ABUJA: A cholera outbreak in Bukkuyum district of Zamfara state, northwest Nigeria, has claimed at least eight lives and infected over 200 people across 11 communities, residents and local officials said on Thursday, as limited health care access and insecurity exacerbate the crisis.

Cholera, a water-borne disease, is not uncommon in Nigeria where health officials cite widespread shortages of clean water in rural areas and urban slums.

The affected rural communities, including Nasarawa-Burkullu, Gurusu, and Adabka, have been overwhelmed, with many patients treated at home due to the lack of primary health care facilities.

“We have over 21 patients presently admitted, although three died due to delays in reaching Nasarawa General Hospital,” Muhammad Jibci, village head of Gurusu told Reuters by phone late on Thursday.

Ya’u Umar, another resident from the affected communities, said 53 people were infected in his village. “We don’t have medicine or drips. Bandits prevent us from going to the city,” he said.