The state government and general public most urgently rise to the occasion and impose sanity on the environment; Lagos may be in for disease outbreak of epidemic proportion. Public health physicians, who gave this warning, expressed concerns over the state of Lagos environment that is currently in squalor. Their fears are worsened by the high population density and congestion of Lagos, the commercial capital of Nigeria, which is already a risk for any form of outbreak. And true to type, the backlash of unkempt Lagos environment is beginning to unfold. Specifically, Lagos residents were last Thursday alarmed at the news of another outbreak of Lassa fever. The rodent-related disease has claimed two victims, with 150 under surveillance. About two weeks ago, it was also reported that two persons have been confirmed dead, while 25 other were receiving treatment in hospitals following an outbreak of cholera at Somolu, Oshodi-Isolo, and Surulere local government areas of the state. Many were, however, not surprised amidst heaps of loose rubbish around major markets and streets. A public health expert, Prof. Akin Osibogun, added that improperly disposed refuse could cause common hazards that are the breeding of vermins and vectors of disease. Vermin (colloquially varmint or varmit) are pests or nuisance animals that spread diseases or destroy crops or livestock. Use of the term implies the need for extermination programmes. Osibogun, former Chief Medical Director of Lagos University Teaching Hospital (LUTH), explained that common houseflies that are in abundance at sites of improperly disposed refuse could also transmit diarrheal causing agents of disease. Rats will breed rapidly in the presence of improperly disposed refuse. He stressed that environmental factors obviously have impact on human health and, therefore, the general public should all be concerned about the state of their surroundings. Other determinant of one’s health includes human genetics, individual lifestyles, and health care system of the people. Emphasizing on the effects associated with dirty surroundings, he said: “We know that rats are associated with the spread of diseases such as Lassa fever, and Leptospirosis. Rats also cause economic losses by consuming and spoiling household food items. Osibogun added: “In addition, improperly disposed refuse also pose fire hazards and can be the source of physical injuries to man in addition to its unsightliness and the psycho-social aversion it creates. “It can also cause blockage of drainage systems with resultant flooding during raining seasons, which also lead to an increased incidence of diarrheal diseases as a result of contamination of food and drinking water sources.” The public health analyst further advised individuals and communities to be properly organised to dispose of their refuse in hygienic manner to prevent the spread of diseases related to improper refuse disposal. “Individuals can bag their refuse in polythene bags or stored in covered bins that prevent access by rats and vermins. There must also be organized mechanisms for the removal and disposal of refuse in every community,” he added. Addressing the media recently on the filthy state of the environment, the Lagos State Commissioner for Health, Dr. Jide Idris, who associated the cause of the outbreak to the heavy rainfall and the aftermath of flooding in the state said, it is obvious that the cause could not be from dirty water but also the general dirt on the streets. Although, the Ministry of the Environment in July said, the Sanitation Intervention Programme would ensure that no vacuum is created during the transition from the old waste management system to the Cleaner Lagos Initiative and had removed refuse dumped indiscriminately in places such as Ojuwoye, Mushin, Eti-Osa, Agege, Alimosho, Ojo, Ikeja, Badagary, Oshodi-Isolo, Lagos Island, Lagos Mainland and other areas in order to restore cleanliness and purity within the environment in Lagos State, there is still a dire need for intense sanitation. Public health practitioner, Dr. Dumebi Owa, expressed worries over the state of the environment, especially considering the health implications. Owa said: “I remembered in March, when Meningitis broke out, I was angry with my country because we do not plan adequately. I warned then that the level of filth in Lagos State would cause a big problem if nothing were done. “Everywhere is dirty, Ikoyi, Ikeja, Surulere is dirty. Even the second avenue of Festac is dirty because of the full canal. The drainages now have materials that are non bio-decaying and this causes flooding and emergence of diseases,” she said. Owa, a former president, Medical Women’s Association of Nigeria (MWAN), added that the effects are already upon the citizenry. “A few weeks ago there was outbreak of cholera, now we are dealing with Lassa fever. I am very angry because these diseases are preventable. I don’t know why we have to wait till there is a crisis, especially when it is on health issue. The outbreak of these diseases (cholera, dysentery, typhoid) is when there is an open defecation, and it goes to contaminate water sources.” Addressing the challenges caused by improper waste management, Owa said it ranges from loss of lives, environmental degradation, to decrease in the state’s economy and psychological distress.