundings. Many food preparing and eating premises are so filthy that they server as regular sources of food contamination. Many consumers could have picked such ailments like typhoid fever, dysenteries, gastroenteritis, cholera and other bowel diseases from food serving as vehicles of infection. This is a challenge that must be faced squarely.
ENVIRONMENTAL HEALTH
Environmental Health is an integral part of PHC but it is an extensive field. It includes water and basic sanitation, housing, food and nutrition, vector control, control of communicable diseases, disinfection and disinfestations, and control of pollution. Some of these components have been highlighted in this paper but I will like to emphasize water and basic sanitation, because these are areas posing challenges to EHOs in the implementation of PHC.
WATER SANITATION
To say water is everywhere and that it is abundant for use is a tantalizing statement, quite misleading and erroneous. Water is a renewable resource and some 70% of the earth's surface is water but 97% of that is ocean. By volume, only 3% of all water on earth is fresh water and most of this is largely unavailable. About three-quarters of the fresh water is locked away in the form of Ice caps and glacier located in polar areas far removed from most human habitations only about 1% easily accessible as surface freshwater. This is primarily the water found in lakes, rivers, and the soil at underground levels shallow enough to be tapped at an affordable cost. Only this amount is regularly renewed by rain and snowfall in form of hydrological cycle.
THE COMING WATER CRISIS
Fresh water is emerging as one of the most critical natural resource issues facing humanity. World population is expanding rapidly. Yet there is no more fresh water on earth now than there was 2,000 years ago, when the population was less than 3% if its current size. Water is, literally the source of life on earth. The human body is 70% water. In growing number of places people are withdrawing water from rivers, lakes and underground serves faster than they can be recharged. Population growth alone will push an estimated 17 more countries with a projected population of 2.1 million into these water short categories within the next 25 years, already 31 countries mostly in Africa and the near East are facing water stress or water scarcity (Population Report Series M, Number 14)
Malin Falkenmanrk developed the concepts of water and water scarcity based on an index of per capita fresh water need. He estimated a minimum need of 100 litre per peron for household use and from 5-20 time a much for agricultural and industrial use.
Water dispute are now a major headache in our community. The available water sources are exposed to gross pollution from animal, domestic and industrial source. What can be more challenging to EHO this time around? The proliferation of packaged drinking water a.k.a. pure water is complicating the problem. Many of this packaged water are constant source of infection. We should create awareness that water is a precious natural resource that should be judiciously used & cared for to make it wholesome.
SANITATION
Sanitation of the environment forms a strong pillar of PHC. If there is 100% immunization cover age, and there is enough food and potable water, filthy or dirty environment will negate and render useless what could have been dividends. Hence, sanitation is basic and fundamental. Sanitation is a system made up of nature, society, process and device.
When discussing sanitation, and particularly in relation to the environment, we have to consider all these components. We cannot afford to neglect any one of them. Effective and efficient environmental sanitations alone is capable of achieving between 70-75% of a healthy population that the entire components of PHC could achieve. This is because many of the PHC problems are environmental based, but this could not be achieved on platter of gold it is an arduous and Herculean challenge to all Environmental Health Officers.
Nobody including layman is satisfied with the present arrangement of refuse disposal or is it disposal or dispersal of refuse? At best, it is refuse removal than refuse disposal.
Surely there is waste crisis, because the three basic principles of waste management are not being applied. For instance, there is the need to protect Health and Environment, minimize the Burden on future generations and conservation of non-removal resources. These three principles have been derived from the philosophy of sustainable development [fig 2].
Fig. 2: Sustainable Development and the Waste Management Principles
As long as these three basic principles are ignored in waste management, problems of wastes shall linger on and remain a stubborn challenge to Environmental Health Officers.
Presently, there is no clear cut policy on the method to be adopted in disposing refuse at local, state and federal government levels. In Oyo state for instance, what is being practiced now is nothing but sanitary landfill. The people in the local government where the municipal wastes are being tipped are experiencing all sorts of environmental hazards and risks. Their land and water are polluted and large quality of farm product destroyed by methane gas. No wonder, such things like ‘not in my backyard’, ‘NIMBY’, ‘not in my term of office’, ‘NIMTOO’, ‘locally unacceptable land use’, ‘lulu’, etc., are in vogue. It is a fact that land is no more available for waste disposal.
Wastes are very democratic-they are produced by each and every one of us, and so we should all contribute to the solution. Because of the populist nature of waste, its management is very much a social problem. It is not sufficient to understand the technical aspects, it is equally important to come grip with the social and political issues, and we must seek effective solution within practical cost limitations.
Environmental Health Officers are also facing the challenge of the nylon used to pack ‘pure water’. This nylon is a non-biodegradable substance and will not accept incineration either ,because it will emit poisonous gas-dioxins . the are other polymers and polyvinyl chloride[PVC]that will emit dioxins ad furan when they are incinerated .
The growth of advertising, along with electronic media, played an important role in evolution to society current level of over consumption. The end result was a dramatic increase in the amount of variety of consumer goods and hence, garbage to compound the problem, packing became dominant force in the way good were marketed ,distributed and sold. Today packaging represent more than one third of entire waste streams [Blumbers & Gottlieb, 1989).
The sustainable development concept is generally applied to the ‘front end’ of the industrial cycle the aim of ensuring that human can feed, clothe, house and entertain themselves. It is particularly relevant in preserving our diminishing resource but sustainable development must also be applied to the ‘back end’ of the consumer cycle, the management and disposal of waste. The situation as it is remains blinds pot.
It is apposite to mention that it will not be in the interest of a clean environment and the general masses to make EHOs subservient to another cadre, it is colloquial, and a manifestation of colonial vestige.
Primary Health Care recognizes professionalism, intesectoral collaboration and concerted approach inform of consortium. The present arrangement whereby in many Local Government Medical Doctors sit down in office to oversee waste management is an aberration and a waste of human resources. They are more needed in the clinics to improve the dwindling curative services. Environment Health Officers (EHOs) can work effectively and efficiently if they are allowed to do this in a conducive atmosphere.
HEALTH EDUCATION
Most of the challenges facing E.H.Os from the implementation of Primary Health Care can be overcome through Health Education approach but Health Education itself as a component of PHC remains a challenge to Environment Health Officers.
We have not tried enough to convince the masses that health is a valued asset that should be worked for, to attain. Our attitude to the masses is that of dealing with lay unintelligent people that should be planed for not planned with. Many of enabling factors in Health Education are violated with impunity resulting to mass failure of many of the policies, programmes and projects in P.H.C.
Communications skills are very important in Health Education and to be effective, health workers need to know the facts on how to prevent ill health and treat illness. This information must be communicated to the people to improve the health of their families.
Good communication is a two-way sharing of information. It involves finding out people’s view, listening carefully to what they say and understanding their situation i.e. includes being observant and appreciating the constraint people face.
Environmental Health Officers (EHOs) should be encouraged to develop behavioural technology adequate far the solution of environmental problems inherent in the implementation of PHC. The root of the word technology is a Greek term that means art, craft, or skill-in other words, knowing how to do something.
The term behavioural technology refers to the science, art, skill or craft of influencing socially important human behaviour. There is imbalance between physical and behaviour technology resulting in many health or environmental problems.
Most behaviour relevant to primary Health Care can be thought of interm of the three components of an operant paradigm described by B.F. Skinner (1953). This model is symbolized by the term SD-R-SR. In the model, a discriminative stimulus (SD) set the occasion for a response®. One could think of an SD as a signal that particular context. The response itself will act upon the environment that the world around us sometimes changes as a function of what we do. These changes are symbolized by SR which can be either positive or (SR+) or negative (SR).
The above analysis simply confirms what Health Education explains that “every behaviour is caused”. It is therefore imperative for EHOs to see laws as a last resort especially for stubborn and recalcitrant people.
Environmental Health Officers (EHOs) should intensify environmental education more than ever before to curb environmental degradation, destruction, distraction and disruption resulting in global warming, Ozone depletion, drought, desertification, the Greenhouse effect urban heat Island, EL-NINO-effects and other natural and anthropogenic hazards and risks. They are environmental challenges that have direct being with PHC. There is new and stronger evidence that most of the warming observed over the last 50 years is attributed to human activities observed the international panel on climate change (IPCC). The 2001 IPCC report says Global surface temperature have increased between 0.4 and 0.80C since the late 19th century. The pertinent question is Global warming armful to health? It is predicted that global warming will expand the incidence and distribution of any serious medical disorders. Mosquito-borne disorders are projected to become increasingly prevalent since mosquitoes proliferate faster and bite more as the air become warmer. As the whole areas heat up, then mosquitoes could expand into formerly forbidden territories bringing illness with them. There are also the effects of flood and drought both of which can result in polluted water supplies:
As I mentioned earlier, environmental degradation and destruction have direct effect on P.H.C planning and implementation. Environmental Health Officers have major role to play in the implementation of PHC, if the implementation is going to be successful.
SUMMARY
This paper has tried to explain in simple language what is Primary Health Care ( PHC), its concepts, and the components and how they are related to Environment Health Officers (EHOs). It was emphasized in the paper, that EHOs are faced with so many challenges in the implementation of PHC and that Environmental Health Officers have crucial role to play in the successful implementation of PHC.
RECOMMENDATION
In order to meet the challenges of PHC by Environmental Health Officers, I am recommending the following:
1. That Environment Health Officers should be well abreast of the PHC concept, aims and objectives and components
2. Environmental Health Officers should realize that PHC requires concerted efforts and that no professional group has the prerogative to dominate PHC
3. Role or professional conflicts should be avoided
4. The (EHOs) should pursue more academic activities than hither to.
5. Environmental Health Officers should know that they are stakeholders and partners in progress in PHC implementation
6. Environmental Health Officers should be more articulate in generating revenue either at Local, State or Federal Government Level.
CONCLUSION
Generally, the tempo of Primary Health Care (PHC) is going down and is no more gathering momentum. Health for all by the year 2000 has been elusive and remain a mirage. The vestige remains the expended programme on immunization (EPI) all other components are almost in moribund. If we cannot achieve health for all by year 2000. PHC should be rejuvenated, resuscitated and brought back to life. It will go long way to improve the health of the masses.
REFERENCE
African Health Volume 22 No 6, Sep 2000 West African Journal of Nursing Vol. II No 2, November 2000.
Akinsola, H.A. (1993). A to Z of community Health and Social Medical and Nursing practice, 3am Ibadan. Communication.
Barrow, C.J. (1995): Developing the Environmental Problems and Management, Longman Scientific Technical, U.K
Cone, J.D. (1993). Environmental Problems/Behavioral Solutions, cahfornia.
Dialogue on Diaorrhea-AHRTAC issue No 58, Sept. – Nov. 1994
West African Journal of Nusing Vol. 10 No 2, Nov. 1999.
Simpson – Herbert, M and Wood, S, (1993). Sanitation promotion-WHO
Tammnagi H., (1999). The West crises (O.V.F New York).
Perman, R & MaGilvary, J. (1996): Natural Resumes & Environmental Economical, Longman, London/New York.
Wilson, G.A & Bryant, R.L, (1997): Environmental Management: New Directions for the Twenty-first Century UCL press London.
Wisher, B & Adams J. (2002). Environmental Health in Emergencies and Disasters ISDR, Hongkong.
Abstract
Since 1977, when the World Health Assembling endorsed Primary Health Care [PHC] as the new model for building health systems, progress in establishing accessible, affordable and appropriate health care has been painfully slow.
Following this, in May 1978, an international conference was headed by WHO member states in a town in former USSR called Alma-Ata where 134 nations including Nigeria declared that PHC is the key to attaining ‘health for all in the year 2000’.
Many health professionals were involved in the policy formulation, planning & implementation of PHC in Nigeria; one of such health cadres is Environmental Health Officer [EHO]. Environmental Health Officers are always in the fore-front since the inception of PHC in Nigeria, diagnosing, sieving & coping with the challenges arising from the implementations of PHC. This paper therefore, discusses where and what these challenges are and how EHOs are coping with the challenges now and in the future.
Introduction
Primary Health Care is posing a lot of challenges to Environmental Health Officers, the challenges, which are implicit or embedded in the definition, concepts, and also in the components of PHC, are so overwhelming and inundating that it is only those Environmental Health Officers that are articulate, well abreast, scientific with adequate native intelligence that could meet and tackle the challenges, many of which have reached crisis or danger point, after all when things [challenges] are going tough only the tough can get going.
Definition of PHC
I would have preferred to define PHC as people oriented service built on the axiom of health of the people, by the people, and for the people [Bamigboye 2001] and not perceived as the exclusive prerogative of health professions as observed by Lambo [1995], but the challenges will not be so glaring as I would want them. Even then, Environmental Health Tutors Officers should have it at the back of their minds that PHC requires concerted efforts and there should not be any role or professional conflicts or wrangling among all the stakeholders.
More importantly, PHC as defined by Alma-Ata in 1978 is essential health care, based on practical, scientifically sound & socially acceptable methods and technology, made universally accessible to individuals and families in the community and country can afford to maintain at every stage of their development in the spirit of self-relevance and self-determination.
Any discerning listener will quickly realize that there is more to the issue of interpreting correctly the definition and concept of PHC than its implementation. There are underlying disagreements over how PHC problems are defined, their degree of seriousness, who is responsible for solving them, and how amenable they are to solution. These disagreements run deep, they are based on different professional training, moral principle, different values and different assumptions.
In Nigeria, every health worker including EHO talks about Primary Health Care (PHC) but if you ask them to define or explain the term, they often offer funny explanations. This shows that as important as the program,, is, it is still not well understood even by those who are expected to plain and implement the programme. We must assist each other in the process of interpretation by identifying the appropriate context, that is which the actions concerned make the most sense.
CONCEPTS OF PHC
The concepts of PHC are equally important in its implementation just as its definition is, of course, the concepts are entrenched in the definition because, it must be socially acceptable to the people, scientifically simple and at a minimal affordable cost.
One may be tempted to gloss over the issue of affordability but it is a serious and indicting challenge. For instance, since 1977, when the World Health Assembly endorsed Primary Health Care (PHC) as the new model for building health systems, progress in establishing accessible, affordable and appropriate health care has been painfully slow. While expanded coverage of preventive and curative services has saved millions of lives, many of these gains have proven to be short lived. In many cases, the benefits of investments continue for only as long as funding lasts. In the poorest countries, Nigeria inclusive, dependency on external support is increasing especially for PHC services. Thus, despite considerable efforts and enthusiasm for PHC, neither governments nor donors have been successful in fostering lasting change in local capacity to deal with health problems in the developing countries. At Local, State and Federal Government levels we have Environmental Health Officers as PHC coordinators, Expanded Programme on Immunization (EPI) or measurement and Evaluation Managers. The big question is how sustainable are these programmes are at local, state and federal levels?
It is reported that the Primary Health Care (PHC) agenda rested on two hidden assumptions. One was the expectation that the world economy would continue to grow as it had throughout the 1960s and 1970s. The Second presumed that the volume of external support for PHC would increase to enable the transitions of PHC in developing countries. Neither of these assumptions was ever realized because of recession and debt, the oil crisis and declining terms of trade began to cripple the economies of many countries, it has not improved to date. What is more challenging than this?
COMPONENTS OF PRIMARY HEALTH CARE (PHC)
I want to further illustrate the challenges of Environmental Health Officers in Primary Health Care (PHC) implementation by making reference to ten components of PHC. In this regard, I am completely ignoring the artificial but lose boundaries created between the components earmarking them for specific health cares. The obvious reason is that the Environment i.e. the sum total of the conditions within which organisms live directly or by implication embraces all the PHC components. It is therefore logical to assert that all the ten PHC components discussed here are sources of challenges to Environmental Health Officers.
MATERNAL AND CHILD HEALTH (MCH)
Maternal and Child Health (MCH) aims at promoting the health of mothers of child being age and their children, so that children have the opportunity for normal growth and development and so that the reproductive life of women does not constitute too much risk to their health and well-being. The situation of MCH is Nigeria today is not encouraging, Nigerian is one of the countries where maternal and infant mortality rates are very high, the condition become exaggerated and exacerbated by poor economic conditions and non-challant attitudes of males to reproductive health.
As long as MCH remains the exclusive reserve of Nurses and Midwives, many husbands and fathers of which Environmental Health Officers are, may not see the need to encourage family planning and exclusive breast feeding (Baby Friendly Initiative). Men should co-operate with women in reproductive health.
Early marriage leading t teenage pregnancy with a; its numerous complications and pregnancy in quick successions are inimical to the health of mothers. Environmental Health Officers should see and accept this as a challenge. They should not be alienated in what MCH or reproductive health is all about. Maternal and child health syllabus could be incorporated into the West African Health Examination Board (WAHEB) Curriculum.
PROVISION OF ESSENTIAL DRUGS AND APPROPRIATE TREATMENT OF COMMON DISEASES
Here Environmental Health Officers (EHOS) are rising up to met the challenges in the areas of Onchocerciasis, Guinea-worm, Tuberculosis and Leprosy (TBL) eradication control programmes. I am aware that many EHOS are TBL managers having undergone an intensive training in Kaduna. But for the Carter Foundation, Nigerians would have known that Dracontiasis is prevalent in our midst. The versatility of EHO training and the resilience of an average EHO are the hall mark which made it possible for the cadre to be actively involved in guinea-worm, Onchocerciasis (River blindness), tuberculosis and leprosy control and eradication programmes. The challenge to wipe out these diseases is not beyond human achievement. Environmental Health Officers (EHOS) played noble and major roles in the total eradication of smallpox in the early 70s.
PREVENTION AND CONTROL OF LOCALLY ENDEMIC DISEASES
In Nigeria, malaria fever, Schistosomiasis, meningitis etc. constitutes endemic diseases which contribute greatly to both morbidity and mortality of children and adults. All these diseases are preventable and can be controlled.
One of the prominent challenges of EHOS is PHC implementations is the problem of malaria fever. The scourge has been with us since and in the South West Region of Nigeria, it was comment in those days to see sanitary inspectors as they were called then holding a big ladle to sample stored water for mosquito larvae and pupae. Culprits were prosecuted and penalized. But this had gone with our colonial masters.
Malaria is a global crisis, which as a household world in the sub region is taken for granted. A Roll Back Malaria (RBM) survey shows that 1/5 of the world’s population is at risk of malaria. This proportion increases yearly as a result of climate change environmental degradation, breakdown in Health care and wars.
This survey also reveals that there are 400 million cases of malaria illness each and at least one million people die annually. Most of these deaths occur in African children and he number is growing. Malaria often in combination with other diseases kills a child every 30 second. The survey further states that among pregnant women malaria is wide spread causing low weight babies and stillbirths. Nearly 60% of miscarriages are due to malaria. It is a major killer of refugees in Africa. This background is necessary as stimulant so that we will know what we are facing.
Roll Back Malaria (RBM) founded by the government of malaria affected countries, WHO, UNDP, UNICEF and the World Bank met in Nigerians in year 2000 to see how they can half the burden of malaria for the world’s people by the year 2010.
Current WHO initiatives in malaria control such as Roll Back Malaria (RBM) emphasize the use of insecticide-treated nets (ITNS) as one of the key strategies for malaria prevention and control in sub-Saharan Africa. UNICEF and WHO have set the goal of providing 32 million nets and 320 million net treatment a year for the next decade to protect 80% of African households from malaria (West African Journal of Nursing Vol. II No. 2, November, 2002).
To start with, the sudden and astronomical rise in cases of malaria is a tacit indictment on our professional competency. We need to brace up and join the other stake holders, we cannot afford to be complacent and rely on past glory old fame, it is a matter of how do we stand now, not how we stood then small pox was eradicated.
It is clear from the information provided in many health education campaigns in sub-Sahara Africa that there is still confusion surrounding effective methods of individual and community malaria control. For instance, in many areas, it is suggested that people and communities should cut the grass and bushes in their premises as means of preventing malaria. However, it has been shown that this does not reduce the incidence of Anopheles (the genus of mosquito that transmits malaria). In sub-Sahara Africa female Anopheles mosquitoes predominantly feed late at night when most people are in bed, most frequently biting between 10:00 pm ad 4.00 am. Day-feeding culex mosquitoes do not carry the malaria parasites and therefore cannot transmit the disease. As of now insecticide treated nets (ITNs) is yielding positive result if field reports are anything to go by. Right now, the net has no contraindication but there are human barriers to the use of this net. This is an aspect of the work of EHOS, to create awareness of the safety and effectiveness of ITNs.
However, ITNs should be seen as a panacea or a fool proof approach to malaria control. Environmental, physical, biological and chemical control should be intensified more than ever before. Premium should be on Environmental, physical and biological control using community based and integrated approach.
FOOD AND NUTRITION AND DENTAL HEALTH
A hungry dog is an angry dog so says a proverb: This is true because except there is abundance supply of food items and at affordable means, the gospel of Primary Health Care will be falling on deaf ears. Environmental Health Officers are not agricultural officers but they can evolve an intersectoral collaboration to ensure food surplus. However, food adulteration, contamination due to poor handling or from dirty premises is quite challenging and common. We should closely work with National Agency for Food and Drug Administration (NAFDAC) in eradicating the use of poisonous chemicals as food additives, flavours enhancers and preservatives. Environmental Health Officers (EHOs) have been too silent and complacent on the war against the use of potassium bromated commonly used by bakers. Reports indicated that potassium bromated is carcinogenic.
Since the supported taking over of anti-mortem inspection of animals by the veterinarians, EHOs are not forthcoming in inspecting meat and meat products when such are display in markets. It is common nowadays to find uninspected meat and meat products being displayed for sale in markets. The gullible and innocent members of the public are paying dearly for this because many must have been infected with one food borne disease or the other especially bovine tuberculosis.
Wholesome food cannot come out from dirty surroundings. Many food preparing and eating premises are so filthy that they server as regular sources of food contamination. Many consumers could have picked such ailments like typhoid fever, dysenteries, gastroenteritis, cholera and other bowel diseases from food serving as vehicles of infection. This is a challenge that must be faced squarely.
ENVIRONMENTAL HEALTH
Environmental Health is an integral part of PHC but it is an extensive field. It includes water and basic sanitation, housing, food and nutrition, vector control, control of communicable diseases, disinfection and disinfestations, and control of pollution. Some of these components have been highlighted in this paper but I will like to emphasize water and basic sanitation, because these are areas posing challenges to EHOs in the implementation of PHC.
WATER SANITATION
To say water is everywhere and that it is abundant for use is a tantalizing statement, quite misleading and erroneous. Water is a renewable resource and some 70% of the earth's surface is water but 97% of that is ocean. By volume, only 3% of all water on earth is fresh water and most of this is largely unavailable. About three-quarters of the fresh water is locked away in the form of Ice caps and glacier located in polar areas far removed from most human habitations only about 1% easily accessible as surface freshwater. This is primarily the water found in lakes, rivers, and the soil at underground levels shallow enough to be tapped at an affordable cost. Only this amount is regularly renewed by rain and snowfall in form of hydrological cycle.
THE COMING WATER CRISIS
Fresh water is emerging as one of the most critical natural resource issues facing humanity. World population is expanding rapidly. Yet there is no more fresh water on earth now than there was 2,000 years ago, when the population was less than 3% if its current size. Water is, literally the source of life on earth. The human body is 70% water. In growing number of places people are withdrawing water from rivers, lakes and underground serves faster than they can be recharged. Population growth alone will push an estimated 17 more countries with a projected population of 2.1 million into these water short categories within the next 25 years, already 31 countries mostly in Africa and the near East are facing water stress or water scarcity (Population Report Series M, Number 14)
Malin Falkenmanrk developed the concepts of water and water scarcity based on an index of per capita fresh water need. He estimated a minimum need of 100 litre per peron for household use and from 5-20 time a much for agricultural and industrial use.
Water dispute are now a major headache in our community. The available water sources are exposed to gross pollution from animal, domestic and industrial source. What can be more challenging to EHO this time around? The proliferation of packaged drinking water a.k.a. pure water is complicating the problem. Many of this packaged water are constant source of infection. We should create awareness that water is a precious natural resource that should be judiciously used & cared for to make it wholesome.
SANITATION
Sanitation of the environment forms a strong pillar of PHC. If there is 100% immunization cover age, and there is enough food and potable water, filthy or dirty environment will negate and render useless what could have been dividends. Hence, sanitation is basic and fundamental. Sanitation is a system made up of nature, society, process and device.
When discussing sanitation, and particularly in relation to the environment, we have to consider all these components. We cannot afford to neglect any one of them. Effective and efficient environmental sanitations alone is capable of achieving between 70-75% of a healthy population that the entire components of PHC could achieve. This is because many of the PHC problems are environmental based, but this could not be achieved on platter of gold it is an arduous and Herculean challenge to all Environmental Health Officers.
Nobody including layman is satisfied with the present arrangement of refuse disposal or is it disposal or dispersal of refuse? At best, it is refuse removal than refuse disposal.
Surely there is waste crisis, because the three basic principles of waste management are not being applied. For instance, there is the need to protect Health and Environment, minimize the Burden on future generations and conservation of non-removal resources. These three principles have been derived from the philosophy of sustainable development [fig 2].
Fig. 2: Sustainable Development and the Waste Management Principles
As long as these three basic principles are ignored in waste management, problems of wastes shall linger on and remain a stubborn challenge to Environmental Health Officers.
Presently, there is no clear cut policy on the method to be adopted in disposing refuse at local, state and federal government levels. In Oyo state for instance, what is being practiced now is nothing but sanitary landfill. The people in the local government where the municipal wastes are being tipped are experiencing all sorts of environmental hazards and risks. Their land and water are polluted and large quality of farm product destroyed by methane gas. No wonder, such things like ‘not in my backyard’, ‘NIMBY’, ‘not in my term of office’, ‘NIMTOO’, ‘locally unacceptable land use’, ‘lulu’, etc., are in vogue. It is a fact that land is no more available for waste disposal.
Wastes are very democratic-they are produced by each and every one of us, and so we should all contribute to the solution. Because of the populist nature of waste, its management is very much a social problem. It is not sufficient to understand the technical aspects, it is equally important to come grip with the social and political issues, and we must seek effective solution within practical cost limitations.
Environmental Health Officers are also facing the challenge of the nylon used to pack ‘pure water’. This nylon is a non-biodegradable substance and will not accept incineration either ,because it will emit poisonous gas-dioxins . the are other polymers and polyvinyl chloride[PVC]that will emit dioxins ad furan when they are incinerated .
The growth of advertising, along with electronic media, played an important role in evolution to society current level of over consumption. The end result was a dramatic increase in the amount of variety of consumer goods and hence, garbage to compound the problem, packing became dominant force in the way good were marketed ,distributed and sold. Today packaging represent more than one third of entire waste streams [Blumbers & Gottlieb, 1989).
The sustainable development concept is generally applied to the ‘front end’ of the industrial cycle the aim of ensuring that human can feed, clothe, house and entertain themselves. It is particularly relevant in preserving our diminishing resource but sustainable development must also be applied to the ‘back end’ of the consumer cycle, the management and disposal of waste. The situation as it is remains blinds pot.
It is apposite to mention that it will not be in the interest of a clean environment and the general masses to make EHOs subservient to another cadre, it is colloquial, and a manifestation of colonial vestige.
Primary Health Care recognizes professionalism, intesectoral collaboration and concerted approach inform of consortium. The present arrangement whereby in many Local Government Medical Doctors sit down in office to oversee waste management is an aberration and a waste of human resources. They are more needed in the clinics to improve the dwindling curative services. Environment Health Officers (EHOs) can work effectively and efficiently if they are allowed to do this in a conducive atmosphere.
HEALTH EDUCATION
Most of the challenges facing E.H.Os from the implementation of Primary Health Care can be overcome through Health Education approach but Health Education itself as a component of PHC remains a challenge to Environment Health Officers.
We have not tried enough to convince the masses that health is a valued asset that should be worked for, to attain. Our attitude to the masses is that of dealing with lay unintelligent people that should be planed for not planned with. Many of enabling factors in Health Education are violated with impunity resulting to mass failure of many of the policies, programmes and projects in P.H.C.
Communications skills are very important in Health Education and to be effective, health workers need to know the facts on how to prevent ill health and treat illness. This information must be communicated to the people to improve the health of their families.
Good communication is a two-way sharing of information. It involves finding out people’s view, listening carefully to what they say and understanding their situation i.e. includes being observant and appreciating the constraint people face.
Environmental Health Officers (EHOs) should be encouraged to develop behavioural technology adequate far the solution of environmental problems inherent in the implementation of PHC. The root of the word technology is a Greek term that means art, craft, or skill-in other words, knowing how to do something.
The term behavioural technology refers to the science, art, skill or craft of influencing socially important human behaviour. There is imbalance between physical and behaviour technology resulting in many health or environmental problems.
Most behaviour relevant to primary Health Care can be thought of interm of the three components of an operant paradigm described by B.F. Skinner (1953). This model is symbolized by the term SD-R-SR. In the model, a discriminative stimulus (SD) set the occasion for a response®. One could think of an SD as a signal that particular context. The response itself will act upon the environment that the world around us sometimes changes as a function of what we do. These changes are symbolized by SR which can be either positive or (SR+) or negative (SR).
The above analysis simply confirms what Health Education explains that “every behaviour is caused”. It is therefore imperative for EHOs to see laws as a last resort especially for stubborn and recalcitrant people.
Environmental Health Officers (EHOs) should intensify environmental education more than ever before to curb environmental degradation, destruction, distraction and disruption resulting in global warming, Ozone depletion, drought, desertification, the Greenhouse effect urban heat Island, EL-NINO-effects and other natural and anthropogenic hazards and risks. They are environmental challenges that have direct being with PHC. There is new and stronger evidence that most of the warming observed over the last 50 years is attributed to human activities observed the international panel on climate change (IPCC). The 2001 IPCC report says Global surface temperature have increased between 0.4 and 0.80C since the late 19th century. The pertinent question is Global warming armful to health? It is predicted that global warming will expand the incidence and distribution of any serious medical disorders. Mosquito-borne disorders are projected to become increasingly prevalent since mosquitoes proliferate faster and bite more as the air become warmer. As the whole areas heat up, then mosquitoes could expand into formerly forbidden territories bringing illness with them. There are also the effects of flood and drought both of which can result in polluted water supplies:
As I mentioned earlier, environmental degradation and destruction have direct effect on P.H.C planning and implementation. Environmental Health Officers have major role to play in the implementation of PHC, if the implementation is going to be successful.
SUMMARY
This paper has tried to explain in simple language what is Primary Health Care ( PHC), its concepts, and the components and how they are related to Environment Health Officers (EHOs). It was emphasized in the paper, that EHOs are faced with so many challenges in the implementation of PHC and that Environmental Health Officers have crucial role to play in the successful implementation of PHC.
RECOMMENDATION
In order to meet the challenges of PHC by Environmental Health Officers, I am recommending the following:
1. That Environment Health Officers should be well abreast of the PHC concept, aims and objectives and components
2. Environmental Health Officers should realize that PHC requires concerted efforts and that no professional group has the prerogative to dominate PHC
3. Role or professional conflicts should be avoided
4. The (EHOs) should pursue more academic activities than hither to.
5. Environmental Health Officers should know that they are stakeholders and partners in progress in PHC implementation
6. Environmental Health Officers should be more articulate in generating revenue either at Local, State or Federal Government Level.
CONCLUSION
Generally, the tempo of Primary Health Care (PHC) is going down and is no more gathering momentum. Health for all by the year 2000 has been elusive and remain a mirage. The vestige remains the expended programme on immunization (EPI) all other components are almost in moribund. If we cannot achieve health for all by year 2000. PHC should be rejuvenated, resuscitated and brought back to life. It will go long way to improve the health of the masses.
REFERENCE
African Health Volume 22 No 6, Sep 2000 West African Journal of Nursing Vol. II No 2, November 2000.
Akinsola, H.A. (1993). A to Z of community Health and Social Medical and Nursing practice, 3am Ibadan. Communication.
Barrow, C.J. (1995): Developing the Environmental Problems and Management, Longman Scientific Technical, U.K
Cone, J.D. (1993). Environmental Problems/Behavioral Solutions, cahfornia.
Dialogue on Diaorrhea-AHRTAC issue No 58, Sept. – Nov. 1994
West African Journal of Nusing Vol. 10 No 2, Nov. 1999.
Simpson – Herbert, M and Wood, S, (1993). Sanitation promotion-WHO
Tammnagi H., (1999). The West crises (O.V.F New York).
Perman, R & MaGilvary, J. (1996): Natural Resumes & Environmental Economical, Longman, London/New York.
Wilson, G.A & Bryant, R.L, (1997): Environmental Management: New Directions for the Twenty-first Century UCL press London.
Wisher, B & Adams J. (2002). Environmental Health in Emergencies and Disasters ISDR, Hongkong.
I am an environmental public health practitioner. Obtained first degree in public health [environmental health and safety] from Federal University of Technology, Owerri.
Saturday, July 28, 2012
NATURAL DISASTERS AND THE ROLE OF ENVIRONMENTAL HEALTH PRACTITIONERS
By Ibaniba Briggs-Iti
A paper delivered during the 41st Annual National Conference/Scientific Workshop f Environmental Health Officers Association of Nigeria [EHOAN] in Yenagoa, Bayelsa State, March, 2008
Health care service delivery is a major factor in the sustenance and development of any nation.
States and the international community as a whole recognize this situation and see it as a challenge to harness all necessary available machinery within their jurisdictions to meet this need.
The United Nations for instance states as one o its objectives to co-operate in solving economic, social, cultural and humanitarian global problems. Consequently the Economic and Social Council which is one of the organs of the organization has established well over fifteen agencies and organizations as a functional response to meeting the needs of peoples of the world. Amongst these specialist organizations are WHO, UNESCO, UNICEF, UNDP, UNFPA, UNHCR, UNFDAC, FAO, UNEP, UNDLP etc that specifically cater for the health needs of the people.
Back home in Nigeria, the Federal Ministry of Health which is the highest body responsible for provision of health services set for itself laudable objectives and about “2 1 point” responsibility which generally encompass provision o material and human resources, coordinating and supervising health programme, participating in inter-sectoral and inter-ministerial collaborations, making of health laws and policies amongst others to meet the health needs of Nigerians.
The federal government has also established several agencies and parastatals to support and complement the functions of FMOH. Some of the agencies so established are NAFDAC, NPHCDA, NHIS, NPI, SON, PAFA, NACA, NDLEA.
Private voluntary organizations, international governmental and other non governmental organizations have also emerged to join the league of organizations established to promote health. USAID, CIDA, ICRC, NRCS, PPFN, Rotary International, WCC, Rochas Okorocha’s Foundation, Kanu Nwankwo Health Foundation are examples.
Health care service delivery generally includes provision of institutional, facilities and man-power resources.
In the aspect of provision of human resources or manpower, the health sector has a chain of professionals in its service. They include Medical Practitioners, Nurses, Pharmacist, Laboratory Scientists, Environmental Health Practitioners and Community Health Practitioners etc.
Each of these professional groups has their specific roles to play in the achievement of the holistic goal of the health sector.
The Environmental Health Officer (EFIO) or practitioner is one of the oldest personnel in the health sector. His emergence dates back to the colonial era and has faced dangers in course of passing through the various stages of metamorphosis to the present day professional that he is.
The modern EHO is educated with diversities of knowledge and skills, is controversial and the envy of other sister professional groups in the sector.
The Environmental Health Officers (Registered) Act of 2000 provides for the registration and practice of persons if the profession. With the governing council created by the law of 2000 and the Environmental Health Officers Association of Nigeria (EHlOAN) which is set to co-ordinate and regulates the activities of members, the today 13110 is set on the path of expertise and relevance.
To be able to keep with the pace, EHOAN is organizing this programme tagged “BAYELSA 2008”, which is the 4 in the series, and the purpose is to sensitize and energize members of the profession. This year’s theme is “Environmental Health Practice in Nigeria: Challenges and Prospects”.
It should be noted that indeed there are challenges and prospects facing the professional group. How these challenges threaten the relevance of the group and how this would be tackled should be a concern for all as well as the ability of it to appropriate the prospects that stand before all.
It is believed that at the end of this conference and workshop, fresh achievable strategies would emerge to this effect.
Six papers have at been earmarked to be delivered:
• Water Sanitation as a Key Strategy Towards Achieving the Goals of International Year of Sanitation (IYS).
• Food Sanitation and its Implications on Environmental Health Practice in Nigeria.
• Natural Disasters and the Role of Environmental Health Practitioners.
• Malaria Prevention Through Environmental Sanitation: A key Strategy for the Achievement of Millennium Development Goals.
• The Essentials o Effective Waste Management as A Tool For The Enhancement of International Year of Sanitation (IYS) in Nigeria.
• Implementation of National Environmental Sanitation Policy: The Journey so far.
This paper titled “National Disasters and the Role of Environmental Health Practitioners will examine the role of EHOS in the management of natural disasters and objectives are as follows:
a. To explain types Natural disasters
b. To identify organizations and agencies involved in managing natural disasters.
c. To explain the composition and functions of disaster response teams.
d. To analyze the role of the EHO in management of natural disasters in Nigeria.
By way justifying the need of this paper, it is worthy to note that it is on record that millions of people die as a result of natural disaster.
Tangiwai volcanic eruption disaster for example killed about 23,000 people in Armen Columbia in 1985, the 2005 Kashmir earthquake caused 79,000 lives in Parkistan.
Disaster incidences have been increasing astronomically over time, in the 1980’s there were only about 100 recorded hydrological disasters per year but the number has risen to over 300 a year since 2000 (source: World Disaster Report 2006).
It is therefore expedient that the management of such situations be tackled seriously. [ the El 10 can be relevant in this business of disaster management is one of the targets of this conference.
MEANING AND TYPES OF NATURAL DISASTERS
Natural Disaster has been defined as the consequence of a natural hazard (e.g. volcanic eruption, earthquake and landslide) which moves from potential into au active phase and as a result affects human activities causing financial, structural and human losses.
Human vulnerability element is incorporated into the definition in some cases stating thereby that disasters occur when hazards meet vulnerability.
Natural Hazard is a situation which has the potential to create an event that has an effect oil people. Natural hazards result from natural processes in the environment and some natural hazards are related e.g earthquakes can result in tsunamis; drought can lead directly to famines and diseases.
The National Emergency Management Agency (NEMA) Act (1999) defines natural or other disasters as including any disaster ansing from crisis, epidemic, drought, flood, earthquake, storm, train, roads, aircraft, oil spillage or other accident and mass deportation or repatriation of Nigerians from any other country.
Natural hazards may be classified into the Following:
• Geological
(Ava kinche, Earthquake, Lahars, Landslide, Mudliows, Sinkholes, Volcanic eruptions).
• Hydrological
(Flood, Limnic eruption, mealstrom, seiche tsunami).
• Climate
(Blizzard, drought, hailstorm, Heat wave, hurricanes, tropical cyclones, typhoons, Ice storm, tornado).
• Fire (wild fire)
• Health and disease
• Space
(Solar flare, impact event)
Types of Natural Disasters
• Avalanche
This occurs when large snow mass slides down a mountain slide into a slope. In an avalanche, lots of’ material or mixtures of different types fall or slide rapidly under the force of gravity.
• Earthquake
This occurs as a result of sudden release of’ stored energy that radiates seismic waves. At the earth’s surface, earthquake may manifest themselves by shaking or displacement of’ the ground. Many earthquakes occur each day but are not large enough to cause to- significant damage.
The. 2004 Indian Ocean earthquake which is the second largest earthquake recorded in history claimed about 229,000 people.
2O0 Kashmir earthquake caused 79,000 lives in Pakistan
• Lahar
Lahar is a type of natural disaster closely related to a volcanic eruption and involves a large amount of material including mud, rock and ash sliding down the side of the volcano at a rapid pace. These flows can destroy entire towns in seconds and kill thousands of people.
Tangiwai disaster killed about 23,000 people in Armen Columbia in l98
• Landslides/Mud Flows
A Landslide is a disaster closely related to an avalanche but instead of occurring with snow, it occurs involving actual elements of the ground including rocks, trees, parts of houses and any thing else which may happen to be swept up. Landslides can be caused by generally instability in the surrounding land.
Mudslidcs or mud flows are a special case of’ landslides in which heavy rainfall causes loose soil on steep terrain to collapse and slide downwards. This usually OCCWS after periods of heavy rain.
• Sink holes
It is a localized depression in the surface topography usually caused by the collapse of a subterranean structure such as a cave. Although rare, large sinkholes that develop suddenly in populated areas can lead to collapse of buildings and other structures.
• Volcanic Eruption
A volcanic eruption is the point in which a volcano is active and releases its power; the erupt ions comes in many forms. They range from daily small erupt R)I is which occur in places like Kilanea in Hawali or extremely infrequent super volcanic eruption.
According to Toba catastrophe theory, 70 — 75 year thousand years ago a super volcanic event in lake Toba reduced the human population to 10,000 or even 1,000 breeding pairs, creating a bottle neck in human evolution.
Flood
Flooding occurs as a result of prolong rainfall including thunderstorms, rapid inciting of large amount of snow or rivers which swell from excess precipitation upstream and cause widespread damage to areas downstream or less frequently the bursting of man — made dams or levees.
The Huange Ho River Flood in China in 1931 caused between 800,000 and 4,000,000 deaths.
Yangtze River floods in China in 1978 rendered 14 million people covered much of the country for three weeks resulting in thousands of death leaving the country devastated for years afterwards.
Tropical/storm Allison in Houston Texas in 2001 was devastating
Hurricane Katrina in New Orleans in 2005 left most of the city under water.
Limnic Eruption
It is also referred to as a “Lake overturn”. A limnic eruption is a rare type of natural disaster in which CO2 suddenly erupts from deep lake water, posing the threat of suffocating wildlife, live stock and human such an eruption may also cause tsunamis in the lake as the rising CO2 displaces waters. Scientist believes landslides, volcanic activity or explosions can trigger such an eruption.
1984 limnic eruption in Lake Monou in Cameroon causing the death of 37 nearby resident
Tsunami
It is a wave of water caused by the displacement of a body of water. The world is Japanese meaning harbor and wave. Tsunami can be caused by undersea earthquakes.
Blizzard
It is a severe winter storm condition characterized by low temperature strong winds and heavy blowing snow.
Drought
It is an abnormally dry period when there is not enough water to support agriculture, Urban or environment. Water needs. Extended drought can result in deaths by starvation or diseases and can result in wildfires
Between 1900-1941 China experienced several cases of droughts killing millions of people.
Since 2006, Western Australia, New South Wales, Victoria and Queens land have been under drought conditions for five to ten years.
Hailstorm
A Hailstorm is a natural disaster where a thousandstornm produces numerous hailstorms which damage the location in which they fall. Hailstorm can be especially devastating to farm fields, running crops and damaging equipment.
• Hailstorm in Munich Germany on August 31, 1986 fell thousands of trees causing millions of dollars in insurance claims
Hurricane, Tropical Cyclones and Typhoon
Hurricane, Tropical Cyclones and typhoon are different names for the same phenomenon. A cyclonic storm system forms over the oceans. It is caused by evaporated water that comes off the ocean and becomes a storm. The carioles effect causes the storm to spin and a hurricane is declared when the spinning mass of storms attains a wind greater than 74 mph.
Hurricane is used for these phenomenon in the Atlantic and Eastern Pacific Oceans, tropical cyclone in the India, Typhoon in the Western pacific.
• 1970 Bhola cyclone is recorded as the deadliest hurricane
• 2005 Hurricane Katrina which devasted the Gulf Coast of the U.S.
Tornado
A Tornado is a natural disaster resulting from thunderstorm. Tornados are violet rotating colomns of air which can blow at speeds between 50 and 300 mph and possibility higher. Tornadoes can occur one at a time or can occur in large tornado outbreaks along sequel lines or other large areas of thunderstorm development. Waster spouts are tornadoes occurring over tropical waters in high rain conditions.
Wild fire
It is an uncontrolled fire burning in wild land areas. Common causes include lightening and drought but wild fires may also be started by human negligence or arson. They can be a threat to those in rural areas and also wild life.
Epidemics
An outbreak of a contractible disease that spreads at a rapid rate through human population.
A pandemic is an epidemic whose spread is global. There have been many epidemics throughout history.
• The 1918 Spanish Flu pandemic killings an estimated 50 million people worldwide
• The 1957-1958 Asian flu pandemic which killed an estimated one million people.
• The 1968-1968 Hong Kong Flu pandemic
• The 2002-2003 SARS pandemic
• The AID epidemic beginning in 1959
• Others are Malaria, Ebola bemorrhage fever, Cholera, Menningitis, Yellow Fever etc.
Impact Event
It is a natural disaster in which an extraterrestrial piece of rock or other material collides with the earth. The exact consequences of a direct earth impact would vary greatly with size of the colliding object, although in cases of medium to large impacts short term climate charge and a general failure of agriculture.
Famine
A social and economic crises that commonly accompanied by wide spread malnutrition starvation, epidemic disease and increase mortality although some famine occur by natural factors, it can and often is a result of economic or military policy that deprives people of food that they require to survive Famines often hit areas like sub-Sahara African and Asia.
Common natural disasters in Nigeria are flooding, erosion and drought. Although natural disasters are situations caused by natural factors some underlying factors have been identified by some experts as being responsible especially in the hydrological disasters. For instance unplanned urbanization in flood prone region increase the likelihood that their towns and villages will be affected by flash floods and coastal floods.
Large areas covered with cement prevents runoff water to get absorbed by the soil thereby causing floods.
ORGANIZATIONS INVOLVED IN MANAGEMENT OF NATURAL DISASTERS
Disaster management is a global issue. States and non governmental agencies efforts towards this direction are laudable. Programmes and activities have been earmarked to ensure disaster relief and reduce the consequential risks. Some of the organizations and bodies involved in management of natural disaster may be stated as follows
National Level
In Nigeria apart from the direct efforts of the Ministries of Health and Environment, there are established several other bodies which engage in disaster management. Some of them include:
National Emergency Management Agency (NEMA)
This is the foremost agency saddled with the responsibility of managing emergencies. The agency has a governing council made up of the following:
• The Vice President (Who is the chairman)
• The secretary to Government of the Federation
• Representatives from the Federal Ministries of Aviation, Foreign Affairs, Health, Internal Affairs, Transport, Water Resources, Works and Housing
• One representative each of the armed forces, the Nigerian Police, the Nigerian Red Cross societies, such voluntary organization as may be determined from time to time.
The functions of the agency are as follows:
• To formulate policy on all activities relating to disaster management in Nigeria and coordinate the plans and programme for efficient and effective response to disasters at national level.
• Co-ordinate and promote research activities relating to disaster management at the national level
• Monitor the state of preparedness of the organizations or agencies which may contribute to disaster management in Nigeria.
• Collate data from relevant agencies so as to enhance forecasting, planning and field operation of disaster management.
• Educate and inform the public on disaster prevention and control measures.
• Coordinate and facilitate the provision of necessary resources for search and rescue and other types of disaster curtailment activities in response to disasters distress calls.
• Coordinate the activities of all voluntary organizations engaged in emergency relief operation in any part of the federation.
• Receive financial and technical aid from international and nongovernmental management in Nigeria.
• Collect emergency relief supply from local and foreign sources and from international and non governmental agencies
• Liaise with state emergency management committees established under section and monitor where necessary the distribution of relief materials to disaster victims.
• Process relief assistance to such countries as may be determined from time to time.
• Liaise with the UN Disaster Reduction organization or such other international bodies for the reduction of natural and other disaster
• Prepare the annual budget for disaster management in Nigeria
• Perform such other functions which in the opinion of the agency are its objectives in the act.
The Nigerian Red Cross Society (NRSC)
NRCS is a non governmental organization directly linked to the International Committee of the Red Cross (ICRC).
It is an independent humanitarian relief and development organization whose mission is to prevent and alleviate human suffering and is guided in its work by the seven fundamental principles of the movement tagged “The Vienna Proclamation of 1965”. The principles include; Humanity, Impartiality, Neutrality, Independence, Voluntary Service, United and Universally.
Activities of NRCS include:
• Recruitment and training of personnel for rendering of first aid, disaster relief and home nursing.
• Dissemination of information on the ICRC activities and international humanitarian law to target groups such as Red Cross volunteers, the military, the police, teachers and media.
• Family training activities
• Planning and implementing disaster preparedness and response
• Render community services in the areas of
Health education
Blood donation
Primary Health care services
First aid training and services
Vacation programme
Environment project such as construction of latrine.
INTERNATIONAL LEVEL
International agencies involved in natural disaster management include:
a. International Committee of the Red Cross (ICRC)
This organization is made up of the following:
The international committee of the Red Cross
International Federation of Red Cross and Red Crescent societies
National Red Cross and Red Crescent societies totaling about 160.
The functions of ICRC include
Assist victims of disasters by providing medical care, setting up hospitals and rehabilitation centre.
Provide appropriate aids as needed such as food, shelter, and clothing
Run central tracing agency
Promote assistance to war disabled
Initiate and promote international humanitarian law ‘
Carryout studies and research on humanitarian work
Reunite families split by war
Visit military prisoners and other detainees
Arbitrate between warring parties in armed conflict
Prohibit in human or degrading treatment e.g. hostage taking, torture, summary executions, deportations etc
Active in conflict resolution, armed and non armed conflict and internal disturbances and tension.
b. Medicines Sans Frontier (MSF)
Provides health and to victims of wars and natural disasters
c. United Nations Development Programme (UNDP)
Fights poverty and diseases and advocates for environmental protection.
d. United Nations High Commissioner for Refugees (UNCHCR)
e. World Bank.
f. United Nations Environmental Programme (UNEP).
g. World Health Organization (WHO).
WHO is active in emergency and humanitarian actions.
Others include:
USAID
Medicine Sans Frontier (MSF) (provides health aid victims of war and natural disasters. Provides aids in chronic emergencies)
World Food Programme (WFP)
UNICEF
CARE USA
Catholic Relief Services (CRS)
Food and agriculture organization (FAO) etc.
COMPOSITION AND FUNCTIONS OF EMERGENCY RESPONSE TEAM.
Composition
A comprehensive emergency response team may be composed of the following:
a. Health Team
Medical doctors
Nurse
Drug dispenser
Health Educator
Nutritionist
Medical records officer
Environmental Health Officer etc.
b. Environmental management team
Environmental Health officer
Civil and other Engineers.
c. Social welfare team
d. Information team
e. Fires control/service team
f. Representative of organizations
g. Security team (Civil Defence Corps/Police).
Functions of Emergency Management team
Functions of emergency response team may be summarized thus.
Assessment of disaster zone and cases
Evacuation of victims to temporary settlement
Render Health services to the needy
Provision of relief materials such as food, water, clothing drugs to victims
Provision of Environmental and general sanitation
Refer serious health cases to hospitals
Provision of security and safety of victims
Publicities/report emergency situations
Seek financial aids for victims.
ROLES OF ENVIRONMENTAL HEALTH PRACTITIONERS IN DISASTER MANAGEMENT
It is difficult to stand before professionals like you and give instructions on what should be done during emergencies. However a reminder of what is normally done is an easier task to accomplish.
It is therefore intended in this part of the paper to highlight what is already known by all, and this will be done with a persuasive note to all the endeavour to take actions in order to maintain the image brushing ad relevance that the professional group requires at this time.
The role of the Environmental Health Officer in disaster management is to carry out environment process, most particularly to note are:
• The Evacuation stage
• The settlement stage
• The Treatment stage
• The clean up stage
• The provision of supplies stage.
In each of these stage, the EHO is expected to:
• Make observations/carryout inspections
• Detect nuisances
• Abate the nuisances
• Prevent the reoccurrence of nuisances.
The specific environmental health actions to be taken by the EHO are as follows:
• Inspect and determine the suitability of means of transportation.
• Ensure that means are not overcrowded or pose health hazards
• Ensure sanitary waste disposal for victims in transit
• Give health education to victims.
Settlement Stage
• Carryout site/facility inspection before arrival of victims
• Ensure provision of waste disposal facilities
• Ensure adequate waster/electricity supply
• Ensure provision for storage and preservation of food
• Give health education to victims
• Carryout disinfections and disinfestations.
Treatment stage
• Ensure that hospital/medical wastes are sanitarily disposed off
• Carryout disinfection of materials.
Clean up stage
• Zone area for proper cleaning
• Determine appropriate cleanup methods
• Supervise clean up exercise
• Ensure sanitary disposal of waste generated
• Coordinate personnel to be used for the exercise
• Ensure that dead bodies are appropriately disposed.
Provision of Supplies Stage
• Ensure safety of supplies
• Ensure storage and preservation of supplies
• Ensure fair distribution of supplies.
The EHO is expected to play his role in the management of disasters and his ability to take quick and relevant actions in what makes the difference.
CONCLUSION
Quick response to emergency situations save life and reduce mobility rates of victims. It is important therefore that the EHO understands the emergency situation and identify areas that pertain to him and take appropriate actions. In this way he becomes relevance and contributes his best whenever and wherever the call comes.
A paper delivered during the 41st Annual National Conference/Scientific Workshop f Environmental Health Officers Association of Nigeria [EHOAN] in Yenagoa, Bayelsa State, March, 2008
Health care service delivery is a major factor in the sustenance and development of any nation.
States and the international community as a whole recognize this situation and see it as a challenge to harness all necessary available machinery within their jurisdictions to meet this need.
The United Nations for instance states as one o its objectives to co-operate in solving economic, social, cultural and humanitarian global problems. Consequently the Economic and Social Council which is one of the organs of the organization has established well over fifteen agencies and organizations as a functional response to meeting the needs of peoples of the world. Amongst these specialist organizations are WHO, UNESCO, UNICEF, UNDP, UNFPA, UNHCR, UNFDAC, FAO, UNEP, UNDLP etc that specifically cater for the health needs of the people.
Back home in Nigeria, the Federal Ministry of Health which is the highest body responsible for provision of health services set for itself laudable objectives and about “2 1 point” responsibility which generally encompass provision o material and human resources, coordinating and supervising health programme, participating in inter-sectoral and inter-ministerial collaborations, making of health laws and policies amongst others to meet the health needs of Nigerians.
The federal government has also established several agencies and parastatals to support and complement the functions of FMOH. Some of the agencies so established are NAFDAC, NPHCDA, NHIS, NPI, SON, PAFA, NACA, NDLEA.
Private voluntary organizations, international governmental and other non governmental organizations have also emerged to join the league of organizations established to promote health. USAID, CIDA, ICRC, NRCS, PPFN, Rotary International, WCC, Rochas Okorocha’s Foundation, Kanu Nwankwo Health Foundation are examples.
Health care service delivery generally includes provision of institutional, facilities and man-power resources.
In the aspect of provision of human resources or manpower, the health sector has a chain of professionals in its service. They include Medical Practitioners, Nurses, Pharmacist, Laboratory Scientists, Environmental Health Practitioners and Community Health Practitioners etc.
Each of these professional groups has their specific roles to play in the achievement of the holistic goal of the health sector.
The Environmental Health Officer (EFIO) or practitioner is one of the oldest personnel in the health sector. His emergence dates back to the colonial era and has faced dangers in course of passing through the various stages of metamorphosis to the present day professional that he is.
The modern EHO is educated with diversities of knowledge and skills, is controversial and the envy of other sister professional groups in the sector.
The Environmental Health Officers (Registered) Act of 2000 provides for the registration and practice of persons if the profession. With the governing council created by the law of 2000 and the Environmental Health Officers Association of Nigeria (EHlOAN) which is set to co-ordinate and regulates the activities of members, the today 13110 is set on the path of expertise and relevance.
To be able to keep with the pace, EHOAN is organizing this programme tagged “BAYELSA 2008”, which is the 4 in the series, and the purpose is to sensitize and energize members of the profession. This year’s theme is “Environmental Health Practice in Nigeria: Challenges and Prospects”.
It should be noted that indeed there are challenges and prospects facing the professional group. How these challenges threaten the relevance of the group and how this would be tackled should be a concern for all as well as the ability of it to appropriate the prospects that stand before all.
It is believed that at the end of this conference and workshop, fresh achievable strategies would emerge to this effect.
Six papers have at been earmarked to be delivered:
• Water Sanitation as a Key Strategy Towards Achieving the Goals of International Year of Sanitation (IYS).
• Food Sanitation and its Implications on Environmental Health Practice in Nigeria.
• Natural Disasters and the Role of Environmental Health Practitioners.
• Malaria Prevention Through Environmental Sanitation: A key Strategy for the Achievement of Millennium Development Goals.
• The Essentials o Effective Waste Management as A Tool For The Enhancement of International Year of Sanitation (IYS) in Nigeria.
• Implementation of National Environmental Sanitation Policy: The Journey so far.
This paper titled “National Disasters and the Role of Environmental Health Practitioners will examine the role of EHOS in the management of natural disasters and objectives are as follows:
a. To explain types Natural disasters
b. To identify organizations and agencies involved in managing natural disasters.
c. To explain the composition and functions of disaster response teams.
d. To analyze the role of the EHO in management of natural disasters in Nigeria.
By way justifying the need of this paper, it is worthy to note that it is on record that millions of people die as a result of natural disaster.
Tangiwai volcanic eruption disaster for example killed about 23,000 people in Armen Columbia in 1985, the 2005 Kashmir earthquake caused 79,000 lives in Parkistan.
Disaster incidences have been increasing astronomically over time, in the 1980’s there were only about 100 recorded hydrological disasters per year but the number has risen to over 300 a year since 2000 (source: World Disaster Report 2006).
It is therefore expedient that the management of such situations be tackled seriously. [ the El 10 can be relevant in this business of disaster management is one of the targets of this conference.
MEANING AND TYPES OF NATURAL DISASTERS
Natural Disaster has been defined as the consequence of a natural hazard (e.g. volcanic eruption, earthquake and landslide) which moves from potential into au active phase and as a result affects human activities causing financial, structural and human losses.
Human vulnerability element is incorporated into the definition in some cases stating thereby that disasters occur when hazards meet vulnerability.
Natural Hazard is a situation which has the potential to create an event that has an effect oil people. Natural hazards result from natural processes in the environment and some natural hazards are related e.g earthquakes can result in tsunamis; drought can lead directly to famines and diseases.
The National Emergency Management Agency (NEMA) Act (1999) defines natural or other disasters as including any disaster ansing from crisis, epidemic, drought, flood, earthquake, storm, train, roads, aircraft, oil spillage or other accident and mass deportation or repatriation of Nigerians from any other country.
Natural hazards may be classified into the Following:
• Geological
(Ava kinche, Earthquake, Lahars, Landslide, Mudliows, Sinkholes, Volcanic eruptions).
• Hydrological
(Flood, Limnic eruption, mealstrom, seiche tsunami).
• Climate
(Blizzard, drought, hailstorm, Heat wave, hurricanes, tropical cyclones, typhoons, Ice storm, tornado).
• Fire (wild fire)
• Health and disease
• Space
(Solar flare, impact event)
Types of Natural Disasters
• Avalanche
This occurs when large snow mass slides down a mountain slide into a slope. In an avalanche, lots of’ material or mixtures of different types fall or slide rapidly under the force of gravity.
• Earthquake
This occurs as a result of sudden release of’ stored energy that radiates seismic waves. At the earth’s surface, earthquake may manifest themselves by shaking or displacement of’ the ground. Many earthquakes occur each day but are not large enough to cause to- significant damage.
The. 2004 Indian Ocean earthquake which is the second largest earthquake recorded in history claimed about 229,000 people.
2O0 Kashmir earthquake caused 79,000 lives in Pakistan
• Lahar
Lahar is a type of natural disaster closely related to a volcanic eruption and involves a large amount of material including mud, rock and ash sliding down the side of the volcano at a rapid pace. These flows can destroy entire towns in seconds and kill thousands of people.
Tangiwai disaster killed about 23,000 people in Armen Columbia in l98
• Landslides/Mud Flows
A Landslide is a disaster closely related to an avalanche but instead of occurring with snow, it occurs involving actual elements of the ground including rocks, trees, parts of houses and any thing else which may happen to be swept up. Landslides can be caused by generally instability in the surrounding land.
Mudslidcs or mud flows are a special case of’ landslides in which heavy rainfall causes loose soil on steep terrain to collapse and slide downwards. This usually OCCWS after periods of heavy rain.
• Sink holes
It is a localized depression in the surface topography usually caused by the collapse of a subterranean structure such as a cave. Although rare, large sinkholes that develop suddenly in populated areas can lead to collapse of buildings and other structures.
• Volcanic Eruption
A volcanic eruption is the point in which a volcano is active and releases its power; the erupt ions comes in many forms. They range from daily small erupt R)I is which occur in places like Kilanea in Hawali or extremely infrequent super volcanic eruption.
According to Toba catastrophe theory, 70 — 75 year thousand years ago a super volcanic event in lake Toba reduced the human population to 10,000 or even 1,000 breeding pairs, creating a bottle neck in human evolution.
Flood
Flooding occurs as a result of prolong rainfall including thunderstorms, rapid inciting of large amount of snow or rivers which swell from excess precipitation upstream and cause widespread damage to areas downstream or less frequently the bursting of man — made dams or levees.
The Huange Ho River Flood in China in 1931 caused between 800,000 and 4,000,000 deaths.
Yangtze River floods in China in 1978 rendered 14 million people covered much of the country for three weeks resulting in thousands of death leaving the country devastated for years afterwards.
Tropical/storm Allison in Houston Texas in 2001 was devastating
Hurricane Katrina in New Orleans in 2005 left most of the city under water.
Limnic Eruption
It is also referred to as a “Lake overturn”. A limnic eruption is a rare type of natural disaster in which CO2 suddenly erupts from deep lake water, posing the threat of suffocating wildlife, live stock and human such an eruption may also cause tsunamis in the lake as the rising CO2 displaces waters. Scientist believes landslides, volcanic activity or explosions can trigger such an eruption.
1984 limnic eruption in Lake Monou in Cameroon causing the death of 37 nearby resident
Tsunami
It is a wave of water caused by the displacement of a body of water. The world is Japanese meaning harbor and wave. Tsunami can be caused by undersea earthquakes.
Blizzard
It is a severe winter storm condition characterized by low temperature strong winds and heavy blowing snow.
Drought
It is an abnormally dry period when there is not enough water to support agriculture, Urban or environment. Water needs. Extended drought can result in deaths by starvation or diseases and can result in wildfires
Between 1900-1941 China experienced several cases of droughts killing millions of people.
Since 2006, Western Australia, New South Wales, Victoria and Queens land have been under drought conditions for five to ten years.
Hailstorm
A Hailstorm is a natural disaster where a thousandstornm produces numerous hailstorms which damage the location in which they fall. Hailstorm can be especially devastating to farm fields, running crops and damaging equipment.
• Hailstorm in Munich Germany on August 31, 1986 fell thousands of trees causing millions of dollars in insurance claims
Hurricane, Tropical Cyclones and Typhoon
Hurricane, Tropical Cyclones and typhoon are different names for the same phenomenon. A cyclonic storm system forms over the oceans. It is caused by evaporated water that comes off the ocean and becomes a storm. The carioles effect causes the storm to spin and a hurricane is declared when the spinning mass of storms attains a wind greater than 74 mph.
Hurricane is used for these phenomenon in the Atlantic and Eastern Pacific Oceans, tropical cyclone in the India, Typhoon in the Western pacific.
• 1970 Bhola cyclone is recorded as the deadliest hurricane
• 2005 Hurricane Katrina which devasted the Gulf Coast of the U.S.
Tornado
A Tornado is a natural disaster resulting from thunderstorm. Tornados are violet rotating colomns of air which can blow at speeds between 50 and 300 mph and possibility higher. Tornadoes can occur one at a time or can occur in large tornado outbreaks along sequel lines or other large areas of thunderstorm development. Waster spouts are tornadoes occurring over tropical waters in high rain conditions.
Wild fire
It is an uncontrolled fire burning in wild land areas. Common causes include lightening and drought but wild fires may also be started by human negligence or arson. They can be a threat to those in rural areas and also wild life.
Epidemics
An outbreak of a contractible disease that spreads at a rapid rate through human population.
A pandemic is an epidemic whose spread is global. There have been many epidemics throughout history.
• The 1918 Spanish Flu pandemic killings an estimated 50 million people worldwide
• The 1957-1958 Asian flu pandemic which killed an estimated one million people.
• The 1968-1968 Hong Kong Flu pandemic
• The 2002-2003 SARS pandemic
• The AID epidemic beginning in 1959
• Others are Malaria, Ebola bemorrhage fever, Cholera, Menningitis, Yellow Fever etc.
Impact Event
It is a natural disaster in which an extraterrestrial piece of rock or other material collides with the earth. The exact consequences of a direct earth impact would vary greatly with size of the colliding object, although in cases of medium to large impacts short term climate charge and a general failure of agriculture.
Famine
A social and economic crises that commonly accompanied by wide spread malnutrition starvation, epidemic disease and increase mortality although some famine occur by natural factors, it can and often is a result of economic or military policy that deprives people of food that they require to survive Famines often hit areas like sub-Sahara African and Asia.
Common natural disasters in Nigeria are flooding, erosion and drought. Although natural disasters are situations caused by natural factors some underlying factors have been identified by some experts as being responsible especially in the hydrological disasters. For instance unplanned urbanization in flood prone region increase the likelihood that their towns and villages will be affected by flash floods and coastal floods.
Large areas covered with cement prevents runoff water to get absorbed by the soil thereby causing floods.
ORGANIZATIONS INVOLVED IN MANAGEMENT OF NATURAL DISASTERS
Disaster management is a global issue. States and non governmental agencies efforts towards this direction are laudable. Programmes and activities have been earmarked to ensure disaster relief and reduce the consequential risks. Some of the organizations and bodies involved in management of natural disaster may be stated as follows
National Level
In Nigeria apart from the direct efforts of the Ministries of Health and Environment, there are established several other bodies which engage in disaster management. Some of them include:
National Emergency Management Agency (NEMA)
This is the foremost agency saddled with the responsibility of managing emergencies. The agency has a governing council made up of the following:
• The Vice President (Who is the chairman)
• The secretary to Government of the Federation
• Representatives from the Federal Ministries of Aviation, Foreign Affairs, Health, Internal Affairs, Transport, Water Resources, Works and Housing
• One representative each of the armed forces, the Nigerian Police, the Nigerian Red Cross societies, such voluntary organization as may be determined from time to time.
The functions of the agency are as follows:
• To formulate policy on all activities relating to disaster management in Nigeria and coordinate the plans and programme for efficient and effective response to disasters at national level.
• Co-ordinate and promote research activities relating to disaster management at the national level
• Monitor the state of preparedness of the organizations or agencies which may contribute to disaster management in Nigeria.
• Collate data from relevant agencies so as to enhance forecasting, planning and field operation of disaster management.
• Educate and inform the public on disaster prevention and control measures.
• Coordinate and facilitate the provision of necessary resources for search and rescue and other types of disaster curtailment activities in response to disasters distress calls.
• Coordinate the activities of all voluntary organizations engaged in emergency relief operation in any part of the federation.
• Receive financial and technical aid from international and nongovernmental management in Nigeria.
• Collect emergency relief supply from local and foreign sources and from international and non governmental agencies
• Liaise with state emergency management committees established under section and monitor where necessary the distribution of relief materials to disaster victims.
• Process relief assistance to such countries as may be determined from time to time.
• Liaise with the UN Disaster Reduction organization or such other international bodies for the reduction of natural and other disaster
• Prepare the annual budget for disaster management in Nigeria
• Perform such other functions which in the opinion of the agency are its objectives in the act.
The Nigerian Red Cross Society (NRSC)
NRCS is a non governmental organization directly linked to the International Committee of the Red Cross (ICRC).
It is an independent humanitarian relief and development organization whose mission is to prevent and alleviate human suffering and is guided in its work by the seven fundamental principles of the movement tagged “The Vienna Proclamation of 1965”. The principles include; Humanity, Impartiality, Neutrality, Independence, Voluntary Service, United and Universally.
Activities of NRCS include:
• Recruitment and training of personnel for rendering of first aid, disaster relief and home nursing.
• Dissemination of information on the ICRC activities and international humanitarian law to target groups such as Red Cross volunteers, the military, the police, teachers and media.
• Family training activities
• Planning and implementing disaster preparedness and response
• Render community services in the areas of
Health education
Blood donation
Primary Health care services
First aid training and services
Vacation programme
Environment project such as construction of latrine.
INTERNATIONAL LEVEL
International agencies involved in natural disaster management include:
a. International Committee of the Red Cross (ICRC)
This organization is made up of the following:
The international committee of the Red Cross
International Federation of Red Cross and Red Crescent societies
National Red Cross and Red Crescent societies totaling about 160.
The functions of ICRC include
Assist victims of disasters by providing medical care, setting up hospitals and rehabilitation centre.
Provide appropriate aids as needed such as food, shelter, and clothing
Run central tracing agency
Promote assistance to war disabled
Initiate and promote international humanitarian law ‘
Carryout studies and research on humanitarian work
Reunite families split by war
Visit military prisoners and other detainees
Arbitrate between warring parties in armed conflict
Prohibit in human or degrading treatment e.g. hostage taking, torture, summary executions, deportations etc
Active in conflict resolution, armed and non armed conflict and internal disturbances and tension.
b. Medicines Sans Frontier (MSF)
Provides health and to victims of wars and natural disasters
c. United Nations Development Programme (UNDP)
Fights poverty and diseases and advocates for environmental protection.
d. United Nations High Commissioner for Refugees (UNCHCR)
e. World Bank.
f. United Nations Environmental Programme (UNEP).
g. World Health Organization (WHO).
WHO is active in emergency and humanitarian actions.
Others include:
USAID
Medicine Sans Frontier (MSF) (provides health aid victims of war and natural disasters. Provides aids in chronic emergencies)
World Food Programme (WFP)
UNICEF
CARE USA
Catholic Relief Services (CRS)
Food and agriculture organization (FAO) etc.
COMPOSITION AND FUNCTIONS OF EMERGENCY RESPONSE TEAM.
Composition
A comprehensive emergency response team may be composed of the following:
a. Health Team
Medical doctors
Nurse
Drug dispenser
Health Educator
Nutritionist
Medical records officer
Environmental Health Officer etc.
b. Environmental management team
Environmental Health officer
Civil and other Engineers.
c. Social welfare team
d. Information team
e. Fires control/service team
f. Representative of organizations
g. Security team (Civil Defence Corps/Police).
Functions of Emergency Management team
Functions of emergency response team may be summarized thus.
Assessment of disaster zone and cases
Evacuation of victims to temporary settlement
Render Health services to the needy
Provision of relief materials such as food, water, clothing drugs to victims
Provision of Environmental and general sanitation
Refer serious health cases to hospitals
Provision of security and safety of victims
Publicities/report emergency situations
Seek financial aids for victims.
ROLES OF ENVIRONMENTAL HEALTH PRACTITIONERS IN DISASTER MANAGEMENT
It is difficult to stand before professionals like you and give instructions on what should be done during emergencies. However a reminder of what is normally done is an easier task to accomplish.
It is therefore intended in this part of the paper to highlight what is already known by all, and this will be done with a persuasive note to all the endeavour to take actions in order to maintain the image brushing ad relevance that the professional group requires at this time.
The role of the Environmental Health Officer in disaster management is to carry out environment process, most particularly to note are:
• The Evacuation stage
• The settlement stage
• The Treatment stage
• The clean up stage
• The provision of supplies stage.
In each of these stage, the EHO is expected to:
• Make observations/carryout inspections
• Detect nuisances
• Abate the nuisances
• Prevent the reoccurrence of nuisances.
The specific environmental health actions to be taken by the EHO are as follows:
• Inspect and determine the suitability of means of transportation.
• Ensure that means are not overcrowded or pose health hazards
• Ensure sanitary waste disposal for victims in transit
• Give health education to victims.
Settlement Stage
• Carryout site/facility inspection before arrival of victims
• Ensure provision of waste disposal facilities
• Ensure adequate waster/electricity supply
• Ensure provision for storage and preservation of food
• Give health education to victims
• Carryout disinfections and disinfestations.
Treatment stage
• Ensure that hospital/medical wastes are sanitarily disposed off
• Carryout disinfection of materials.
Clean up stage
• Zone area for proper cleaning
• Determine appropriate cleanup methods
• Supervise clean up exercise
• Ensure sanitary disposal of waste generated
• Coordinate personnel to be used for the exercise
• Ensure that dead bodies are appropriately disposed.
Provision of Supplies Stage
• Ensure safety of supplies
• Ensure storage and preservation of supplies
• Ensure fair distribution of supplies.
The EHO is expected to play his role in the management of disasters and his ability to take quick and relevant actions in what makes the difference.
CONCLUSION
Quick response to emergency situations save life and reduce mobility rates of victims. It is important therefore that the EHO understands the emergency situation and identify areas that pertain to him and take appropriate actions. In this way he becomes relevance and contributes his best whenever and wherever the call comes.
I am an environmental public health practitioner. Obtained first degree in public health [environmental health and safety] from Federal University of Technology, Owerri.
TRENDS IN INDUSTRIAL AND RESIDENTIAL DEVELOPMENT IN NIGERIA: IMPLICATIONS FOR HEALTH AND SAFETY
By: Rotimi M. A
An invited paper presented at the 39th National Conference/Scientific Workshop of the Environmental Health Officer Assoociation of Nigeria [EHOAN], October, 2003
INTRODUCTION
The principal aim of all sound development is the promotion of human welfare and happiness. It is extremely difficult to set down objective welfare or human happiness, especially the latter. Happiness is essentially a state of mind, but it is generally associated with a feeling of contentment and the knowledge that one’s aspirations are either being fulfilled or stand a reasonable chance of being fulfilled.
No programme of development can be regarded as complete unless it includes at least certain basic human needs whose satisfaction can be regarded as an essential condition for human existence. The achievement of these needs/objectives demands the application of human effort and intelligence. Just as man is the ultimate beneficiary of all development efforts, so also is he the originator of all development programme and goals. Thus, unless man is healthy in mind and body, the development process cannot even begin. Nor can the fruits of development be fully utilized and enjoyed unless those whom they are intended to benefit are in a fit state of health to make use of the resulting benefits and assist in extending them to the rest of the society.
Health and development thus have mutual beneficial effects on each other; but quite plainly health comes first in order of priority. Good health implies not just the absence of illness, but a positive state of well-being in which body and mind are fit and all the faculties are working harmoniously at their maximum level of efficiency. A healthy person needs to be assured of all basic physical requirements of life – good job and safe work place, good food in adequate quantities, reasonable standards of shelter and clothing, adequate and safe water supply, facilities for wastes management and means of social existence. To a large extent the provision of these basic needs turns on the availability of adequate financial intellectual and technological skills for directing these resources along productive and useful channels.
In Nigerian Society of today which is astronomically industrializing and diversifying its economy profound changes are taking place in the environment as is now evident. Some of these changes have beneficial effect on health, safety and socio-economic well-being of our people, whilst some other aspects have demonstrable adverse effects on health.
ENVIRONMENT, HEALTH AND DEVELOPMENT
It has now become clear beyond any doubt that the task of bringing about a new socio-economic order at the national level is very daunting. And added to this is the Herculean task of achieving, in collaboration with the rest of the international community, and particularly the other Third World regions, fundamental structural changes in national economic relations.
Economic development implies growth and change in a sustained manner. It is closely bound to environmental concerns. Man cannot hope to improve his world without economic growth. But quality of life cannot advance unless the working and living environment is nurtured and valuable resources are protected.
Man uses the natural resources which abound in his environment in a variety of ways to meet his needs. This often results in environmental deterioration; a problem aggravated by rapid population growth and urbanization – resulting in uncontrolled urban growth and expansion of environmentally marginal settlements; and industrialization, with attendant environmental pollution; and deterioration o the rural resource base through deforestation, soil erosion and degradation.
The question that arises is how to establish a harmonious and realistic relationship between man and nature which is a long-standing and largely unresolved one. Following years of mindless onslaught on and depletion, degradation and in some cases complete destruction of environmental resources, leading to real fears as to how long man can hope to survive on this planet without health and safety being endangered, efforts are being made to discover the right approach to man-nature interaction.
In order to ensure that possible negative impacts of development projects are predicted and addressed prior to project take-off and are environmentally sound and sustainable, an Environmental Impact Assessment programme was adopted in December, 1992.
The goals of the EIA include:
- Responsible use and exploitation of natural resources
- Sustainable productivity of ecosystems
- Maintenance of the carrying capacity and the absorptive capacity of air, land and water
- Prevention of the degradation of environmental quality
- Use of appropriate technology
Like most other developing countries, Nigeria had for a long time embraced the concept of rapid industrial growth as the vehicle for overall economic development. Since the 1960s, the various National Development plans have consistently emphasized industrialization as the means of achieving rapid increase in the nation’s productive capacity as well as improving the standards of living of the citizenry. As a result of this pursuit, and with the advent of the oil industry in particular, environmental degradation has been on the increase.
Rapid population growth at a rate of 3.4% per annum is straining the urban environment. The United Nations Development Programme in its 1986 Annual Report has it that one quarter of the world’s people call misery home;
- That nearly 100 millions are actually without shelter, eating and sleeping along public streets in all major metropolitan centres.
- That squatter settlements abound lacking water, sewage facilities, removal of solid waste etc.
These problems are taking a toll on the Nation’s Economy!
INDUSTRIAL DEVELOPMENT
Industrialization is an important life-wire in the economic development of any nation and an important barometer for measuring the nation’s stature in the international community. It provides ready employment opportunities for a good percentage of the population. It facilitates the upliftment of standards of living and social well-being.
Industrialization therefore begets development which is a very desirable end.
There are over three thousand industries in Nigeria today. The operation of these industries varies according to their technological process, size, nature and products, characteristics of the waste produced and the receiving environment of discharged waste. Presently, these industries have been classified into the following ten sectoral groups by the Manufacturers Association of Nigeria (MAN), via:
a. Food, Beverages and Tobacco
b. Chemical and Pharmaceuticals
c. Domestic and Industrial Plastic and Rubber
d. Basic Metal, Iron and Steel, and Fabricated Metal Products
e. Pulp, Paper and paper Products, Printing and Publishing
f. Electrical and Electronics
g. Textile, Wearing Apparel and Leather
h. Wood and Wood Products including furniture
i. Non-Metallic Mineral Products
j. Motor Vehicle and Miscellaneous Assembly
Every industrial activity involves the input of raw materials through some mechanical process and the usual result is the finished desired economic good and some unwanted by products or wastes. The wastes come in various forms of solid, liquid or gas.
Inevitable as industrialization is, the siting of industries and the process technology employed in them are sometimes determined by various criteria, some o which are environmentally inappropriate. For example, industrial estates are sometimes established alongside residential areas and large urban centres.
Again, the process technology of some industries often result in unacceptable levels of toxic and dangerous industrial wastes, effluents and emissions.
The most common problems associated with industrial facilities are: air and water pollution, the creation of solid wastes, noise and modification of traditional land use.
Assessment of industrial projects should therefore consider:
- Identifying potentially harmful effects of a particular project on the environment, health and society
- Ensuring that appropriate mitigating measures are incorporated into the project, and
- Preventing unnecessary depletion of domestic natural resources.
Lagos State is Nigeria’s most industrialized state. Reportedly, it accounts for over 60% of the federation’s total industrial investment. According to the Nigerian Industrial Directory, 1994 edition, published by the manufacturers’ Association of Nigeria and the report prepared for and submitted to the Lagos State Ministry of Environment and physical planning by the World Environment System (an Industrial Data Base, 1997) over 2000 industries have been identified in Lagos State.
Two things would immediately strike one concerning the large quantities of industries in Lagos State. The first is that economic activities, employment opportunities etc is high. The second is that pollution from industrial discharge/waste is high as well.
Indeed, pollution has bothered conservationists for decades. It is now of sufficient intensity to concern the public. Economists have turned their attention to the causes, cost, and possible cures for pollution. On the other hand, however, economists are also concerned about economic growth and environmentalists often assert that economic growth is accompanied by pollution of the air, contamination of water supplies, and destruction of wildlife habitats.
To complicate the issue, energy, which is essential to life and to the preservation of the standard of living we most desire, has become increasingly expensive. Unfortunately, to increase the energy supplies we must often aggravate the pollution problem. And when industrial wastes are ill-managed, ther are potential dangers viz:
i. Water Pollution:-
Industrial waste from such industries as breweries, textiles, bottling, pulp and paper, pharmaceutics, meat-packing, dairies, paint, metal finishing, and so on, contain carbonaceous and nitrogenous substances, organic/inorganic matter, toxic chemicals, heavy metals. If such harmful or potentially harmful industrial wastes are dumped in surface dumpsites, or in gulleys, valleys or drainage basins, leachates from them (i.e. liquids from dissolved solid wastes) percolate freely and are swept by rain flood into surface water (such as streams lakes, rivers) and into burst water pipes and nearby underground water system. The result is extensive chemical pollution of water. An example is River Kaduna which plays a very important role as the major sources of water supply and common sink of all water-borne wastes produced by the industries.
This is also true of the stream serving as waste sink to NICHEMTEX in Ikorodu in Lagos Sate. Most other industries along Aromire area (Ikeja), Ijora, Apapa, discharge their effluents and untreated directly into open public drains.
ii. Air Pollution:-
The quality of air is affected by smoke, dust, automobile exhausts and gaseous waste from factories. The important gaseous emulsions from Nigerian Industries are sulphur dioxide, carbon monoxide and oxides of nitrogen particulate matter, heavy metal dust etc. These gaseous irritate the lungs and pose a serious threat to the health, particularly of older people and children.
Quantitative data are not readily available on air pollution because it is rarely monitored by Government agencies and the industries do not want to monitor it. The two biggest sources of air pollution are vehicular emissions and industrial plants. The population of vehicles in Lagos State is about 500,000 while industries number over 2000.
Air pollution is also a phenomenon of ill-managed waste. Technically, air is said to be polluted when its natural capacity to dilute various atmospheric pollutants is over-burdened. The air gets easily polluted when chemically – laden industrial effort and toxic gaseous emission or dissolving industrial waste solids are released into it.
iii. Land Pollution:-
Land includes all the natural resources used in the production of the things we want i.e. the minerals in the ground, forests, waterfalls, fertile soil etc. Disposal of solid and hazardous waste on land is dangerous when not dealt with in an environmentally sound way. The danger is that these wastes may pollute ground water used or drinking and soils used for grazing and farming. Cost of land is made higher. Unwanted health and environmental impacts such as contamination of soil and possibly of food products grown thereon are potential consequences of improper disposal of hazardous wastes.
Other includes:- Land degradation which sets in motion a chain of events that lead to declining food production and increase children’s malnutrition.
- Creation of an aesthetic blight that harms the natural beauty, historical sites and tourism.
All the above environmental hazards-to human health, animal life, plant life, and the economy show that proper waste management and control is intimately connected with the on-going global concern for sustainable development.
RESIDENTIAL DEVELOPMENT
Nigeria’s Population is estimated at 126 million persons by World Health Organization (WHO) and has been increasing annually at 3.4 percent. At this rate the population is set to reach 281 million persons in 2015 and 338 million by the year 2025. As is typical in countries where fertility has been high for a long period of time, (between 4 and 7 children per woman). Nigeria has a very young population. Population projections indicate that in 1985 over 47 percent of the population is under the age of 15. Consequently, Nigeria has a high child dependency ratio which is the proportion of children under 15 to adults in the economically productive ages, is to 64.
Nigeria is experiencing rapid urban growth. In 1960, only two urban centre- Lagos and Ibadan-had more than 500,000 residents; by 1980, 9 cities had more than 1/2million persons. Between 1960 and 1970, the urban population grew by 4.7 percent per year, and between 197o and 1982, the population of the cities grew by 4.9 percent per year. 1980, about 20 percent of the population of Nigeria lived in the urban centres. Rapid urbanization has contributed to poor housing conditions, inadequate water supply, and waste disposal, congestion, high rates of unemployment and underdevelopment, crime and other social problems.
HOUSING REQUIREMENTS
Every family and individual has a basic right to a decent home and a suitable =living environment. However, large segments of the population in urban and rural areas do not enjoy one or both of these fundamental needs. The realization of a decent home in a suitable living environment requires clean air, pure (good) water and food, adequate shelter and unpolluted land. Also required are freedom from excessive noise and odours, adequate recreation facilities, and convenient services in an environment that provides safety, comfort, and privacy.
Housing is expensive and difficult to find in many urban areas of Nigeria, particularly the capital. Construction has not kept pace with the rapidly expanding population, leading to severe overcrowing. In Lagos, the master plan assumes the following projections of an average of 6.3 persons per household! And with high fertility rate, about 1.6 million new housing units would have been required between 1985 and 2000 simply to accommodate the growth of the population. Another 1.9 million units would be needed between 2000 and 2015 for a total of 3.5 million new units over the 1985-2015 period.
Practically, all urban and rural areas contain substandard, slum and blighted areas. With the movement of large numbers of people to cities, urban areas became congested, desirable housing became unobtainable. Inadequate facilities for transporting people rapidly and cheaply to and from work made it necessary for many people to accept less desirable housing in the cities, close to their work. The inability of the ordinary wage earner to economically afford satisfactory housing left him with choice but to accept what housing was available. Some landlords took advantage of the situation by breaking up large apartments into smaller dwelling units and by constructing cheap housing-of course with the attendant problem of none provision of sanitary offices and wastes management facilities.
In recent years, about 25 percent of households requiring new housing in Lagos have been able to obtain housing through private markets, while the other 75 percent are low income households unable to obtain adequate housing with their own resources.
Slums therefore abound! This may start with the expansion or spill-over of business into the contiguous residential areas, thereby making the housing less desirable. Poor people next door or in the same building, desiring quit and privacy, move. Owners are hesitant to continue maintenance work, causing buildings to deteriorate. The landlord is even ready to convert the building or a segment of it to commercial use. There is therefore a progressive degradation from blight to slum. And as blight spreads so does crime, delinquency, fires and housing decay.
There are also the areas that are slums from the start. The absence or failure to enforce building, sanitary and health regulations leads to the development of “shanty towns” or poor housing areas. Added to this, are cheap, new and converted dwellings and tenements that are poorly located, designed and constructed-just to provide shelter.
In recent years the population growth has been taking place outside the major cities, but the rate of housing construction and rehabilitation has not kept pace with the needs of population growth. The loss of housing due to decay, and demolition further compound the problem.
A notorious feature of our major cities and towns over the years has been haphazard development. Many of the popular towns and districts were unplanned. The direct results of the unplanned developments is that there are no infrastructural services in most of them, and such as exist are grossly inadequate.
In Lagos State, in the past decade, the Government has created a number of Agencies to tackle, among other things, the problems of unplanned development. The New Towns Development Authority has, as part of its functions, control and monitoring of unauthorized developments within Government Estates.
The task force on Environmental Sanitation and special offences assists in removing illegal structures and building without approved plans. The Committee on illegal conversions of residential buildings to other uses is a new creation in the State. It was established in 1994. And in 1996 came the Lagos State Environmental Protection Agency (LASEPA) both having relevance to the problem of unplanned developments.
HOUSING, HEALTH AND SAFETY
Substandard housing trends contribute to the aggravation of health and safety problems; viz:
a. Over crowing and congestion of living yards
b. Inadequate water supply
c. Inadequate or absence of sewage disposal facilities
d. Inadequate waste disposal facilities
e. Poor drainage facilities resulting in pollution of domestic water sources, flooding and dampness of living quarters ‘
f. Poor ventilation and lighting
g. Clustering of living quarters with junk, tins and cans
h. Atmospheric pollution
i. Lack of privacy and recreational facilities
j. Lack of access-ways into the settlement
k. Excessive noise from a variety of sources
l. Transmission of diseases and frequency of physical injuries
m. Unhygienic food handling and storage
n. Harbourage of vectors and hosts of disease
o. Conversion of the home as a workplace with increased health risks from chemicals or accidents
p. Higher morbidity and morbidity rates and the lower life expectancy.
The realization that millions of people lived a life consistent with human dignity, that many people were deprived of basic human requirements such as shelter, water supply, sanitation, employment, health services, education and recreation and the rates of urbanization are increasing while conditions in human settlements are deteriorating a an alarming rate must lead to the decision that national/state/local governments and private organizations must be act to improve the living conditions of the people.
In this connection, the following steps are pertinent:
a. A though study of the housing development situation in the major urban and rural settlements of this country, aimed at an understanding of the nature and magnitude of the housing and settlement problems encountered by the people
b. Enactment/Enforcement of appropriate legislation that will lead to the progressive and incremental realization of the housing rights of the citizens
c. Formulating and adopting a national housing policy that will lead to provision of housing for all with facilities for waste management
d. Provision of such facilities to protect preserve, promote that physical and mental health and social well-being of the people; to prevent and control the incidence of communicable diseases; to reduce environmental hazards to health and to maintain adequate sanitation and public health, to protect the safety of the people and to promote the general welfare.
e. Without tearing down existing buildings, gradual improvements be made, involving as much as possible the participation of the residents in slum areas.
The urgency of coming to grips with the successes and failures in residential development project as it affects health and safety has been heightened by the severe economic and financial strains now affecting many countries. Resources available for development have become scarce. Yet investing to make residential developments more sanitarily efficient and healthy places is a key factor not only in the fate of the urban poor, but in national economic recovery and growth.
The need at this juncture to evaluate the experience of the past decade and identify ways of improving the effectiveness of future residential developments, with particular attention to waste management.
HEALTH AND SAFETY IMPLICATIONS OF DEVELOPMENT
The common threat running through this paper is that Nigeria can afford sustained industrial and residential development to the extent that it manages wastes in productive and domestic activities. Waste management can reduce physical constraints which hamper economic expansion-in the human environment as well as in the supply of energy, and other critical or scarce resources.
The quality of life depends on human security, safety, comfort and other factors relating to health, pleasure and happiness.
The implications of waste on health and safety include
Waste Creates/increases costs
- Organizing and operating costs
(time, supplies, equipments, power, capital costs)
- Costs borne by the people
Waste Cause Changes
- In physical, social or emotional functioning
- In resource use (inequities in allocation of resources)
- In the quality of life of people e.g. deafness, impairment of hearing
Waste Cause serious public health problems
- Supports the growth of large population of flies (which can transmit typhoid fever, cholera, dysentery etc)
- Encourages the proliferation of rats
- Promotes the prolific breeding of roaches and mosquitoes
- Gives rise to noxious and offensive oddurs
- Gives rise to smog and air pollution
- Causes flooding when dumped on water ways
- Obstructs free flow of traffic when dumped on motorways.
Waste Cause health impairment/death
- Through land degradation which sets in motion a chain of events that lead to declining food production and increase children’s malnutrition. In some parts of the country, some 20%-40% of children under age five are reported to be below 75% of the standard weight for their age
- Through pollution of water bodies from discharge of domestic sewage and industrial waste
- Through air pollution linked with incidence or respiratory and pulmonary diseases
- Destruction of wildlife.
Waste Assaults the senses/diminishes value
- Creation of an aesthetic blight
- Strong objectionable odour
- From slum/blighted housing.
Waste Tends to increase
- Risk of road accidents
- Risk of community health from certain industrial processes e.g. fire explosion, poisoning etc
- Impact on existing health and safety services
- Environmental hazards and deterioration of natural resources
- Exposure to local diseases e.g. malaria.
RECOMMENDATION
Protect the resource base, through:
- Land use planning
- Preventing the discharge of pollutants and sustain development through environmental impact assessment
- Establishment of environmental education that enculturizes hygiene practices
- Beautification of the environmental through tree planning and protection of the greenbelt areas of the country.
Control aggravation of existing hazards by:
- Introducing polluter-pay-principle i.e. an economic disincentive package for environmental restoration on pollution abatement
- Enforcement of environmental legislation programmes which defines the responsibilities of the users of the environment
- Establishment and strengthening of an Environmental Services Department at the Local Government level
- Establishment of institutional framework for environmental lay reporting and data collection, analysis and utilization
- Gradual improvement to slum/blighted areas.
CONCLUSION
For effective management of the environment, contamination of the air, water and land resources must be kept low enough to avoid deleterious effects on human health and welfare.
Future generations will inherit this country after us and will pay for our mistakes and carelessness. We should therefore not fold our aims as if nothing is happening. Every effort must be made to made to counter the deterioration in the quality of life that will occur if the environmental resource base continues to be debased.
Thank you and God bless.
REFERENCES
1. Federal Ministry of Heal (F.M.H) and National Population Bureau 1985. The Effects of Population Factors on Social and Economic Development.
2. International Bank for Reconstruction and Development 1985. The environment/Public Health and Human Ecology
3. United Nations Development Programme (U.N.D.P) 1986. A better Environment for Developing Annual Report.
4. Philip Hardwide et al 1988. An Introduction to Modern Economics
5. World Health Organization (WHO) – Urbanization and its implications for Child Health 1988.
6. Federal Environmental Protection Agency (F.E.P.A)– The Environmental and Sustainable Development in Nigeria 1990.
7. Sanford D. Gordon et al – Introductory Economics 1990.
8. Rotimi Braimoh – Industrial Pollution and Prevention: Implications on Health 1991.
9. Rotimi Braimoh – Environmnetal Pollution: Effects on Community Health 1991.
10. M.A. Ajomo et al – Environmental Law and Sustainable Development in Nigeria 1994.
11. Prof. Adeniyi Osuntogun – Waste Management for Sustainable Development (A Keynote address) 1994.
12. Lagos State Government – Lagos State Environmental Action Plan (LSG) 1997
13. Shelter Rights Initiative – Practical issue in Human Settlements and Health 1997
14. Shelter Rights Initiative – Improving the Living Environment in Slum Settlements 1999
An invited paper presented at the 39th National Conference/Scientific Workshop of the Environmental Health Officer Assoociation of Nigeria [EHOAN], October, 2003
INTRODUCTION
The principal aim of all sound development is the promotion of human welfare and happiness. It is extremely difficult to set down objective welfare or human happiness, especially the latter. Happiness is essentially a state of mind, but it is generally associated with a feeling of contentment and the knowledge that one’s aspirations are either being fulfilled or stand a reasonable chance of being fulfilled.
No programme of development can be regarded as complete unless it includes at least certain basic human needs whose satisfaction can be regarded as an essential condition for human existence. The achievement of these needs/objectives demands the application of human effort and intelligence. Just as man is the ultimate beneficiary of all development efforts, so also is he the originator of all development programme and goals. Thus, unless man is healthy in mind and body, the development process cannot even begin. Nor can the fruits of development be fully utilized and enjoyed unless those whom they are intended to benefit are in a fit state of health to make use of the resulting benefits and assist in extending them to the rest of the society.
Health and development thus have mutual beneficial effects on each other; but quite plainly health comes first in order of priority. Good health implies not just the absence of illness, but a positive state of well-being in which body and mind are fit and all the faculties are working harmoniously at their maximum level of efficiency. A healthy person needs to be assured of all basic physical requirements of life – good job and safe work place, good food in adequate quantities, reasonable standards of shelter and clothing, adequate and safe water supply, facilities for wastes management and means of social existence. To a large extent the provision of these basic needs turns on the availability of adequate financial intellectual and technological skills for directing these resources along productive and useful channels.
In Nigerian Society of today which is astronomically industrializing and diversifying its economy profound changes are taking place in the environment as is now evident. Some of these changes have beneficial effect on health, safety and socio-economic well-being of our people, whilst some other aspects have demonstrable adverse effects on health.
ENVIRONMENT, HEALTH AND DEVELOPMENT
It has now become clear beyond any doubt that the task of bringing about a new socio-economic order at the national level is very daunting. And added to this is the Herculean task of achieving, in collaboration with the rest of the international community, and particularly the other Third World regions, fundamental structural changes in national economic relations.
Economic development implies growth and change in a sustained manner. It is closely bound to environmental concerns. Man cannot hope to improve his world without economic growth. But quality of life cannot advance unless the working and living environment is nurtured and valuable resources are protected.
Man uses the natural resources which abound in his environment in a variety of ways to meet his needs. This often results in environmental deterioration; a problem aggravated by rapid population growth and urbanization – resulting in uncontrolled urban growth and expansion of environmentally marginal settlements; and industrialization, with attendant environmental pollution; and deterioration o the rural resource base through deforestation, soil erosion and degradation.
The question that arises is how to establish a harmonious and realistic relationship between man and nature which is a long-standing and largely unresolved one. Following years of mindless onslaught on and depletion, degradation and in some cases complete destruction of environmental resources, leading to real fears as to how long man can hope to survive on this planet without health and safety being endangered, efforts are being made to discover the right approach to man-nature interaction.
In order to ensure that possible negative impacts of development projects are predicted and addressed prior to project take-off and are environmentally sound and sustainable, an Environmental Impact Assessment programme was adopted in December, 1992.
The goals of the EIA include:
- Responsible use and exploitation of natural resources
- Sustainable productivity of ecosystems
- Maintenance of the carrying capacity and the absorptive capacity of air, land and water
- Prevention of the degradation of environmental quality
- Use of appropriate technology
Like most other developing countries, Nigeria had for a long time embraced the concept of rapid industrial growth as the vehicle for overall economic development. Since the 1960s, the various National Development plans have consistently emphasized industrialization as the means of achieving rapid increase in the nation’s productive capacity as well as improving the standards of living of the citizenry. As a result of this pursuit, and with the advent of the oil industry in particular, environmental degradation has been on the increase.
Rapid population growth at a rate of 3.4% per annum is straining the urban environment. The United Nations Development Programme in its 1986 Annual Report has it that one quarter of the world’s people call misery home;
- That nearly 100 millions are actually without shelter, eating and sleeping along public streets in all major metropolitan centres.
- That squatter settlements abound lacking water, sewage facilities, removal of solid waste etc.
These problems are taking a toll on the Nation’s Economy!
INDUSTRIAL DEVELOPMENT
Industrialization is an important life-wire in the economic development of any nation and an important barometer for measuring the nation’s stature in the international community. It provides ready employment opportunities for a good percentage of the population. It facilitates the upliftment of standards of living and social well-being.
Industrialization therefore begets development which is a very desirable end.
There are over three thousand industries in Nigeria today. The operation of these industries varies according to their technological process, size, nature and products, characteristics of the waste produced and the receiving environment of discharged waste. Presently, these industries have been classified into the following ten sectoral groups by the Manufacturers Association of Nigeria (MAN), via:
a. Food, Beverages and Tobacco
b. Chemical and Pharmaceuticals
c. Domestic and Industrial Plastic and Rubber
d. Basic Metal, Iron and Steel, and Fabricated Metal Products
e. Pulp, Paper and paper Products, Printing and Publishing
f. Electrical and Electronics
g. Textile, Wearing Apparel and Leather
h. Wood and Wood Products including furniture
i. Non-Metallic Mineral Products
j. Motor Vehicle and Miscellaneous Assembly
Every industrial activity involves the input of raw materials through some mechanical process and the usual result is the finished desired economic good and some unwanted by products or wastes. The wastes come in various forms of solid, liquid or gas.
Inevitable as industrialization is, the siting of industries and the process technology employed in them are sometimes determined by various criteria, some o which are environmentally inappropriate. For example, industrial estates are sometimes established alongside residential areas and large urban centres.
Again, the process technology of some industries often result in unacceptable levels of toxic and dangerous industrial wastes, effluents and emissions.
The most common problems associated with industrial facilities are: air and water pollution, the creation of solid wastes, noise and modification of traditional land use.
Assessment of industrial projects should therefore consider:
- Identifying potentially harmful effects of a particular project on the environment, health and society
- Ensuring that appropriate mitigating measures are incorporated into the project, and
- Preventing unnecessary depletion of domestic natural resources.
Lagos State is Nigeria’s most industrialized state. Reportedly, it accounts for over 60% of the federation’s total industrial investment. According to the Nigerian Industrial Directory, 1994 edition, published by the manufacturers’ Association of Nigeria and the report prepared for and submitted to the Lagos State Ministry of Environment and physical planning by the World Environment System (an Industrial Data Base, 1997) over 2000 industries have been identified in Lagos State.
Two things would immediately strike one concerning the large quantities of industries in Lagos State. The first is that economic activities, employment opportunities etc is high. The second is that pollution from industrial discharge/waste is high as well.
Indeed, pollution has bothered conservationists for decades. It is now of sufficient intensity to concern the public. Economists have turned their attention to the causes, cost, and possible cures for pollution. On the other hand, however, economists are also concerned about economic growth and environmentalists often assert that economic growth is accompanied by pollution of the air, contamination of water supplies, and destruction of wildlife habitats.
To complicate the issue, energy, which is essential to life and to the preservation of the standard of living we most desire, has become increasingly expensive. Unfortunately, to increase the energy supplies we must often aggravate the pollution problem. And when industrial wastes are ill-managed, ther are potential dangers viz:
i. Water Pollution:-
Industrial waste from such industries as breweries, textiles, bottling, pulp and paper, pharmaceutics, meat-packing, dairies, paint, metal finishing, and so on, contain carbonaceous and nitrogenous substances, organic/inorganic matter, toxic chemicals, heavy metals. If such harmful or potentially harmful industrial wastes are dumped in surface dumpsites, or in gulleys, valleys or drainage basins, leachates from them (i.e. liquids from dissolved solid wastes) percolate freely and are swept by rain flood into surface water (such as streams lakes, rivers) and into burst water pipes and nearby underground water system. The result is extensive chemical pollution of water. An example is River Kaduna which plays a very important role as the major sources of water supply and common sink of all water-borne wastes produced by the industries.
This is also true of the stream serving as waste sink to NICHEMTEX in Ikorodu in Lagos Sate. Most other industries along Aromire area (Ikeja), Ijora, Apapa, discharge their effluents and untreated directly into open public drains.
ii. Air Pollution:-
The quality of air is affected by smoke, dust, automobile exhausts and gaseous waste from factories. The important gaseous emulsions from Nigerian Industries are sulphur dioxide, carbon monoxide and oxides of nitrogen particulate matter, heavy metal dust etc. These gaseous irritate the lungs and pose a serious threat to the health, particularly of older people and children.
Quantitative data are not readily available on air pollution because it is rarely monitored by Government agencies and the industries do not want to monitor it. The two biggest sources of air pollution are vehicular emissions and industrial plants. The population of vehicles in Lagos State is about 500,000 while industries number over 2000.
Air pollution is also a phenomenon of ill-managed waste. Technically, air is said to be polluted when its natural capacity to dilute various atmospheric pollutants is over-burdened. The air gets easily polluted when chemically – laden industrial effort and toxic gaseous emission or dissolving industrial waste solids are released into it.
iii. Land Pollution:-
Land includes all the natural resources used in the production of the things we want i.e. the minerals in the ground, forests, waterfalls, fertile soil etc. Disposal of solid and hazardous waste on land is dangerous when not dealt with in an environmentally sound way. The danger is that these wastes may pollute ground water used or drinking and soils used for grazing and farming. Cost of land is made higher. Unwanted health and environmental impacts such as contamination of soil and possibly of food products grown thereon are potential consequences of improper disposal of hazardous wastes.
Other includes:- Land degradation which sets in motion a chain of events that lead to declining food production and increase children’s malnutrition.
- Creation of an aesthetic blight that harms the natural beauty, historical sites and tourism.
All the above environmental hazards-to human health, animal life, plant life, and the economy show that proper waste management and control is intimately connected with the on-going global concern for sustainable development.
RESIDENTIAL DEVELOPMENT
Nigeria’s Population is estimated at 126 million persons by World Health Organization (WHO) and has been increasing annually at 3.4 percent. At this rate the population is set to reach 281 million persons in 2015 and 338 million by the year 2025. As is typical in countries where fertility has been high for a long period of time, (between 4 and 7 children per woman). Nigeria has a very young population. Population projections indicate that in 1985 over 47 percent of the population is under the age of 15. Consequently, Nigeria has a high child dependency ratio which is the proportion of children under 15 to adults in the economically productive ages, is to 64.
Nigeria is experiencing rapid urban growth. In 1960, only two urban centre- Lagos and Ibadan-had more than 500,000 residents; by 1980, 9 cities had more than 1/2million persons. Between 1960 and 1970, the urban population grew by 4.7 percent per year, and between 197o and 1982, the population of the cities grew by 4.9 percent per year. 1980, about 20 percent of the population of Nigeria lived in the urban centres. Rapid urbanization has contributed to poor housing conditions, inadequate water supply, and waste disposal, congestion, high rates of unemployment and underdevelopment, crime and other social problems.
HOUSING REQUIREMENTS
Every family and individual has a basic right to a decent home and a suitable =living environment. However, large segments of the population in urban and rural areas do not enjoy one or both of these fundamental needs. The realization of a decent home in a suitable living environment requires clean air, pure (good) water and food, adequate shelter and unpolluted land. Also required are freedom from excessive noise and odours, adequate recreation facilities, and convenient services in an environment that provides safety, comfort, and privacy.
Housing is expensive and difficult to find in many urban areas of Nigeria, particularly the capital. Construction has not kept pace with the rapidly expanding population, leading to severe overcrowing. In Lagos, the master plan assumes the following projections of an average of 6.3 persons per household! And with high fertility rate, about 1.6 million new housing units would have been required between 1985 and 2000 simply to accommodate the growth of the population. Another 1.9 million units would be needed between 2000 and 2015 for a total of 3.5 million new units over the 1985-2015 period.
Practically, all urban and rural areas contain substandard, slum and blighted areas. With the movement of large numbers of people to cities, urban areas became congested, desirable housing became unobtainable. Inadequate facilities for transporting people rapidly and cheaply to and from work made it necessary for many people to accept less desirable housing in the cities, close to their work. The inability of the ordinary wage earner to economically afford satisfactory housing left him with choice but to accept what housing was available. Some landlords took advantage of the situation by breaking up large apartments into smaller dwelling units and by constructing cheap housing-of course with the attendant problem of none provision of sanitary offices and wastes management facilities.
In recent years, about 25 percent of households requiring new housing in Lagos have been able to obtain housing through private markets, while the other 75 percent are low income households unable to obtain adequate housing with their own resources.
Slums therefore abound! This may start with the expansion or spill-over of business into the contiguous residential areas, thereby making the housing less desirable. Poor people next door or in the same building, desiring quit and privacy, move. Owners are hesitant to continue maintenance work, causing buildings to deteriorate. The landlord is even ready to convert the building or a segment of it to commercial use. There is therefore a progressive degradation from blight to slum. And as blight spreads so does crime, delinquency, fires and housing decay.
There are also the areas that are slums from the start. The absence or failure to enforce building, sanitary and health regulations leads to the development of “shanty towns” or poor housing areas. Added to this, are cheap, new and converted dwellings and tenements that are poorly located, designed and constructed-just to provide shelter.
In recent years the population growth has been taking place outside the major cities, but the rate of housing construction and rehabilitation has not kept pace with the needs of population growth. The loss of housing due to decay, and demolition further compound the problem.
A notorious feature of our major cities and towns over the years has been haphazard development. Many of the popular towns and districts were unplanned. The direct results of the unplanned developments is that there are no infrastructural services in most of them, and such as exist are grossly inadequate.
In Lagos State, in the past decade, the Government has created a number of Agencies to tackle, among other things, the problems of unplanned development. The New Towns Development Authority has, as part of its functions, control and monitoring of unauthorized developments within Government Estates.
The task force on Environmental Sanitation and special offences assists in removing illegal structures and building without approved plans. The Committee on illegal conversions of residential buildings to other uses is a new creation in the State. It was established in 1994. And in 1996 came the Lagos State Environmental Protection Agency (LASEPA) both having relevance to the problem of unplanned developments.
HOUSING, HEALTH AND SAFETY
Substandard housing trends contribute to the aggravation of health and safety problems; viz:
a. Over crowing and congestion of living yards
b. Inadequate water supply
c. Inadequate or absence of sewage disposal facilities
d. Inadequate waste disposal facilities
e. Poor drainage facilities resulting in pollution of domestic water sources, flooding and dampness of living quarters ‘
f. Poor ventilation and lighting
g. Clustering of living quarters with junk, tins and cans
h. Atmospheric pollution
i. Lack of privacy and recreational facilities
j. Lack of access-ways into the settlement
k. Excessive noise from a variety of sources
l. Transmission of diseases and frequency of physical injuries
m. Unhygienic food handling and storage
n. Harbourage of vectors and hosts of disease
o. Conversion of the home as a workplace with increased health risks from chemicals or accidents
p. Higher morbidity and morbidity rates and the lower life expectancy.
The realization that millions of people lived a life consistent with human dignity, that many people were deprived of basic human requirements such as shelter, water supply, sanitation, employment, health services, education and recreation and the rates of urbanization are increasing while conditions in human settlements are deteriorating a an alarming rate must lead to the decision that national/state/local governments and private organizations must be act to improve the living conditions of the people.
In this connection, the following steps are pertinent:
a. A though study of the housing development situation in the major urban and rural settlements of this country, aimed at an understanding of the nature and magnitude of the housing and settlement problems encountered by the people
b. Enactment/Enforcement of appropriate legislation that will lead to the progressive and incremental realization of the housing rights of the citizens
c. Formulating and adopting a national housing policy that will lead to provision of housing for all with facilities for waste management
d. Provision of such facilities to protect preserve, promote that physical and mental health and social well-being of the people; to prevent and control the incidence of communicable diseases; to reduce environmental hazards to health and to maintain adequate sanitation and public health, to protect the safety of the people and to promote the general welfare.
e. Without tearing down existing buildings, gradual improvements be made, involving as much as possible the participation of the residents in slum areas.
The urgency of coming to grips with the successes and failures in residential development project as it affects health and safety has been heightened by the severe economic and financial strains now affecting many countries. Resources available for development have become scarce. Yet investing to make residential developments more sanitarily efficient and healthy places is a key factor not only in the fate of the urban poor, but in national economic recovery and growth.
The need at this juncture to evaluate the experience of the past decade and identify ways of improving the effectiveness of future residential developments, with particular attention to waste management.
HEALTH AND SAFETY IMPLICATIONS OF DEVELOPMENT
The common threat running through this paper is that Nigeria can afford sustained industrial and residential development to the extent that it manages wastes in productive and domestic activities. Waste management can reduce physical constraints which hamper economic expansion-in the human environment as well as in the supply of energy, and other critical or scarce resources.
The quality of life depends on human security, safety, comfort and other factors relating to health, pleasure and happiness.
The implications of waste on health and safety include
Waste Creates/increases costs
- Organizing and operating costs
(time, supplies, equipments, power, capital costs)
- Costs borne by the people
Waste Cause Changes
- In physical, social or emotional functioning
- In resource use (inequities in allocation of resources)
- In the quality of life of people e.g. deafness, impairment of hearing
Waste Cause serious public health problems
- Supports the growth of large population of flies (which can transmit typhoid fever, cholera, dysentery etc)
- Encourages the proliferation of rats
- Promotes the prolific breeding of roaches and mosquitoes
- Gives rise to noxious and offensive oddurs
- Gives rise to smog and air pollution
- Causes flooding when dumped on water ways
- Obstructs free flow of traffic when dumped on motorways.
Waste Cause health impairment/death
- Through land degradation which sets in motion a chain of events that lead to declining food production and increase children’s malnutrition. In some parts of the country, some 20%-40% of children under age five are reported to be below 75% of the standard weight for their age
- Through pollution of water bodies from discharge of domestic sewage and industrial waste
- Through air pollution linked with incidence or respiratory and pulmonary diseases
- Destruction of wildlife.
Waste Assaults the senses/diminishes value
- Creation of an aesthetic blight
- Strong objectionable odour
- From slum/blighted housing.
Waste Tends to increase
- Risk of road accidents
- Risk of community health from certain industrial processes e.g. fire explosion, poisoning etc
- Impact on existing health and safety services
- Environmental hazards and deterioration of natural resources
- Exposure to local diseases e.g. malaria.
RECOMMENDATION
Protect the resource base, through:
- Land use planning
- Preventing the discharge of pollutants and sustain development through environmental impact assessment
- Establishment of environmental education that enculturizes hygiene practices
- Beautification of the environmental through tree planning and protection of the greenbelt areas of the country.
Control aggravation of existing hazards by:
- Introducing polluter-pay-principle i.e. an economic disincentive package for environmental restoration on pollution abatement
- Enforcement of environmental legislation programmes which defines the responsibilities of the users of the environment
- Establishment and strengthening of an Environmental Services Department at the Local Government level
- Establishment of institutional framework for environmental lay reporting and data collection, analysis and utilization
- Gradual improvement to slum/blighted areas.
CONCLUSION
For effective management of the environment, contamination of the air, water and land resources must be kept low enough to avoid deleterious effects on human health and welfare.
Future generations will inherit this country after us and will pay for our mistakes and carelessness. We should therefore not fold our aims as if nothing is happening. Every effort must be made to made to counter the deterioration in the quality of life that will occur if the environmental resource base continues to be debased.
Thank you and God bless.
REFERENCES
1. Federal Ministry of Heal (F.M.H) and National Population Bureau 1985. The Effects of Population Factors on Social and Economic Development.
2. International Bank for Reconstruction and Development 1985. The environment/Public Health and Human Ecology
3. United Nations Development Programme (U.N.D.P) 1986. A better Environment for Developing Annual Report.
4. Philip Hardwide et al 1988. An Introduction to Modern Economics
5. World Health Organization (WHO) – Urbanization and its implications for Child Health 1988.
6. Federal Environmental Protection Agency (F.E.P.A)– The Environmental and Sustainable Development in Nigeria 1990.
7. Sanford D. Gordon et al – Introductory Economics 1990.
8. Rotimi Braimoh – Industrial Pollution and Prevention: Implications on Health 1991.
9. Rotimi Braimoh – Environmnetal Pollution: Effects on Community Health 1991.
10. M.A. Ajomo et al – Environmental Law and Sustainable Development in Nigeria 1994.
11. Prof. Adeniyi Osuntogun – Waste Management for Sustainable Development (A Keynote address) 1994.
12. Lagos State Government – Lagos State Environmental Action Plan (LSG) 1997
13. Shelter Rights Initiative – Practical issue in Human Settlements and Health 1997
14. Shelter Rights Initiative – Improving the Living Environment in Slum Settlements 1999
I am an environmental public health practitioner. Obtained first degree in public health [environmental health and safety] from Federal University of Technology, Owerri.
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