Environmental
Health in By Sani
Garba Environmental
health is as old as man is though changes name from time to time, so it
has been with us time immemorial. Environmental health is the control of
all factors that may have direct or indirect effect on physical, social
and mental well being of man in his society. As such, its public health
importance cannot be overemphasized. This is because it dealt with many
things that affect man's life in one way or the other from environmental
and food hygiene to building/water sanitation technology and waste
treatment disposal to healthful housing and control of disease[s]
vectors and others. In
view of this, this paper looks at the historical background of
Environmental Health Officer[s] [EHOs] in YESTERDAY:
HISTORICAL BACKGROUND IN "This
cadre of public health workers came into existing during the colonial
era, their statutory function was purely sanitary inspection then as
sanitary assistants to the colonial masters. "In
the 19th century, the colonial masters who executed the
sanitary duties of our environment in "As
time went on these sanitary attendants were given more responsibility
such as routine sanitary inspection, collection of water samples, survey
for breeding places of mosquitoes, as well as acting as guides and
interpreters. “During
the early 20th century, with improved educational background,
these attendants gathered enough experience from their colonial masters,
they were assigned duties such as cutting down tall trees that were
close to the residential buildings, identification of infectious disease
cases, disinfection and disinfestations, liaison between the colonial
masters and villagers, verification of notices issued by their colonial
masters [sanitary inspectors], retention of daily, weekly and monthly
returns. 1920s-1980 "Dr
Isaac Ladipo Oluwole brought about changes in the status of "The
first problem that faced the modern day Nigerian sanitary inspectors as
early as the 1920 was the outbreak of bubonic plague in 1924. The
professional was actively involved in the control of the plague
epidemic. Dr. Oluwole revamped port health Duties and made sanitary
inspection a vital instrument for the control of communicable diseases
using entirely the Nigerian sanitary inspectors. "All
these brought recognition to the sanitary inspectors among other cadre
of health workers in "In
the 1930s, the educational qualification and training of sanitary
inspectors had greatly improved. Thus, the colonial government assigned
them the following statutory functions. *
Routine sanitary inspection of houses, markets, schools and communities. *
Waste disposal and environmental sanitation, pollution control and
industrial sanitation. *
Water sampling and sanitation. *
Port health duties [air, land and seaports]. *
Control of communicable disease [infectious diseases]. Other
duties were, *
Building and urban planning *
Vector and pest control e.g. Malaria control *
Prosecution of public health offenders in the court
&n
bsp;
*Meat and food inspection
* The disposal of the dead [corpses]
*Occupational health and factory inspection
*Vaccination/inoculation of both schoolchildren and adults.
*Health education on personal and public hygiene was also
included. “The
establishment of the World Health Organization [WHO] in 1948, brought
about changes in the profession, thus many people with higher
educational qualification were recruited into the profession and
enhanced curriculum to accommodate the need of the society. “This
was evidenced in their immense role in the eradication of Yaws and
Smallpox in the late 1940s and early 1970s respectively. The
1980- to the present day “In
1988, the name of the profession was changed to environmental health
officers in line with the internationally accepted name of practitioners
of the profession and also to accommodate members of the profession who
graduated from the university with a degree in public health,
environmental health and epidemiology. “Apart
from the general environmental health duties which had hitherto been
mentioned this cadre of officer has been very useful in the
implementation of primary health care services in the country at all
level of government [federal, state, and local government]”. But
one may ask who is this environmental health officer [EHO], what even
qualifies one to be called so? In attempting to answer these questions,
I will still quote the paper I have been quoting. “The
present day EHO is a professional group whose nomenclature had changed
over the years from the then nuisance inspector of the 1930s to the
sanitary inspector of the 1950s and 1960s to the public health
superintendent of the 1970s and finally to the present day environmental
health officer. “Today,
an environmental health officer in Nigeria under goes four
years training in public health with courses as Epidemiology,
Anatomy and Physiology, Control of epidemic and control of infectious
diseases, First aid treatment, Emergency preparedness and response,
Waste management, Building technology, Entomology, Public health laws
and administration, Microbiology, Environmental monitoring, Pollution
control and abatement, Biostatistics among other course. “After
the four years training, a compulsory one year practical attachment is
required as part of training [THOUGH NOW IT IS NOT SO]. This training is
either in a By
the civil service nomenclature the holder of this diploma is an
Environmental Health Technologist or Officer” [emphasis mine]. Their
duties world over which among others include the following: protection
of water sources, waste water treatment, waste management, vector
control, prevention and control of land, air and water pollution, food
hygiene and safety, air quality management, occupational noise
management, occupational health and safety, accommodation establishment,
port health duties, accident prevention environmental health aspect of
public recreation and tourism etc. Today:
The Present circumstances With
all the roles they have played, now the story is different. The
profession is dying and being painted or branded as olden days
profession and has nothing to offer in the health sector by some other
health professionals. Even though a federal ministry was created and
other agencies of environment, yet they cannot perform to the
expectation due to poor structures that incorporate environmental health
officers in most or all department and non challant attitude of our
governments. There
is no part of Nigeria that has no environmental health problems ranging
from waste [solid, liquid, and gaseous ], erosion, desert encroachment,
environmental pollution [air, water, and land] etc, yet not much is
being done to tackle the problems. Now
environmental health officers are not regarded as it was before due to
government I do not care attitude to their services. It is not even
amazing for our leaders to see how dirty and unhygienic our environment
is with waste everywhere, markets, schools, drainages, health
institution, government offices, residential and occupational
environment etc, yet the concern that the leaders ought to show in
giving more attention in tackling the situation by reviving public
health laws and environmental sanitation is no where to be found. Environmental
health officers are not properly represented in many aspect of health
that border on their profession. More so, each Dick and Harry is
claiming to be an environmentalist despite not being so. It now reach a
stage where by most or all the policy makers in federal, state
ministries of environment and other environmental control agencies are
occupied by wholly[and or partially] none any environmental health
officer[s] or other professional that has little or no knowledge on the
environmental health. The
position of Environmental Health Officers in Primary Health Care [PHC]
has been hijacked by medical health practitioners [Most especially
medical doctors], whom their professional orientation centred wholly on
curative health, thus they are not giving any attention to the
preventive aspect of health due to their poor knowledge on environmental
health. They now dictate where the pendulum of the PHC will swing by
hijacking every thing whether or not it is within their profession, for
they do not separate their duty with those of other profession. Another
lack of attention to the environmental health officers by the government
is that majority of government or all institution has no provision of
office of environmental health officers. For instance, no any federal
medical centres have such office, federal hospitals [with the exception
of the few], states hospitals and many other health
institution/ministries. While in hospitals, no any health professional
that you will not see, it is only environmental health officers that
cannot be found, as if they do not have any role to play. A case of
example is one specialist hospital in At
educational level, EHO also are facing lack or even non-availability of
wide ranges of courses in relation to their profession that they can
further their education. Even the degree programme of environmental
health and epidemiology started by OAU Ile-Ife has been cancelled since
with no standard reason. Courses like occupational health, preventive
and social medicine, public health etc are nowhere to be found in our
universities. Prior to 1995, the highest level of qualification EHO
holds is Diploma [of 3 years], it was only in 1995 that HND programme is
introduced which produced the first graduate it first set in 1998.
Despite of Environmental health as the oldest profession in Next
wonder is when diseases that are environmentally preventable are being
discussed in term of prevention and control, you hardly hear or see any
role[s] assigned to the environmental health officers. For instance,
this Roll Back Malaria [RBM] programme, among its four intervention
strategies, prevention and responses to epidemics [which To
cap it all, environmental health officers in Nigeria are not in proper
set up[which is in contrast with our South African
brothers as presented in www.hst.org.za/sahr/99/chap20.htm
that gives them room and chances of practice without being interfered or
not allowed at all as a result of government factor by preferring other
health services [precisely curative] to the detriment of their service
and other health professionals factor
that see environmental health as stumbling block to their source of
livelihood which they must not allow to thrive and become relevant, and
also the problem that the officers might have created on their own by
being very passive in
protecting and fighting for their professional rights. Therefore, if
these kinds of problems are allowed unchecked, the officers will remain
where they are and nowhere to go. Though all these problems are being
address one by one by EHOAN at the national level [though some how
passive], I hope better and reliable position will be reach and taken as
we stand to hear from them, for they [we] have an arduous task ahead. What
we are hoping to see is the outcome of the recent meeting of technocrats
and experts on environmental issues on environmental sanitation policy,
which took place in
Tomorrow: Recommendation For
the recommendation, I quote [from 1-5] that of the 36th
national conference/workshop of the Professional association of
Environmental Health Officers of Nigeria [PAEHON] now EHOAN, which state
thus: 1
“If public health must improve and get back to the level it was
during the colonial era and in the early years after independence, the
training and deployment of adequate number of Environmental Health
Officers must be reconsidered and pursue as a developmental option on
Nigeria. 2
“The increase in
number of Environmental Health Officers in the service of the various
tiers of government must be increased to meet the world Health
Organization minimum requirement for the cadre
which is 1 EHO to 8000 population. 3
“With
industrialization, so many chemicals are being indiscriminately disposed
of in various communities in 4
“Urban development in 5
“The relationship between disease and the environment is well
documented and accepted. 6
Lastly, the government at all level should create room or office
or department for environmental health officers in their entire
establishment [be it ministries, agencies, health institutions, local
government in particular etc.], for their roles there cannot be
overemphasized. So also in industries, markets, estate, residential
settlements etc. We
do hope our leaders at all level will see reason and give more emphasis
on preventive health services rendered by environmental health officers
and other professional to the community, in order to save millions of
naira being spent on diseases that are preventable with little or no
success. Sani
Garba, contribute this piece from No 302, |