Ebola: South-East Strategies On Preventive Measures

The Ebola virus scare had put
the Anambra State in a frenzy; and the South East caught the fever. The scare was on the faces of the people; they couldn’t stop talking about this “latest deadly visitation.” The buzz was virtually everywhere. With arms akimbo, long forlorn faces, people huddled in corners just to talk and with shuddering resignation, exchanges uninformed conclusion on the “impending Armageddon.” The talks continued at various homes, in the motor parks, offices, churches and hospitals.
In the one week that the uncertainty reigned, while six people waited in apprehension in the hospital for coming in contact with suspected human remains, the fear was couched in the dreadful realization that “no one even knows how to contract this thing.”         While the thought that “this disease could be transmitted by a mere touch was incomprehensible,” the inclusion of the “bush meat,” a choice dish in most part of the South East as a link was seen as manageable. Many swore to forgo the delicacy. The fragility of the unfolding scenario led to more fears, anxiety, confusion, conflicting prognosis.
Few people wanted to shake hands with anyone that works in a hospital. Few people looked eager to shake hands. No one dared contemplate the thought of contracting a disease with no known cure, yet.
“This is a life style changing situation that is blowing out before us,” said a curious health worker at the Anambra State Ministry of Health. “Even if you can turn a blind eye to the bush meat, how do you avoid body contact or the traditional handshake. If there is an outbreak in this zone, there will be chaos. People at too closely knit and families will be wiped out,” he said.
The evolving questions didn’t offer immediate answers. For example: Does anyone run a risk when they touch money handled by someone infected by Ebola? What happens when passengers bump into one another in a bus? How much contact with a victim can guarantee safety?
The questions grew, alongside the Ebola lore. First, there was a quiet resignation that there was Ebola in the air, and everyone was breathing it. Last Friday, it was said that a bomb was exploded somewhere, dispersing the virus. Most men, even without any contact are perpetually chewing bitter kola, with one or two more in their pockets. Said Chuks Nwoke, a property speculator in Enugu, “we are told that an ingredient in bitter kola can suppress the Ebola virus.”
Then, the rumour of the salted warm water therapy, which no one could ascertain its source broke out as a way to prevent Ebola. A medical doctor in Enugu said “there is nothing wrong in bathing with warm water,” while he dismissed as “hogwash” the idea that it could prevent Ebola.
People in Ebonyi, which has remained quiet since the scare broke out, were jolted like many others in other states in the morning of Friday about warm salted water. The State Health Commissioner Dr. Sunday Nwangele, dismissed the claim and said: “We have asked people to ignore such messages.”
A housewife said that she has asked her husband to buy gloves for their children, while she warned her husband not to touch the children when he is home from work until he has taken his bath. At a commercial bank in Enugu, customers deserted a particular teller after she left her counter briefly and returned with gloves. She aroused unspecified suspicions, none the customers wanted to explain.
To put a perspective on the strength of Ebola, it was compared with HIV and kidnapping. A prominent billionaire in Anambra joked that he was relocating to Enugu because kidnappers and his enemies could find a dreadful use for this Ebola to hunt their victims. No one lives with Ebola, but there are people living with HIV.
In Anambra, the Ebola scare, reportedly, nearly reignited the ancient war between the Aguleri and Umueri communities, in Anambra East Council. Both communities have been locked in a bloody war for decades. Famed as the longest war over ancestral lands in Nigeria, the war has been fought in trenches, farms, the Supreme Court in 1984 and the Privy Council long before Nigeria gained independence. And despite the several peace moves, a mutual air of suspicion continues to reign in both communities.
The primordial elements in that suspicion rose to the fore when on August 22, 2014, the six men, who were suspected to have come in contact with the corpse of one Ikechukwu Charles Okoye, the man, who was suspected to have been a victim of Ebola, were quarantined at the Umueri General Hospital.  Immediately the news filtered from the Hospital, some youths in Umueri became restive. They quickly summed that the development should be regarded as part of the ancient war, this time declared by the State Governor, Willy Obiano, an Aguleri man. The major question was: “Has the governor decided to further decimate the Umueri population by bringing and infecting them with the deadly Ebola virus?” And, “why did the Government decide to use the Umueri General Hospital for the quarantine?”
According to the youths, there were better equipped hospitals in the neighborhood. An Umueri man in government who would not want to be mentioned said, “this might sound stupid to an outsider but it is not stupid to an Umueri man. Certainly, the Aguleri people would have nursed the same apprehension that the youths are quietly nursing. Why didn’t they go to the Charles Borromeo Hospital or the General Hospital in Onitsha. There is also the General Hospital in Iyienu, in Ogidi. These hospitals have better facilities in terms of equipment and manpower than what is available in Umueri.” While the speculations that the apprehension was building towards a protest by the youths thrived, the anxiety eased last week when the State Ministry of Health released the six persons restricted at the Umueri hospital.
The State Epidemiologist, Dr. Emmanuel Okafor, who conducted the release, said that the men were discharged after they showed no signs of being infected by Ebola and added emphatically that, “by this we can safely say that there is no Ebola in Anambra, for now.”
The men have been restricted since August 1st after they came in contact on July 22 with the remains of Okoye who died in Liberia on July 6, was flown to Lagos through Gambia Bird on July 21, arrived Anambra by road on July 22 and deposited at Apex Mortuary, Nkwelle Ezunaka, in Oyi Council.
A source in the state Ebola investigation team said, “during the period of their restriction, we didn’t notice any signs of the symptoms. The blood tests also support our observations and during this period, we didn’t notice any change in their body temperatures.”
However, the air of optimism is being relished with caution in some quarters as the state ministry of health awaits the results of tests carried out on the tissue taken from the human remains. “The blood tests are usually faster than the tests on the tissues. Tissues require extensive tests. We are waiting for the results from the tissue test from the Lagos University Teaching Hospital (LUTH),” said the source.
Although the responses from some state governments followed almost immediately, it is uncertain if it has matched the fears of a citizenry, dwelling in the dark and relying on pure instincts to devise how to deal with an “this new disease.” Said Chike Maduekwe, lawyer and politician from Anambra who lives in Enugu, “we are all afraid. But we shouldn’t be paranoid about the situation considering the range of stories about the Ebola. Right now, the government should impose stricter controls at the borders and do more on information and public enlightenment. Right now, anything could be said to cause Ebola and the people don’t know what to believe.”
The immediate concern of some state governments was to respond to the fears and anxieties of the citizenry by harping on the rehabilitation of medical facilities and putting in place structures to deal with any emergencies. The response sounded as if there was already an epidemic in the South East.
In Abia, the Governor, Theodore Ahamefula Orji told the people of Abia to continue to “pray that the virus doesn’t come to Abia,” to be wary and avoid certain bush meats. In addition to the prayers, the state has designated certain hospitals across the state as Ebola centers, where anyone who showed symptoms could quickly and easily be taken to.
The Imo State Government moved quickly to compile a number of measures it has put in place to protect the citizenry from the Ebola virus. The Health Commissioner, Dr. Edward Ihejirika, while cautioning against panic by the residents, told journalists that the state government has arranged the procurement of personal protective equipment for health workers just as he warned against the consumption of such bush meats as monkeys and similar delicacies.
The Health Commissioner in Enugu State, Dr. George Eze, dismissed the presence of Ebola in the state, calling on the public not to panic but to take adequate precautions. Insisting that the state was not taking anything for granted, he said that measures have been put on the ground to guard against the disease.
“Up till now,” he said, “we have not established any Ebola case in Enugu. The threat is elsewhere across the country but we are guarding against it. We have a well trained manpower and our specialists have put heads together on how to manage the situation.”
Unsure of how to prepare for Ebola, he said, that “our best approach is to prepare ourselves to tackle this scourge if it comes. Previous ones have been contained, so we believe that this one will be contained.”
In Anambra, where all this started, the Governor, Willie Obiano ordered the state Health Ministry to acquire at least 400 Personal Protective Equipment to prevent the state health workers from contracting the virus. The Health Commissioner for Health, Dr. Josephat Akabuike noted the inauguration of a rapid response team to handle emergencies in the health sector.
As the state kicked into action by the setting up of a committee to work out a proper response in future, a member of the committee, who is also on the state’s team that investigated the Ebola scare, said, “we want to proactive in health matters. We know that our people are well travelled, they live in various parts of the world, some in the Ebola belt, and we need to be careful.
“The process is on for the training of laboratory scientists and clinicians for the management of epidemics. We have ordered the printing of posters, pamphlets and endorsed other public enlightenment methods to educate people on Ebola.”
Akabuike, a gynaecologist, had noted that, “In Anambra, we have epidemiologists who monitor the environment and we are planning to purchase mobile ambulances and clinics to move them to areas of emphasis to enable us respond timely in case of emergencies. We are also doing public enlightenment through the media, communities and churches to keep people at alert.”
Symptoms associated with Ebola include malaria, persistent diarrhea (gastroenteritis) and fever, weakness, waist pain and bleeding from every opening in the body.
With the illness incurable, why all the activity? Akabuike said: “Although Ebola virus disease is incurable, symptomatic treatment can be given to an Ebola patient to rehabilitate the person and that is why the State government has moved to acquire personal protective equipment for health workers to protect them from contracting it.”

Kodilinye Obiagwu

L-R: Minister of State for Health, Dr Khaliru Alhassan, Minister of Health, Prof. Onyebuchi Chukwu and Minister of State 2 for Foreign Affairs, Mr Nurudeen Mohammed briefing Heads of Foreign Missions in Nigeria on Ebola Virus in Abuja, recently.