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The probable impact of the proposed Jebba Dam on the health aspects of the River Niger basin of Nigeria
PubL tilth, Lond. (1980) 94, 235-242
The Probable Impact of the Proposed Jebba Dam on the Health Aspects of the River Niger Basin of Nigeria E. O. A d e k o l u - 3 o h n M.B., B.S.(tb.)., M.P.H.(Harv.}
Kainji Lake Research Institute New Bussa, Kwara State, Nigeria
The health facilities in the proposed Lake Jebba area are described. A hospital, four dispensaries and a maternal and child-health centre exist, among which, only two dispensaries and the maternal and child-health centre ~rovide free medical care to the people. A survey of the household and compound composition in Awuru and Sabonpeggi (villages close to the Niger River below the Kainji Dam) showed that the interpersons contact which could promote the spread o f communicable diseases is higher in Awuru ~han in Sabonpeggi. The mortality of children born in the two villages showed that about 30% died before the age of 5 years mostly from fever (49-7%) and gastroenteritis (12-86%). Of the deaths occurring in persons aged 0 - 3 5 years about (86%) occurred in children below 5 years. The impact o f the proposed Lake Jebba on the already known endemic diseases and on the child mortality is discussed. Suggestions are made to define the Lake Jebba area for development, emphasize maternal and child-health care in the healIh planning and to establish a port health station where the River Niger enters Nigeria.
Introduction One investigation which has always been neglected in the preliminary studies into the resource potential o f proposed man-made lakes in Nigeria, is the impact o f the proposed dam on the health status o f the people living close to the river and who may be displaced following the creation o f the lake. Before rivers and streams are impounded, it is Ilatural to speculate that there will be a widespread increase in the vector populations e.g. mosquitoes, tsetse, snails transmitting schistosomes and an increase in vector borne diseases in the communities close to the impounded water. The breeding o f such disease vectors is promoted by a newly created large 'body o f water. There may also be the psychological, emotional and nutritional problems which could arise from resettling the displaced communities living close to the impounded water. At the same time it is also wise to speculate on a decrease in the prevalence of onchocerciasis following impoundment o f water in those areas where the disease is endemic. Changes in the disease phenomena in communities affected by the proposed lake can only be appreciated if a survey into all the health problems is undertaken prior to lake formation. The health studies conducted in 1960, prior to the construction of the Kainji Dam were on the insect vectors o f human diseases around the proposed dan] site. l The aim o f the study was to institute control measures against those diseases and their vectors that were likely to impair the working capacity o f the labour force. Because Waddy's study did not cover other areas outside the Kainji Dam site in the lake basin and because of this, the information gathered was limited in evaluating the impact of the Kainii Lake on the health status of the people around 0038-3506180]040235+08 $0t.00/(9
O1980 The Society of Community Medicine
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E. O. Aaj:olu-John
the lake basin. The present study attempts to provide preliminary information on the health stalus o f the communities close to the River Niger below the Kainji Dam to Jebba. It is hoped that the information will form pan o f the study necessary to determine the impact o f Lake Jebba on the health of the communilies living close to the lake in file future. ff NO$0rowO ~
~Sobonpegg~
N
\ N N
Loc0hon mop of proposed reservoir
\ *%,
/urtt~
\
\ X
\ \
( Zugurumo
m, o D
S
\
B@ibo
To Mokwo
KEY
. . . . H MCH D
Roods Rivers HOspital Moternat and Child Health centre Dispensary debba
H
MCH D
F.igure 1. The proposed lake Jebba area and existing health facilities 1977.
hnpact of the Proposed Jebba Dam
237
General Cimracteristics o f the Proposed l a k e Jebba Lake Jebba, when completed in 1982, will be about 100 km in length and the Darn will be about the same distance downstream of the Niger as the Kainji Dam. The Jebba Reservoir will be located betx~een latitudes 9 ° 03' and 9 ° 57' N and longitudes 4 ° 39' to 4 ° 57" -Fast, and will be mainly confined m the valley of the Niger and its tributaries: Awuru, Eku, Moshi, Wuruma and Oli (Figure I). The greatest width o f the reservoir will be attained on lhe lowlying area on the right bank opposite the mouth oi Eku River. Consequently the Awuru rapids, the navigation canals at Awuru and the Bajibo rapids will be submerged. The Jebba Dam project will require a labour force o f about 2300 (2100 Nigeria,s and 200 expatriate) for i~s excavation. This population will compound the health requirements o f over t0,000 people wh~ will be displaced from the Niger and Eku valleys as a result of flooding.:z The Jebba Reservoir w/ll fall wiihin the Guinea-Savannah vegetation zone as classified by (,]ayton.-~ Along the River Niger from Awuru there are considerable stretches o f well formed fringing forest, whose fallen leaves provide attachment sites for the aquatic stages of Sim,.:!&m damnosum and are the preferred habitat of Glossina morsitans. Away from the river valley ihe vegetation ks generally fn~7lyopen Savannah. The proposed Jebba Reservoir will be situated in areas governed by the Kwara State on its west bank and the Niger State on its east bank. Presently 'there is no accurate information on lhe nt~mber of villages located close to the bmlk o f the proposed reservoir, ltowever, Babalola (unpublished Kainji Lake Research Project Document)identified 16 fishing villages on the west bank of Rivel Niger and 19 fishing villages on the east bank between the Kainji Dam and Jebba. 4 The only access to these ~illages, at present, is along the River Niger. The annual rainfall near Jebba is approximately 115 nun with the greater percentage occurring in July, August and September. March, A,pril and May are the hottest months, wl~ile November, December'and January are the coolest.
Research Methods In July 1977, a visit was paid to the health institutions located close to the proposed Jebba Reservoir basin, to inspect the disease reports and to ascertain from the health providers, the area covered by each of the health institutions. The diseases reported were analyzed to identify the most common. Between March 1975 and July 1975 two villages: Sabo~qpeggion the eastern bank, and Awuru, on the western bank, of tile proposed Jebba Reservoir were chosen among other five villages for tile assessment "of the health status o f tile villages within the Niger basin. Initial surveys were conducted into the demographic features, including the compound and household composition, in terms o f the number of compounds and the number o f households within eacll village. The head of each household was then asked the names, sex, age, ethnic group and the occupations of the household members. A household, for the purpose of this study, is a group of people living together, usuaUy under the same roof and eating from the same pot. A further survey was also conducted. In this, each woman living in the two villages was asked the number of children she had delivered and the number o f her children who had died. She was then asked in detail, the age at which each child had died and the cause of death. Care was taken throughout tiffs last survey to retrieve as much information as possible from each respondent. Result Figure 1 shows the health facilities existing as of August 1977 in the proposed Jebba Lake area. Four dispensaries, one hospital and one maternal and child-health centre were available. The
238
E. O. Adekolu-John
hospital and dispensary at Jebba, are private health institutiom that do not provide free med~,eal care . TABLE 1. Common ailments from dispensaries located elo~e If proposed Lake Jebba Diseases
Malaria Diseas~ of alimentary canal Leg ulcers Respiratory infections Skin disea~s Eye diseases Burns Venereal diseases Cerebrospinal menir~tis Urinary schistosomiasis Guinea-worm *Others Total
Nasarawa Number
%
1790 1677 !723 1113 988 689 170 69
19"8 18"5 19"1 I2"3 10"9 7"6 1"9 0"7
10 2 $12 9043
0-1 0-02 9"98 100-9
lbi (Zuguruma) Number % t494 918 614 665 360 302 30 57 19 3
32"2 19-8 13-2 14-3 7-7 6"5 0"6 1"2 0"4 0-06
177 4639
3"8 99"76
Total 3284 2595 2337 1778 1348 991 200 126 19 13 2 989 13682
%Total 24"00 18-97 17"1 13"00 9-9 7-2 1"5 0"9 0"1 0-09 0-01 7"2 99"97
*Includes: mumps, snake bite, gingivitis, L~.fectivehepatitis. Table 1 summarizes the commoner ailments recorded in the Nasarawa and Zuguruma Dispensaries for 1977. Altogether, six conditions: malaria, disease~ of the alimentary system, leg ulcers, respiratory infections, skin diseases and eye diseases were c~mmon in both dispensaries, whilst cerebrospinal meningitis and guinea-worm are recorded only in Zuguruma and Nasarawa dispensaries respectively. Table 2 shows the age and sex distribution o f members o f the household, and the compound and h~usehold distributions in Sabonpeggi and Awuru villages. The age distribution in each of the two villages is typical o f the developing countries with a broad base tapering towards the 80 and above. Although there are more compounds and households in Sabonpeggi than in Awuru, the density of the population in each compound and household o f Awuru is higher than that of Sabonpeggi. There are two major ethnic groups: the Nupes and the Hausas, the other ethnic groups being represented only in relatively small numbers. The major occupations are farming and trading. Relatively little fishing is going on. Table 3 gives the number of births and the age distribution at which death occurred among persons born in Sabonpeggi and Awuru. The causes and age o f 12 deaths were not specified because o f taboo, forbidding some o f the women from mentioning the causes of death of their children. These were subsequently excluded from the analysis. Of deaths, 85-8% occurred within the first 5 years and Table 4 shows that the commonest causes of death were fever and gastroenteritis. Discussion Previous studies o f the health situation on the River Niger, between Bussa and Jebba, the Rivers Off, Kontagora - Maingyara, Moshi, Eku and Iesger tributaries have established the
lmpact o f the Proposed Jebba Dam
239
TABLE 2. The age and ~x of~he household members, compound and household distribution
Age groups 0-1 1-4
5-9 10-14 15-19 20-24 25-29 30-34 35 - 39 40 -,14 45 - 4 9 50-54 55 - 5 9 60-64 65 - 69 70-74 75-79 80--84 85 - 8 9 90 and above Total
Sabonpeggi
Awtxru
21 112 48 67 59 99 98 1O0 60 9 38 20 23 14 6 4 6 2 2 910
9 52 61 42 31 34 44 40 26 24 20 11 5 I3 7 3 5 5 432
173 90 98 93 143 138 126 84 29 49 25 36 21 9 9 6 2 7 1342
432 478 910 210 252 4-3 3-6
209 223 432 65 94 6-7 4"6
641 701 1342 275 346 4-9 3"9
122
Total
30 174
Sex
Male Female Total N.,atuber of Compounds Number of ltouseholds Average *Cpd. Size Average "{'HH/Size *Compound. ~"Ho u~.hold
presence o f onchocerciasis s t~panosomiasis; malaria 6 and schisiosomiasis. 7 Burden s described moderate infection o f onchoo~rciasis in the Wawa and J e b b a districts and Dugga.n 9 described Jebba as the western limit o f an endemo-epidemic zone o f human trypanosomiasis that extends from the Niger River t o the Benue River in the east. Although no special investigation has been carried out o n malaria in the proposed Lake Jebba areas, it is likely that the malaria situation will be similar to the h o l o e n d e m i c status, with high intensity o f transmission in t h e Kainji Lake area ~ since the ecological conditions in b o t h areas are indentical. In comparison to Lake Kainji, the Lake Jebba, wb.en created, will b e smaller and will displace a smaller population (50,000 in Lake .Kainji as against 10,000 o f Lake Jebba). However, the Lake Jebba area will share certain factors in c o m m o n with the Lake Kainji area. Although the size a n d location o f t h e lake are k n o w n , the actual geographical area to be identified with Lake Jebba has yet to b e defined. This geographical area needs t o b e def'med from the outset if the lake area is to be developed in the future. It would be sensible if the
240
E. O. Adekoludohn
TABLE 3. Number of births, total deaths, percentage of total deaths and percentage of deaths over children born Sabonpeggi
Awuru
Total deaths
Number of b~rths
582
446
0--I i --4 5--9 I0-14 I5-19 20-24 25--29 30-34
61 91 14 4 4 2 1
82 66 14 4 3 2 2 -
143 157 28 8 7 4 2 1
Total
177
173
350
% of total d eat hs
Total number of births
% of deaths or births
1028 40"9 44"9 8"0 2"3 2'0 1"14 0"57 0"29
13"91 15-27 2-72 0-78 0"68 0"39 0"19 0"1
100"1
34"04
TABLE 4. Distribution of causes of death Sabonpeggi Causes of death Fever Gastroenteritis Measles Cough Stillbirth Accident Leprosy Jaundice *Others Total
Number
90 22 12 14 2 3 3 31 177
Awuru
%t
Number
% i"
50-8 12-4 6"4 7-9 I- 1 l'7 1"7
84 23 3
48"6 ! 3"3 1-7 6"4 1-2
17-5
11 2 2 48
100
173
Total
% of 1" total
1"2 27-7
174 45 15 14 13 5 3 2 79
49-7 12"9 4.3 4-0 3-7 1-4 0"9 0-6 22.6
100
350
100
'qneludes: uvuleetomy, snake bite, eeUulities. ~" %: Approximate percentage.
smallest political area surrounding a n y relocated village were included as a part o f the Lake J e b b a area. Thus the relocated populations, the host populations and o t h e r populations e.g. fishermen living within the political areas would be included in health planning for a def'med area. Villages in the l a k e J e b b a area, as in the Lake Kainji area,, are both scattered and located in areas not easily accessible and can o n l y be reached b y boat o n the River Niger. The o n l y m o t o r a b l e route to either side o f the Niger River f r o m the Kainji Dam to J e b b a is the route joining Kainji D a m - N e w Bussa road at 10 k m and running to A w u r u o n the western b a n k o f t h e Niger River. Villages out o f A w u r u and o n the eastern b a n k o f the River Niger are o n l y
lmpact of the Proposed Jebba Dam
241
accessible by boat. In relocating the people displaced by Lake Jebba, the policy o f replacing, exactly, what was lost as a result of flooding from the River Niger (Kainji Resettlement) should be modified to include construction of accessible roads to kink the relocated villages with neighbouring villages, at least those located within the same political area. Tile health facilities presently available, both in quality and quantity, are few. The existing health facilities (one hospital, four dispensaries and one maternal and child-health centre; Figure I) would be unable to meet the health problems o f the people who would be displaced by Lake Jebba. The pyramidal shape of the age-group distribution in Table 2 is typical of underdeveloped countries in which many of the children do not survive to adulthood ~a, n This can be infered from Table 3 which shows that about 30% of those born in the villages Sabonpeggi and Awuru died within the first 5 years and of all the deaths that occurred betweeen the ages of 0 - 3 5 years, approximately 86% are in the 0 - 5 years group. The main symptoms of the fatal illnesses died within the first 5 years and of all the deaths that occurred between the ages of 0-35 years, approximately 86% are in the 0 - 5 yeats group. The main symptoms of the fatal illnesses were fevers and gastroenteritis (62"6% of total deaths; Table 3). In planning for the health care of the people around the Lake Jebba area, emphasis should be placed on maternal and child health. The smaller size of the average households and average compound size in Sabonpeggi as compared to Awuru, should be interpreted cautiously in view of population movement into and out of Sabonpeggi at present. If the population movements become more stable and the community eventually retains the present household size, one should anticipate a low transmission of communicable disease in Sabonpeggi as compared to Awuru because of the limited inter-persons contact. It is therefore, advisable that in the relocation exercise, the existing household size should be retained to minimize any outbreak of communicable diseases that can accompany population resettlement. The dispensary data in Table 1 cannot be relied upon in assessing the parasitic diseases in the proposed Lake Jebba area in view of the distortion that often exists between the prevalence o f diseases reported by the dispensaries and what actually exists in the villages. A comprehensive survey into parasitic and other diseases prevalent in the conmmnities close to the proposed Lake Jebba area should be conducted. When Lake Jebba is formed, the incidence rates of onchocereiasis, trypanosomiasis and schistosomiasis will change tremendously. The prevalence of onchocerciasis will fall over the years, as the major breeding sites (Bajibo and Awuru rapids) along the River Niger are flooded. The fall in the prevalence of onchocerciasis will be further increased if the vector control activities currently being used in a 50 km radius of the Kainji Dam are extended to other rivers that will feed the proposed lake, The spillway release is frequently adjusted to prevent the breedhlg ofSimulium damnosum below Jebba Dam. Lake Jebba will also be capable of developing its own fringing forest that may serve as a suitable habitat for vectors of human trypanosomiasis. This factor, in addition to the suitable habitat already provided by the Zuguruma game reserve at the northeastern end of the proposed lake, the possibility of carriers of human trypanosomes from the neighbouring epidemo-cndemic zones (Bida district according to Duggan 9) migrating into this area and the unpredictable nature of transmission of human trypanosomiasis may well cause epidemics o f sleeping sickness around Lake Jebba area in future. The lake will also form a suitable habitat for the breeding of snails translrtitting truman schistosomes in certain areas along the banks.
242
£. O. Adekolu-Yohn
Tlle holoendemic status of malaria may not change bul the intensity of malaria parasitaenfia will increase. This increase in malaria intensity may further increase the deatb toll of the 0-5 age group. However, a booming fishing industry and hence a change of occupation from farming to fishing wllidl is often noticeable following the creation of man-made lakes, may increase protein intake if fishing is not solely commercially orientated. This would have a beneficial effect on under-nourishment and malnutrition and would enhance community immunity. The creation of Lake Jebba will also improve navigation along the River Niger. The establishment of a Port Health Station where the River Niger enters Nigeria should be considered along with the utilization of the Jebba and Kainji Lakes as international waterways.
Acknowledgement i am indebted to my field staff for demonstrating tremendous patience throughout the collection and analysis of the data. The iDiree.tor of the Kainji Lake Research Institute, New Bussa, granted me permission to publish tt~is paper.
References 1. Waddy, B. B. (I 975). Researchljnto the health problems of man-made lakes with special reference to Africa. Transactioni. of the l¢oyal Society of Tropical Medicine and Hygiene
69, 39-50. 2. Motor Columbus (1975). Plan for Electrical Power System Development. Lagos, Nigeria: National Electric Power Authority 1~, ! - 19. 3. Clayton, W. D. (i 957). A preliminary Survey of Soil and Vegetation in Northern Nigeria. Departmental Report. Samaru, Regional Research Station, Northern Nigeria. 4. Babalola, M. O. (1974). A Surge), of River Commerchd Fishery (Kainfi Sam-LokojaJ. Kainji Lake Research Project Report, New Bussa. 5. Crosskey, R. W. (1956). The distributiDn of Simulium damnosum Theobald in Northern Nigeria. Transactions of the Royal Soeiety of Tropical Medicine and Hygiene 50, 379-392. 6. Nedeeo & Balfour (I961-62). Entomology Disease Vector Surveys and Control Interim Report. 7. Walsh, T. F. & Mellink, J. J. (1970). Kainji Lake Studies. (.Nigerian Institute of Social and Economic Research). 8. Burden, F. H. (1956). The epidemiology of onchoeerciasis in Northern Nigeria. Transactions of the Royal Society of Tropical Medicine and ltygiene 50, 366-378. 9. Duggan, A. J. (1962). Surveys of sleeping sickness in Northern Nigeria from the earliest times to the present day. Transactions of the Royal Society of Tropical Medicine and Hygiene 55,439-80. 10. Ogunlesi, T. O.,Sofoluwe, G~ O. & Barber, C. R. (1965). Baselines for health studies for human populations in African countries. Demographic concepts. Nigerian Medical Association 2, 173-81. I I. Demeny, P. (1974). The populations of the underdeveloped countries. Scientific American 231~ 149-59.
The Probable Impact of the Proposed Jebba Dam on the Health Aspects of the River Niger Basin of Nigeria E. O. A d e k o l u - 3 o h n M.B., B.S.(tb.)., M.P.H.(Harv.}
Kainji Lake Research Institute New Bussa, Kwara State, Nigeria
The health facilities in the proposed Lake Jebba area are described. A hospital, four dispensaries and a maternal and child-health centre exist, among which, only two dispensaries and the maternal and child-health centre ~rovide free medical care to the people. A survey of the household and compound composition in Awuru and Sabonpeggi (villages close to the Niger River below the Kainji Dam) showed that the interpersons contact which could promote the spread o f communicable diseases is higher in Awuru ~han in Sabonpeggi. The mortality of children born in the two villages showed that about 30% died before the age of 5 years mostly from fever (49-7%) and gastroenteritis (12-86%). Of the deaths occurring in persons aged 0 - 3 5 years about (86%) occurred in children below 5 years. The impact o f the proposed Lake Jebba on the already known endemic diseases and on the child mortality is discussed. Suggestions are made to define the Lake Jebba area for development, emphasize maternal and child-health care in the healIh planning and to establish a port health station where the River Niger enters Nigeria.
Introduction One investigation which has always been neglected in the preliminary studies into the resource potential o f proposed man-made lakes in Nigeria, is the impact o f the proposed dam on the health status o f the people living close to the river and who may be displaced following the creation o f the lake. Before rivers and streams are impounded, it is Ilatural to speculate that there will be a widespread increase in the vector populations e.g. mosquitoes, tsetse, snails transmitting schistosomes and an increase in vector borne diseases in the communities close to the impounded water. The breeding o f such disease vectors is promoted by a newly created large 'body o f water. There may also be the psychological, emotional and nutritional problems which could arise from resettling the displaced communities living close to the impounded water. At the same time it is also wise to speculate on a decrease in the prevalence of onchocerciasis following impoundment o f water in those areas where the disease is endemic. Changes in the disease phenomena in communities affected by the proposed lake can only be appreciated if a survey into all the health problems is undertaken prior to lake formation. The health studies conducted in 1960, prior to the construction of the Kainji Dam were on the insect vectors o f human diseases around the proposed dan] site. l The aim o f the study was to institute control measures against those diseases and their vectors that were likely to impair the working capacity o f the labour force. Because Waddy's study did not cover other areas outside the Kainji Dam site in the lake basin and because of this, the information gathered was limited in evaluating the impact of the Kainii Lake on the health status of the people around 0038-3506180]040235+08 $0t.00/(9
O1980 The Society of Community Medicine
236
E. O. Aaj:olu-John
the lake basin. The present study attempts to provide preliminary information on the health stalus o f the communities close to the River Niger below the Kainji Dam to Jebba. It is hoped that the information will form pan o f the study necessary to determine the impact o f Lake Jebba on the health of the communilies living close to the lake in file future. ff NO$0rowO ~
~Sobonpegg~
N
\ N N
Loc0hon mop of proposed reservoir
\ *%,
/urtt~
\
\ X
\ \
( Zugurumo
m, o D
S
\
B@ibo
To Mokwo
KEY
. . . . H MCH D
Roods Rivers HOspital Moternat and Child Health centre Dispensary debba
H
MCH D
F.igure 1. The proposed lake Jebba area and existing health facilities 1977.
hnpact of the Proposed Jebba Dam
237
General Cimracteristics o f the Proposed l a k e Jebba Lake Jebba, when completed in 1982, will be about 100 km in length and the Darn will be about the same distance downstream of the Niger as the Kainji Dam. The Jebba Reservoir will be located betx~een latitudes 9 ° 03' and 9 ° 57' N and longitudes 4 ° 39' to 4 ° 57" -Fast, and will be mainly confined m the valley of the Niger and its tributaries: Awuru, Eku, Moshi, Wuruma and Oli (Figure I). The greatest width o f the reservoir will be attained on lhe lowlying area on the right bank opposite the mouth oi Eku River. Consequently the Awuru rapids, the navigation canals at Awuru and the Bajibo rapids will be submerged. The Jebba Dam project will require a labour force o f about 2300 (2100 Nigeria,s and 200 expatriate) for i~s excavation. This population will compound the health requirements o f over t0,000 people wh~ will be displaced from the Niger and Eku valleys as a result of flooding.:z The Jebba Reservoir w/ll fall wiihin the Guinea-Savannah vegetation zone as classified by (,]ayton.-~ Along the River Niger from Awuru there are considerable stretches o f well formed fringing forest, whose fallen leaves provide attachment sites for the aquatic stages of Sim,.:!&m damnosum and are the preferred habitat of Glossina morsitans. Away from the river valley ihe vegetation ks generally fn~7lyopen Savannah. The proposed Jebba Reservoir will be situated in areas governed by the Kwara State on its west bank and the Niger State on its east bank. Presently 'there is no accurate information on lhe nt~mber of villages located close to the bmlk o f the proposed reservoir, ltowever, Babalola (unpublished Kainji Lake Research Project Document)identified 16 fishing villages on the west bank of Rivel Niger and 19 fishing villages on the east bank between the Kainji Dam and Jebba. 4 The only access to these ~illages, at present, is along the River Niger. The annual rainfall near Jebba is approximately 115 nun with the greater percentage occurring in July, August and September. March, A,pril and May are the hottest months, wl~ile November, December'and January are the coolest.
Research Methods In July 1977, a visit was paid to the health institutions located close to the proposed Jebba Reservoir basin, to inspect the disease reports and to ascertain from the health providers, the area covered by each of the health institutions. The diseases reported were analyzed to identify the most common. Between March 1975 and July 1975 two villages: Sabo~qpeggion the eastern bank, and Awuru, on the western bank, of tile proposed Jebba Reservoir were chosen among other five villages for tile assessment "of the health status o f tile villages within the Niger basin. Initial surveys were conducted into the demographic features, including the compound and household composition, in terms o f the number of compounds and the number o f households within eacll village. The head of each household was then asked the names, sex, age, ethnic group and the occupations of the household members. A household, for the purpose of this study, is a group of people living together, usuaUy under the same roof and eating from the same pot. A further survey was also conducted. In this, each woman living in the two villages was asked the number of children she had delivered and the number o f her children who had died. She was then asked in detail, the age at which each child had died and the cause of death. Care was taken throughout tiffs last survey to retrieve as much information as possible from each respondent. Result Figure 1 shows the health facilities existing as of August 1977 in the proposed Jebba Lake area. Four dispensaries, one hospital and one maternal and child-health centre were available. The
238
E. O. Adekolu-John
hospital and dispensary at Jebba, are private health institutiom that do not provide free med~,eal care . TABLE 1. Common ailments from dispensaries located elo~e If proposed Lake Jebba Diseases
Malaria Diseas~ of alimentary canal Leg ulcers Respiratory infections Skin disea~s Eye diseases Burns Venereal diseases Cerebrospinal menir~tis Urinary schistosomiasis Guinea-worm *Others Total
Nasarawa Number
%
1790 1677 !723 1113 988 689 170 69
19"8 18"5 19"1 I2"3 10"9 7"6 1"9 0"7
10 2 $12 9043
0-1 0-02 9"98 100-9
lbi (Zuguruma) Number % t494 918 614 665 360 302 30 57 19 3
32"2 19-8 13-2 14-3 7-7 6"5 0"6 1"2 0"4 0-06
177 4639
3"8 99"76
Total 3284 2595 2337 1778 1348 991 200 126 19 13 2 989 13682
%Total 24"00 18-97 17"1 13"00 9-9 7-2 1"5 0"9 0"1 0-09 0-01 7"2 99"97
*Includes: mumps, snake bite, gingivitis, L~.fectivehepatitis. Table 1 summarizes the commoner ailments recorded in the Nasarawa and Zuguruma Dispensaries for 1977. Altogether, six conditions: malaria, disease~ of the alimentary system, leg ulcers, respiratory infections, skin diseases and eye diseases were c~mmon in both dispensaries, whilst cerebrospinal meningitis and guinea-worm are recorded only in Zuguruma and Nasarawa dispensaries respectively. Table 2 shows the age and sex distribution o f members o f the household, and the compound and h~usehold distributions in Sabonpeggi and Awuru villages. The age distribution in each of the two villages is typical o f the developing countries with a broad base tapering towards the 80 and above. Although there are more compounds and households in Sabonpeggi than in Awuru, the density of the population in each compound and household o f Awuru is higher than that of Sabonpeggi. There are two major ethnic groups: the Nupes and the Hausas, the other ethnic groups being represented only in relatively small numbers. The major occupations are farming and trading. Relatively little fishing is going on. Table 3 gives the number of births and the age distribution at which death occurred among persons born in Sabonpeggi and Awuru. The causes and age o f 12 deaths were not specified because o f taboo, forbidding some o f the women from mentioning the causes of death of their children. These were subsequently excluded from the analysis. Of deaths, 85-8% occurred within the first 5 years and Table 4 shows that the commonest causes of death were fever and gastroenteritis. Discussion Previous studies o f the health situation on the River Niger, between Bussa and Jebba, the Rivers Off, Kontagora - Maingyara, Moshi, Eku and Iesger tributaries have established the
lmpact o f the Proposed Jebba Dam
239
TABLE 2. The age and ~x of~he household members, compound and household distribution
Age groups 0-1 1-4
5-9 10-14 15-19 20-24 25-29 30-34 35 - 39 40 -,14 45 - 4 9 50-54 55 - 5 9 60-64 65 - 69 70-74 75-79 80--84 85 - 8 9 90 and above Total
Sabonpeggi
Awtxru
21 112 48 67 59 99 98 1O0 60 9 38 20 23 14 6 4 6 2 2 910
9 52 61 42 31 34 44 40 26 24 20 11 5 I3 7 3 5 5 432
173 90 98 93 143 138 126 84 29 49 25 36 21 9 9 6 2 7 1342
432 478 910 210 252 4-3 3-6
209 223 432 65 94 6-7 4"6
641 701 1342 275 346 4-9 3"9
122
Total
30 174
Sex
Male Female Total N.,atuber of Compounds Number of ltouseholds Average *Cpd. Size Average "{'HH/Size *Compound. ~"Ho u~.hold
presence o f onchocerciasis s t~panosomiasis; malaria 6 and schisiosomiasis. 7 Burden s described moderate infection o f onchoo~rciasis in the Wawa and J e b b a districts and Dugga.n 9 described Jebba as the western limit o f an endemo-epidemic zone o f human trypanosomiasis that extends from the Niger River t o the Benue River in the east. Although no special investigation has been carried out o n malaria in the proposed Lake Jebba areas, it is likely that the malaria situation will be similar to the h o l o e n d e m i c status, with high intensity o f transmission in t h e Kainji Lake area ~ since the ecological conditions in b o t h areas are indentical. In comparison to Lake Kainji, the Lake Jebba, wb.en created, will b e smaller and will displace a smaller population (50,000 in Lake .Kainji as against 10,000 o f Lake Jebba). However, the Lake Jebba area will share certain factors in c o m m o n with the Lake Kainji area. Although the size a n d location o f t h e lake are k n o w n , the actual geographical area to be identified with Lake Jebba has yet to b e defined. This geographical area needs t o b e def'med from the outset if the lake area is to be developed in the future. It would be sensible if the
240
E. O. Adekoludohn
TABLE 3. Number of births, total deaths, percentage of total deaths and percentage of deaths over children born Sabonpeggi
Awuru
Total deaths
Number of b~rths
582
446
0--I i --4 5--9 I0-14 I5-19 20-24 25--29 30-34
61 91 14 4 4 2 1
82 66 14 4 3 2 2 -
143 157 28 8 7 4 2 1
Total
177
173
350
% of total d eat hs
Total number of births
% of deaths or births
1028 40"9 44"9 8"0 2"3 2'0 1"14 0"57 0"29
13"91 15-27 2-72 0-78 0"68 0"39 0"19 0"1
100"1
34"04
TABLE 4. Distribution of causes of death Sabonpeggi Causes of death Fever Gastroenteritis Measles Cough Stillbirth Accident Leprosy Jaundice *Others Total
Number
90 22 12 14 2 3 3 31 177
Awuru
%t
Number
% i"
50-8 12-4 6"4 7-9 I- 1 l'7 1"7
84 23 3
48"6 ! 3"3 1-7 6"4 1-2
17-5
11 2 2 48
100
173
Total
% of 1" total
1"2 27-7
174 45 15 14 13 5 3 2 79
49-7 12"9 4.3 4-0 3-7 1-4 0"9 0-6 22.6
100
350
100
'qneludes: uvuleetomy, snake bite, eeUulities. ~" %: Approximate percentage.
smallest political area surrounding a n y relocated village were included as a part o f the Lake J e b b a area. Thus the relocated populations, the host populations and o t h e r populations e.g. fishermen living within the political areas would be included in health planning for a def'med area. Villages in the l a k e J e b b a area, as in the Lake Kainji area,, are both scattered and located in areas not easily accessible and can o n l y be reached b y boat o n the River Niger. The o n l y m o t o r a b l e route to either side o f the Niger River f r o m the Kainji Dam to J e b b a is the route joining Kainji D a m - N e w Bussa road at 10 k m and running to A w u r u o n the western b a n k o f t h e Niger River. Villages out o f A w u r u and o n the eastern b a n k o f the River Niger are o n l y
lmpact of the Proposed Jebba Dam
241
accessible by boat. In relocating the people displaced by Lake Jebba, the policy o f replacing, exactly, what was lost as a result of flooding from the River Niger (Kainji Resettlement) should be modified to include construction of accessible roads to kink the relocated villages with neighbouring villages, at least those located within the same political area. Tile health facilities presently available, both in quality and quantity, are few. The existing health facilities (one hospital, four dispensaries and one maternal and child-health centre; Figure I) would be unable to meet the health problems o f the people who would be displaced by Lake Jebba. The pyramidal shape of the age-group distribution in Table 2 is typical of underdeveloped countries in which many of the children do not survive to adulthood ~a, n This can be infered from Table 3 which shows that about 30% of those born in the villages Sabonpeggi and Awuru died within the first 5 years and of all the deaths that occurred betweeen the ages of 0 - 3 5 years, approximately 86% are in the 0 - 5 years group. The main symptoms of the fatal illnesses died within the first 5 years and of all the deaths that occurred between the ages of 0-35 years, approximately 86% are in the 0 - 5 yeats group. The main symptoms of the fatal illnesses were fevers and gastroenteritis (62"6% of total deaths; Table 3). In planning for the health care of the people around the Lake Jebba area, emphasis should be placed on maternal and child health. The smaller size of the average households and average compound size in Sabonpeggi as compared to Awuru, should be interpreted cautiously in view of population movement into and out of Sabonpeggi at present. If the population movements become more stable and the community eventually retains the present household size, one should anticipate a low transmission of communicable disease in Sabonpeggi as compared to Awuru because of the limited inter-persons contact. It is therefore, advisable that in the relocation exercise, the existing household size should be retained to minimize any outbreak of communicable diseases that can accompany population resettlement. The dispensary data in Table 1 cannot be relied upon in assessing the parasitic diseases in the proposed Lake Jebba area in view of the distortion that often exists between the prevalence o f diseases reported by the dispensaries and what actually exists in the villages. A comprehensive survey into parasitic and other diseases prevalent in the conmmnities close to the proposed Lake Jebba area should be conducted. When Lake Jebba is formed, the incidence rates of onchocereiasis, trypanosomiasis and schistosomiasis will change tremendously. The prevalence of onchocerciasis will fall over the years, as the major breeding sites (Bajibo and Awuru rapids) along the River Niger are flooded. The fall in the prevalence of onchocerciasis will be further increased if the vector control activities currently being used in a 50 km radius of the Kainji Dam are extended to other rivers that will feed the proposed lake, The spillway release is frequently adjusted to prevent the breedhlg ofSimulium damnosum below Jebba Dam. Lake Jebba will also be capable of developing its own fringing forest that may serve as a suitable habitat for vectors of human trypanosomiasis. This factor, in addition to the suitable habitat already provided by the Zuguruma game reserve at the northeastern end of the proposed lake, the possibility of carriers of human trypanosomes from the neighbouring epidemo-cndemic zones (Bida district according to Duggan 9) migrating into this area and the unpredictable nature of transmission of human trypanosomiasis may well cause epidemics o f sleeping sickness around Lake Jebba area in future. The lake will also form a suitable habitat for the breeding of snails translrtitting truman schistosomes in certain areas along the banks.
242
£. O. Adekolu-Yohn
Tlle holoendemic status of malaria may not change bul the intensity of malaria parasitaenfia will increase. This increase in malaria intensity may further increase the deatb toll of the 0-5 age group. However, a booming fishing industry and hence a change of occupation from farming to fishing wllidl is often noticeable following the creation of man-made lakes, may increase protein intake if fishing is not solely commercially orientated. This would have a beneficial effect on under-nourishment and malnutrition and would enhance community immunity. The creation of Lake Jebba will also improve navigation along the River Niger. The establishment of a Port Health Station where the River Niger enters Nigeria should be considered along with the utilization of the Jebba and Kainji Lakes as international waterways.
Acknowledgement i am indebted to my field staff for demonstrating tremendous patience throughout the collection and analysis of the data. The iDiree.tor of the Kainji Lake Research Institute, New Bussa, granted me permission to publish tt~is paper.
References 1. Waddy, B. B. (I 975). Researchljnto the health problems of man-made lakes with special reference to Africa. Transactioni. of the l¢oyal Society of Tropical Medicine and Hygiene
69, 39-50. 2. Motor Columbus (1975). Plan for Electrical Power System Development. Lagos, Nigeria: National Electric Power Authority 1~, ! - 19. 3. Clayton, W. D. (i 957). A preliminary Survey of Soil and Vegetation in Northern Nigeria. Departmental Report. Samaru, Regional Research Station, Northern Nigeria. 4. Babalola, M. O. (1974). A Surge), of River Commerchd Fishery (Kainfi Sam-LokojaJ. Kainji Lake Research Project Report, New Bussa. 5. Crosskey, R. W. (1956). The distributiDn of Simulium damnosum Theobald in Northern Nigeria. Transactions of the Royal Soeiety of Tropical Medicine and Hygiene 50, 379-392. 6. Nedeeo & Balfour (I961-62). Entomology Disease Vector Surveys and Control Interim Report. 7. Walsh, T. F. & Mellink, J. J. (1970). Kainji Lake Studies. (.Nigerian Institute of Social and Economic Research). 8. Burden, F. H. (1956). The epidemiology of onchoeerciasis in Northern Nigeria. Transactions of the Royal Society of Tropical Medicine and ltygiene 50, 366-378. 9. Duggan, A. J. (1962). Surveys of sleeping sickness in Northern Nigeria from the earliest times to the present day. Transactions of the Royal Society of Tropical Medicine and Hygiene 55,439-80. 10. Ogunlesi, T. O.,Sofoluwe, G~ O. & Barber, C. R. (1965). Baselines for health studies for human populations in African countries. Demographic concepts. Nigerian Medical Association 2, 173-81. I I. Demeny, P. (1974). The populations of the underdeveloped countries. Scientific American 231~ 149-59.