1. Management of feacal (fecal) and solid waste in Nigerian cities: Focus on Federal Capital Territory Abuja Ijeoma P.C. Nnani(Ph.D: PUBH Epidemiology) Walden University PUBH 8165 Instructor: Dr. Denise Feda 2012, July 18th

2. Real Life Experience Freedom is to pee in the open by the road side and toss banana peels out of moving car windows!!

4. Rationale Sanitation and hygiene key to healthy life Contributed to great public health achievements Reduce and prevent infectious disease like cholera, thyphoid Improve quality and life expectancy Still inadequate provision in Nigerian cities and villages Centers for Disease Control and Prevention (CDC, 1999, April).. Ten Great Public HealthAchievements -- United States, 1900-1999. Retrieved fromhttp://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm

5. Description of Issue Inadequate toilet and waste disposal facilities Consequences include; poor hygiene and sanitary conditions spread of infections disease, illness, death and economic cost Environmental and public health challenge in Nigeria.

7. Incredible Scenario Poor government oversight of waste disposal Scarcity/lack of public water supply by government Urine, feces and trash disposed freely in the open Open often stagnant street gutters used as toilets Incinerating land fills next to populated residence Non-availability of public toilet facilities

8. Incredible Scenario Free roaming animals including cattle everywhere Industrial waste disposal on land and water ways Fecal disposal in streams and rivers Same water sources for domestic use Public toilet facilities not part of urban plans Scarce to find rest areas with toilet facilities for travelers

10. Public Health Challenge Poor sanitation and Hygiene Bad odor and poor air quality Environmental pollution and degradation High BOD5 in soils leading to depletion of oxygen Disease outbreak and death Author nknown (n.d.). The Health Hazards of Excreta: Theory and Control Retrieved from www.unc.edu/courses/2007spring/envr/890/ ​ 003/readings/Fe...

11. Public health Challenges Contamination of food and drinks Lack of effective disease surveillance High incidence of diarrhea Other fecal/waste borne disease-Hepatitis A &E, typhoid fever, E.coli, Cholera outbreaks Global Security.Org. (n.d.) Military Nigeria Retrieved from http://www.globalsecurity.org/military/world/nigeria/intro.htm Okeke,I. N., Ojo, O., Lamikanra, A. & Kaper J. B. (2003, October) Etiology of Acute Diarrhea in Adults in Southwestern Nigeria. J Clin Microbiol.; 41(10) PMCID: PMC254369 Retrieved 7/30/12 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC254369/S: 4525–4530. doi: 10.1128/JCM.41.10.4525-4530.200310.1128/JCM.41.10.4525-4530.2003 Prüss, A., Kay, D., Fewtrell, L.& Bartram, J. (2002, May). Estimating the Burden of Disease from Water, Sanitation, and Hygiene at a Global Level. Volume 110 | number 5 | May 2002 Environmental Health Perspectives. Retrieved from www.who.int/quantifying_ehimpacts/global/.../ArticleEHP052002.pd...

12. Evidence 150,000 death annually from diarrhea Diarrhea is second highest cause of under five mortality Over 18% prevalence High incidence of malaria Sanitations coverage average of 28% Low life expectancy ranking 112 in the world Limlim, R. (2008). Goodwill message by Dr. Robert Limlim, acting UNICEF representative in Nigeria, during the national launching of hand washing campaign at Sheraton hotel and towers Abuja on May 22, 2008. Retrieved 7/30/12 from http://www.unicef.org/nigeria/media_2364.html WHO/UNICEF. (n.d.). A Snapshot of sanitation in Africa a special tabulation for Africa San based on preliminary data from the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation. Retrieved from http://www.who.int/water_sanitation_health/monitoring/africasan/en/index.htmlhttp://www.who.int/water_sanitation_health/monitoring/africasan/en/index.html CIA (n.d.). WorldFact Book. Retrieved 7/31/12 from https://www.cia.gov/library/publications/the-world- factbook/rankorder/2102rank.html?countryName=Nigeria&countryCode=ni&regionCode=afr&rank=211#ni

13. Evidence Toxic chemicals and microbes are in water samples High nitrates, coliform microbes in overhead tank and stream samples Mountains of polyethylene and plastic bottles Breeding grounds for mosquitoes, malaria vector Lack of or inadequate water supply in and around Abuja Ukhun, M.E., Tobi S.B, & Okolie N.P. (2005). Toxic chemicals and microbes in some Nigerian water samples. Journal of Medical Sciences, 5: 260-265. Retrieved from http://scialert.net/abstract/?doi=jms.2005.260.265 DOI: 10.3923/jms.2005.260.265

14. Needed Action Policy and regulatory control Cultural change and public awareness Provision of water, public toilet and efficient waste disposal facilities Disease surveillance system

15. Responsible stakeholder- Government Provide policy and leadership for sanitation Provide effective water, public toilet and waste disposal system Strengthen and implement environmental sanitation standards Mount health campaign on sanitation Reward local governments that meet sanitation targets

16. Others Stakeholders Media Drive behavioral change to embrace sanitation and hygiene General public Change of habit of freely urinating and defecating in the open Businesses- gas stations, eating places and others Provide access to public toilets Provide commercial rest areas for travellers

17. Other Stakeholder International and National organizations Assist to ensure water and waste disposal safety Funding for projects including public enlightenment

20. Thank you Comments welcome!!!!

21. References Author unknown (n.d.). The Health Hazards of Excreta: Theory and Control Retrieved from www.unc.edu/courses/2007spring/envr/890/ ​ 003/readings/Fe... Centers for Disease Control and Prevention CDC, (1999, July). Ten great achievements in Public Health, 1900-1999: Control of infectious diseases. Morbidity and Mortality Weekly Report (MMWR) July 30 1999/498(29); 621-629 Retrieved 7/31/12 from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm CDC ( 2011, September). Global Water, Sanitation, & Hygiene (WASH). Retrieved 7/31/12 from http://www.cdc.gov/healthywater/global/wash_diseases.html CIA (n.d.). WorldFact Book. Retrieved 7/31/12 from https://www.cia.gov/library/publications/the-world- factbook/rankorder/2102rank.html?countryName=Nigeria&countryCode=n i&regionCode=afr&rank=211#ni

22. References Global Security.Org. (n.d.). Military Nigeria. Retrieved from http://www.globalsecurity.org/military/world/nigeria/intro.htm Limlim, R. (2008). Goodwill message by Dr. Robert Limlim, acting UNICEF representative in Nigeria, during the national launching of hand washing campaign at Sheraton hotel and towers Abuja on May 22, 2008. Retrieved 7/30/12 from http://www.unicef.org/nigeria/media_2364.html Okeke,I. N., Ojo, O., Lamikanra, A. & Kaper J. B. (2003, October). Etiology of acute diarrhea in adults in southwestern Nigeria. J Clin Microbiol.; 41(10) PMCID: PMC254369 Retrieved 7/30/12 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC254369/S: 4525–4530. doi: 10.1128/JCM.41.10.4525-4530.200310.1128/JCM.41.10.4525-4530.2003

23. References Prüss, A., Kay, D., Fewtrell, L.& Bartram, J. (2002, May). Estimating the Burden of Disease from Water, Sanitation, and Hygiene at a Global Level. Volume 110 | number 5 | May 2002 Environmental Health Perspectives. Retrieved from www.who.int/quantifying_ehimpacts/global/.../ArticleEHP052002.pd... Ukhun, M.E., Tobi S.B, & Okolie N.P. (2005). Toxic chemicals and microbes in some samples of Nigerian water Journal of Medical Sciences, 5: 260- 265. Retrieved from http://scialert.net/abstract/?doi=jms.2005.260.265 DOI: 10.3923/jms.2005.260.265 WHO/UNICEF. (n.d.). A Snapshot of sanitation in Africa a special tabulation for Africa San based on preliminary data from the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation. Retrieved from http://www.who.int/water_sanitation_health/monitoring/africasan/en/index. html