While the COVID-19 pandemic has reminded all of us that handwashing with soap is the cornerstone of infection control, rural villagers in Nigeria remain out of reach of proper hand hygiene facilities. In commemoration of this year’s Global Handwashing Day on 15 October, Olajide Adelana explores the far-reaching impact of washing hands on not only spreading the virus but also increasing communal productivity and ending chronic poverty.
The first thing 14-year-old Favour hears on a Sunday morning is the creaking sound of metal buckets beyond her wooden windows as villagers make an early dash to Ogamaenanga Stream. An hour’s walk away, the stream is one of the best sources of water for residents of Ikpariyong, an agrarian community in Nigeria’s Cross River State.
Favour says it is a commonplace for her family to ration water use, especially during periods of limited rainfall, and this makes handwashing negotiable.
“There is no water. How do you expect us to practice handwashing even if we wanted to?” she asks.
“It has not been easy to source water for our domestic use in this community. The only water facility we had was a borehole that went bad a long time ago. We are left with only the stream, which is very far and not very clean,” says Favour.
A lack of access to good hand hygiene threatens human well-being in many ways. Washing hands is crucial to prevent diseases such as diarrhoea and cholera, which are transmitted through faecal contamination, and, of course, to contain the spread of COVID-19. The ability to practice good handwashing is suddenly understood to be matters of life and death with a direct impact on livelihoods, productivity and household income.
In Nigeria, the lack of basic hygiene infrastructure with clean water and handwashing facilities, and the resulting costs of poor hand hygiene, is staggering. A survey on water, sanitation and hygiene (WASH), conducted by the Nigerian government in 2019, showed that 75 percent of household members who suffered diarrhoea within the six-week period of the survey were children under the age of five.
In a country where the availability of WASH infrastructure and services is skewed towards urban and semi-urban areas, rural dwellers, like Favour, are left with little choice but to relegate sanitation and hygiene issues, including handwashing, to the background despite its obvious importance.
“How do you want people to regularly wash their hands without any resources?” asks Gabriel Saawuan, who resides in the community of Tse Norma, where people face the same problem as in Ikpariyong.
“It won’t be wise of me to travel four and sometimes six kilometers to get water for domestic use, only for me to see a considerable amount of it used to wash hands,” he says.
When it comes to hand hygiene, the role of governance in the WASH sector cannot be relegated to the background, says Ms Ann Iyonu, Executive Director, Goodluck Jonathan Foundation.
“If the primary purpose of government is the welfare and security of citizens, then it is high time the government takes the issue of water, sanitation and hygiene seriously, considering the fact that it is an important health indicator and a major determinant of economic productivity,” she says.
According to Ms Abenmire Adi, gender rights advocate working with women and girls in communities in Cross River State, there is always a direct correlation between the non-availability of hand hygiene infrastructure and poor WASH-inclined behavioural practices.
“Communities with no hand hygiene infrastructure often lag behind in other aspects of WASH, such as open defecation and poor sanitary conditions, among others,” she says.
What this does, Ms Adi says, is set back other aspects of WASH and herald a complete degradation of WASH architecture, setting the stage for outbreaks of cholera, diarrhoea and other preventable, life-threatening diseases.
In Tse Norma, it is a commonplace for children and even adults to visit the hospital because of diseases such as malaria, typhoid, cholera and diarrhoea, says Saawuan.
“Imagine this scenario where, from the beginning of their lives, millions of children have no idea of the importance of handwashing and good hygiene behaviour. Those who survive till adulthood have no water or toilets and still live in poor sanitary conditions where poverty is rife,” says Ms Elsie Doolumum Ozika, founder of Toilet Kulture Initiative (TKI), a stakeholder of Nigeria’s National Task Group on Sanitation.
“Children are always in and out of hospitals, struggling with life-threatening diseases that render them unproductive, and life expectancy is short. The country loses, national development is stifled, and the poverty cycle continues,” she says.
While Nigeria’s recent efforts in the WASH sector are quite commendable, Ms Iyonu says, there is a need to do more.
“WASH is critical and vital to the attainment of other Sustainable Development Goals (SDGs),” she says.
“It is not difficult to know the priority of a country when you look at its budget for important sectors such as health, education and infrastructure.”
Dr Kelechukwu Okezie takes it even further. The founder of Neighborhood Environment Watch (NEW) Foundation, a Nigerian NGO advancing sustainable environmental practices, says there is a need for Nigeria to have a special fund dedicated to sanitation and hygiene.
“We should have a fund dedicated to sanitation and hygiene because prevention is better than cure. It is not ideal for the government to spend so much on the health sector, procuring drugs, vaccinations and so on, when they know that prevention is better than cure. The best way to prevent is through proper handwashing ethics and through sanitation practices,” he says.
“Therefore, I am strongly advocating that every state in Nigeria should set aside a percentage of their budget for WASH, just as it should be done at the national level. Health is development, and it is tied to good hygiene and sanitation practices.”
Lending his voice to increase funding of the WASH sector, Saawuan says, if given a chance to speak with the government, he would ask for increased access to sanitation and hygiene facilities.
“We want to practice hand hygiene, but how can we do that when there is no water or sanitation facility? That is what everybody prays for every day.”
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