By Iliya Kure
This report follows a month of investigation carried out by a team of five journalists which this Reporter is a member.
Kaduna (Nigeria) — “I can’t see with my left eye as I talk to you right now and this problem started last year. I don’t know the cause, but it began with inching, now the right eye too is having problem which is making me worried, because it seems I will soon lose my sight completely,” said 65 year old Malam Garba, a resident of Iri Station.
His case is one among several others in Iri District of Kajuru Local Government Area of Kaduna State, northern Nigeria. Cases of river blindness are not new in Kaduna State, especially to communities around Kajuru, where certain rivers continued to breed black flies which cause the blindness.
These flies when they bite, they inject into their victims filarial worms, called Onchocerca volvulus worms. These worms live beneath the skin of their victim and continue to multiply, leading to severe skin itching and skin disease.
This eventually leads to the blindness. Intervention on river blindness in Kaduna State is mainly through the work of a Non Governmental Organisation – Sight Savers International Key area of intervention is the annual provision of Mectizan drugs to residents of the affected communities.
The residents take between two to four tablets (depending on age) to keep them safe from blindness. According to a Kaduna State budget document, Sight Savers International spends over 11 million naira annually on provision of Mectizan drugs and other services.
Mectizan, a brand of Ivermectin, is a drug used in the treatment of river blindness. The drug is believed to paralyse or kill the worms gradually, reducing the severe itching suffered by the host. In some cases, the drug does not stop a person from becoming blind, especially if the worms have matured in their host.
According to World Health Organisation (http://www.who.int/apoc/cdti/ivermectin/en/) Mectizan “does not kill the adult worms but suppresses the production of microfilariae by adult female worms for a few months following treatment, so reduces transmission. As the adult worms can continue to produce microfilariae until they die naturally, ivermectin has to be taken once a year for 16–18 years to break transmission.”
In other intervention, people of Iri community said a helicopter had fumigated the river banks in the 1970’s, which resulted in the eradication of the black flies, as well as killed fishes in the river.
“Since then we did not see the flies again,” says Paul Sanda, a retired military man, “but today the flies are back and are biting our people, especially those who go near the river.”
The team of the journalists was unable to substantiate the helicopter fumigation claim through further investigations.
But today, fresh cases of blindness are prevalent and over 77,000 people in 119 communities are at risk of becoming blind.
These people are scattered in 9 wards of Kajuru Local Government Area, namely;
Maro ward – 1 district (Maro District)
Idon ward – 2 districts (Idon and Iri districts)
Tantatu ward – 1 district (tantatu district)
Afogoh ward – 1 district (Afogoh district)
Kufana ward – 2 districts (Kufana and Angwan Aku districts)
Rimau ward – 1 district (Rimau district)
Kalla ward – 1 district (Kalla district)
Kajuru ward – 4 districts (Kyamara, Dawaki, Buda and Kajuru districts)
Kasuwan Magani ward – 1 district (Dusten Gaiya district)
Most endemic communities in the LGA include Iri village, Uguwan Fada, Unguwan Makama in Robo and Unguwan Aku. This is in addition to what obtains in 14 other endemic LGAs of Kaduna State.
According to the Desk Officer of Neglected Tropical Diseases of Kajuru LGA, Francis Habakuk, studies conducted last year by a researcher from Ahmadu Bello University Zaria, indicates that black flies in the communities still carry worms.
This findings is a deviation from other researches that shows the flies not carrying the worms.
To arrive at the new finding, Habakuk said the researcher took some black flies, as well as blood and skin specimen of residents of Unguwan Fada community for laboratory analysis.
Probed further, Habakuk said, “since I assume office in the last five years, it’s only old cases of river blindness that we have on record, except for one new case M&E reported in Agwala community, in Afogoh district.”
Asked on supervision, he said “We go out for supervision, the state Ministry of Health also go out on supervision, Sight Savers International also come for supervision.
“In fact last year, in November, we received a delegation of some visitors from the United States in collaboration with NPHCDA in Abuja.
“Communities visited by the Team included Rafin Kunu and Angwan Fada, but Iri was not included. The visitors were led by the Coordinator, Neglected Tropical Diseases, NTD, Kaduna State.”
He said Community members are expected “to report cases of river blindness to us, but they don’t report to us. They just sit at home.” Habakuk said.
It is currently a story of confusion for most residents of Iri District, who are scared of the return of the black flies and new cases of blindness.
60 year old Abdulmumini Ali is among people who are scared, he said “I started having this eye problem three years ago, it started with itching, sometimes I feel as if I am being bitten inside.
“Although, some people from the city do visit us to distribute drugs to us. They told us that the drugs will help protect us.
“My elder brother already lost his sight and the problem is the same. It all started last three years. We know something was wrong in the village but we don’t know what it is,” he said.
65 year old Mrs. Danladi said her issue began 5 years ago. “It began with itching before I went to hospital once and they gave me drugs, but the pains and itching still continues.
My daughter too 18 year old have started complaining about same eye itching last year. “The truth is before we moved from the city to village, we never had this symptoms.
So, we were all worried because we don’t know the cause,” she said.
Absence of supervision by government officials to monitor river blindness in communities visited by the investigative journalists have clearly been established.
No villager attest to any government, or health official visiting them for any information gathering.
As in the case of river blindness, the only Primary Healthcare Centre serving the community has been abandoned – it is an eyesore – more of a centre to acquire disease than to find cure.
The story is the same with their public Primary School, which also begs for a facelift from its owners.
Key among challenges these people face is the absence of alternative source of water for domestic and other uses.
Despite knowledge of black flies in the rivers, women and children still go to fetch water from what can be described as the only source of water for the communities.
Settlements using water from river Iri for domestic use include Hayin Sarki, Sabon Gida, Inkirmi, Karmai, Makoro and Gadan Malam Mamman among others.
The visit by the team had rekindled the ‘search flame’ of the District Head of Iri, Peter Magaji, to investigate new cases of river blindness in his domain.
At the request of the journalists team, more than ten people with unreported fresh cases of river blindness had assembled in his palace, in less than an hour.
On further investigation, the team discovered 31 new cases of blindness in various degrees, which all started between 2012 & 2016.
None of the cases is on government record.
The District Head said, “We are appealing to government to help provide us with boreholes in Iri District, because River Iri is the only source of water for this village and those around us.
The river sometimes get dried off, but people still go there to dig in search of water.
“I’m afraid that people from Hayin Sarki and neighbouring villages still fetch water from the dried river despite the risk involved.
I think if the local government can provide us with a borehole, it will go a long way in addressing the water problem,” he said.
The team of the journalists contacted the Public Relations Officer of Nigerian Institute For Trypanosomiasis Research (NITR) Kaduna, for an interaction with the Director-General of the Institute.
The team was given an appointment, but when it visited the Institute on Monday as arranged, the team was told the Director-General was in Ibadan for a workshop.