The Emir of Gusau in Zamfara, Alhaji Ibrahim Bello, has identified abject poverty and illiteracy as the major causes of death during Cerebro Spinal Meningitis (CSM) outbreak in the state.
Bello disclosed this in Gusau during an assessment tour by the Nigeria Centre for Disease Control (NCDC) to the CSM most affected states in the country.
He said that once there is no sufficient food that would give energy and protection in the body, there would be low resistance and low resistance give room to infection.
"People don't have sufficient food that they are supposed to eat to give them energy and protection; once there is no money, no good food, there will be low resistance and low resistance gives room for infection.
"They cannot eat three square meals, talk less of buying soap to bath or wash their clothes," he said.
Bello said that during the outbreak children were mostly affected and the moment it was identified, they were rushed to the health care facilities.
"Those who were largely affected were the almajiri, those who come to learn their religion of Islam, they congregate, and because of that togetherness anybody who is affected can easily spread it to others.
"We had to use our mosques and churches to educate the people about the disease and how it can be prevented and that anyone who is affected should report to the nearest hospital that the treatment is free.
"The state government came with immediate intervention of drugs, the Federal Government also released drugs and staff, and we went round educating people," Bello said.
The traditional ruler said that initially the people did not believe that it was a disease that warranted medical attention, they preferred to go to native doctors to try their luck.
He said that the people were not interested in going to health facilities initially, so we had to convince, educate and enlighten them, then they understood the need for orthodox medicines and started going to health facilities.
He said that they spoke to their people and philanthropists among them gave donations quietly to support the fight against CSM outbreak at that time.
"There is need to revisit the issue, the need for legislation so that the people who want to read or educate themselves about their religion can stay in their country.
"Because somebody will send his son from Niger Republic or somewhere far to learn about Arabic and other languages and do not care to visit or know how the child is doing.
"The child will not have enough resistance because nobody takes care of them, and they do not feed well, they have to go about begging for food.
"These are some of the issues that are really tormenting and needs to be addressed urgently. All health facilities need to be equipped, we have to be bottle ready and not to wait for outbreaks before acting," he advised.
Bello added that there was need for adequate budgeting for health care services, the need to train health workers and improve rural roads for easy access.
Besides, he underscored the need to educate and enlighten people through all forms of media so that people can understand the meaning and severity of the disease.
Mr Lawal Bello, Officer in charge, Liman Dara Women and Children Welfare Clinic, Gusau, said that there was urgent need to improve health education and decongest schools.
The official also called for training of health personnel, noting that during the outbreak, health workers conducted treatment blindly until NCDC officials came and did testing before treatment commence.
"The almajiri schools are overcrowded and needs decongestion, and if health workers are trained appropriately to carry out tests, it will not be difficult to handle such outbreak.
"We also have less manpower, we attended to 180 patients but seven died and we referred three during the outbreak," he said.
Ms Aisha Kabiru, a survivor of CSM, said that when she complained of headaches, neck stiffness and body pain, her mother first treated her with herbal medicine.
Kabiru noted that the herbal treatment did not work and when it persisted, that was when she was rushed to the hospital, she said that though she was unconscious, but she woke up in the hospital.
"I was scared thinking that I would die, but the doctors did their best, as soon as they started treatment, I started getting better, my mother didn't spend much money because the treatment was free," she said