As flood disaster continues to wreck havocs in some communities across Nigeria, many questions have cumulated in the minds of emergency stakeholders both within and outside the country on the subsequent disasters that may likely emerge after the flood.

It no more news that in the last three months Nigerians have experienced unprecedented heavy rain that has resulted in flooding, claiming dozens of lives and rendered thousands of people homeless in some states such as Jigawa, Adamawa, Kogi, Anambra, Benue, Lagos, Bayelsa, Delta, among others. The accelerating rate of the disaster has called for anxieties on the health and other socio-economic damages the affected communities may suffer after the flood.

Although no fewer than over 140 people have been reportedly killed so far, while about 10,000 others were rendered homeless. Grossly, National Emergency management Agency (NEMA) and the Nigerian Red Cross Society have confirmed that an estimated 130,000 people across the federation have been affected. Yet, the Federal Ministry of Environment has predicted that 16 more states will suffer more torrential flooding, warning people living in such vulnerable states to evacuate their homes before they are taken unawares.

Meanwhile, in an effort to ensure adequate safety of lives and property, NEMA under the leadership of the Director General, Alhaji Muhammed Sani-Sidi has counseled individuals and governments across the states to prepare ahead of various dangers that may occur after the flood.

Giving the increase in the statistics of outbreak of diseases that may transpire from flood, it was noted that in recent times many Nigerian communities have become conversant with several diseases such as cholera, meningitis, malarial and polio making it urgent for the governments at various levels to step up their quest towards ensuring vivacious healthcare system in the country.

Coping with the ongoing flood disaster, among the deadly epidemics that should be expected is Cholera which may be experienced in some flood-affected zones like the North, South and Eastern parts of the country. Cholera has been described as acute enteric infection caused by the ingestion of bacterium Vibrio cholerae present in faecally contaminated water or food, known to have spread across the Northern part Nigeria like a hurricane.

It is an extremely virulent disease that affects both children and adults. Unlike other diarrhoeal diseases, it can kill healthy adults within hours. The epidemic is characterized by profuse watery diarrhea, vomiting, and leg cramps. Through these, an infected person, rapid losses body fluids which lead to dehydration and shock; and in absence of treatment or early awareness, death can occur within hours.

So far, Cholera outbreak has claimed thousands of lives and renders hundreds hospitalized. For instance, about 150 lives were lost and over 1,300 others hospitalized in August, 2010 in Bauchi state; this was followed by another loss of 67 lives and 1,742 hospitalised in the same state in 2011. Similarly, over 47 lives were reportedly lost while about 735 others were hospitalised in Gombe state in 2010 with more than 190 other cases reported in the state in the same year; and generally no fewer than 4,600 lives were reportedly lost to cholera outbreaks between 2008 and 2010 in Nigeria.

Also, a study conducted by the United States Centre for Diseases Control and Prevention (2010) revealed that influenza spreads around the world resulting in seasonal epidemics and eventual death of between 250,000 and 500,000 people every year, while on the average, 41,400 people died each year in the United States between 1979 and 2001 from influenza.

To gain instant control of epidemic outbreaks in Nigerian NEMA in collaboration with other stakeholders must conduct adequate sensitisation programs across the six geo-political zones in the country purposely to educate and immune the public, especially those in the rural areas against avoidable deaths from outbreak of a disease such as Cholera.

While government at all levels must institute a regular, reliable and accurate surveillance data to monitor the trend and evolution of the outbreaks and enhance adequate preventive measures as it was successfully exploited in United States Cholera Outbreaks in the 1800s.

Regular environmental sanitation is the key to effective control of Cholera. It has been argued that human beings are surrounded by thousands of harmful organisms. In five years investigation using four different communities carried out by World Health Organisation (WHO) in the 2011, it was obtained that the provision of sanitary facilities for human waste disposal can reduce the incidence of Cholera by as much as 68%.

Effective effort must be made by the governments to properly fumigate the flood-affected environments, while water from all sources must be adequately tested and treated for human consumption after the flood to protect the communities from unwarranted spread of epidemics that may arise in the areas.

In several occasions NEMA has encouraged communities to protect themselves against Cholera and other epidemics, by adhering to proper food safety practices as well as to good personal hygiene. Regular sanitation is very essential to health and wellbeing of every community. Insufficient sanitary systems will definitely result to the epidemic outbreaks. Improper disposal and accumulation of rubbishes in our surrounding result to micro-organisms that transform into epidemics that harm thousands.

At individual level, personal hygiene is strictly required to help combat epidemic outbreaks. This is vital to prevent spread of the epidemic after the flood. Henceforth, the affected communities and members of public must wash their hands with soap and water before cooking, eating or after visiting the toilet and latrines; wash plates, cups, cutlery and utensils with soap and water before use; boil drinking water and keep it in clean covered containers, or disinfect water with chlorine-food should be cooked before being eaten and it should be eaten hot food; and wash all the fruits thoroughly before eating them.

Drink only tea and coffee made with boiled water and bottled soft drinks served with no ice; eat only foods that have been thoroughly cooked and are still hot; and fruits that a person peels himself just before eating. NEMA advises the affected communities to avoid among other things raw fruits and vegetables undercooked or raw shellfish or fish, foods or drinks from street vendors.

It would be recalled that the International Journal of Hygiene and Environmental Health has stressed three different types of hygiene for safety living; the body hygiene which includes constant cleanness for healthy living, optimal health, sense of well-being, social acceptance, and prevention of spread of illness; while individual personal hygiene practices must comprise adequate medical checkup, regular washing, bathing, and healthy living.

NEMA has through its numerous enlightenment campaigns advised on the need for individuals to keep their environment clean. It also accentuated the importance of maintaining germ-free atmosphere as capable reducing widespread social related diseases.

Another method of enhancing pandemics, according to the medical practitioners across the world, is that an infected person be isolated to prevent contagious diseases from being spread among other patients, health care workers, and visitors.

The use of quaternary ammonium compounds and bleach in hospitals so as to sanitize equipment that may be occupied by patient with influenza symptoms has been recommended by NEMA and Federal Ministry of Health. Also, at home, this can be done effectively with diluted chlorine bleach. This practice can help prevent spread of these diseases after the flood.

Governments at all levels should ensure adequate provision of drinkable water supply, especially in the rural areas. For instance in a study conducted by WHO, it was discovered that provision of a safe water supply can decrease Cholera by 73%. Where both toilets and water supplies are provided, the incidence can be reduced by as much as 76%. Inadequate water supply and basic facilities will expose several communities to dangers of Cholera outbreak after the flood.

On this note, NEMA must strengthen its partnership with healthcare stakeholders to provide effective sensitization campaign against epidemic outbreaks through adequate education and public enlightenment so that every community can be taught how epidemics can be prevented and cured, immediately they are noticed.

Public health measures for the maintenance of adequate control against sources of environmental pollution such as refuse from butchers, slaughterhouses, tanneries, fishmongers, bone boilers, starch makers, clothes dyers, and other nuisance industries that may emerge in the affected states after the flood. Others include, regulating privies, cleaning streets, spreading lime, and removing garbage, dead animals, and stagnant pools of water; and provision for sewer systems, water supply systems to avoid water related diseases across the country.

Creating Public Health Boards across the six geo-political zones in the country for the provision of free consultation and sensitization on public health would help in timely prevention and control of chronic diseases; reduction of disparities in healthcare and health status; improvement of grassroots public health infrastructure; boosting the health and well-being of the people; enhancing health workers-community collaboration; supporting improved access to preventive and primary healthcare services; educating the public concerning the importance of health promotion and protection policies and programs.

The Board will also help in the provision of practical and timely advice to the state governments and state Health Commissioners on public health policy issues; review and promulgation of regulations.

The extent of early detection mechanism plays vital role in control of epidemics, and by this, the National Emergency Management Agency (NEMA) must strengthen its relationship with the World Health Organization (WHO) and other relevant organization to pin down some health challenges.

Through these collaborations, NEMA can benefit from programmes like Global Public Goods for Health (GPGH) and International Health Regulations (IHR) established by WHO to provide useful aids to various part of world in line with the earlier control and detection against epidemics.

In the United States, the Committee of the American Public Health Association (APHA) has issued various fundamental measures to control epidemics. These were aimed at reducing the transmission of the pathogen by preventing contact. Consequently, it framed public health orders in scientific ideas of its understanding of how the influenza microbe spread through the air by coughing and sneezing, and their conception of the pathogenesis of influenza.

Furthermore, in the event of epidemic outbreak, there is need to maintain a restriction to non-essential gathering of people with the mixing of bodies and sharing of breath in crowded rooms; in meetings, in saloons, dance halls, and cinemas, public funerals, unnecessary assemblies; and encourage staggering of opening and closing hours in stores and factories to prevent overcrowding and for people to walk to work when possible.

Also, there is need to look into rampant cases of building collapse in various parts of the country as a result of accelerated number and proportion of floods. In recent times, the frequent incidence of building collapse in Nigeria is no more news, drawing the attention of the general public as hundreds of lives and property worth billions of naira are lost.

At several occasions, citizens are seen not be heeding professional advice and services when erecting their structures. Other factors that may be held accountable for the subsequent collapses are the use of inferior materials, inappropriate planning, poor designs, diversion from plan specifications, poor workmanship, lack of soil investigations, greed and desire to maximize profit, unethical dealing between project providers and the relevant planning authorities.

In view of the rising incidents of building collapse, a study carried out by the NEMA in partnership with the Nigerian Council of Engineers, Nigerian Institute of Structural Engineering (NIStructE) and other stakeholders across the country have revealed among other causes, the use of inferior building materials, and inconsideration for professional advice

Consequently, it was recommended that only structural engineers should be entrusted with such professional responsibilities as the execution and supervision of structural construction projects in the country. This will allow for professional creativity in structural erection to achieve standardization in the project’s procedures.

Proper assessments and verifications must be carried out on every building in the affected communities after the flood before the displaced persons return to their homes. After this, strength lost building must be instantly demolished, while the owners should be adequately relocated and compensated.

To prevent the future occurrence of collapse, membership professional competence must be strictly demanded by the Nigerian Council of Engineers to strengthen the level of proficiency in part of the structural engineers in the country. This can be done through organization of seminars, conferences, workshops, Continuing Professional Educational Programme on modern developments in building constructions for its members on professional improvement and sensitization, through which they will be taught on integrity and accuracy in discharging their duties.

Henceforth, a proper geotechnical soil investigation and testing must be carried out before embarking on any project, for proper foundation design. The British Standards Institutions (2011) has stressed the importance of geotechnical investigation and testing standards establishing the basic principles for the identification and classification of soil used to access the suitability of a site for geotechnical engineering purposes such as foundations, ground improvements, roads, embankments, dams and drainage systems.

Also, construction of various kinds should be strictly based on specialty; while no construction professional works in specialty for which he is not qualified. NIStructE must establish regulatory codes that will restrict specialization to each aspect of building construction such as planning and designs, foundations, wall and ceiling insulation, window and door specifications, heating, ventilation, equipment installations, lighting fixtures and controls. The adoption of these codes should be mandated on members at federal, states and local governments in both public and private organizations.

Abubakar Jimoh is the National Coordinator, Youths Against Disaster Initiative (YADI), Abuja.