Invest in Environmental Health, Preventive measures to control Lassa fever- Ebisike urges FG

Mr Augustine Ebisike is a former Registrar, Environmental Health Officers Registration Council of Nigeria (EHORECON), In this exclusive interview with NaijaEnvironment News, he spoke about the Lassa Fever menace, what Nigeria could do to eliminate it completely.


Question: In your opinion, what do you think Nigeria could do to control continuous outbreak of Lassa fever in the country?

We need to make Lassa fever cease to be a public health concern, I led a team that went for control of outbreak of Lassa Fever in Edo and Ondo in 2018.

During one of those meetings, we raised the issue of Lassa fever being a vector-borne disease and if you want to get it under control, you must attack the vector.

Let us not make the mistake we made with mosquitoes and malaria of rolling back mosquitos, people didn’t understand, they said it should be roll back malaria.

So how do you roll back malaria? If you want to roll back mosquitos, you will clean the gutters, increase refuse management and control, collection and keep the environment clean.

If you do that, mosquitos will not become the problem that it is, even if you want to spray, we will do what the British did back then, by looking at the low-line lands whereby if it rains, excess water flows into that area thereby stagnating for weeks, you however spray those places.

But if we talk about roll back malaria, you will talk about medicine, you can continue giving medicines and get to the level we are today in which we are paying `Malaria Tax’, and that means that some person treats themselves monthly or yearly by getting anti-malaria drugs, and within two or three days, you are okay.

But if we compare the amount of money Nigerians pay for treating malaria, it runs into billions, and we will continue doing it, it is a cycle, it’s not working, that is why I used it as an example for Lassa fever.

If there is no man-rodent contact, it will be difficult for Lassa fever to transmit initially. But if I have Lassa fever, it could infect the next person around me.

So, that is why we are saying that we should build all our interventions in Lassa fever around the rodents, and what we need to do is to assess the rodent’s way of life. What we have found out is that these rodents live in the bush, and with the recent information around, it is going to get worse.

A recent study has shown that it is not only the `mastomys natalensis’ rodent that is spreading Lassa, but other types like the `ratus ratus’ and `vegicus’, have been found to be spreading the disease, that is bad news, because what that means is that it is going to become a major health problem, not only in few states, but with a national spread.

My position is that we need to look at the rodent, its habitation which is in bush and see why it moves from the bush around September and October into houses.

We need to see that it may be because foods have been harvested like corns, some other foods are being taken away from the farms and the rats understands that it may get these foods in houses and that contact between man and rodent is established.

And during that time, the infection starts spreading, so what we need to do is to decide that between September and December, Lassa fever endemic areas should be mapped out, and for health officers to be mobilised into those communities.

The tools of rodent control should be developed like baiting, spray etc, for all rats in human habitation to be killed, if we do that during that season, it will be better.

By the time we would have halt this disease becoming a national problem.

There were some communities that we used rodenticides and killed off all the diseases, they had it in 2018, 2019, we came and treated those communities, by 2020, they didn’t have one case in those places, that is a confirmation that it could be effective.

If we can do these annually, we would not be having these high figures.

We can have these diseases controlled, and that is in the area of rodent control in these communities where these diseases have annual outbreaks.

Question: Can we say low capacity of Environmental Health Officers is a major challenge towards eliminating Lassa fever in the country?

The problem we have is not low capacity, there are many of them who are not employed. The problem we have is that Environmental Health is not popular, if it is popular, you will be asking and funding to train more.

People like us were trained by the Federal Government, I was sent to the School of health technology to train as an Environmental Health Officer (EHO), Federal Government paid my salary and school fees, when we finished, they deployed us. There is no low capacity, government does not want capacity to increase, if Government wants capacity to increase, it will train more.

We can train 5,000 today if we so desire, but the problem is that government has not seen that need. What is more popular is medicine, you will see a child sick and given injections for cure for an ailment, that is what is popular.

It is still not popular that disease is devastating us, it is the politics of these treatment that is popular, and that is what brings out money. When we trained then, the only university that was awarding bachelor’s degree in Environmental Health was OAU Ife, an official of federal ministry of health, wrote to the school that Government does not need that programme anymore, WHO brought it and was funding it, sadly, this opportunity was moved to University of Kenya, and it is still fully funded by WHO.

Today, we have seven universities training EHOs, government must decide that Environmental Health training is necessary for our manpower, because we want to shift from curative to preventive medicine which is cheaper. Today, we have a disease that is killing our health workers in the hospitals, we cannot continue with these curative medicine.

If we decide that we no longer want Lassa fever cases, let us map out all the Lassa Fever-endemic communities, get how much it costs to kill one rat, it is not expensive, we go ahead within that season that rats are active in bringing Lassa fever into people’s homes, we can wipe them out and we would stop having outbreaks. We have tried it in Ondo and Edo states, and it worked.

Question: What should Nigerians do to protect themselves from Lassa fever?

If you live in Lassa fever-endemic communities, between the months of October and December, look for rodenticides, sold at markets, seal all opened holes and entrances that rats could pass through, keep all foods away from rats.

If rats are already in your homes, get baits like rat poisons, rat catchers and eliminate all of them, physical killing also is good.

If you or your neighbours do not have rats in your homes, the disease will not be found around, if everyone knows this, it will be reduced to the barest minimum. Before we know it, rats will go on extinction and Lassa fever will be eliminated.

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