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Infection Control and Hygiene in the Face of Ebola

By Adeyemi Adewole

On July 20, 2017, it will be three years to the day since a man infected with the Ebola virus arrived in Lagos aboard a plane from Liberia. Nigeria has not forgotten the sacrifices of the health practitioners who laid down their lives to fight the spread of the disease, such as Dr. Ameyo Stella Adadevoh, the lead physician and endocrinologist at a family clinic in Lagos whose efforts prevented a major outbreak in the country and catalyzed government action. In honor of her contributions and those of others like her, international infection control experts are heading to Lagos and will conduct training workshops for health personnel.

I participated in the recent Water for Sustainable Development Symposium, hosted by the Sustainability Centre, Lagos Business School of the Pan Atlantic University, Nigeria. At the event, the representative of the USAID WASH (Water, Sanitation, and Hygiene) program in Nigeria brought up worrying statistics:

57 million Nigerians, more than half of whom live in rural areas, do not have access to a safe water supply

15 million rural inhabitants drink water from rivers, lakes, ponds, streams, and irrigation canals 

8 percent of rural households have hand-washing facilities with soap and water

46 million Nigerians practice open defecation, 33 million of whom live in rural areas

130 million Nigerians, more than half of whom live in rural areas, use an unsatisfactory sanitation facility

45,000 children under five years old die annually from diseases caused by poor access to water, sanitation, and hygiene

According to the United Nations, a child dies from water-related diseases every 15 seconds

The representative posited that there is low prioritization and poor funding of rural sanitation in Nigeria, as well as most other African countries. Across Africa, high child mortality rates are largely a function of poor hygiene, poor sanitation, and unsafe water. An estimated 644,000 children die from diarrhea every year in sub-Saharan Africa. The facilitation of hand washing and hygiene education are simple, cost-effective ways to reduce diarrhea cases by up to 45 percent. The importance of establishing mechanisms to promote hygiene and infection control can thus not be overemphasized.

In developing countries like Nigeria, response to epidemics is often impaired due to the lack of physical resources and prevalence of unhygienic behaviors—and increased incidence of infectious diseases is directly proportional to the dearth of basic hygiene. The resulting massive loss of human lives, as well as reduced productivity and increased poverty, undermines the country’s overall economic growth. To avoid these outcomes, approaches to public health issues must shift from reactive to proactive.

Several programs are making efforts to tackle the severe problems associated with sanitation, water, and hygiene. UNICEF runs WASH to provide clean water and promote basic hygiene practices in conflict areas and following natural disasters, as well as WASH in Schools, which offers hygiene education and hand-washing campaigns. USAID Development Innovation Ventures in partnership with Gates Foundation supports new technologies and innovations that are sustainable and can be scaled in developing countries. 

My own company, Adcem Pharmaceuticals Limited, Nigeria, (ADCEM) and the Dr. Ameyo Stella Adadevoh Health Trust (DRASA) are co-developing hygiene and infection-control initiatives in Nigeria. This partnership’s aim is a sustained policy for hygiene and infection control in Nigeria that can be replicated in other West African countries. ADCEM and DRASA plan to convene other partners with expertise in each stage of the value chain. Bringing these solutions to scale requires multiple steps: obtaining government support, creating awareness, logistics and distribution, funding, research and data collection, and developing technology-based payment systems and communication.

The first challenge to be addressed is the behavioral attitude toward hygiene; many people do not attach much importance to proper practices. To change these behaviors in everyday life, ADCEM-DRASA seeks to provide continued sensitization and awareness campaigns in partnership with institutions and development agencies. 

To meet the anticipated demand, ADCEM will be responsible for local manufacturing of hand sanitizers, disinfectants, and other infection control products. These will be made available in schools, hospitals, churches, mosques, hotels, corporate organizations, and other places where large numbers of people congregate. In addition to manufacturing, ADCEM is building a distribution system to guarantee sustained access to these products, even in remote areas. The company is also seeking local partners to monitor uptake and resupply the products, as well as initiate innovation around ancillary products such as dispensers that can be sustainably deployed. Government buy-in will also be needed to ensure that there is a readymade stock of products in the event of the outbreak of an epidemic.

The threat of infectious disease possesses an enormous potential to negatively affect the global population. The developed world is currently dealing with the perceived problems of migration—seen as threats of terrorism, job insecurity, and cultural encroachment—but a catastrophic, worldwide epidemic would make this situation pale in significance. To address this issue, the U.N. Sustainable Development agenda seeks to ensure availability and sustainable management of water and sanitation for all. The guidelines advise that we implement measures through international cooperation and capacity development, as well as local participation. Consolidated efforts are necessary in order to address social problems of this magnitude.

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Adeyemi Adewole is the founder and CEO of Adcem Pharmaceuticals LTD Nigeria, established in 1992, as a pharmaceuticals and renal dialysis service provider specializing in health-care technological innovation. He is also co-promoter of Sustainability School Lagos (SSL), for which he is developing  the Center for Sustainable Health and the Environment. SSL is associated with the Global Institute of Sustainability, Arizona State University, USA. 

[Photo courtesy of Effsamuel3]

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