The scandal of 95% of healthcare centres in Nigeria and 150 million Nigerians without access to water and hygiene facilities in the face of the COVID-19 pandemic

Without access to adequate water, sanitation and hygiene (WASH) facilities, majority of healthcare centres in Nigeria are ill equipped to manage the COVID-19 crisis, while the poorest and most vulnerable people in the country are being left to face the pandemic alone with not even the most basic defence - clean water and a bar of soap. Ahead of the World Health Assembly on 18 May 2020, WaterAid Nigeria is urging the Minister of Health to make hygiene and clean water a major part of Nigeria’s plan to respond to the coronavirus pandemic.

Despite handwashing with soap being one of the critical first lines of defence against the spread of the highly contagious and deadly coronavirus disease, 95% of all healthcare centres in Nigeria are at risk of becoming epicentres of the disease because of lack of access to combined water, sanitation and hygiene (WASH) services, putting the lives of doctors, nurses, midwives and patients at risk. Worse still, about 150 million people (79%) in Nigeria do not have somewhere to wash their hands with soap and water.[1]  

Ahead of the most important global health meeting of a generation – the World Health Assembly- WaterAid Nigeria is calling on the Minister of Health, Dr. Osagie Ehanire and the Minister of State for Health, Senator Adeleke Olorunnimbe Mamora, to protect the lives of Nigerians and healthcare workers by taking necessary measures to support access to clean water, sanitation and hygiene particularly in health care facilities as well as testing, isolation and treatment centres. 

There are currently no approved treatments or vaccines for coronavirus (COVID-19) and everyone is reliant on good hygiene practices like handwashing with soap, infection prevention and control to stop the spread. Whilst vaccines and therapeutics are urgently needed, lives are being put at risk every day because the very basics of disease prevention are being ignored. Last year, the world’s health ministers committed to ensuring clean water is available in every hospital and healthcare centre, sadly there has been very little progress.

Despite the dire statistics, the importance of access to hygiene and clean water has been worryingly overlooked by world leaders in the current crisis. The Federal Government has been quick to promote hand hygiene and handwashing, but without acknowledging that this is shockingly still impossible for the 150 million people in Nigeria who lack handwashing facilities with soap, the 60 million people who lack access to basic water supply and for thousands of frontline health workers and their patients in clinics and hospitals.  

The draft World Health Assembly (WHA) resolution on COVID-19, which will be discussed at the virtual high-level meeting next week, highlights water, sanitation and hygiene access as fundamental to preventative and control measures, especially in health care settings. However, a clear plan to achieve this is yet in place. This follows similar omissions of water, sanitation and hygiene from almost all of the COVID-19 emergency funding released by Governments and donor agencies over the past two months. Out of 51 major announcements of financial support from donor agencies to developing countries, only six have included any mention of hygiene*.

Cases in Africa were trailing far behind the hotspots in the USA and Europe, but cases are now rising in nearly all countries on the continent, even as they begin to fall elsewhere. There have been more than 63,000 reported cases and over 2,000 deaths, and the World Health Organisation (WHO) has raised alarm that the African continent may see as many as 190,000 deaths in the first year of COVID-19. With over 5,000 cases from Nigeria already, every state in the country is vulnerable whilst the virus is still spreading – especially those with low access levels to water, sanitation and hygiene services.

Aligning with WHOs advice to Member States, WaterAid calls for increased prioritisation and urgent provision of clean water and hygiene services in communities and health centres in Nigeria’s response to tackling the Coronavirus pandemic.

Evelyn Mere, Country Director, WaterAid Nigeria says:

“We’ve rightfully seen huge investment in a search for COVID-19 vaccines and treatments, but this has failed to go hand in hand with any real commitment to prevention. Clean water and hygiene facilities have hardly been prioritised as part of government’s response to the pandemic. We cannot preach handwashing as a country but ignore the millions of people who don’t have soap and water to wash their hands.  

“Leaders are being willingly complacent in addressing a decades-old crisis that is driven by deeply entrenched inequality. This now threatens the health of everyone. No country can claim to have beaten COVID-19 whilst poor hygiene and weak health systems allow it to run rampant through other parts of the world. This is a threat to all of us and it is time that our response included proper commitments to prevention as well as to cures.”