INVESTIGATION: How water contamination, poor healthcare fuel Kano’s cholera crisis
After devastating floods swept through Mikiya and Ballagaza communities in Gabasawa Local Government Area of Kano State in August 2024, a cholera outbreak left several dead and many more critically ill, exposing the chronic healthcare neglect and infrastructure gaps in rural Kano communities. Uzair Adam reports.
On a rain-soaked evening in August 2024, torrential floods tore through the remote communities of Mikiya and Ballagaza in Gabasawa Local Government Area, Kano State.
The waters, thick with debris and pollutants, swept into the community wells which was the only source of water for many residents, turning them into reservoirs of disease. Within days, cholera began to spread, leaving families scrambling for medical help that was too far away, and in some instances, simply nonexistent.
These rural communities lack even the most basic healthcare facilities. Ballagaza has a single small clinic with just two Community Health Extension Workers (CHEW) and a handful of volunteers, while Mikiya is entirely without functional health infrastructure. With no alternative, residents continue to drink the contaminated water, perpetuating the outbreak in an unending cycle of sickness and desperation.
Sadly, these communities are amongst many rural communities in Kano facing the same fate. Findings by SolaceBase revealed that systemic neglect, inadequate healthcare infrastructure, and unsafe water sources in rural Kano communities continue to exacerbate the vulnerability of residents to diseases with preventable outbreak turned into a humanitarian crisis.
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Despite significant government budgets allocated to health and water development, these communities remain on the margins of care and forced to endure avoidable tragedies.
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Struggles for survival amidst a healthcare crisis
As cholera wreaks havoc across Mikiya and Ballagaza, their daily struggles highlight the deep-rooted challenges of living in under-resourced communities. Compared to the lack of a functional clinic in Mikiya, Ballagaza’s health post is merely managed and staffed by two Community Health Extension Workers (CHEW) and a few volunteers. The facility has only six beds and struggles to meet the needs of patients from within and outside the community.
Sauwa`una Aliyu, a resident of Ballagaza, recounted the heart-wrenching loss of his parents due to delays in accessing medical care.
Sauwa`una Aliyu, a resident of Ballagaza, who lost lost parents to the cholera
“It happened in separate instances. On both occasions, they were rushed to Gabasawa PHC (at the LGA headquarters) for medical attention,” he said, “but there were no beds available. We then decide to take them to a hospital in Kano (state capital), but before we could reach Kano, we lost them.”
His story mirrors those of many others, whose loved ones have succumbed to preventable deaths in the absence of adequate care. Even at Gabasawa PHC, healthcare workers are overwhelmed.
“We try our best, but the facility is stretched thin,” said one staff member, describing how they frequently direct patients to larger hospitals in Kano. For many, these referrals come too late.
Water contamination worsens the toll
While healthcare challenges persist, the underlying cause of the cholera outbreak lies in the absence of safe and clean water. Most residents of Mikiya and Ballagaza rely on wells for their water, but these open sources are prone to contamination. During the August floods, the wells became filled with debris and waste, making the water unsafe for consumption. Despite this, residents continue to use it for drinking, cooking, and cleaning due to a lack of alternatives.
The oldest well in Mikiya that remains the community’s source of water despite its alarming state
Yusuf Lado, a resident of Ballagaza, described the desperate situation: “We strain the water through cloth to remove debris, but it’s still dangerous. We know but what can we do? I’ve lost ten family members to cholera since the floods.”
Yusuf Lado, a resident of Ballagaza, who claimed to have 10 family members to cholera
Similarly, Muhammad Umar from Mikiya explained how the outbreak spread between the two communities stating that: “Our daily interactions meant cholera moved from Ballagaza to Mikiya within days.”
Muhammad Umar, another resident of Mikiya who lost his eldest son to the cholera outbreak in the community.
According to findings, previous efforts by NGOs to provide boreholes have failed to offer a lasting solution. Many boreholes have dried up, leaving residents with no choice but to return to the contaminated wells.
One of the broken down and abandoned boreholes that leave Mikiya residents in a desperate battle for water
A frightening death toll
The accounts of loss and illness reveal the severe consequences of inadequate infrastructure, while expert opinions point to urgent actions needed to prevent further crises.
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Community leader Alhaji Ado captured the weight of the crisis in an interview with this reporter. His voice was undeniably filled with grief.
Alhaji Ado, a community leader of Mikiya, who also lost his parents to the cholera outbreak.
“This is the worst tragedy we have ever faced. I lost my father and elder brother. There was a day when several people died within hours. It’s unimaginable,” he said.
For Yushe’u Abubakar, the outbreak left him with more than just memories. According to him, it left him with scars of helplessness.
Another resident of Mikiya, Yushe’u Abubakar, who lost his uncle as a result of the cholera outbreak
“It’s a pain that lingers. We did everything we could, but we couldn’t save him,” he said, describing the anguish of watching his father succumb to cholera.
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Umar Usaini, a resident of Mikiya, recalled the harrowing reality of back-to-back funerals. “We stopped counting after a while. The cries felt endless,” he said.
Another resident of Mikiya, Yushe’u Abubakar, who lost his uncle as a result of the cholera outbreak
The psychological toll on these communities is undeniable. Residents speak of living in constant fear, watching their families fall ill, unsure of whether help will arrive in time. “Each passing day feels like waiting for a disaster,” Usaini added.
In Ballagaza, Alhaji Abubakar Atiku Badawa, the village head of Badawa, also traced the outbreak to the floodwaters that ravaged their wells. Speaking through his eldest son and translator, Zahraddeen, he recounted how the tragedy began. “The floods swept waste into our wells, and cholera spread like wildfire. We couldn’t stop it,” he said.
Zahraddeen Abubakar, the representative of Alh. Atiku Abubakar, the village head of Badawa – Ballagaza.
While government health workers eventually intervened, treating water sources and distributing medication, the response, many felt, came too late for those already buried.
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“The government sent health workers who provided us with free medications and treated our wells to help curb the rising loss of lives in both communities. But by that time, we had already lost too many,” Badawa lamented.
Unhygienic conditions fuel cholera outbreak – Public Health Expert
As communities in Mikiya and Ballagaza continue to reel from the devastating cholera outbreak, experts are pointing to the root causes behind the crisis. Dr. Usman Bashir, Consultant Public Health Physician at Aminu Kano Teaching Hospital, attributed the outbreak in parts of Kano to unsanitary living conditions and poor hygiene practices.
According to Dr. Bashir, contaminated food and water remain primary drivers of the epidemic, perpetuating the cycle of illness in affected communities.
“Cholera thrives in environments where hygiene is compromised. Contaminated water sources, poorly managed waste, and unhygienic food handling are key factors behind the spread of this disease,” Bashir explained.
He urged residents to adopt simple yet effective preventive measures to reduce the risk of future outbreaks. “Maintaining clean water sources, ensuring wells are properly covered and distanced from soakaways, and regularly purifying water using alum can significantly curb the spread of cholera,” he advised.
Bashir also stressed the importance of proper food hygiene, encouraging thorough washing of uncooked food items and proper storage of leftovers.
“People should wash their hands with soap after using the toilet, or at the very least, use ash if soap is unavailable. Ensure fingernails are kept clean. Leftovers should not only be stored correctly but reheated thoroughly to eliminate bacteria,” he added.
Bashir highlighted these steps as essential not just in addressing the current outbreak but in preventing future occurrences, reinforcing that proactive hygiene practices are the community’s first line of defense.
Beyond the immediate health crisis, experts also warn that systemic corruption and leadership failures continue to undermine progress in public health and sanitation. Sulaiman Ahmad, a public analyst, attributed much of the ongoing crisis to mismanagement and lack of accountability within government agencies responsible for health and water infrastructure.
“Funds are allocated, but the work on the ground doesn’t reflect it. Some public officials misuse these funds for selfish gains, stemming from a lack of patriotism,” Ahmad said.
Ahmad highlighted the shortage of permanent healthcare staff, noting that many facilities are run by volunteers or students rather than trained professionals. He called for patriotic leadership, stricter accountability, and transparency in the management of public resources, particularly in the health and water sectors.
“While transparency and auditing are crucial in every sector, ensuring them in the health and water sectors is even more important, particularly considering the significance these sectors hold,” Ahmad added.
Tackling Water Contamination in Rural Communities
“We are making efforts to tackle water contamination, healthcare challenges in rural communities” – Govt Officials
As underserved communities continue to suffer devastating impact of cholera outbreaks, Kano state government has admitted that the focus has to shift to long-term solutions targeted at addressing the root causes of the disease. Recently, the Managing Director of Kano State Rural Water Supply and Sanitation Agency (RUWASA), Alhaji Shamawilu Abdulkadir Isa, outlined the government’s initiatives to combat water contamination in rural areas.
Ballagaza residents fetching water from an aging well – one of their only lifelines for years
Isa revealed in an interview with SolaceBase that the state’s commitment includes repairing damaged boreholes and drilling new ones to provide safe and clean water to vulnerable communities.
“Our delegation recently visited Mikiya community to ensure the provision of quality water to address contamination issues in the area,” Isa said.
The Kano State Government has reiterated its commitment to tackling these challenges head-on, concerns about broader health and sanitation issues persist across Kano State
Commissioner for Health, Dr. Abubakar Labaran, highlighted in an interview with this newspaper the state government’s ongoing efforts to enhance healthcare services, including the rehabilitation of hospitals and recruitment of medical personnel.
Labaran called for patience from residents, noting that hospital renovations and medical outreach programs are part of the state’s strategy to bridge healthcare gaps.
“We are renovating all our facilities to ensure they are conducive. We are also employing doctors, nurses, and other health workers. Additionally, we are conducting medical outreach programs for those who cannot access hospitals,” he stated.
Labaran disclosed that nine hospitals had already been renovated with 12 more also slated for renovation very soon.
“Special attention is also being given to local government hospitals to ensure equitable healthcare services between rural and urban areas,” he added.
Despite these assurances, findings by SolaceBase suggest that many of the government’s promises remain largely unfulfilled. Efforts to verify employment claims and renovation projects yielded little evidence of significant progress. Many hospitals in rural communities continue to operate under deplorable conditions, with no visible improvements to infrastructure or staffing levels.
While the government’s pledges project an image of progress, residents in communities like Mikiya and Ballagaza continue to grapple with inadequate healthcare, deteriorating facilities, and an absence of tangible change.
This SolaceBase report is produced with support from the Wole Soyinka Centre for Investigative Journalism (WSCIJ) under the collaborative Media Engagement for Development, Inclusion, and Accountability Project (CMEDIA) funded by the MacArthur Foundation.
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