Nigeria: Water is the source of life… and disease in Pulka

People, especially children, are suffering because of lack of clean and safe water

16 Mar 21

"We have to be grateful that we now have water, but we don’t usually have enough water when we enter the dry and hot season," says Adama. She was forced from her home by the violence that has spread throughout Borno state, in northeast Nigeria. Adama now lives in a camp for displaced people in Pulka, a small garrison town located 115 km southwest of Maiduguri, the state capital. Adama is only one of around 37,039 displaced people trying to survive here.

The Sahel season

The dry, hot season in the part of western Africa known as the Sahel usually lasts from November until May.

Access to water is limited during the dry season, and the population - especially IDPs - often has to use untreated water from open wells, or to buy it from local community leaders, paying for it with food.

Not a single drop of rain touches the cracked earth for nearly seven months, while the Harmattan, a dry wind coming from Sahara, brings desert sand and hot air during the day and cold air at night.

The temperature can go from 9 and 35 degrees Celsius in a day

The dry, hot season in the part of western Africa known as the Sahel usually lasts from November until May. The temperature can go from 9 and 35 degrees Celsius in a day.

This extreme climate was challenging for local farmers even before the armed conflict in Borno began.

The situation now, after 10 years of violence, has worsened due to the high number of displaced people, limited farming land and clean water, and a lack of other basic resources and means to produce food.

Most people do not have the arable land or water to farm or grow food in the displaced person camps because there is not enough space and also because the situation outside the camps is too dangerous.

Lack of clean water- an essential resource

Even if people somehow manage to produce food often they have to exchange it for water.

"Those of us with four or five jerry cans are usually asked to wait for the pushcart owners from the community to get water before we can get water," explains Maryam, a camp resident.

In some places, some groups are making money by selling water, from pre-existing water points or built by humanitarian actors, to displaced people, sometimes recognize by some community leaders.

“There are men who are in control of the water points; they are the ones that usually tell us to wait our turn in the queue. But we don’t usually wait," explains Maryam, a camp resident.

Often the only water that people can get is polluted or not properly treated with chlorine, which can cause health problems, especially among children who are part of one of the most vulnerable groups.

Organisations in charge of water and sanitation in the area recently built an artificial lake, or a ‘pond’ as it is called by locals.

However, due to a non-functioning chlorine treatment unit and no existing connection to the pumping system, the pond has had little impact and is mostly used by people to do laundry or water their cattle.

Artificial lake in Pulka.

“The problem of insufficient water is very serious,” says Fati, another displaced person who has settled in Pulka.

“When we have money, we buy water from the well, but if we don’t have any, we have to fetch it from the pond and this makes our children sick.”

“The problem of insufficient water is very serious,” says Fati, another displaced person who has settled in Pulka.

Water trucking was also introduced by different WASH actors as temporary solution.

However, logistical issues due to frequent closures on the main road to Maiduguri mean this option is not reliable, leaving Pulka residents with no choice but to use the pond.

Even when there is enough water, the bigger issue is the quality of this essential resource

"We force our way to get the water whenever the person at the water point has had their fill. And this, in most cases, lead to scuffles and injuries,” explains Maryam, a camp resident.

People are trying to find a way to make the ends meet

Most people do not have the arable land or water to farm or grow food in the displaced person camps because there is not enough space and also because the situation outside the camps is too dangerous.

Stones for sale in Pulka. Hand-crushing stones is the only source of income for numerous families there.

Farming land is located on the periphery of Pulka, outside the trenches and fences that make the town more resistant to attacks and intruders, but also cut off the population from the outside world.

In such conditions stress, tension, even conflict, is to be expected.

"The major problem we are having here is inadequate supply of food. Four of my grandchildren are staying with me, and the food rations given to us are not enough," said Fatima, while hand-crushing stones.

"Those of us with four or five jerry cans are usually asked to wait for the pushcart owners from the community to get water before we can get water," explains Maryam, another camp resident.

"My name is Maryam, I came from the ‘bush’. We are being supplied water four times in a day via trucking. When we get five jerry cans or buckets of water, we may not need water again until the following day as that will serve us for the day."

“There are men who are in control of the water points; they are the ones that usually tell us to wait our turn in the queue. But we don’t usually wait."

"We force our way to get the water whenever the person at the water point has had their fill. And this, in most cases, lead to scuffles and injuries.”

Access to water is limited during the dry season, and the population often has to use untreated water from boreholes for their needs, or to buy it from local community leaders.

Polluted or untreated water hurts children

Médecins Sans Frontières/Doctors Without Borders (MSF) runs a 97-bed hospital in Pulka, which offers free-of-charge general and specialist healthcare to all residents, including displaced people.

Patients waiting in OPD ward. MSF runs a 97-bed hospital in Pulka, which offers free-of-charge general and specialist healthcare to all residents, including displaced people.

Roughly 58,000 patients were treated in the hospital’s outpatient department in 2020 with respiratory tract infections and polluted water-induced diseases being vast majority of cases.

MSF also conducts regular health education in the displaced person camps about the importance of clean water, especially when water is a scarce and very valuable resource.

As much as 57,974  patients were treated during 2020 in outpatient department, with infections of the respiratory tract, and polluted water-induced diseases being vast majority of cases.

Cecilia came to the hospital because her baby had diarrhoea.

“He has abdominal pain and catarrh. The abdominal pain makes him pass watery stool. We usually get our drinking water from the solar borehole in the morning. If we didn’t go in the morning, we wouldn’t get any water."

Cecilia, baby's mother: "He’s having abdominal pain and catarrh. The abdominal pain makes him to be passing watery stool."

"We sometimes drink the water from the local pond, but only if we have the chemicals to treat it. But for now, we don’t drink the water from the pond because children play and have their bath in it."

MSF run a 97-bed hospital in Pulka, which offers free-of-charge primary and secondary healthcare to all residents.

Lack of coordination among water and sanitisation organisations 

Mohammed, another patient in the hospital, called on water and sanitation providers to take serious measures to improve the current conditions.

"We, the people of Pulka, are appealing for assistance in the provision of potable water", said Mohammed, a residentof Pulka, who has been sick for days due to poor quality of water.

"We get our water from the pond. But the water has lots of dirt in it; it’s not treated and that is why we constantly have abdominal problems and related illnesses." 

Our major problem here in Pulka is the problem of water, as it gives us abdominal pain

Mohammed, a patient in MSF hospital PULKA

"Musa (the boy) is having abdominal pain. He's also having catarrh and rashes in his mouth. One may experience abdominal discomfort, if the water is not fit for drinking," said Fati, who took her son to MSF hospital.

"For about two weeks now, I’ve not been feeling well. From one illness to another; today, it could be abdominal pain, tomorrow it’ll be catarrh. We are appealing to those in charge to fix our boreholes, as some of them are not functioning."

An internally displaced person in Pulka.

"There is a clear lack of coordination and communication among different water and sanitation organisations here, which impacts the situation,” says Siham Hajaj, Head of Mission in Nigeria.

MSF runs a 97-bed hospital in Pulka, which offers free-of-charge general and specialist healthcare to all residents, including displaced people.

“People of Pulka need immediate action of humanitarian actors, which need to improve both the access to and the quality of the drinking water."

Unless WASH actors in Pulka act right now, we will witness even more suffering by population there

Siham Hajaj, Head of Mission in Nigeria

Population of Pulka as of 1 January 2021 is around 65,215 individuals out of which 37,039 are internally displaced persons (IDPs) accommodated either in formal camps, or in host communities.

MSF has been working in Nigeria since 1996 and in Borno since 2014.

In Borno state, our medical teams provide emergency treatment, surgery, malnutrition treatment, maternal and antenatal services, vaccinations, mental health care, and prevention and treatment for malaria and other diseases.

"We used to see unaccompanied minors coming (to Pulka) alone from the inaccessible areas, their condition was very bad," said Usman Ahmadu, MSF social worker, illustrating the condition in Pulka.

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