Making Nigeria Ebola Free?

In the 20th century, 1966 to be
precise, small pox, an acute contagious disease caused by a  virus was described by  the World  Health Organisation (WHO) as “one of the world’s most devastating disease known to humanity.”
Notwithstanding the fact that this disease was the first of its kind to have been fought on a global scale, WHO revealed that by the time small pox was declared eradicated in 1980, it claimed “as many as 300 million people, far more than all the wars of that century combined.”
Once more, the world is plagued with another massive killer-Ebola, a filo virus disease. The death rate   in some West Africa countries hit by the virus underscores this fact. The Director-General of WHO, Margaret Chan disclosed that as at September 9, “the five West African countries had recorded more than 4,366 cases of Ebola including at least 2,296 deaths.
This figure, at a glance, may appear  insignificant especially in comparison with small pox which claimed as many as 300 million in 14 years, but Sylvie Briand, WHO’s Director of Pandemic and Epidemic Disease Department disclosed to newsmen in Geneva on           Thursday that “there is evidence of substantial  under reporting of cases and deaths. “Dr Jeffery L. Shaman, an Associate Professor of Environmental Health Sciences at the Columbia University, Mailmen School of Public Health supported this.  Shamai disclosed that “Ebola  has a simple trajectory, it’s growing exponentially.” Thus, U.S  scientist  and Virginia Technical Epidemiologist, Dr. Leivis forecast that Ebola “is likely to last 12 to 18 months duration and with very high case count.
It is therefore very worrisome that  despite the serious warning from Nigeria Medical Association (NMA) and Nigerian Union of Teachers (NUT), the Federal Government has maintained that  there is no one with Ebola virus in the country.
However, the Nigeria Medical Association (NMA), speaking through its National Secretary-General, Dr Olawunmi Alayaki faulted the Federal Government’s directive to schools to resume on September 22 until all those under surveillance for EVD in the country are certified free. “The resumption of schools could be shifted till December or early part of next year because if Ebola should spread to any school, it would assume another dimension. Government should have enough time to follow the standard procedure for containing the virus. It will not augur well for the country if we have another outbreak due to carelessness,” said Alayaki.
Similarly, NUT directed all its members nationwide to stay away from schools until they are convinced beyond reasonable doubt” that the government has provided all preventive and protective gadgets such as infra-red thermometers, sanitisers, running water, gloves and that the teachers are adequately trained.
Indeed, the Federal Government’s declaration may be seen as unrealistic especially considering the fact that in previous Ebola outbreaks in the world, an outbreak was not declared  until over a period of 42 days had lapsed since the last known infection. But the index case of Ebola in Nigeria, Patrick Sawyer was barely 42 days old while some of his secondary contacts in different parts of the federation are still under surveillance and some are even yet to be discovered.
What then can account for this haste to declare that Ebola had been eradicated in Nigeria in less than two months of its index case? Can the answer to this lie in what the Minister of Information, Labaran Maku said over the weekend in a political rally in Minna, Niger State? In recounting the many achievements of Mr. President,  Maku had without mincing words added in his list, “the ability of the Jonathan-led administration to contain Ebola in Nigeria in less than two months.” Considering the fact that Nigeria is close to the countries at the centre of this epidemic as well as some other factors such as the fact that “many of the public and private schools  in the country lacked basic hygiene and sanitary facilities” as the chairman of the Lagos State chapter of NMA, Dr Tope Ojo observed and also the fact that “only, a few states have trained any techer in the EVD.”  As the National President of the NUT, Dr Micahel Alogba Olukoye told journalists in Abuja yesterday that  one could imagine the grave consequences of such unguided utterances by the Federal Government.
The cheapest method of eliminating health problems is prevention. Thus, despite the assurance by the Minister of Education who spoke through his Special Adviser, Mr. Nnamdi Olebara in Abuja last week that the ministry had put in place adequate measures to guard against the spread of the Ebola virus in schools ahead of the September 22 resumption date, one may still doubt such measures.
It would be recalled that before the onset of the dreaded EVD in Nigeria, despite admitting in its Federal Executive Council, meeting that the country was in danger of possible spread of the deadly virus from across West and East African countries, the Federal Government did nothing proactive to safeguard her borders except to print leaf lets and produce T.V and radio jingles. The Minster of Health, Prof Chukwu told journalists after such meeting that Ebola had been moving east wards towards Nigeria and that “we are  already facing the danger from Central African Republic… so Nigeria is in danger of Ebola but we have recently said that in addition to the leaflets that we are producing for Lassa and other hemorrhagic fevers, we will now emphasise Ebola fever. As I speak to you, we have already approved jungles to be produced in  various languages by the Nigeria Centre for Disease Control to be aired on radio, TV and newspaper adverts.”
And so while her nearest neighbours were busy sealing their borders and beefing up their security, Nigeria relied on her usual last-minute preparation approach  until she became the 4th country to be invaded by the Ebola  virus.
Despite the N2billion  emergency fund (as well as the hundreds of millions by some state governments) released to tackle the virus, going by the statement of the National President of NUT, Dr Michael Alogba Olukoye and the Country Director of WHO, Rui Vaz, one may be tempted to conclude that the country is still unprepared to fight the virus. While addressing  journalists at a press briefing in Abuja, Olukoye said, “asking teachers to resume without equipping the schools is like asking them to go with bare hands into the Sambisa forest.” Similarly, Rui VAz who spoke in Port Harcourt said  the fight against the dreaded Ebola disease, entailed that everyone needed to be trained to have the basic knowledge of Ebola disease and how it spreads.
The most important thing in Ebola control is early diagnosis of any potential suspected cases and taking necessary precautions in terms of isolation where it is needed and other measures to stop the chain of infection.”
Surprisingly, the result of an opinion poll on public awareness of the virus showed that the average Nigerian see Ebola virus as a political propaganda to steal public funds. This attitude is very worrisome and can spell doom for the country in case of another outbreak.
Again, it has been widely reported that apart from the Centre for Disease Control (CDC) laboratory in Atlanta, USA or the Institute Pasteur (IP) laboratory in Dakar, Senegal, no Nigerian laboratory has the requisite infrastructure to culture and manipulate the deadly virus. The Registrar of the Medical Laboratory Council of Nigeria (MLCN), Prof Anthony Emeribe confirmed this in an interview with Sunday Independent over the weekend. “Agreed, Nigeria has the capacity (personnel and space) that can  detect Ebola virus. There is however, no laboratory in Nigerta that has the safety levels needed for the diagnosis of the virus.” Emeribe further disclosed that the most advance laboratories in Nigeria that can handle similar cases have a maximum level  3  bio safety level as against level 4 which is the basic for Ebola virus culturing and manipulation.
Can this be the reason why Ebola confirmed cases were mostly only detected after the death of the  victim  and also why Ebola suspects move in and out of the country and also from one state to another? It would be recalled that barely one month after Patrick Sawyer imported Ebola into Nigeria, another Liberian citizen was also reportedly diagnosed with the killer disease. Dr Akinbayo, a senior registrar with Igbobi Orthopedic Hospital, Lagos disclosed this while speaking at a morning TV programme in Lagos. Again on September 12, yet another Ebola suspect was arrested at the Murtala Muhammed International Airport. The transit passenger from Morocco identified as Fosuve Elizabeth Maria was on board Royal Air Maroc. According to the Special Assistant on Media and Communications to the Minister of Health, Das Nwomeh, the South African national suspected of showing symptoms of Ebola at the international airport was quarantined at the isolation ward in Lagos while her case is being investigated.”
The case of the ECOWAS diplomat, Olu Ibukun Koye who brought Ebola to Port Harcourt is still fresh in the mind of people. Although government denied it, about 60 quarantined persons were also alleged to have been missing in Port Harcourt and Lagos to mention but a few. The sporadic bolting of these Ebola victims or suspects is not a mere wild-goose-chase as the wife of late Patrick Sawyer, Mrs Decontee Sawyer hinted in her face book profile.
Against this backdrop, the advice by the President of West African Civil Society Forum (WACSOF), Madame Naphelie Traore that leaders in the sub-region should tighten measures to prevent the spread of Ebola virus should be taken seriously especially following the recent confession of the Liberian President, Ellen Johnson Sirleaf that she expects the Ebola crisis gripping her country to worsen in the coming weeks before a decline.
The control  of Ebola virus also requires the same strategy that was used to eradicate small pox, namely surveillance and containment.
If Nigeria must be Ebola free or rather remain Ebola free, containment measures should be strictly disserved and according to W.H.O. standards too. “One way of achieving this would be to cajole Ebola victims or suspects to give up the comfort of their home freely. To this end, quality care, good food and even salaries should be given to cases or contacts placed in isolation.;
Lastly, the fight against Ebola virus should not be done in secrecy, the mass media as the watchdog of the society should be involved.
Obasi is a student of Communication in CIWA, Port Harcourt.

Marie Obasi