PUBLIC HEALTH AND ECOSYSTEM INTEGRITY
IN THE 21ST CENTURY:
THE WAY FORWARD IN NIGERIA
By
Dr. (Mrs.) Ngeri S. Benebo, JP, MD, MPH, FMCPH NPMA, MFR
Director General/Chief Executive Officer,
National Environmental Standards and Regulations Enforcement Agency (NESREA)
Paper presented as Keynote Speaker for the Isaac Oluwole Memorial Lecture,
at the Scientific Conference and Annual General Meeting of the
Association of Public Health Physicians of Nigeria (APHPN)
Port Harcourt, Rivers State,
9-14 March 2014
… ensuring a cleaner and healthier environment for Nigerians
OUTLINE
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Introduction
Environmental Health
Celebrating An Icon
The 2014 Dr. Isaac Oluwole Memorial Lecture
The 1992 Earth Summit
Public Health
Ecosystem Integrity
Millennium Summit
Millennium Ecosystem Assessment
Impacts Of Human Activities On Ecosystem Integrity
Government Efforts
Way Forward
Conclusion
INTRODUCTION
• I would like to congratulate the Association of Public
Health Physicians of Nigeria (APHPN) on its 30th
National Scientific Conference and Annual General
Meeting and to commend the Association for her
choice of theme for this year’s Conference –
“Environmental Health Strategies for National
Development”.
• The choice of the theme is most apt at this critical time
in our national development, as it provides a veritable
discourse in putting public health issues on the front
burner of our national development agenda.
• I would also like to commend the Local Organizing
Committee for a job well done.
ENVIRONMENTAL HEALTH
Environment and
Health are
inseparable. They are
intricately linked and
are both very key to a
nation’s socioeconomic
development.
The natural
environment consists
of the air we breathe,
the water we drink,
the land/space we
occupy, and
biodiversity,
including wildlife.
Environmental Health
is the control of all
factors in man’s
environment which
exercise or may
exercise a deleterious
effect on his
development, health
or survival.
CELEBRATING AN ICON
Today’s memorial
lecture is in honour
of the father of
Public Health in
Nigeria, Dr. Isaac
Ladipo Oluwole
(1892–1953):
At the time he
died in 1953, he
was justifiably
regarded as the
Father of
Public Health
in Nigeria.
Pioneer student
at Kings’ College,
Lagos
(September,
1909) and first
Senior Prefect of
the School
Qualified in
medicine and a
postgraduate in
Public Health,
all at the
University of
Glasgow
Appointed the
first African
Medical Officer
of Health in
Lagos Colony
(1936);
Dr. Isaac Oluwole
Awarded the
Order of the
British
Empire
(OBE).
Founded the
First School
of Hygiene in
Yaba, Lagos;
THE 2014 DR. ISAAC OLUWOLE MEMORIAL LECTURE
The title of my lecture is ‘Public Health and Ecosystem Integrity in the
21st Century: The Way Forward in Nigeria.’ The choice of my title is
informed by my work and experience in the health and environment
sectors over the years and my firm conviction that public health and
environmental protection are inseparable if we are to achieve sustainable
development in Nigeria.
The lecture explains the concept and principles of ecosystem integrity. It
discusses the linkages and interactions between public health and the
ecosystem. It highlights the national and global efforts at the turn of the
21st Century to protect the ecosystem and explains how public health
including human wellbeing is impacted by changes in ecosystems, at
local, national, regional, and global levels.
Finally, the lecture proffers some concrete recommendations for a way
forward towards protecting the ecosystem and public health in Nigeria.
THE 1992 EARTH SUMMIT
The Global
Agenda for
Change adopted
at the 1992
Earth Summit
heralded a new
approach to
environment
and
development
which is known
as Sustainable
Development
(SD)
Brundtland
Commission
defined SD as
“development
that meets the
needs of the
present
without
compromising
the ability of
future
generations to
meet their own
needs”.
The United
Nations
Conference on
Sustainable
Development
(Rio+20 Summit)
in 2012, adopted
an Outcome
Document, ‘The
Future We Want’
which provides a
global
framework to
protect
ecosystem
integrity.
PUBLIC HEALTH
Public Health is the science of
protecting and improving the
health of communities through
education, promotion of healthy
lifestyles and RESEARCH into the
prevention of disease/injury.
The focus of a public health
intervention is to PREVENT and
manage diseases, injuries and
other untoward health
conditions.
Many diseases are preventable
through simple, non-medical
methods. For example, simple act
of hand washing with soap and
clean water can prevent the
spread of many communicable
diseases.
Modern public health
practice requires
multidisciplinary team of
professionals.
ECOSYSTEM INTEGRITY
An ecosystem is
a community of
living organisms
(plants, animals
and microbes) in
conjunction
with the nonliving
components of
their
environment
(air, water and
mineral soil),
interacting as a
system.
The system
maintains an
equilibrium
which can be
disturbed by
external
forces.
A disturbance in
the ecosystem is
termed
ecological
stress, which
can be physical,
chemical or
biological.
Disruption in
ecosystem
integrity leads
to lowered
productivity,
food
insecurity and
public health
problems.
MILLENNIUM SUMMIT …I
To address ecosystem stress, 149
world leaders came together in a
Millennium Summit and adopted
the Millennium Declaration.
The world leaders committed their nations
to a new global partnership to reduce
extreme poverty, and set out a series of
time-bound targets, with a deadline of
2015, that have become known as the
Millennium Development Goals (MDGs).
MILLENNIUM SUMMIT … II
HEADS OF STATE AND GOVERNMENT AT THE MILLENNIUM SUMMIT IN NEW YORK IN 2000
MILLENNIUM SUMMIT … III
MDGs 4, 5 and 6 deal directly
with health.
MDG 7 is focused on environmental
protection and ecosystem integrity. It is
tagged the most important goal because
the environment is our natural resource
base and all life on earth depends on its
sustainability.
Without fulfilling MDG 7, MDGs 4, 5,
and 6 would not be achieved. For
example, improvement in sanitation
and provision of water in adequate
quantity and quality will aid the
reduction in the incidences of
childhood diseases, maternal death
and communicable diseases.
MILLENNIUM ECOSYSTEM ASSESSMENT
MILLENNIUM
ASSESSMENT (MA)
The Global
Millennium
Ecosystem
Assessment (MA)
was
commissioned by
the United
Nations in 2000.
OBJECTIVES
To assess the
consequences of
ecosystem change for
human well-being
and the scientific
basis for action
needed to enhance
the conservation and
sustainable use of
those systems and
their contribution to
human well-being.
BOTTOM LINE
Human actions were
depleting Earth’s
natural capital and
are putting such
strain on the
environment such
that the ability of the
planet’s ecosystems
to sustain future
generations could no
longer be taken for
granted.
IMPACTS OF HUMAN ACTIVITES ON
ECOSYSTEM INTEGRITY
Human activities are altering the capacity of ecosystems to
provide their goods (e.g. freshwater, food, medicinal
products, etc) and services (e.g. purification of air, water,
soil, sequestration of pollutants, etc). Some specific
examples include:
Biodiversity Loss
Rich Biodiversity
Biodiversity (or biological
diversity) is the variability
among living organisms
from all sources, including
terrestrial, marine and
other ecosystems, and the
ecological systems of
which they are part.
Biodiversity Loss
Biodiversity loss is due to
land conversion, climate
change, pollution,
unsustainable harvesting
of natural resources and
the introduction of exotic
species.
Health Effects of Biodiversity Loss
Rich Biodiversity
Biodiversity Loss
Food and Agriculture
Agriculture, forestry
and fishing provide
the food and natural
resources on which
human society
depends and these
are under stress
owing to the rapid
degradation of land
and water resources.
Hazardous
chemicals,
including
pesticides are
used to enhance
productivity.
Water reservoirs and
canals for irrigation
constructed without
Environmental Impact
Assessment, can lead
to great increase in
vector borne diseases.
PLANT LOSS AND AGRICULTURAL DAMAGE
AS A RESULT OF IMPROPER USE OF
PESTICIDES
Undue Exposure
to pesticides can
lead to death or
serious illnesses,
pollution of
surface and
groundwater.
Persistent Organic Pollutants (POPs)
• Persistent Organic Pollutants (POPs) (e.g. pesticides)
are organic compounds that are resistant to
environmental degradation capable of long-range
transport, and they bioaccumulate in human and
animal tissue, biomagnify in food chain, and have
potential significant impacts on the environment and
public health.
• POPs include DDT, polychlorinated biphenyls, furans,
chlordane, heptachlor, aldrin, dieldrin and endrin.
• Exposure to POPs can take place through diet,
environmental exposure, or accidents.
• Health effects include skin irritation and cancer.
Some Health Effects of Persistent Organic Pollutants
SKIN INFECTIONS FROM UNPROTECTED LONG TERM CONTACT WITH
POLYCHLORINATED BIPHENYLS (PCBs)
SKIN INFECTION FROM UNPROTECTED LONG TERM
CONTACT WITH ENDOSULFAN
Electronic and Hazardous Waste … I
Electronic/electrical
equipment (EEE)
contains useful
substances such as lead,
mercury, cadmium, etc,
which when packaged in
the equipment pose no
danger. At the end of its
functional life, the
electronic/electrical
equipment, becomes
electronic waste (ewaste).
Open burning of
e-waste to recover
precious metals
especially copper, or
open burning of
circuit boards to
melt the lead solder,
results in exposure
to toxic fumes.
When e-wastes are
dismantled
inappropriately,
these chemical
substances are
released, thereby
impacting on the
environment and
the health of the
operator or handler.
Electronic and Hazardous Waste … II
EXPOSURE TO THE HAZARDOUS SUBSTANCES IN E-WASTE
HANDLING OF BALKANIZED E-WASTE
Health Effects of Hazardous Substances in E-waste
CANCERS
ENDOCRINE DISRUPTION AND BIRTH
DEFECTS
Energy
Fossil fuels are the single
largest source of atmospheric
pollution. When burnt, they
release into the air particulate
matter, carbon monoxide,
carbon dioxide, oxides of
nitrogen and sulfur, and metal
compounds associated with
respiratory diseases and
increased mortality.
Biomass fuels (wood
or crop waste) are
burnt in open fires
or inefficient stoves
in poorly ventilated
houses, and could
give off smoke and
chemicals.
WOOD AS A SOURCE OF ENERGY FOR COOKING
Energy - Hydropower
Flowing water creates energy that can be captured and
turned into electricity. Impacts of hydropower on the
environment and public health include:
• Stress and other impacts on populations displaced by
the filling of reservoirs;
• Catastrophic floods in case of dam failure; and
• Prevalence of water borne diseases resulting from
the creation of conducive environmental conditions
for the disease vectors.
Energy - Nuclear Power
This is the use of exothermic (heat generating) nuclear
processes to generate useful heat and electricity.
The principal environmental concerns in connection with
nuclear power systems are:
• The potential for reactor accidents releasing large
amounts of radioactive materials, as occurred at
Chernobyl in 1986;
• The potential diversion of material from the nuclear fuel
cycle for production of weapons of mass destruction; and
• The radioactive releases from long-term disposal of
nuclear waste.
Vehicular Emission
• Emissions from vehicle exhausts pollute the air with
carbon monoxide and lead. Vehicular emissions also
contribute to the formation of ozone and photochemical
smog, which may decrease lung performance.
VEHICULAR EMISSIONS
Flood … I
Flood results from
unusually heavy
downpour of rains. It
could be exacerbated by
man as a result of not
adhering to town
planning laws; building
on flood plains; absence
of drainage system;
blockage of existing
water channels; storm
drains and drainage
system.
The most devastating
flood disaster was
experienced in August
2012 as a result of
heavy downpour,
release of water from
Lagdo Dam, Cameroon,
inadequate drainage
system, blocking of
water channels and
building on flood plains.
Floods damage property
and endanger the lives
of humans and animals.
Flood … II
DRAINAGE BLOCKED WITH WASTE
DAMAGING EFFECTS OF FLOODING
Coastal and Marine Degradation
Pollution sources from municipal, industrial and
agricultural wastes and run-off, as well as atmospheric
deposition, derived from land-based activities affect the
marine environment.
The very survival of people living in coastal areas are
closely tied to the condition of coastal ecosystems
(estuaries and wetlands), and their associated watersheds, drainage basins and near-shore coastal waters.
Coastal and marine degradation pose threats to marine
life and human health.
Industry
Industrialization is central to economic development and
improved prospects for human well-being. Industry is a major
consumer of natural resources - mineral and non-mineral ores,
agricultural produce and energy in different forms.
They are major sources of air and water pollution, hazardous
wastes, etc, if proper abatement technology is not
incorporated into their Environmental Management Plans..The
environmental impact of industrial activities extend over the
entire chain – from raw material extraction or pre-processing,
through the manufacturing process, right up to the disposal of
wastes.
Lack of use of personal protective equipment by industry
workers increases their exposure to toxic substances at the
work place and leads to disease conditions. Highly toxic heavy
metals, etc are discharged into the environment with serious
environmental and health consequences.
These toxic pollutants are often associated with various
cancers. Little wonder, cancers have been observed occurring
at relatively younger age groups.
TOXIC INDUSTRIAL EMISSIONS
Mining … I
Illegal mining is still being practiced in virtually
all States of the Federation.
Adequate consideration is not given to health and
safety issues in the process of mining.
Miners do not use personal protective equipment.
The most
notable is
the Zamfara
State lead
poisoning
epidemic.
In 2010, 355 cases of lead poisonings from illegal
extraction of gold ore by some artisanal miners recorded.
At least 163 people died between March and June 2010,
including 111 children, mostly under 5.
Gold processing took place in homes, exposing family
members to poisonous levels of Lead.
Mining … II
Deep exploration for lead and zinc in
Nasarawa State
Typical Illegal mining sites in
several States of the
Federation
Locally fabricated grinding
machine for crushing of gold in
Zamfara State.
A typical house plastered (wall and
floor) with lead contaminated soil in
Zamfara
Excavation of lead-contaminated soil
to be replaced with clean laterite in
Zamfara State.
Water … I
Freshwater resources are threatened not
only by over-exploitation of groundwater
and surface water and poor resource
management but also by environmental
pollution and degradation.
Sources of freshwater pollution include:
discharge of untreated sewage into rivers and
lakes, dumping of industrial wastes, and runoff from agricultural fields treated with
herbicides and pesticides.
Availability of water in sufficient quantity and quality
will aid the prevention of Neglected Tropical Diseases.
Water … II
INDUSTRIAL EFFLUENT DISCHARGE INTO WATER COURSES
POLLUTED POND, NATURAL HABITAT FOR VECTORS
Solid Wastes and Sewage
Rapidly growing
quantities of garbage and
sewage from cities pose
threats to the
environment and public
health.
Open dumpsites and
uncontrolled garbage
become breeding grounds
for insects, pests, and
rodents of public health
importance.
Diarrhea diseases,
typhoid, scabies,
cholera, helminthiasis,
are some health risks
created by the
unsanitary disposal of
waste.
The best option to cope
with waste problems is
through a wasteprevention approach,
focused on changes in
lifestyles and in
production and
consumption patterns.
IMPROPER WASTE DISPOSAL
Human Settlements and Urbanization
Rapid
urbanization
poses a great
challenge to
ecosystem
integrity and
hence to public
health.
Unplanned
urbanization is
responsible for many
public health
challenges - those
related to water,
sanitation,
environment,
violence, injury, and
other risk factors like
tobacco and alcohol
use, and unhealthy
diet.
SQUATTER SETTLEMENT
Climate Change
There are now strong evidences that the earth’s climate is changing mainly as a
result of the increasing concentration of greenhouse gases in the atmosphere that
are emitted from various human activities.
Climate change phenomenon gives a clear evidence that the carrying capacity and
ability of the planet’s ecosystems to sequestrate pollution and render goods and
services have been exceeded.
Some of the
potential
climate
change
impacts of
current
concern for
Nigeria
include:
Disruption of seasonal cycles and ecosystems manifesting as fiercer
weather, increased frequency and intensity of storms, floods,
droughts, with series of health and socio-economic consequences;
Adverse impacts on especially vulnerable populations – sea
level rise would affect low-lying coastal States with social
disruption resulting in millions of environmental refugees; and
Adverse impacts on forestry agriculture, hydro-electric
generation, and human health.
Human Health and Ecosystem Integrity
HUMAN HEALTH AND ECOSYSTEM INTEGRITY – THE KEY LINKAGES
Health Effects of Pollution
The Driving Forces and Pressure of Environmental Degradation
and Pollution
Although exposure to a pollutant or other environmental hazards
may be the immediate cause of ill-health, the driving forces and
pressures leading to environmental degradation and pollution may
be the most effective ways for controlling the hazard.
The driving forces create conditions in which environmental health
hazards can develop or be averted and they include policies that
determine trends in economic development, technological
development, consumption and production patterns, e.t.c.
Preventive interventions can be implemented to reduce or control
the environmental hazards at the source, for example, by limiting
emissions or installing flood-control systems, by eliminating the
breeding sites of mosquitoes through effective environmental
management. Therefore the most effective long-term interventions
should aim at eliminating or reducing the effects of driving forces
and the ecological stresses that produce the hazards.
GOVERNMENT EFFORTS … I
Government has made tremendous efforts to address the daunting challenges facing
ecosystem integrity and public health, in line with its Transformation Agenda. Some
of the notable actions of government are:
• Establishment of relevant institutional and legal mechanisms in an effort to
strengthen environmental governance in line with the nation’s Vision 20:2020;
• Strengthening of established institutions to discharge their mandates;
• Establishment of an Office within the Presidency for the effective implementation
of MDG projects;
• Implementation of National Strategic Health Development Plan (NSHDP) towards
achieving the human capital development goal of the Vision 20:2020;
• Implementation of the National Policy on Environment that seeks to secure for all
Nigerians a quality environment adequate for their health and well-being;
• Adoption of the National Environment Pledge titled “Our Environment, Our
Heritage, Our Today and Tomorrow” signed by Mr. President and all State
Governors;
• Implementation of the National Housing and Urban Development Policy to ensure
sustainable housing, urban renewal and better living conditions for all Nigerians;
GOVERNMENT EFFORTS … II
• Emphasis on the rational utilization of agricultural resources and the general
preservation of the environment for the sustainability of agricultural
production;
• Establishment of a Department of Mines Environmental Compliance in the
Federal Ministry of Mines and Steel Development to ensure environmentally
sound, safe and sustainable mining development and operations in the
country;
• Designation of relevant Departments and Units in the Transport Sector to
collaborate with the Environment Sector towards a cleaner and more
sustainable transport development and operations across the nation;
• Establishment of the National Oil Spill Detection and Response Agency
(NOSDRA) to address the persistent environmental degradation and
devastation of the coastal ecosystem resulting from oil and gas activities; and
• Establishment of the National Environmental Standards and Regulations
Enforcement Agency (NESREA) with the mandate to enforce all environmental
laws, guidelines, policies, standards and regulations in Nigeria; and to prohibit
processes and the use of equipment or technology that undermine
environmental quality.
WAY FORWARD … I
• Improving Institutional Mechanisms and Arrangements
There is need to reinforce the existing relevant institutional mechanisms and
arrangements bearing on public health and the environment. There should be more
cooperation, collaboration and partnerships between APHPN and all MDAs at Federal
and State levels. APHPN should undertake a critical study of the enabling Act or policy
instruments establishing key MDAs whose actions or inactions can directly or indirectly
impact on ecosystem integrity. It should identify a niche and collaborate closely with
them in implementing their programmes and projects.
• Implementation of Relevant Environmental and Health Laws,
Regulations and Standards
Any laws and regulations that are not effectively enforced are as good as not
promulgated in the first instance. Many health and environment laws and regulations
have been promulgated, and there is need for concerted efforts at enforcing them.
• Capacity Building and Human Resources Development
Public health is multidisplinary. There is need to thoroughly review the current
educational curriculum of our tertiary institutions in this regard. The programmes
should be more broad-based, touching on all key environment-health linkages and
interactions, including the emerging issues.
WAY FORWARD … II
• Improvement of Research and Development
For us to fully understand the root causes of certain illnesses, including those we
know and those we are yet to know, there is need for scientific studies and research.
APHPN should conduct well thought-out epidemiological studies and research to
define and understand the disease driving forces and pressures in the community,
growth trend and linkages to other diseases. Such research efforts will assist
Government in creating new policies and channeling the required resources, as well
as attracting meaningful technical assistance from the international community. All
research findings should not be allowed to gather dust in one obscure corner of an
office. The research findings should be widely publicized, disseminated and discussed
at various relevant fora like this Annual General Meeting and Scientific Conference.
• Intensification of Public Education and Awareness
Since human beings are the key drivers of the forces that impact on ecosystem
integrity and hence public health, they must be adequately informed on the
consequences of their actions and inactions. Such information should be properly
packaged to address specific issues for specific target audience. There should be
innovative approaches to communicate the key messages through radio and TV talkshows, jingles and advertorials, civil society and local community engagements and
consultations, including through our religious institutions.
WAY FORWARD … III
• Promotion of Public Private Partnerships
Addressing public health problems is not the responsibility of the Government
alone. Private sector has a key role to play since industry and business are
among the greatest polluters of the environment; and yet they still make their
money from the same people and their environment. There is need for industry
and business to imbibe the spirit of – “My Neighbours’ Keeper” and carry out
appropriate Corporate Social Responsibility (CSR) initiatives. They should
identify and implement programmes and projects to protect and improve the
health and environment of their host communities. They should sponsor
research studies bearing on the operations of their facilities that impact on the
environment and human health. APHPN should drive this process by making
appropriate proposals to the private sector for research funding.
• Contribution to National Discourse
The APHPN should be proactive and make presentations at every opportunity to
propagate the course of Public Health at the Federal and State levels of the
Executive, Legislature and Judiciary arms of government. There should be a
“think tank” which, even at short notice, can submit memoranda and defend
same at any public hearing.
CONCLUSION … I
•
As we advance within the second decade of the 21st century and fully aware of the
implications on public health of a fragile ecosystem whose integrity has been severely
affected by anthropogenic activities, it is necessary for us to have a rethink of how we
protect the ecosystem integrity, and hence public health.
•
Therefore, the effective collaboration and partnership between the health and the
environment sectors should continue to be intensified in recognition of the intricate
linkage between public health and the environment.
•
There is no gain saying that Nigeria, like most developing countries is still grappling with
basic access to water and sanitation to prevent primary environmental health problems.
This calls for an urgent need not to allow secondary environmental health problems of
pollution, land degradation and climate change, among others to bedevil us too.
•
For the public health sector, the indices are clear and there is need to strengthen the
implementation of the sound strategies already identified within the National Strategic
Heath Development Plan (NSHDP) 2010-2015, through the participatory approach
involving all relevant stakeholders.
•
For the environment sector, implementation of the National Policy on Environment and
adherence to the tenets of the National Environment Pledge by all tiers of Government
will promote ecosystem integrity.
CONCLUSION … II
•
The Association of Public Health Physicians of Nigeria as a major stakeholder in ensuring
optimum public health should be interested in the driving forces and pressures leading to
environmental degradation. It is not enough to provide management for the neglected
tropical diseases through training of health workers, provision of drugs, etc, we should
source for research grants and tackle the underlying driving forces and pressures in the
environment promoting the disease conditions.
•
I, therefore, urge you as a statutory Professional Association of this great nation, to
intensify actions on your part as able partners with Government towards the
achievement of healthy people in a healthy environment.
•
The present day public health is not only multidisciplinary, it is multisectoral and it is a
total package that should consider all determinants of the health of the populace.
•
Let us take cue from the international community. Let us work and share information to
appreciate best practices, with their attendant success stories and buy into such.
•
I have no doubt that as we commit ourselves to the implementation of sound strategies
for Public Health and Ecosystem Integrity, as true patriots of our fatherland, we would
have played a worthy part in the “Health for All” for the 21st Century and in bequeathing
to the next generation a worthy legacy and equitable share of this ‘One Earth’ for a
sustainable future.
THANK YOU
NESREA… ensuring a cleaner and healthier environment for Nigerians