NIGERIA: “People are dying of hepatitis E because they don’t have soap or clean water”

Friday, August 11, 2017 — Hundreds of people in a camp in northeastern Nigeria have been infected with hepatitis E after the disease spread from neighbouring Niger. The highly contagious disease has spread quickly through Ngala camp due to a combination of poor living conditions and flooding. MSF medical coordinator Nicoletta Bellio describes the situation in the camp, which shelters some 45,000 people who have fled violence stemming from the conflict between Boko Haram and the military.

“The situation in Ngala is very worrying. The onset of the rainy season has caused repeated flooding in the camp and water gushes across pathways, latrine holes and into people’s shelters. When it rains, the whole camp gets covered in mud and dirty water. This is a recipe for spreading bacteria and disease – particularly as people don’t always use the latrines that have been installed in the camp, so wastewater washes out everywhere. 

There have been more than 400 cases of hepatitis E in the past two months and we have treated 170 patients at our hospital, so it’s no surprise that an outbreak of hepatitis E has been declared.

Generally people recover from hepatitis E if they receive treatment, but the disease can be very dangerous for pregnant women and their unborn babies. Hepatitis E leads to high rates of spontaneous abortions and stillbirths, as well as babies being born prematurely. It can also cause severe haemorrhages in mothers, both during childbirth and after giving birth.

In the past two months, four pregnant women in Ngala camp have died of complications linked to the disease, and that is four too many. Something as simple as soap and clean water could have prevented these deaths.

Our health promotion teams are working with the community to clean the camp of dirty water and waste. We have also distributed soap and chlorinated the water supply, although chlorine is less effective against hepatitis E than it is against cholera, for example. Other humanitarian organisations have also worked to improve the water supply.

The rains will continue for several months, and we fear that this could mean more cases of hepatitis E or, even worse, an outbreak of cholera. If this happens, Ngala’s remote location and the security situation in the area will make it very difficult for us to respond. In fact it would be a disaster.”

MSF has been working in Ngala camp since October 2016 and currently runs a hospital providing inpatient and outpatient treatment, malnutrition treatment and maternity services.

ENDS

Every morning the camp residents rush to the water point to line up their buckets to be filled. Access to water is a major problem for the displaced. Photographer: Sylvain Cherkaoui
Every morning the camp residents rush to fill their water buckets.<br/>Access to water is a major problem for the displaced. Photographer: Sylvain Cherkaoui
Every morning the camp residents rush to the water point to fill their water buckets. Access to water is a major problem for the displaced. Photographer: Sylvain Cherkaoui
MSF set up a circuit to vaccinate children under 5 years old, they also receive an anti-parasite and vitamin A and parents receive relief items such as soap and mosquito nets. In one day nearly 4,000 children were vaccinated. Photographer: Sylvain Cherkaoui
Mariam, 20m mother of two-year old Hussein.<br/><br/>"Nine months ago, Boko Haram attacked my village, and I fled to the camp."<br/>"The vigilance committee denounced my husband to the Nigerian army, they arrested him and asked for witnesses in his favor. But the captain was changed and the new one killed my husband without waiting for the witnesses. There are a lot of similar cases here. " Photographer: Sylvain Cherkaoui
General view of the IDP camp in Ngala. Photographer: Sylvain Cherkaoui
Chlidren pounding beans. Photographer:  Sylvain Cherkaoui
Newly dug graves in the graveyard. Photographer: Sylvain Cherkaoui