Outrage over outbreak of measles in Rivers communities

The journey to Akani-Kugbo and Emago-Kugbo was tough, rough and painstaking. The communities located in Abua-Odual Local Government Area, Rivers State are cut off from civilisation. In fact, there is no road to the communities. It has never been constructed. Most of the children don’t know what cars look like. None has been driven into the community since they were born. Only muddy, bushy and waterlogged pathways created in forests and farmlands by constant feet and motorcycles lead to the communities.

Indeed, one travelling by road from Port Harcourt to Lagos may get to his destination before another moving from the same Port Harcourt at the same time can reach the communities. It was a journey of hours laced with fear of possible attacks by wild animals. First, there is no direct link between the communities and Port Harcourt, their state capital.

The only way to access the communities is through Otu-Asiga, in Ogbia Local Government Area, Bayelsa State. The road stops at Otu-Asiga. Only commercial motorcycles move people from Otu-Asiga to the Rivers communities, and it is expensive. Trips to and from the Ogbia community to Emago-Kugbo on commercial motorcycles cost as much as N30,000 depending on your bargaining power.

The trip to the communities became expedient following the outcries of residents that measles was killing their children. Some claimed that over 50 children had been killed by the outbreak, while others said the number was not definite. Still some health officials said no child had died of measles.

Meeting with Joy Stephen, however, dispelled that position of the officials.

Joy was full of tears, and she said it has not been easy for her, as she was still mourning the death of her two children. “Both of them died of measles. I know it is measles that killed them. One died on Monday and the other gave up on Tuesday, the same week”, she wept.

Joy was sure her children were victims of the outbreak. They were all below three years. “I saw the symptoms of the measles as they came out of their bodies. Rashes covered them and bruises were evident inside their mouths.” She said all efforts made to save them proved abortive.

Rose Semene was distraught and confused. She already lost her five-year-old child to the outbreak. Now her newborn is also afflicted by the disease.

She said: “My child died of measles. Our doctor (the chemist) told me that it is measles that caused the death of my child. I saw rashes and he was scratching his eyes, coughing and had catarrh. He was five years. I brought him to the chemist for treatment. He was immunised when I gave birth to him. I feel terrible to have another child that has measles”.

Joy Jackson could not hold her tears while recalling how her child died of measles. She said: “My child fell sick and we discovered it was measles. It first started when she had high fever. At times, she coughed and all over her body was covered with rashes.

“Later on his mouth became red and she could not eat and whenever she farted, the odour was offensive to the point nobody could stay around and her faeces were dark and smelly. So later they told me that it was measles. Later she could not eat and was placed on drip before she gave up”.

Another mother, who identified herself as Likeness is battling to save her two children from the disease. Fortunately, she said they were currently receiving treatment but lamented that the condition had lasted two weeks.

She said: “My two children have been suffering from measles and they’ve been sick for two weeks. I have been bringing them to this chemist. I knew it was measles by mere looking at their bodies. I have taken them to the health center for immunisation.

Like Likeness, another mother, Wololu, was battling to keep her child alive. “My baby is sick, so I took her to the hospital (chemist) to treat her. The doctor told me that this sickness is measles. He remained in the hospital (chemist) for more than one week.

“They gave us some drugs and other things. I suspected that it was measles when I saw rashes all over her body; she was scratching her body and it affected both the tongue and nose and there is no way to clean her nose. She started to have fever with cough for more than two weeks. That is why I went to the hospital (chemist)”.

Lifeless health centre and overwhelmed drugstore

In Emago-Kugbo, which has high rate of spread, the health centre is sick. Though it is a modern structure, it is empty. It has no sickbay, no doctor and the health officers assigned to the community are hardly on ground. But on Wednesday, some of them were around and it was obvious that their presence was because of the outcry of the community. Some youths were seen clearing the overgrown vegetation surrounding the structure.

The drugstore, which they popularly call chemist, is therefore all the community relies on when they have health issues. Some even refer to it as hospital. Joy Stephen, who lost her two children, said she could not afford to take them to a hospital. “There is no hospital here. I couldn’t afford to take them out of the community. I only took them to the chemist before they died”, she said.

Even Joy Jackson, who also lost her three-year-old child to the disease, said the health centre was not always functional. She said occasionally when health officials came with drugs, a town crier would go round the community to announce and call on pregnant women and sick people to come to the health centre for drugs.

She said: “I was unable to take the child anywhere because there is no hospital here. Even the health centre is not available; so when we fall sick, we take them to the chemist and he gives us first aid which usually cures us. So we did not take the child to anywhere. She died two weeks ago”.

The drugstore owner, Marcus Levi, is known in the community as ‘doctor’. He is chairman of the Community Development Committee (CDC). Apparently overwhelmed by the outbreak, Levi raised the alarm to call the attention of the state government.

Controversy over death rate

There is no doubt there is an outbreak of measles in the community. And it is spreading. The dispute is centred on the mortality rate. Levi claimed that over 50 children had been buried. He pointed out the graveyards to this reporter, stating that their culture does not permit strangers to visit graveside. Levi also has multiple pictures of children who were victims.

He said: “Since July, we have been experiencing measles outbreak. It started from Amaritor and has extended to Emago. So the thing is getting out of hand and I had to make a report so that it will attract the government’s attention to come and help us. We have lost so many children.

“I have pictures to show. Just two days ago, health workers came here. People from the state arrived here and they confirmed the cases and left, but promised to return two days after for treatment.

“We have recorded about 50 deaths. And since the data cannot be proven, we have photos of the people buried at the burial ground. We do not have statistics of the number of sufferers of measles but you can count over 200 children. Our community is very large, the largest community in Abua/Odual LGA”.

But Eneni Emmanuel Eritebo, the Health officer of Emago, claimed nobody had died of measles. “In terms of the measles outbreak in Emago, as much as I know, there is no death recorded. One single child has not died due to the outbreak in Emago.

“And if at all there is any doubt anywhere, other persons can still come for investigation; but I am telling the world as the number one health officer representing the community”.

Issues around immunisation

While the affected women claimed that their deceased children and those suffering the disease were immunised, the health officers said the turnout for immunisation was usually poor.

Eritibo said: “The cause of this outbreak from my experience as a health officer is the failure of their guardians to bring their children for immunisation.

“Government has sent vaccines here and immunisation has been going on. I raised an outcry and warned that their failure to bring their children for immunisation would lead to outbreak of measles. We just organised the last immunisation on Friday last week.

“If the people say they suffered from measles, the question to ask is if their children were vaccinated. That is why I said the cause of the measles is the low turnout for vaccination”.

Also, the Head, Record Officer in the health centre, Ogberima Okadi, blamed the outbreak on residents’ nonchalance to immunisation.

He said: “The last immunisation we carried out was on the 26th of July, just two week ago and these parents refused to bring their children. The turn-out was very poor; so, we were left with no option but to immunise the ones we saw. And that has been our system.

“Imagine a situation where they give us BCG for about 50 and only two or three show up. They should advise their people to come for immunisation so that this outbreak will not occur again. The last outbreak was in 2012 during the flood at the headquarters”.

Levi confirmed that the last immunisation ended two weeks ago and that the measles vaccine was only given to nine-month-old babies. He observed that during outbreak of such disease, children under nine months were also affected. He lamented that immunised children were also suffering the disease.

Other causative factors

Levi pointed out that measles appeared to be seasonal in the community. He said each time the dry season approached, measles occurred in the area.

He said: “Each time we want to enter into the dry season, we usually experience measles. In the whole of July we didn’t get rain, so due to the hotness of the weather the measles appeared”.

He said the spread of the outbreak was always aided by the clustered nature of the community. The community is rustic, rural and comprises close nit makeshift shanties. Like a typical Ijaw community, the houses are in proximity and linked together. Levi said it made it difficult to isolate infected persons to curtail the spread.

Besides, Levi said there is no potable water in Emago. The community depended on the Emago creek as its only source of water. Levi said all efforts to sink boreholes in the area failed to yield positive results.

We need serious interventions

Levi insisted that the community was in dire need of serious interventions from the government. He said though the health officials from the state government promised to return on Thursday to tackle the outbreak, they were yet to come back. He asked the government to find a way to make the health centre fully functional, while providing other basic amenities in the area.

Unlike Emago, the Akani community, which was mentioned among areas ravaged by measles, denied the outbreak. Akani is the first community before Emago, but the two on the same stretch of bush path do not enjoy warm physical relationship. They are far from each other and separated by forest.

Akani’s health centre is an uncompleted building. A health officer in charge of the community, Umor Walter, said there was no measles outbreak in the area.

Walter said: “Over the past two years, we have not recorded any infant mortality. And the news we heard on the radio is not fact. You can go and ask around the community, there is no single trace of any measles case and we have not recorded any infant death in the past one year.

“As for immunisation, we are sensitising on daily bases, and this week, on Saturday, we are going to carry out this month’s (August) immunisation session. And mothers and children are attending because the health awareness of our advocacy and orientation make the turn up very nice.

“There are many challenges here. We do not have an access road to this place. So we who are posted to this place have been suffering because we find it difficult to pass the road. We want the government to come and provide road to this area.

“The community has tried to provide portable water. There is water in this place. As for our Health Centre, we do not have a permanent structure now but the community has tried its best to provide us with a place we can manage to do our job.

“The one under construction was started by the previous local government administration but was abandoned so the community has to renovate two rooms for us to manage and carry out our job”.

Furthermore, the paramount ruler of Akani, Chief Michael Edighotu, said there was no outbreak of measles in the community.

“In my community, although there are small fevers but to say an outbreak of measles, we have not experienced such. No child has died; the health officers are working.

“We have no access either by water or by land. So we need the government to come and help us. We are predominantly farmers and there is no way to transport our goods to the market”.