By Princess Don, Uyo
In Osuk Ntan, a quiet rural community tucked deep within Akwa Ibom State, survival once depended on a stagnant stream. It was the only source of water for drinking, cooking, washing clothes, and bathing newborns.
Around it, bushes bore the marks of open defecation. For pregnant women, the daily search for water meant trekking more than two hours along narrow, rocky paths,often while weak, nursing, or heavily pregnant, just to fetch water that was unsafe even by rural standards.
Today, that reality has changed.
Clean water now flows from Osuk Ntan’s first-ever borehole, not as a result of a government programme or political intervention, but because a research paper refused to remain trapped in academia.
The transformation began quietly when Prof. Dorothy Ngozi Ononokpono, an Associate Professor in the Department of Sociology and Anthropology at the University of Uyo, submitted an abstract to an international conference on population and health. Her study examined the relationship between Water, Sanitation and Hygiene (WASH) and maternal health in rural Akwa Ibom communities.
Although financial constraints prevented her from travelling abroad to present the paper, the research followed her home as she she was able to touch the lives of women whose struggles statistics often fail to capture.
What the data revealed was deeply troubling. Every pregnant woman and woman of reproductive age, between 18 and 40 years, surveyed in Osuk Ntan lacked access to safe water.
Many reported recurrent infections, persistent weakness, and frequent hospital visits. Others spoke of falls and injuries sustained while navigating the rocky terrain, with some linking these incidents to miscarriages and pregnancy complications. Children often accompanied their mothers to fetch water, compounding risks and reinforcing a gendered cycle of labour and vulnerability.
“When I saw the photographs of the stream, iwas burdened. I could not imagine that people were still drinking this kind of water in this century.” Prof. Ononokpono recalled
Faced with the stark reality, she knew awareness alone was not enough. Treating the contaminated water was beyond her expertise, so she chose what she believed was the most sustainable solution: drilling a borehole.
It was no easy task. Osuk Ntan’s rocky terrain discouraged many contractors. The access roads were barely navigable. Costs escalated quickly. Yet, supported by a research grant, personal sacrifice, and unwavering community cooperation, the borehole was eventually drilled successfully.
The community itself played a vital role. Residents contributed labour to erect a local water tank stand. In the absence of electricity, Prof. Ononokpono personally purchased a generator to power the system. What began as an academic setback became a lifeline.
But beyond the flowing water lies a deeper truth: maternal health does not begin in hospitals alone. It begins with safe water, sanitation, and dignity.
Public health experts warn that Osuk Ntan is far from an isolated case. Across Nigeria, countless rural communities face similar conditions, largely invisible to policymakers. Global health evidence consistently links unsafe WASH conditions to maternal mortality, neonatal infections, and preventable childhood diseases.
The borehole at Osuk Ntan has therefore become more than infrastructure. It is a symbol of what is possible when evidence meets empathy, and when communities are treated not as statistics, but as partners in change. Still, one borehole is not enough.
Without deliberate government investment, integrated WASH, health policies, and gender-responsive planning, thousands of rural women will continue to pay for policy failure with their health and sometimes, their lives.
The Osuk Ntan experience underscores urgent policy priorities: scaling up rural water infrastructure, especially in underserved and off-grid areas; integrating WASH into maternal and child health services; strengthening sanitation systems through community-led approaches; establishing community-based WASH governance with strong female representation; and expanding rural health outreach and disease surveillance.
Experts argue that WASH must no longer be treated as an afterthought. Antenatal care should include hygiene education. Safe water access points must feature in rural development budgets. Sanitation campaigns should be embedded within health outreach programmes.
“We need political will,” Prof. Ononokpono said. “When maternal health policies include water and sanitation, lives will change. Safe water isn’t a luxury—it’s a right.”
She made the following Policy Recommendations based on her findings: “Scale Up Safe Water Infrastructure in Underserved Communities.
The successful drilling of the first borehole in Osuk Ntan demonstrates the transformative impact of
accessible potable water. State and Local Government authorities should prioritise the expansion of
boreholes and protected water systems in other rural communities with similar vulnerabilities. In the case
of Osuk Ntan community where grid electricity is unavailable, restoration of electricity in this community
is required to enable continuous operation of this borehole and its reliable access to households. Water
access points should be reticulated to other locations within safe walking distance of households to reduce
physical strain, especially for pregnant and nursing women. Regular water quality testing and maintenance
systems should also be institutionalised to ensure sustainability.
;
“Integrate WASH into Maternal and Child Health Programming
WASH interventions should be formally integrated into maternal and child health strategies at the state and
local levels. Antenatal and postnatal care services should include hygiene education, safe water practices,
and infection prevention guidance. Collaboration between the Ministry of Water Resources and the
Ministry of Health can strengthen coordinated planning to address environmental risk factors that contribute
to maternal complications and child morbidity. Integrating WASH into maternal and child health
programming aligns with WHO recommendations advocating intersectoral collaboration between health
and water sectors to reduce maternal and neonatal morbidity (WHO, 2018). Community-led total sanitation
(CLTS) approaches are internationally recognised as effective strategies for reducing open defecation and
improving hygiene behaviours in rural settings (UNICEF, 2021).
” Improve Community Sanitation and Hygiene Practices: To prevent recontamination of water sources, local authorities should support the development of
community sanitation facilities and promote behavioural change campaigns addressing open defecation and
unsafe hygiene practices. Community-led total sanitation (CLTS) approaches and hygiene education
initiatives can reduce disease transmission and complement infrastructure investments.
“Establish Community-Based WASH Management Committees: To ensure long-term sustainability of the newly commissioned borehole, a community WASH management
committee should be established and trained in maintenance, accountability, and minor repairs. Women
should be meaningfully represented in these committees, given their central role in water management and
caregiving. Local ownership will strengthen accountability and facility longevity.
“Strengthen Rural Health Outreach and Disease Surveillance: Given the documented burden of waterborne diseases, mobile health outreach services should be expanded
to rural communities such as Osuk Ntan. Strengthening disease surveillance and early treatment
mechanisms will reduce preventable complications among pregnant women and children. Linking WASH
improvements with routine health outreach can accelerate measurable health gains.
“Promote Gender-Responsive Rural Development Planning: Water access planning should explicitly recognise and address the gendered burden of water collection.
Policies should aim to reduce women’s time poverty and physical strain by ensuring equitable access to
basic infrastructure. Gender-responsive budgeting within local government development plans can
institutionalize this commitment”. She added
In Conclusion, She said that evidence from Osuk Ntan community clearly demonstrates that inadequate access to safe water, sanitation, and hygiene is not merely an environmental concern, but a maternal and child health
emergency.