Eradicating guinea worm without wells: unrealized hopes of the Water Decade.

Abstract:

:At the start of the United Nations International Drinking Water Supply and Sanitation Decade in the 1980s, guinea worm disease was targeted as the major indicator of the success of the Decade's efforts to promote safe water. By the late 1980s, most of the guinea worm endemic countries in Africa and South Asia had established guinea worm eradication programmes that included water supply as one of their main technical strategies. By surveying the water supply situation in Ifeloju Local Government Area (LGA) in Oyo State, Nigeria, in June 1996, as a case study, it was possible to determine the role that water supply has played in the eradication effort. Although two major agencies, the former Directorate for Food, Roads and Rural Infrastructure and UNICEF, provided hand dug and bore-hole wells respectively in many parts of the LGA, coverage of the smaller farm hamlets has been minor compared to efforts in the larger towns. This is ironic because the farm hamlets served as a reservoir for the disease in the 1980s, such that when the piped water system in the towns broke down, guinea worm was easily reintroduced into the towns. The survey of 188 ever-endemic hamlets with an estimated population of 23,556 found that 74.3% of the people still drink only pond water. Another 11.3% have wells that have become dysfunctional. Only 14.4% of this rural population has access' to functioning wells. Guinea worm was eliminated from 107 of the hamlets mainly by the use of cloth filters and chemical treatment of ponds. While this proves that it is possible to eradicate guinea worm, it fails to leave behind the legacy of reliable, safe water supplies that was the hope of the Water Decade. :The 1980s were designated by the UN as the International Drinking Water Supply and Sanitation Decade, and guinea worm disease was targeted as the major indicator of the campaign's success. The campaign conceptualized guinea worm disease as a symbol of the isolation of poor rural residents from national development programs such as water supply, education, and health care. The Nigerian Guinea Worm Eradication Program, launched in 1987, committed to provide drinkable treated water to areas with endemic guinea worm disease. However, less expensive interventions such as monofilament nylon cloth filters were given priority over water supply provision. This article examines the eradication program in Ifeloju Local Government Area in Oyo State, Nigeria. The former Directorate for Food, Roads, and Rural Infrastructure provided hand-dug wells in several settlements, but made no provisions for maintenance and repairs. UNICEF assisted in the drilling of bore-hole wells, but restricted this intervention to settlements with more than 250 people. A 1996 survey of 188 ever-endemic hamlets with an estimated population of 23,556 found that 74.3% of residents drank only pond water. Another 11.3% had wells that had become dysfunctional. Only 14.4% of these rural residents had access to functioning wells. Guinea worm was eliminated from 107 of the hamlets, chiefly through use of cloth filters and chemical treatment of ponds. These results show a striking lack of commitment to the eradication of guinea worm disease through the safe water strategy. In 1995, only 43% of Nigeria's population had access to safe water. There is a need for financial investment in less expensive and more appropriate hamlet-level technologies, as well as community mobilization to dig and maintain hand-dug wells.

journal_name

Health Policy Plan

authors

Brieger WR,Otusanya S,Adeniyi JD,Tijani J,Banjoko M

doi

10.1093/heapol/12.4.354

subject

Has Abstract

pub_date

1997-12-01 00:00:00

pages

354-62

issue

4

eissn

0268-1080

issn

1460-2237

journal_volume

12

pub_type

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