The human health effects of oil exploration and exploitation in the Niger delta region of Nigeria

Abstract

A product of a public lecture, this monograph provides an insight into the human health effects of oil exploration and exploitation in the Niger delta region of Nigeria

Full text

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The Health Impact of Oil
Exploration and Exploitation
in the Niger Delta region
A lecture delivered at the 2008 Annual
General Meeting of The National
Association of Resident Doctors of Nigeria
Dr. BEST ORDINIOHA

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THE HEALTH IMPACT OF OIL
EXPLORATION AND EXPLOITATION
IN THE NIGER DELTA REGION
Being originally a lecture delivered at the 2008 Annual
General Meeting of the National Association of
Resident Doctors of Nigeria at Delta Hotels, Port
Harcourt, on 18th September, 2008.
By
Dr. Best Ordinioha fmcph
Consultant, Community Physician, UPTH
Lecturer, Dept of Preventive and Social Medicine,
University of Port Harcourt, Rivers State
Nigeria.
Preventive and Public Health Consult 2009

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DEDICATION
This monograph is dedicated to all those who have
struggled against all odds to tell the story of the poor and
the marginalized in the Niger delta
And
To the memory of my Grand Father Aaron Otunna
Ordinioha who was knocked down and killed by a
vehicle involved in drilling of the first oil well in my
community (Mgbede I)
First printed, March, 2009
All rights reserved.
No part of this publication may be reproduced or transmitted in any
form or by any means, electronic or mechanical including
photocopying, recording, or any other information storage and
retrieval system without prior permission from the publisher.
ISBN 978 978 900 210 8
Published by:
Preventive and Public Health Consult Port Harcourt.
P. O. Box 162 Omoku, ONELGA – Rivers State, Nigeria.
Email: pphconsult@gmail.com
Tel: 0803 – 7075300, 08053837699, 08085601355

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Acknowledgement
The text of this monograph was originally delivered at the
2008 Annual General Meeting of the National Association
of Resident Doctors of Nigeria, held at Delta Hotels, Port
Harcourt, on 18th September, 2008. The discussions it
generated, and the requests I received to make the lecture
available to a wider audience, have resulted in the
publication of this monograph.
I am grateful to the organizers of the conference for finding
me worthy of delivering such a lecture, and for providing
such a nation-wide audience to do it. I am particularly
grateful to Dr. Golden Owhonda – the Chairman, Central
Organizing Committee of the conference, Dr. DD Alasia,
the Chairman, Scientific Subcommittee, and Dr. Jeremiah
Israel.
Dr. Best Ordinioha

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Protocols
Let me start by thanking the organizers of this conference for
giving me the honour to deliver a lecture at the Annual General
Meeting of the most potent and vibrant union in our
professional association. I am indeed grateful!
I am a Community Physician. In Community Medicine, we use
the knowledge of Medicine and Public Health to attend to the
health problems of a group of people (Community). Because
we work both in the hospital and in the community, this
presentation would have a different flavour as I attempt to
bring the unique Community Medicine approach to the topic
being discussed. I hope I won’t bore you to sleep!
When I was approached by the Central Organizing Committee
to present a paper at this AGM, with the freedom to choose my
topic, I decided without hesitation to say something about the
health impact of crude oil exploitation and exploration in the
Niger Delta region. Traditionally, impact studies are carried
out before the commencement of a policy or development
project, but I chose the topic because:
• As it is said, it is better late than never
• The impacts of oil exploration and exploitation in
the Niger delta have been said to be partly
responsible for the restiveness in the region; and
• The need to present to you an unbiased, scientific
view of the impact, devoid of the usual sentiments
that flavour the media coverage of the situation in
the Niger delta.

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To do justice to the topic, I have adopted the following format:
• First, I will give an introduction to the land and
people of the Niger delta region
• Next, I will give an overview of oil exploration and
exploitation activities; and
• Finally discuss the health impact of the activities.
The land and people of the Niger delta region
The Niger Delta is the fan-shaped area at the southern part of
the country through which the River Niger and River Benue
empty into the Atlantic Ocean. It covers an area of about
70,000 square kilometers, the third largest wetland in the world
and the largest in Africa. Politically, the region is much larger
as the nine States that make up the region (Edo, Delta,
Bayelsa, Rivers, Akwa-Ibom, Cross-River, Imo, Abia, and
Ondo) occupy some 112, 1110 square kilometers 1, 2.
Fig 1: Map of southern Nigeria showing the Niger delta region

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The Niger delta is basically a huge floodplain formed primarily
by centuries of silt washed down by the Niger and Benue
Rivers. It is criss-crossed by a web of creeks that link together
the main rivers of Benin, Bonny, Brass, Cross, Forcados, Kwa-
Ibo, Nun, and other rivulets and streams (all estuaries of the
Great River Niger) 1, 2.
Fig 2: Niger delta region as seen from outer space
The Niger delta region is made up of four main ecological
zones:
• Coastal barrier islands,
• Mangrove forests,
• Fresh water swamp forests, and
• Lowland rainforests

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The mangrove forest of the Niger delta makes up over 60
percent of the mangrove forests in Nigeria, while the
freshwater swamp forest is the most extensive in West and
Central Africa. These two habitats have very high biodiversity,
with many unique species of plants and animals.
The Niger delta region is a region of dense cultural diversity.
Although, it forms 7.5% of Nigeria's total land mass, it is
inhabited by at least 25 million people in nine States and 186
Local Government Areas. The indigenous people are from
roughly forty ethnic groups, and speak an estimated 250
dialects.
Fig 3: The linguistic groups in Nigeria

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The Ijaws are the fourth most populous tribe in Nigeria and by
far the largest in the Delta region. They are divided as a
consequence of the difficult territory which they inhabit, into
subgroups speaking mutually unintelligible dialects of the Ijaw
language (by some definitions thus themselves different
languages).
Today, most of the people of the Niger delta are either farmers
or fishermen, farming and fishing in lands and rivers
devastated by oil exploration and exploitation activities
without even an indirect benefit from the huge revenue from
oil.
Though poverty is widespread in Nigeria, the level in the Niger
delta region is exacerbated by the high cost of living caused by
the influx of people employed in the well-paid energy sector.
The oil sector employs only a small percentage of the
workforce: a labor aristocracy of high wages surrounded by a
great mass of un- or underemployed people.
Oil exploration and exploitation activities in the Niger delta
region
Oil was first discovered in commercial quantities in Nigeria in
1956 at Oloibiri, about 90km west of Port Harcourt, in what is
now Bayelsa State; other discoveries soon followed and
exports began in 1958, although significant quantities only
began to flow from 1965, with the completion of a terminal on
Bonny Island, in Rivers State, and pipelines to feed the
terminal. Following a drop in production due to the civil war
of 1967 to 1970, output rose rapidly from 1970, and by 1974
oil revenues constituted over 80 percent of total federal
revenues and over 90 percent of export earnings, figures which

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have remained similar since then4.
Nigeria is currently the largest oil producer in Africa, and the
fifth largest in the Organization of Oil Producing Countries
(OPEC). In 2004, Nigeria exported an average of 2.5 million
barrels of crude oil every day, and with an oil reserve
conservatively put at 35 billion barrels, this would continue for
at least the next 40 years4.
Fig. 4: Nigerian Crude oil production, 1980 – 2004.
All of Nigeria’s proven oil reserves are located in the coastal
area of the Niger delta, in about 250 small (less than 50 million
barrels) oil fields. As a result, there is a need for a developed
network of pipelines between the fields, as well as for constant
exploration to augment existing oil reserves4.
The oil industry is basically made up of two activities:
• Oil exploration; and

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• Oil exploitation
Both activities include several contaminating processes, but
the extent of these polluting processes depends mainly on the
environmental practices and technology used by the oil
companies. In the Niger delta, these practices have repeatedly
been questioned.
Fig. 5: A sketch of a seismic survey
Oil exploration activities are to locate the oil several
kilometers below the earth’s surface. This often begins with a
3-D seismic survey that requires a caravan of survey
equipment, and the use of explosives like dynamites.
These carry particular risks for plant habitat, wildlife and
human communities, and have been noted to cause:
• Deforestation
• Destruction of farm lands
• Exposure to infectious disease agents like jungle

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yellow fever
• Access to explosives (dynamites)
• Cultural clashes with local populations
• Even without considering the big possibilities of
industrial accidents.
Once the oil is found in commercial quantity, oil exploitation
begins with the drilling of oil wells. This produces a large
quantity of waste consisting of crude oil, drilling fluids and the
byproducts of drilling, including water, drill cuttings and mud.
It is estimated that onshore oil production operations produce
60,000 to 300,000 gallons of cuttings and mud everyday, while
offshore oil platforms use and discard nearly 400,000 gallons
of water per day5.
Fig. 6: A drilling rig

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Fig. 7: A drilling operation
The drilling wastes are often stored in lined pits, but leaches
are common. The water used and contaminated during the
drilling of the oil well contains varying quantities of heavy
metals, volatile aromatic hydrocarbons (such as benzene,
toluene and xylene) and a vast array of other potentially toxic
compounds.
In most countries with strict environmental guidelines, the
waste water is treated using a range of mitigation techniques
including filtration, biological processes, and reverse osmosis

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before being reintroduced into the environment. But these
methods entail a great deal of expense, and one can be assured
that they are not often used in Nigeria. This much was said by
CAJ Herkströter, the Group Managing Director of Shell. He
implied at an annual meeting of the company held in the
Netherlands, that higher environmental standards could harm
local economies:
“Should we apply the higher-cost western
standards, thus making the operation
uncompetitive and depriving the local work force
of jobs and the chance of development? Or should
we adopt the prevailing legal standards at the site,
while having clear plans to improve towards ‘best
practice’ within a reasonable timeframe?”6
Fig. 8: An oil well

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During production, oil is extracted from the oil well in a
mixture with formation water and gas, and then piped to a
central facility (called flowstation) where the various
components are separated. At each flowstation, several million
gallons of formation water are generated and discharged every
day; and several million cubic feet of “associated gas’ from the
separation process is mostly burnt in Nigeria on a daily basis,
without temperature or emissions controls.
Fig. 9: A flow station in the Niger delta
Although, the oil companies are required to decontaminate
their effluent discharges according to DPR and the Federal

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Ministry of Environment set limits, these are rarely followed,
such that several water bodies where these effluents are
discharged into have an oily sheen. In April 1997, samples
taken from water used for drinking and washing by local
villagers were analyzed in the U.S. A sample from Luawii, in
Ogoni, where there had been no oil production for four years,
had 18 ppm of hydrocarbons in the water, 360 times the level
allowed in drinking water in the European Union (E.U.). A
sample from Ukpeleide, Ikwerre, contained 34 ppm – 680
times the E.U. standard6,7.
Oil companies operating in Nigeria flares more gas than any
other place in the world: approximately 75% of the “associated
gas” is flared in Nigeria; compared 20% in Saudi Arabia, 5%
in Mexico, 4.3% in Britain, 1.5% in the former Soviet union,
0.6% in the US, and zero percent in the Netherlands5.
Flaring is the cheapest way to dispose the associated gas that
most companies operating in Nigeria are not equipped to
utilize. Apart from the tons of carbon dioxide released
everyday, gas flares in Nigeria have been noted to also emit a
lot of methane gas, and soot due to their very low efficiency.
Methane has a higher greenhouse effect than carbon dioxide.
This is unfortunate, because as early as 1969, there was a
Nigerian legislation that required oil companies to set up
facilities to use the “associated gas”. But at the moment, most
of the companies still prefer to pay the little fine imposed by
the government for gas flaring.
The narrow diameter pipes that carry oil from wellheads to
flowstations are called flowlines, while pipelines are larger

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diameter pipes that carry oil from the flowstations to the big
storage facilities. As a result of the small size of the oilfields in
the Niger Delta, there is an extensive network of pipelines and
flowlines that provide numerous opportunities for leaks,
especially as most of the pipelines and flowlines in the onshore
operations of the oil companies are laid above ground, old and
therefore subject to corrosion.
Fig. 10: Oil and gas fields of the Niger delta
The best practice is to have the pipes buried and changed every
15 years, but most of the pipelines in the Niger delta region are
more than 20 years old, and are laid above the ground.
Although pipes laid above the ground are cheaper for the oil
company, they can be obstructive to man and animals.

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Spills are the direct consequences of the use of old, above the
ground pipelines; and they occur very often in the Niger delta.
According to the official estimates of the Nigerian National
Petroleum Corporation (NNPC), based on the quantities
reported by the operating companies, approximately 2,300
cubic meters of oil are spilled in 300 separate incidents
annually. It can be safely assumed that, due to underreporting,
the real figure is substantially higher: conservative estimates
place it at up to ten times higher1, 6.
Fig. 11: Above the above pipeline is obstructive
Also, statistics from the Department of Petroleum Resources
indicate that between 1976 and 1996 a total of 4,835 incidents
resulted in the spillage of at least 2,446,322 barrels (102.7
million U.S. gallons) of crude oil, of which an estimated

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1,896,930 barrels (79.7 million U.S. gallons; 77%) were lost to
the environment 1, 6. This is more than nine times the 10.8
million gallons (40.9 million liters) spilled in the Exxon Valdez
tanker disaster in 1989 in Alaska, one of the largest sea oil
spills that ever occurred.
In recent years, sabotage has been a growing cause of oil
spillage in the Niger delta6, fuelled by the criminal action of
contractors who cause spillage, sometimes with the connivance
of oil company staff, for the profit to be made from cleaning
the spill; and the growing discontentment of the indigenes over
the sharing of the oil revenue. This has reached a new
crescendo this decade with the rise of armed militant groups.
DPR regulations require the body responsible for a spill to
clean the site and restore it to its original state as far as
possible. Soil at a spill site on land must contain no more than
thirty parts per million (ppm) of oil after six months. This is
often not achieved in Nigeria due to the use of improper
methods such as burning.
It is interesting to know that Exxon spent $2 billion in its
Alaskan clean-up operations, and was subsequently ordered to
pay $287 million in damages to about 14,000 commercial
fishermen and landowners. The US District Court also
awarded another $5 billion in punitive damage against Exxon.
But, how much has been spent in compensations and clean-ups
for the oil spills in the Niger delta region?8
The health impact
Most people often see health as the absence of disease or
infirmity, but for the purpose of this presentation, I will use

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both the WHO definition, and the definition used in most of
our traditional communities. The WHO in 1948 defined health
as a state of complete physical, social and mental wellbeing,
and not merely the absence of disease or infirmity. While in
most of our traditional communities, people are said to be
healthy when their spiritual, physical, mental, social and moral
well-being are properly blended, permitting them to carryout
their day to day activities according to the customs and
traditions of their community.
These definitions see health not in terms of absence of disease,
but in terms of wellbeing, peace of mind, and human
solidarity. Adopting these definitions gives me the freedom to
consider all the likely impact oil exploration and exploitation
activities could have in the Niger delta, well beyond the
traditional purview of public health. This approach is not
entirely new as it is the standard practice in most Health
Impact Assessment (HIA) studies9; though such broad focus is
not often adopted in HIA studies carried out in Nigeria10.
Oil exploration and exploitation activities can have:
• Direct; as well as
• Indirect effects
Direct health effects are those that result from the direct
consequences of oil exploration and exploitation activities.
These include those associated with:
• Land expropriation for oil company use
• Exposure to drilling wastes
• Gas flares; and
• Oil spillages
Indirect health effects are those that result from the presence of
the highly lucrative oil industry in the largely impoverished
Niger delta communities. These effects include those

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associated with:
• Prostitution; and
• Social disintegration
In discussing the health impact of oil exploration and
exploitation in the Niger delta, it is sad that not all of my
references would be drawn from studies carried out in Nigeria.
This is because there are very few published works on the
subject; not because of lack of effort, but because the
objectivity required for the studies to scale through the peer
review process, is often compromised by the survival instinct
of working to stay in the good books of the rich and powerful
oil companies. According to a Dutch biologist formerly
employed by SPDC for two years as head of environmental
studies, and quoted in the Human Right Watch publication –
The Price of Oil6:
“There was/is a major problem with most of the
environmental studies carried out in the Niger
Delta, as they are carried out by Nigerian
universities or private consultancies, which have a
generally low scientific level and little
technical/industrial expertise.” 6, 11
Also a review of two of SPDC’s EIAs for pipeline projects
conducted in 1994 concluded that the assessments were:
“Lengthy, generally poorly constructed, and
therefore difficult to envisage how they could
either assist the Nigerian planning authorities in
determining authorization of the development, or
enable SPDC employees in Nigeria to better
manage their (potential) environmental impacts.”6,
12

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The reviewers of the substantial Environmental Impact
Assessment document for the Bonny Liquefied Natural Gas
project concluded that:
“Although some sections of the report were of high
quality, there were serious defects. Overall, “the
Environmental Statements fall well short of what
would be required in any developed country and
do not allow the reader to make an informed
judgment about the relative environmental benefits
and costs of the scheme. It is normal practice to
consider alternatives in an environmental
assessment, but this has not been done. Significant
issues have been overlooked or deferred to a later
date.”
Even the Niger Delta Environmental Survey (NDES) initiated
in 1995 by Shell to head off international criticisms of its
Nigerian operations did not fare better, even after it was
incorporated as a limited by guarantee company, with funding
provided not only by Shell, but by other oil companies
operating under the aegis of the Oil Producers Trade Section
(OPTS) of the Lagos Chamber of Commerce and Industry, as
well as governments of Rivers and Delta States. The survey
was billed to be both people- and community-centered, but
soon degenerated into an opportunity for patronage for its
members, such that its report of over 50 volumes was still
largely unpublished6.
So, I hope I would be excused to quote from studies carried out
in far away lands!

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The health impact of the Land expropriated for oil
company use
For oil production to take place, land is expropriated for the
construction of oil facilities (a process referred to by the oil
companies as “land take”). This land is taken under Nigerian
laws which are difficult to interpret. Although the Nigerian
constitution provides that no right or interest in property may
be acquired compulsorily except under a law providing for the
payment of prompt compensation, and for the amount of
compensation to be determined by a court of law or other
tribunal. This right has been substantially eroded by:
• 1978 Land Use Act (originally Decree No. 6 of
1978),
• The Petroleum Act; and
• The Oil Pipeline Act.
The Land Use Act provides that:
• All land comprised in the territory of each State in
the Federation are vested in the Governor of that
State and that such land shall be held in trust and
administered for the use and common benefit of all
Nigerians. Under this law, land in urban areas is
under the control and management of the State
governor; while all other land falls under the
control of the local government authority.
• The governor has the absolute right to grant
“statutory rights of occupancy” to any land, to issue
“certificates of occupancy,” and to demand
payment of rental for that land. Local governments
have the right to grant “customary rights of
occupancy” to land not in urban areas.

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• The governor also has the power to revoke a right
of occupancy for reasons of “overriding public
interest.” Overriding public interest is defined in
section 28 of the Act to include “the requirement of
the land for mining purposes or oil pipelines or for
any purpose connected therewith.”
• If the land is acquired for mining purposes, the
Land Use Act provides that the occupier is entitled
to compensation as provided under the Minerals
Act or the Mineral Oils Act (now superseded by the
Petroleum Act).
• If compensation is due to a community, it may be
paid “to the community,” “to the chief or leader of
the community to be disposed of by him for the
benefit of the community,” or “into some fund
specified by the Governor for the purpose of being
utilized or applied for the benefit of the
community.”
As is common with most military decrees, the Land Use Act
suspended the provisions of the constitution, and ousted the
jurisdiction of the courts to inquire into executive acts. This
was stated as follows in the Land Use Act “notwithstanding
anything to the contrary in any law or rule of law, including
the Constitution ... and ... no court shall have jurisdiction to
inquire into any question concerning or pertaining to the
amount or adequacy of any compensation paid or to be paid
under this Act.”

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This is no doubt an unconstitutional law especially in a
democracy, as even in secondary school Government subject
classes, the supremacy of the constitution is a common refrain.
It is also reflected in all Nigerian constitutions, including the
subsisting 1999 constitution. Chapter 1, Section I and III
states as follows:
“This Constitution is supreme and its provisions
shall have binding force on the authorities and
persons throughout the Federal Republic of
Nigeria….. If any other law is inconsistent with the
provisions of this Constitution, this Constitution
shall prevail, and that other law shall, to the extent
of the inconsistency, be void.”
The Petroleum Act (originally Decree No. 51 of 1969),
however, makes no provision for compensation to be paid for
land acquisition. Section 1 of the Act vested on the State the
entire ownership and control of all petroleum in, under or upon
any land within the country or beneath its waters.
Although the Act requires the oil companies to pay “fair and
adequate compensation for the disturbance of surface or other
rights” to the owner or occupier of any land or property,
nothing is paid for the expropriation of the land itself. This
means that individual owners of the land where oil is being
extracted are paid only for the disturbances caused, while the
government collects the rent paid for the land, and the royalties
paid for the extracted oil.
The Oil Pipelines Act on its part provides for compensation
both in respect of surface rights and in respect of the loss of
value of the land affected by a pipeline. Disputes as to the

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compensation due may be referred to court, which “shall award
such compensation as it considers just,” taking into account
not only damage to buildings, crops, and “economic trees,” but
also damage caused by negligence or disturbance, and the loss
in value of the land or interests in the land.
These laws give the government the power to expropriate land
for the oil industry, but with no effective due process
protections for those whose livelihoods may be destroyed by
the confiscation of their land. While the paternalist posture of
government is recognized, justice demands that those whose
lands have been so expropriated should have the right to voice
opposition to the acquisition, to challenge it before an
impartial court, and to obtain adequate compensation.
The 1999 Nigerian constitution clearly stated in Chapter II,
Section 14 that:
“The Federal Republic of Nigeria shall be a state
based on the principles of democracy and social
justice….It is hereby, accordingly declared that the
security and welfare of the people shall be the
primary purpose of government”
Had this constitutional provision been fully taken into heart,
perhaps the numerous agitations for resource control would
have been more muted.
The Niger delta is a flood plain with very small habitable land,
a big chunk already taken up by oil company operation.
According to one estimate, the length of oil and gas pipelines
in the Niger Delta is over 7,000 kilometers, and traverses a
land area of about 31,000 square kilometers2, 13. Also, Shell in
2001, reportedly held about 400 square kilometers of land for

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its operations, most of it reserved for future use. This excluded
land acquired for ‘short-term’ purposes (such as for seismic
projects and temporary staff), and land not acquired for
petroleum development but, nonetheless, rendered useless as
part of ecological collateral damage arising from oil operations
13. On its part, Chevron’s operations in the Niger delta was
reported in 1998 to span over 5000 kilometers offshore and
2,600 kilometers onshore’ as of 199813, 14.
Oil companies operating in the Niger delta use more land than
those in the Persian Gulf, because the oil in the Niger delta are
mostly onshore, and found in small fragmented oil fields.
Land expropriation for oil industry use has resulted in
shortages, especially as the average landholding per farming
family in the Niger delta is slightly more than two hectares.
Land shortage can have serious health impact including:
• Deforestation as people are forced to deforest
swamps in search of arable land uncontaminated by
oil. The encroachment into the mangrove forest and
the deleterious effects of crude oil spills on the
forest are considered two of the most long-lasting
side effects of oil exploration and exploitation
activities in the Niger delta15. Without the
mangrove forests, riverbanks will erode, leading to
flooding that could further harm the Niger Delta.
• Cultivation of marginal agricultural fields
resulting in poorer crop yield, and subsequently
loss of household food security. According to the
July 2008 Famine Early Warning System Network
report published by USAID16, the Niger delta

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region has a much more serious food insecurity
problem compared to the south-east and the south-
west regions of Nigeria
• Increase in mental health problems due to the
destruction of deities and ancestral burial places
during oil exploration and exploitation activities. In
most communities in the Niger delta, deities and the
ancestors are the guardian angels of the living.
Their desecration represents the loss of a vital life
force.
Fig. 12: Current food security conditions in Nigeria, July-Sept 2008
(courtesy of the Famine Early Warning System Network of USAID

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• Communal crisis resulting from disputes over the
available arable land. Environmental factors have
been fingered as the underlying causes of most
resource-based conflicts like the Rwandan
genocide. Although there is the tendency to
attribute the Rwandan conflict to the historical
antagonism between Hutu and Tutsi ethnic groups,
a 1997 study revealed the significant role played by
environmental factors like population pressure,
decline of agricultural land per family land-holding,
soil degradation, and shortage of firewood 17.
The health impact of exposure to drilling wastes
Drilling waste and other waste products of oil exploration and
exploitation activities have been found to contain:
• Aromatic hydrocarbons, including heterocyclic
chemicals that can mimic hormones
• bactericides,
• soluble chromates,
• mercury and other heavy metals
• corrosion inhibitors, and
• Naturally Occurring Radioactive Materials
(NORMs) commonly found in underground
geologic deposits and frequently brought to the
surface during the drilling of oil well. Human
contact is often through water-borne pathways.
Although they are found in small quantity, NORMs
are dangerous as even the low-level radiation they
generate has been found to have mutagenic
effects18.
Potential health effects of exposures to the chemicals

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contained in drilling wastes include:
• Increased risk of spontaneous abortion. A study
carried out in the Amazon basin of Ecuador found
that the risk of spontaneous abortions was 2.5 times
higher in women living in the proximity of oil
fields19.
• Increased risk of infertility. Two studies 20, 21
carried out using the Nigerian crude oils (Qua Iboe
Brent crude, and Bonny Light) found a significantly
dose-related reduction in the cauda epidymal sperm
reserves of rats exposed to the crude oils; including
widespread degeneration of the cells of the testes.
This underlies both the infertility-causing potentials
of exposure to crude oil, as well as the possible
carcinogenic effects of long term exposure such as
the type suffered by the inhabitants of the Niger
delta.
• Menstrual irregularities possibly due to exposure
to "endocrine disrupters" such as polyaromatic
hydrocarbons and alkyl phenols. One study found
that female petrochemical workers exposed to these
chemicals for 3 or more years have up to a 53%
higher risk of developing oligomenorrhea5.
• Increase in physical symptoms. Another study in
Ecuador found that women living in communities
near oil fields reported higher rates of various
physical symptoms than did women in control
areas. These symptoms included skin mycosis,
tiredness, itchy nose, sore throat, headache, red

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eyes, ear pain, diarrhea, and gastritis. After
adjustment for possible confounding factors, the
symptoms significantly associated with exposure
were those expected from known toxicological
effects of oil22.
• Increased risk of cancer. Yet another study in
Ecuador examined the differences in cancer
incidences over the period of 1985 to 1998 in the
oil-producing Amazon region of Ecuador, and
found a significantly higher overall incidence of
cancer in both men and women in the provinces
where oil exploitation had been going on for at least
20 years. Significantly elevated levels were
observed for cancers of the stomach, rectum, skin
melanoma, soft tissue, and kidney in men and for
cancers of the cervix and lymph nodes in women.
An increase in hematopoietic cancers was also
observed in children 23, 24.
• Increased risk of mercury poisoning. Mercury is
a component of most drilling waste. In a study
carried out in the Gulf of Mexico5, the mercury
levels in the muds and sediments beneath oil
platforms were found to be 12 times higher than the
approved level. Fish and shellfish have the capacity
to accumulate mercury in their bodies several times
the concentration of mercury in the water in which
they live. When eaten, these fish and shellfish cause
alkylmercury poisoning, and present as Minamata
disease, named after Minamata bay, Japan where
the phenomenon was first noticed. Mercury is a

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neurotoxin; Minamata disease is characterized by
severe neurological symptoms that might result in
death. It is also capable of causing birth defects and
heart problems.
The health impact of gas flaring
Gas flaring has a significant contribution to global warming
since it produces Carbon dioxide and methane, two very potent
greenhouse gases. Although, the resultant climate change has a
global connotation, the Niger delta region, like most coastal,
communities is in great danger of being submerged within this
century, if the current rates of producing the greenhouse gases
persist. The International Panel on Climate Change (IPCC)
estimated that at the current rate of production of the
greenhouse gases, the sea level will rise by 9 – 88cm within a
century25; while it was estimated that a mere 30cm rise in sea
level would displace at least 80% of the inhabitants of the
Niger delta 26.
Apart from flooding, a rise in the sea level would cause the
intrusion of sea water into both the surface and underground
water sources in the region. This will cause the death of
aquatic plants and animals that can not tolerate the high
salinity. It will also cause the shortage of fresh water, which
can be incapacitating, especially as most of the inhabitants of
the region depend on these water sources for drinking, and
other domestic uses.

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Fig. 13: A gas flare in the Niger delta
Climate change has also been linked to:
• Climatic variability and extreme weather events
(the rains are now late in coming, while the
harmattan season is virtually absent. Yet, our
traditional festivals are tied to the agricultural
season. While people in northern Nigeria now
routinely pray for rain in July to enable them plant
their crops, how many people in southern Nigeria
actually celebrate their new yam festival with the
yam produced in their communities? These
traditional festivals were fixed based on the premise
that the planting of crops would start after the first

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rain, in the month of March or April, which is
currently being hampered by the disruption in the
pattern of rainfall, caused by climate change.
Farmers in the Niger delta, and others in Nigeria
who depend on rain for their planting (irrigation is
seldom practiced) now have to delay the planting of
their crops, or risk having the planted crops
scorched due to delayed rain.
Fig 14: Effects of climate change is also being reported in
Nigerian newspapers
• Natural disasters such as drought and heavy rain,
operating according to Charles’ law, the secondary
school chemistry law
• Infectious diseases such as malaria and
cerebrospinal meningitis. Epidemics of
cerebrospinal meningitis commonly occur in the
part of Nigeria lying within the so called

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Meningitis Belt of tropical Africa, a zone lying 5-
15 o N of the equator, and characterized by annual
rainfall of between 300-1100mm. it is said that
continuing climate change would rush southwards
this meningitis belt to include more of Nigeria 25, 27.
Fig. 15: Flooding, a natural and increasing cause of disaster worldwide.
• Social disruption. Though, the Darfour problem in
Sudan receives most of the international attention,
the Hausa farmers and in fact farmers in most parts
of Nigeria have their own pitched battle with the

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nomadic Fulani herdsmen. Due to desertification,
the Fulani herdsmen have left their parched grazing
reserves in search of food for their livestock. This
has led to the destruction of some farmlands
fuelling conflicts with the farmers 25, 27
• Food insecurity. The WMO/UNEP
Intergovernmental Committee on Climate Change
(IPCC) estimates that climate change may increase
the yield of cereals in regions in high and mid
latitudes, and decrease the yield in regions in lower
latitude. Most of the additional people at risk of
hunger due to climate change would be in Africa.
Yet nearly half of the populations in sub-Saharan
Africa are currently undernourished. Under
nutrition is a fundamental cause of stunted physical
and intellectual development in children, of low
productivity in adults, and susceptibility to
infectious diseases in everybody 25, 27.
Fig 16: Pathways by which climate change affects health

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Gas flares in the Niger delta also produce a lot of smoke,
because of their low efficiency. This not only fills the air with
soot, but also causes:
• Acidic rain. Gas flares are known to produce sulfur
dioxide and nitrogen oxides that form sulfuric acid and
nitric acid respectively in the atmosphere. These acids
dissolve readily in water to help form acidic water
droplets that returns to the earth as acidic rain.
Unpolluted rainwater has an inherent acidic PH of 5.6,
but acidic rain commonly reach PH level as low as 4,
about 40 times the acidity of natural rainwater.
Although oil company sources in Nigeria claim that gas
flare in Nigeria produce little sulfur dioxide and
nitrogen oxides, the well known effects of acidic rain
on man and the environment have all been noticed in
the Niger delta. These include:
1. The fast corrosion of the metal sheets
commonly used for roofing in the region. This
is an economic burden to individual house
owners who have to change their roofing sheets
more often than any other part of the country.
2. The acidic rain water filled with soot, is
undrinkable, and cannot even be used for
domestic purposes. This deprives the
inhabitants of the Niger delta communities, an
important source of drinking water. Although,
most of the communities have bore-hole water
supply (often provided by the oil companies as
compensation for oil spill, or provided by
government and government agencies like

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NDDC, and OMPADEC), the water sources are
often nonfunctional, as they are often provided
on ad-hoc basis, with little arrangement made
for their maintenance.
Fig. 17: “Pure water” is big business in most riverine communities of
the Niger delta
3. The acidic rain also acidifies the soil causing
poor agricultural yield, and the disruption of the
ecosystem. Studies carried out at the Izombe
flow station in Imo State showed a 100% loss of
the crop yield within 200 meters of the flare
site, 45% loss at 600m and 10% at one
kilometer28. Studies done in Europe showed that
acid rain is capable of damaging the forest
through defoliating, discolouration, growth
decrease and tree dieback. The studies also

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showed that the acidification of the soil through
acid rain can lead to the overgrowth of such
plants as tall grasses (e.g. Elephant Grasses) and
a decline in the growth of ever green dwarf
shrubs 25. A study carried out in the Niger delta
found that air, leaf and soil temperatures were
increased up to 80 - 100 meters from the stack
of the gas flare, and that there were changes in
species composition of the vegetation of the
affected area 29.
Fig 18: Farming close to a flare site, a common finding in the Niger
delta

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4. Acidic rain also causes the acidification of
water bodies, resulting in the disruption of their
natural balance. While some organisms are able
to flourish under such conditions, others are
harmed. Several studies have shown the
susceptibility of several fish species to low PH5.
Fig 19: Soot deposited to leaves in a Niger delta community
• Respiratory and cardiovascular diseases. The smoke
produced by gas flaring in the Niger delta is a major
contributor of PM10 (Particulate Matter with diameter
less than 10 microgram) in the ambient air of most of
the communities. These microscopic components of
smoke do not just cause nose and throat irritation, but
are also capable of lodging deeper into the respiratory
tract to trigger off asthmatic attack and even
cardiovascular illnesses. According to the 2003 NDHS,

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12.2% of under-five children in the Niger delta region
(south-south Nigeria) had symptoms of Acute
Respiratory Infections compared to 6.8% in the south-
west zone and 6.3% in the south-east zone. The
national average was 10.3%30.
A study carried out in Alaska, United States 5, 31, showed that
asthma visits were positively correlated with atmospheric
concentrations of PM-10s as shown below.
Fig. 20: Average monthly asthma visits compared with PM10
concentrations (Health Effects Institute, Boston MA, USA)
Another study 5, 32 assessed the effects of PM-10s on daily
mortality rates in 20 of the largest cities and metropolitan areas
in the United States from 1987 to 1994, and found that PM-10s
contribute between 20 and 200 early deaths each day in
America’s largest cities.

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The health impact of crude oil spillages in the Niger delta
Oil leaks in the Niger delta are usually from high pressure
pipelines, and therefore spurt out over a wide area, destroying
crops, artificial fishponds used for fish farming, “economic
trees” (that is, economically valuable trees, including those
growing “wild” but owned by particular families) and other
income-generating assets.
Fig. 21: An oil spill from a well head
Even a small leak can thus wipe out a year’s food supply for a
family, with it wiping out income from products sold for cash.
The consequences of such loss of livelihood can range from
children missing school because their parents are unable to
afford the fees, to virtual destitution.

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Fig. 22: Artificial fishponds and “economic trees” destroyed by a oil
spill
Although oil spillages are common fallout of oil exploration
and exploitation, it however appears that inhabitants of the
Niger delta region are unusually affected. A study carried out
by the department of Community Medicine, University of Port
Harcourt Teaching Hospital, and published by the Nigerian
Journal of Medicine33 found that:
• Sore-eyes, nausea, headache, sorethroat, diarrhea, itchy
skin, cough, and occupational injuries that often follow
contact with the mists and fumes generated by crude oil
spillage were far more reported amongst residents
affected in the Niger delta, than those affected in
grounded oil tanker ships in Scotland, Wales, Spain,
and Alaska, USA.

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The reasons adduced for these findings include:
• The inhabitants of the affected Niger delta
communities, being farmers and fisher-folk, continued
to carry out their occupational activities, without
protective gadgets, even when the environment was
still seriously contaminated
• Members of the affected communities were provided
with little or no relief materials, so to survive, they
were forced to eat the fishes and animals killed by the
spilled oil.
Fig. 23: Fish killed by an oil spill often eaten by the affected
communities

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• They also had to drink from, and bath in the polluted
rivers and streams. A situation made worse by the
contamination of rain water by the mists and fumes
generated by the oil spill, especially as the Nigerian
crude oil is known to be “very light”, because of its
high volatility.
Another study34 by the same department found that a major
crude oil spill in the Niger delta is capable of causing up to a
60% decrease in household food security and significant
increases in the prevalence of underweight and wasting in
under-five children. These findings were also attributed to the
stance of no compensation payment for oil spills caused by
sabotage prescribed by the Oil Pipeline Act.
Although this clause was added in the Oil Pipeline Act to
discourage sabotage, but blatantly allowing whole
communities to suffer the full consequences of a crime
committed by a few individuals, can be viewed as collective
punishment. It is unfair for any government in Nigeria to allow
citizens to go through hunger no matter the circumstance,
when it was clearly stated in Chapter II, Section 14 of the
Nigerian constitution that the primary purpose of government
is the welfare of the people.
The right to food is a fundamental human right that should not
be denied any citizen, especially in the circumstances the
communities affected by the oil spillage found themselves. The
Food and Agriculture organization of the United Nations had
in a 2003 publication35 remarked that “hunger in the midst of
plenty is not just a moral outrage, but an infringement of the
most basic of human rights: the rights to adequate food.

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The hunger suffered by the communities affected by the oil
spillage cannot just be counted in terms of hunger pangs,
because under-nutrition is often a harbinger for other health
and productivity problems36, 37. For example, 50 -70% of the
burden of diarrhoeal diseases, measles, malaria and lower
respiratory infections in children are attributable to
undernutrition36, while several studies have established a
relationship between productivity and malnutrition36.
Major oil spillages have occurred through out the world, and
there is a precedent on how affected communities are dealt
with. For example, even without establishing culpability in the
grounding of the Prestige oil tanker ship in the Galicia coast of
northwest Spain, the Spanish authorities made provisions for
compensation of all those whose livelihood were tied to fishing
in the contaminated coast39. This no doubt would have saved
the affected persons from hunger. People affected by oil
spillage in Nigeria, at least, deserve food aid, medical
assistance, and money to tide them over the lean months
created by oil spill. This is the least they expect from the
government and the oil companies, especially as they had
ceded their rights to this highly priced resource to the Nigerian
state.
The prostitution caused by oil exploration and exploitation
activities
The oil company workers are about the best paid in the
country. Sadly, few indigenes of the Niger delta region are
directly employed in the oil companies, creating a distinct
community of affluent oil company staff in the midst of very
impoverished host communities. This situation has created

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among other things, the exchange of sex for financial and other
gratifications, especially as the oil company workers usually
come to work without their families.
Fig. 24: Floating refuse seen in a settlement close to an oil facility in the
Niger delta.
According to 2003 National HIV/AIDS and Reproductive
Health Survey40
• The age at first sexual intercourse is about the lowest in
the country at 16.7 years; lower than the national
average of 16.9 years.
• 20.9% of women in the south-south zone had sex with
a non-marital partner in the 12 months before the study,
which is much higher than the national average of 9%.

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• 15.3% of women aged 15 – 29 years in the south-south
zone had sex in exchange for gift or favour, compared
to 2.8% in the North east zone, and 8.3% in the South
east zone. The national average was 6.9%
• 5.9% of women aged 15 – 29 years in the south-south
zone had sex with multiple partner in the 12 months
before the study, compared to 1.1% in the North West
zone and 2.0% in the South west zone. The national
average was 2.7%
• 18.2% of women aged 15 – 29 years in the south-south
zone had at least one non-marital partner, while 2.6%
had more than one partner, compared to 1.3% and 0.5%
in the North West, and 8.9% and 2.5% in the South-
East. The national averages are 7.6% and 1.3%.
Fig. 25: Many people in the Niger delta still rely on “native protection”
against HIV

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These sexual behaviours are not without any adverse health
effects:
• The STI and HIV prevalence rates in the Niger delta
region are about the highest in the country, and are
above the national averages. According to the 2003
HIV Sero-Prevalence Sentinel Survey41, the south-
south zone recorded the joint second highest HIV sero-
prevalence rate with 5.8%. The national average was
5%. One of its component States, Cross River State had
the highest sero-prevalence of 12.0%
Also, according to the 2003 National HIV/AIDS and
Reproductive health Survey41, although current condom use
amongst sexually active respondents in the Niger delta region
(south-south zone) was the highest in the country at 37.5%
(national average was 23%), the region still recorded the
highest percentage of respondents (9.7%), who had
experienced STI symptoms in the 12 months before the survey.
This is in contract to the 1.8% recorded in the North East zone,
the 3.8% recorded in the South East, and the 6.1% recorded in
the South West zone. The national average was 6.3%.
Contractive use amongst female respondents in the region, at
16.8% was second only to the South West zone which had
17.8%. The national average was 9.3%. Yet, teenage
pregnancy, and other unwanted pregnancies are very common
in the region. Dr. Anochie of the Paediatrics department,
University of Port Harcourt Teaching Hospital in 2001 found a
pregnancy rate of 27.0% among sexually active female
secondary school students, with 24.8% of the pregnancies
ending in induced abortion42.

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Although abortion is a common recourse in the event of
unwanted pregnancy in Nigeria, especially amongst young and
single women; the situation in the Niger delta is such that even
widows and divorcees routinely carry out the procedure. This
is because even older women in the Niger delta commonly
exchange sex for financial and other gratifications. A cross-
sectional study carried out in five abortion clinics in Port
Harcourt found that clients who identified themselves as either
widowed, divorced, or separated formed more than 17% of the
clients43.
The widespread exchange of sex for gratification has resulted
in a change in the attitude towards sex in most Niger delta
communities. Historically, traditional communities do not
cordon sex outside wedlock, and have severe sanctions for
abortion. All these have changed in the Niger delta, as
communities literally let loose their women to enable them
grab from the affluent oil company staff. In a study carried out
in a semi-urban community in Rivers State44, it was found that
although the youths of the community had the powers to
investigate, arrest, detain, try, and sentence people found to
have gone against the customs and traditions of the
community, more than 70% of them would still advice their
sisters to procure an abortion in the event of an unwanted
pregnancy.
The social disintegration caused by oil exploration and
exploitation activities in the Niger delta region
The presence of the oil companies not only promote
prostitution, but have entrenched communal crisis and
corruption in the region. The oil companies in their
relationship with their host communities often use community

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leaders as middlemen. It is to these community leaders that the
companies funnel employment slots, development and security
contracts to the communities. This made traditional leadership
positions very lucrative; and in communities where there are
very few sources of decent income, it is not surprising that the
struggle for a traditional leadership position can easily
degenerate into a matter of do or die. Indeed, chieftaincy
struggles in the Niger delta are often fought with armed
supporters, a fact reflected in the growing incidence of gun
shot injuries seen at various hospitals in the region. A study
carried out in the University of Port Harcourt Teaching
Hospital found that a total of 135 patients were treated for
gunshot injury between January 2002 and December, 2004,
with a fatality rate of 22.2%45. This is considered just a tip of
the iceberg, considering the legal technicalities involved in
seeking treatment for a gun shot injury.
Fig 26: Houses destroyed as a result of oil company related communal crisis

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Fig 27: A community deserted due to an oil company related communal crisis
Without doubt, the presence of the oil companies in the Niger
delta has destroyed the community spirit that helped built the
famous Niger delta city-states like Opobo, Bonny, Warri,
amongst others; and replaced it with treachery geared towards
cornering a larger proportion of the largesse from the oil
companies.
Even as members of the Niger delta communities lock horns
amongst themselves, the staffs of the oil companies, even with
their huge salaries, still engage in corrupt practices, to further
fleece the ordinary indigenes. The following was lifted from
“The Price of Oil” – a publication of the Human Rights
Watch6:

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“The corruption pervading the Nigerian political
system applies not only to the sums of millions of
dollars that can be involved at federal level, but feeds
down into each community in the delta, where oil
money flows into the hands of local elites in the same
way as it does to national elites.
Contractors working in the oil industry report that oil
company employees in middle management routinely
take a percentage of the value of a contract,
effectively selling the contract to the highest bidder—
rather than the lowest, according to the usual
practice of tendering. This system applies equally to
development projects as to contracts directly
connected to the construction or management of oil
facilities: in 1995, a European Shell executive was
quoted anonymously in the London Sunday Times as
stating “I would go so far as to say that we spent
more money on bribes and corruption than on
community development projects.” Local contractors,
often traditional leaders, in turn take their own
percentages before passing a share of the benefit of
the oil money to their own supporters; and so on
down the chain. A small elite in each oil producing
community thus becomes rich, and is prepared to
tolerate the inconveniences of oil company
presence—such as environmental pollution—for the
sake of continued financial again. Because of this
relationship, oil companies are always able to show
that some members of the community support their
presence”.

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The way forward
The health and environmental impact of oil exploration and
exploitation activities are obvious, especially in a fragile
environment like the Niger delta. What is therefore needed is
to ensure that the principles and practice of sustainable
development are applied in all aspects of the oil activity in the
Niger delta. Sustainable development has been defined as
development that meets the needs of the present generation
without compromising the ability of the future generation to
meet their own needs. Sustainable development concedes that
whereas the present generation has the right to exploit the
earth’s resources for equitable economic growth, and for the
eradication of poverty, it should be able to bequeath the
environment in a state that the future generation won’t find it
difficult to meet their own developmental aspirations. To
achieve this balance requires that:
• The oil companies do not operate a double standard
in their operation in the region. They must adopt in
the Niger delta the same operating standard they
use in the developed countries, without much
consideration to the financial implications; and
• The oil wealth should be used to build an
egalitarian society where citizens are taken care of
according to their needs, not according to their
closeness to the corridor of power
To be able to bequeath an environment that would meet the
developmental aspirations of the future generation requires the
full adoption of principles recommended by the United
Nations Agenda 21, especially:
• The precautionary principle that requires
precautionary measures be taken when an activity
raises threats of harm to human health or

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environment, even when the cause-effect
relationships have not been fully scientifically
established.
• The polluter pays principles that requires the
polluter to bear the full cost of monitoring,
managing, and lowering the pollution; and
• The prevention principle that requires action to be
taken to prevent the pollution, at source.
It would also require carrying out an Environmental Impact
Assessment of all future development project or policy.
Environmental Impact Assessment according to the
International Association for Impact Assessment (IAIA) is the
process of identifying, predicting, evaluating, and mitigating
the biophysical, social, and other relevant effects of
development proposals prior to major decisions being taken
and commitments made. EIA is already entrenched in Nigeria
through the EIA Decree No. 86 of 1992.
Using the oil wealth to build an egalitarian society would no
doubt bring peace and development to the Niger delta region.
The people of the region having transferred the control of their
oil wealth to the government, by virtue of the Land use Act,
and the Petroleum Act deserve that the resources be equitably
distributed, and social welfare policies adopted to take care of
the socially handicapped. These expectations are
accommodated in Article 25 of the Universal Declaration of
Human Rights:
“Everyone has the right to a standard of living
adequate for the health and well-being of himself and
of his family, including food, clothing, housing and
medical care and necessary social services, and the

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right to security in the event of unemployment,
sickness, disability, widowhood, old age or other lack
of livelihood in circumstances beyond his control”
This is further reinforced by Chapter IV of the Nigerian
constitution that specifically listed the fundamental rights of all
Nigerians.
Infrastructures in some of the Niger delta communities
Fig 28: There several nonfunctional water facilities in the Niger delta

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Fig 29: A water project provided by an interventionist government
agency
Fig. 30: Yet “Pure water” forms a part of most meals eaten in the
Niger delta communities

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Fig. 31: The roads are barely passable even during the dry season
Fig. 32: Water and electricity in an impoverished community, as
compensation for an oil spill.

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Fig. 33: A Water side settlement in the Niger delta
Fig. 34: Toilet facility commonly used in the Niger delta

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Ensuring that social and economic rights are granted to
everybody in the Niger delta would help:
• Reduce corruption: Because it would help
eliminate the urge to accumulate wealth for one’s
present needs, and the needs of one’s future
generation.
• Engender the spirit of ownership of the oil
infrastructure and wealth, a spirit destroyed by
the Land use Act and the Petroleum Act. This
will help reduce the increasing incidence of
sabotage of oil infrastructure.

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• Arouse support for the sustainable development
of the region. Presently, the people of the region
are so engrossed with thinking for their own
survival, to consider the survival of their future
generation. As it is said, the poor live one day at a
time; and
• Promote social mobility as it will give the children
of the poor the opportunity to climb the social
ladder, through education and hard work. This will
empower the youths, and prevent them from being
used to cause trouble.
As medical doctors, we should fight to ensure that the right to
health is achieved not only in the Niger delta region, but

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everywhere in the country. I need to emphasize the fact that
health is a fundamental human right; therefore it should not be
left to be sold as an article of trade, to be purchased only by
those who can afford it.
Although health as a human right was first reflected in the
WHO constitution, and then reiterated in the 1978 Declaration
of Alma Ata, it has also been firmly endorsed in a wide range
of international and regional human right instruments
including:
1. Article 12 of the International Covenant on Economic,
Social and Cultural Rights (ICECR) and the
International Covenant on Civil and Political Rights

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(ICCPR) which are together called the “International
Bill of Human Rights”
2. The African Charter on Human and Peoples Rights
3. The International Convention on the Elimination of all
forms of Discrimination against women
4. Convention on the Rights of the Child.
5. Universal Declaration of Human Rights
6. African Charter on the Rights and Welfare of the Child
Also, Section 17 of the Nigerian Constitution seems to grant
the right to health when it states:
“The state social order is founded on ideals of
freedom, equality and justice. In furtherance of the
social order…there should be adequate medical
and health facilities for all persons”
When health is seen as a human right, the health of the poor is
not seen as a charity or benevolence, or a question of
purchasing power, it is seen as an entitlement of everyone by
virtue of being born human, and it is the responsibility of the
government to provide a level social playing field to ensure
that all have the desired standard of health.
A review of the international instruments and interpretive
documents makes it clear that the right to health as it is
enshrined in international law extends well beyond health care,
to include basic preconditions for health, such as potable water
and adequate sanitation and nutrition. These are enormous
responsibilities that prompted the former UN High
Commissioner for Human Rights, and former President of
Ireland, Mary Robinson to remark:

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“The right to health does not mean the right to be
healthy, nor does it mean that poor governments
must put in place expensive health services for
which they have no resources. But it does require
governments and public authorities to put in place
policies and actions plans which will lead to
available and accessible health care for all in the
shortest possible time”
The Committee on Economic, Social and Cultural Rights
(CESCR) issued a General Comment on the right to health to
specify the minimum core obligations. These require
governments to at least:
• “ensure the right of access to health facilities, goods
and services on a non-discriminatory basis, especially
for vulnerable and marginalized groups;
• ensure access to minimum essential food that is
sufficient, nutritionally adequate and safe, to ensure
freedom from hunger to everyone;
• ensure access to basic shelter, housing and sanitation,
and an adequate supply of safe and potable water;
• ensure equitable distribution of all health facilities,
goods and services;
• adopt and implement a national public health strategy
and plan of action, on the basis of epidemiological
evidence, addressing the health concerns of the whole
population;

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• ensure reproductive, maternal (pre-natal as well as
post-natal) and child health care;
• provide education and access to information
concerning the main health problems in the
community, including methods of preventing and
controlling them; and
• provide appropriate training for health personnel”
These are the least expected from governments. It is said that a
country under any circumstance whatsoever, cannot justify its
inability to comply with these minimum obligations. For
countries constrained by lack of funds, the principle of
progressive realization applies, where the state may proceed
“progressively” using the maximum of its available resources.
When this has been done, it becomes the responsibility of the
international community to support the country in the form of
Official Development Assistance (ODA) for health. The
Commission on Macroeconomics and Health of the World
Health Organization estimated that it would cost US $35 per
person per year to provide the minimum core obligations in
poor countries, and it is widely accepted that 15% of the total
government expenditure can be taken as the maximum use of
the available resources36.
Providing the minimum core obligations for the right to health
would no doubt require increased expenditure on health and
other social services. This brings me to the issue of resource
control, another agitation of the people of the Niger delta.

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Fig 35: A Nigerian cartoonist depicting the reactions of the citizens of
various oil producing countries to a rise in crude oil price.
The Nigerian government even during the colonial period uses
the derivation principles in revenue allocations8. For instances,
the 1946 Phillipson Commission and the 1964 Binn
Commission recommended that 50% of the revenue be
retained by the region where such revenue was generated; 15%
of the revenue went to the central government, while 35% was
shared among all the other regions including the revenue-
generating region. This revenue sharing formula was used
throughout the period of the agricultural boom. It was however
reduced to 30% by decree No 9 of 1971, promulgated during
the administration of General Yakubu Gowon, as oil

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production picked up in the Niger delta. This was further
reduced to 25% by the military administration of Olusegun
Obasanjo, dropped to 5% in 1981 during the civilian
administration of Alhaji Shehu Shagari, pegged at 1.5% by the
administration of General Mohammadu Buhari, before being
raised to 3% by General Ibrahim Babangida. It is currently
pegged at 13%.
Whatever the derivation, the people of the Niger delta deserve
full enjoyment of social and economic rights, including the
right to health; not with the huge oil revenue. Money must
therefore be provided to fund the enjoyment of these rights in
full, without taxing the people. This is not too much to ask for
considering that there has been the policy of directly sharing
the oil revenue to affected indigenes in some countries,
including Libya and the United States. In the United States, the
Alaska's Permanent Fund shares out an annual dividend from
oil's proceeds to residents of Alaska.

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Conclusion
While the martyrdom of Ken Saro-Wiwa resulted in the greater
appreciation of the environmental impact of oil exploration
and exploitation activities in the Niger delta; its effect on
human health is less well recognized. I believe that oil
activities have caused severe public health problems in the
Niger delta, as I have tried so hard to show in this presentation.
But, going by the principles of sustainable development, and
considering the huge revenue derived from oil, it would be
ludicrous to advocate for the stoppage of oil exploration and
exploitation activities in the Niger delta. It is only appropriate
to request that such activities be conducted using international
standards, and that the revenue earned be better used in
guaranteeing the social and economic rights of the people.
Thank you for listening!
Dr. Best Ordinioha, fmcph
Port Harcourt, 2008.
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Dr. Best Ordinioha is a 1995 graduate of the University of Port
Harcourt medical school where he currently teaches preventive
and social medicine. This monograph which is fallout of the
lecture he delivered at the 2008 Annual General Meeting of the
Association of Resident Doctors of Nigeria is designed to help
bring to the fore the health impact of oil exploration and
exploitation activities in the Niger delta