The latter part of the Dutch saying, “Sickness comes on horseback but departs on foot”, did not quite apply to the recent case of Ebola outbreak in Nigeria. Between President Jonathan and Governors Babatunde Fashola and Rotimi Amaechi of Lagos and Rivers States, respectively, the collective response was swift, focused and determined. The World Health Organisation (WHO) said of the disease: “The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level 4 pathogen infected so many people so quickly, over such a broad geographical area for so long.” So what did we do right and what impact has Ebola left behind?
In March 2014, the WHO reported the worst outbreak of Ebola ever known, having started in Guinea and later spread to Sierra Leone, Liberia, Nigeria, Mali and Senegal. From when it was first identified in 1976 through 2013, the cumulative number of cases reported was 1,716 compared to the 10,141 reported already as at 25 October, 2014 after only seven months of its outbreak this year. Ebola is a disease of humans and other primates caused by a virus of the same name. Signs and symptoms appear between two days and 21 days after contracting the virus and death may occur following six to 16 days after symptoms first appear. The virus spreads by direct contact of skin or mucous membrane with blood or other body fluids of an infected human or other animal or by surfaces which had contact with these fluids. Possibility of air-borne communication has not been confirmed but Ebola may be spread by semen or breast milk several weeks to months after recovery of a hitherto infected person.
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There is no doubt in anyone’s mind locally or internationally that Nigeria provided strong, visible leadership which facilitated the rapid implementation of detection-diagnosis-isolation-tracing-treatment required to effectively contain the virus. Unlike in the US where after its first case was reported on 30 September, 2014, President Obama has been at pains persuading Americans not to panic, that the initial missteps were not necessarily catastrophic and that if Nigeria can do it, then America can too! It is not unlikely that no one in America in her wildest dreams ever thought that Ebola would reach the shores of the most powerful nation on earth.
Before we get carried away, recall that between March 2014 and 20 July, 2014 when the index case, Patrick Sawyer, arrived Lagos from Monrovia, the Federal Ministry of Health and other relevant agencies had about four months to put in place necessary measures to detect and isolate any Ebola case immediately on arrival at any port of entry on land or at sea. Did Sawyer have his temperature checked when he arrived Murtala Muhammed International Airport? What did the airport health services do after he was reported to have collapsed? Is there any standard protocol in place to handle such emergencies? Was the protocol followed? Were all airport staff fully aware of the outbreak of Ebola in neighbouring countries and did they have any training on how to spot or handle an emergency like Ebola? Was an equipped isolation centre set up within the vicinity of the airport? Why was the infectious disease hospital in Lagos not functional? I am not able to accurately answer these questions but it is arguable that the casualties at First Consultant Hospital, Obalende would have been fewer if they had been forewarned (following medical due diligence [not] carried out at the airport) about the Ebola symptoms or the potential of it, of Patrick Sawyer.
Dr. Stella Adadevoh – may your sweet soul rest in peace. Mr. President, sir, death should not be the reward for her courage. This is a golden opportunity to bestow on her Nigeria’s first “Medal of Honour”. Her equally courageous young entrepreneur son, Bankole Cardoso, will be there to take the honour on her behalf. Fact is, Mr. President, no one wants to die for Nigeria. Why? The “Medal of Honour”, which should only be conferred annually on the three most deserving of citizens living in Nigeria after rigorous scrutiny by an independent board comprising the most honourable women and men, will send a message that will reverberate across the land and beyond, that the life of every Nigerian is of inestimable, irreplaceable value.
On 20 October, the WHO declared Nigeria Ebola-free. Even though Rui Gama Vaz, WHO’s spokesman, described the success as spectacular, the economic consequences of its outbreak is considered high, if difficult to quantify. For instance, border closures affected regional trade. The loss in Nigeria is nothing compared to that of Guinea, Sierra Leone and Liberia where the International Monetary Fund (IMF) is considering providing financial assistance. The World Bank estimates that, depending on how long the outbreak lasts, the overall economic impact across the countries affected could be between $3.8 billion and $32.6 billion – due to reduction in tourism, farm production, investment programmes, etc. African solidarity is well spoken of internationally and now Nigeria in its characteristic fashion has mobilised human and material resources to assist our sisters and brothers in the countries that are still affected by the disease. It is heartening that Nigeria itself remains on high alert because re-entry of Ebola remains possible.
It is true that apart from successful application of technology and social media to sensitise and mobilise the public, we were supported by public health experts from WHO, America’s CDC and that some Nigerian doctors involved in the effort were trained in the UK, US, etc; hence, Nigeria still received international assistance. It doesn’t matter. Nigeria is very happy to collaborate and share the spotlight. But praise and accolades are not as important right now as is the need for trials to be concluded ethically and safely on the experimental vaccine rVSV and ChAd3 so that thousands, if not millions of lives, can be saved and the disease completely eradicated. Thereafter, the debate on the perceived decline of US power and the rise, albeit glacial, of Nigeria, will follow. In the mean time, Chapeau Nigeria!
Mayowa Amoo
