"Sati-Ikov," a community that had been neglected for decades, leaving the inhabitants to cope with a parasitic tropical disease that has multiple effects, including visual impairment and blindness, as well as intense itching, rashes, or nodules under the skin.
This investigation can reveal that 3 out of 5 people in the community are affected. In many households, between five to ten persons were seen suffering of the disease. The investigation followed on-the-ground visits to the community and interviews with some residents.
"We are suffering a lot in this community, the workforce keeps depleting; this blackfly hides in the caves, forest and in the rivers around the community where it lay eggs and hatch, both children, young persons and adults are affected. Many children who are supposed to be in school are blind and now at home as a result of the bites by this blackfly."
Those were the words of a 65-year-old man, Atser Ikyotser, who spoke in his native Tiv language.
Elder Atser was not the only voice.
Bridget Agber is 35-years old. The disease has taken a toll on her. Wallowing in self-pity, she told SMI's WR how she couldn't continue as Bible student due to vision problems caused by the disease.
"I was a Bible student. All of a sudden, the Bible texts began to appear blurry. I gradually lost the ability to read written texts. "Bridget tells her story, looking obviously shattered as tears began to fall.
What is this dreaded disease?
The disease wreaking havoc is river blindness. As the local name suggests, the blackfly, which is the vector that transmits the infection, lives and breeds near fast-flowing rivers and streams, mostly near remote rural villages. Onchocerciasis is the medical term for it. It is transmitted through repeated bites by blackflies.
According to open-source records, river blindness threatens around 120 million people globally. The disease is reported to be most prevalent in Nigeria. In Nigeria, around 50 million people in over 40,000 communities are affected by the disease or at risk of being infected. Among the catastrophic socioeconomic consequences of the disease are food insecurity, when people who are affected can no longer go to their farms, and a lack of education for children who are affected or who will have to care for their parents who have become blind. There is also the problem of social stigma and generational poverty.
A case of neglect for decades
Terhemba Kashinla, the 38-year-old chief of the Sati Ikov village, claims that neglect is pervasive in his community. "I'm worried why a community with five district heads will be left to their fate with a specific problem that is causing us a major health crisis; this river blindness has severely set back the Sati Ikov community; most young people affected can no longer go to the farms.
"Before now we were not even aware that the level to which our people were losing their sight was as a result of the bites until some health expert visited our community, and that was when we were meant to understand that it was as a result of the bites by the blackfly." The 38-year-old chief told our reporters.
He stated that the bites are more severe during the rainy season, when farming activities begin completely, and since people would have to go to their farm as it is their primary occupation, they will pay the price of constant rashes on their skin, and as it affects the skin, the sight will be next.
Ephraim Imbor Gube, a 46-year-old man from Ingorov, a Sati Ikov community, is unhappy with a situation in which a health expert would visit the community, even take water samples, and then go away without ever returning with a solution to help the community.
Their appeals
"I am appealing to the government, good-spirited individuals, and the international community to look for ways to completely kill these flies so that our people will have a sigh of relief. As you see me, I am already affected, and it is a source of worry. "I'm appealing to you as well; as you go, help us tell whoever is concerned to come to the plight of our people, especially us fishermen, who are going blind by the day, and relieve our pains. "Ephraim told SMI's WR.
Continuing, Ephraim said, "We are at the mercy of these flies because this is where we were born and we have been living with the blackfly as long as the community has existed. This is because we are living in between the mountains, the rivers Kastina/Ala and Amile, and the forest.
"We were told that they lay eggs in the caves, the shrubs in the forest, and the waters, so it has affected us adversely."
In another appeal, 42-year-old Zaki Zege Shima said, "I am calling on the government, philanthropists, and international community to come to the aid of the Ikov community and completely eliminate this fly so as to save the incoming generation from the effects caused by the bites of this fly."
He added, "Since the existence of this community, they have been plagued by this fly, and it has crippled the development of the community because most of the able young men in the community get blind at the peak of their age, and the bites, which are accompanied by rashes, make our people get old quick.
"Look at me; I'm not even 50 years old, but the bite has made me look older than my age; it has even affected my eyes, because when a fly bites you, it affects your blood, changes your skin, and eventually affects your eyes, resulting in blindness."
He also suggested the establishment of a special eye clinic to help those whose sight has already been infected, as well as the drilling of boreholes to enable members of the Ikov community to stop drinking water from the streams where these flies lay and hatch their eggs will help. "This is the only way to save the present and yet-to-be-born generations." He appealed.
The Sati Ikov community is located along the Ugbema-Jato-Aka road in the Ushongo area council of Benue State. It’s one of the agrarian communities in Benue State, a state that prides itself on being Nigeria’s food basket.
The community is within the senatorial district that produced Gabriel Suswam as governor of the state and who is now a serving senator. Despite that, we observed a total absence of government presence. The living conditions in the community are deplorable.
It lacks basic amenities such as portable water and a hospital to serve the community's over 7,000 residents. The absence of portable water alone can worsen the crisis being caused by the presence of the blackfly. As the only source of water for the residents is the rivers that breed those blackflies.
Government Response
Dr. Terna Kur is the State Director of Public Health. He told SMI's WR in a telephone conversation that "most of the communities are benefiting from the free distribution of Mectizan."
Mectizan is a drug used in the treatment of river blindness.
SMI's WR also reached out to Mark Debam, who is the Benue State Coordinator of Neglected Tropical Diseases (NTDs). We sought to find out about the drug distribution.
"We are using the state primary health centers (PHCs) across the 23 LGs so that the health workers there can train community drug distributors, who normally go from one community to the other to register and give drugs to eligible people aged 5 and above." He explained.
According to Mark, the government intends to distribute the drug to 80 percent of the population. "The population of Benue State as at last year was over five million, and at that time we were targeting a population of over four million, but as you know every year, the population growth is 2.5 percent, so this year, 2022, the population of Benue is estimated based on that projection, which is over six million, and we are targeting 80 percent of the population, which will give us over five million persons."
Mark is not uninformed of the socioeconomic causes of river blindness disease.
"Most patients suffering from these neglected tropical diseases (NTDs), in addition to being blind, frequently encounter mental health difficulties owing to neglect, stigma, and depression sustainability." Those were the words of the NTD’s boss.
He also noted that "the worst hit community for the black fly and river blindness is the Ikov community in the Ushongo LG area of the state."
NGO intervention
A non-government organization, Sight Savers, through the Senior Program Manager, Anita Gwom, told our reporter that the organization has been using so many strategies like mass drug administration, integrated vector control disease management, and disability inclusion to enable members of endemic communities to live healthy and normal lives.
The community is not satisfied with the interventions.
"Even though the government has given us Mectizan to reduce the impact of river blindness on our people; the truth still remains that without completely eradicating the fly, the Ikov community still stands the risk of losing its population to river blindness because as one takes the drug today, he or she will still be bitten by the fly, which will infect them the more." Elder Atser, 65, told SMI and WR
For Ikyotser, who also lives in the community, "my suggestion is for the government to first of all eliminate this fly before giving us drugs; they should also provide safe drinking water for us."
He believes that the government has done little to help his community by simply providing mectizan to those who are already infected. He insisted that "the government can do more to save the community's next generation from the bites; taking Mectizan is of no use if the black fly is not eliminated."
Can the blackfly be eliminated?
Our search of open-source records shows that four countries have been verified by the WHO as free of river blindness after successfully implementing elimination activities for decades: Colombia (2013), Ecuador (2014), Mexico (2015), and Guatemala (2016). On 5 April 2013, the Director-General of WHO issued an official letter confirming that Colombia has achieved elimination of onchocerciasis. Colombia was the first country in the world to be verified and declared free of onchocerciasis by WHO. This has been followed by Ecuador in September 2014, Mexico in July 2015, and Guatemala in July 2016. More than 500 000 people no longer need ivermectin or mectizan in the Americas.
This investigation is produced by Safer-Media Initiative (SMI) with the support of the Wole Soyinka Centre for Investigative Journalism (WSCIJ) under The Collaborative Media Engagement for Development, inclusivity and Accountability Project (C-Media Project) funded by the MacArthur Foundation.