By. GREGORY NNAM*
The first case of Ebola in Nigeria was confirmed in Lagos on July 20, 2014. The disease entered the country through an infected Liberian diplomat Patrick Sawyer who had reportedly come to Nigeria to seek medical attention. The days that followed this confirmation were thick with media reports on the apocalyptic projections of health experts and political commentators who had admitted the possibility of an epidemic. In fairness, the experts should not be blamed for their early convictions because with the conditions in Nigeria it would have been unwise to infer the contrary. Nigeria had for a while been standing on the edge of a precipice. The health system management was in ruins. Poor facilities, lack of trained professionals and lack of organisation all added up to make the condition grim and the unstable socio-political landscape snuffed out whatever hope there might have been for an improvement. Even the outbreak of Ebola in neighbouring West African countries drew only a passing attention from the government and the media alike. Therefore when the disease came calling the country was almost unprepared. As if to confirm our worst fears, Patrick Sawyer died 5 days after his arrival in Nigeria leaving behind a number of infected persons. Before long, the initial fears of the people spiraled into a nationwide panic. In the midst of the confusion, every kind of wrong information was spread and sadly it led to the loss of some lives. Unlike other diseases the country has had to contend with, the high population in the country presented a perfect condition for the transmission of the disease from Lagos to other parts of the country. The situation was dire and therefore needed an immediate and well directed response. Thankfully the Nigerian government was on hand to provide this response.
The government set up isolation wards and treatment centres in Lagos and equipped the health ministry with specially adapted mobile communication systems to trace the contacts made by sawyer. Prior to the outbreak of Ebola, Nigeria already had teams in place to investigate the outbreaks of Lassa fever and Cholera. There were also about 100 Nigerian doctors being trained in epidemiology by the US Centre for Disease control. These formed the health team that spear-headed the attack on Ebola in the country. Although the disorganization in Nigeria’s disaster management system presented a challenge, the health operatives were able to trace 100% of all primary and secondary contacts linked to the first Ebola case. The health team handled the treatment of the Ebola patients and the monitoring of the suspected carriers of the virus. It is unclear what had informed the decision of a certain Ebola patient who ignored the treatment centres in Lagos and sought medical assistance in Port-Harcourt. The patient got what he came for but not without infecting the doctor who was treating him, further expanding the coverage area of the virus. The health ministry swung into action and with a robust financial and technical backing from the government 98.9% of all primary and secondary contacts of the first patient in Port-Harcourt were found and isolated for observation. According to a report by the US Centres for Disease control and prevention, about 900 people-nearly everyone who had contact with patient zero (Patrick Sawyer) were identified, interviewed and monitored with approximately 18500 face to face visits conducted by investigators of the Nigerian centre for Disease control and the Ministry of Health. This without doubt is a vivid manifestation of a high level of dedication and diligence. These two virtues unfortunately are gradually becoming extinct in modern societies largely because of the comfort-seeking lifestyle led by many. This African example speaks eloquently of the benefits of these virtues. With renewed efforts by the health team a good number of the patients responded to treatment and before long there were recorded cases of 11 complete recoveries out of the 19 diagnosed cases.
The widespread misinformation that resulted from the chaos witnessed in the early stages of the disease’s outbreak was effectively nullified by the government’s public enlightenment initiatives. The media was awash with announcements, shows and jingles that threw more light on the nature of Ebola, its prevention and the efforts made in its control. The government banned indefinitely all inter-state movement of corpses to restrict the spread of the disease. Within a few weeks of relentless efforts all cases of Ebola in Nigeria were under control. It came as no surprise to any when on October 20, 2014 Nigeria was declared an Ebola-free nation after 42 days without any new infection. The WHO allows 42 days to pass before declaring a country Ebola-free because this period represents twice the length of time required for any infected person to manifest symptoms of the disease (window period). Besides this, the WHO requires that active surveillance must be in place to detect “chains of transmission that might remain hidden”. Three days earlier neighbouring Senegal was declared Ebola-free after a less serious battle with the virus.
During a media briefing, the WHO labelled the effective control of Ebola in Nigeria “a spectacular success story”. Besides the literal implication of this statement, it also means that the rest of the world especially those countries still struggling to control the virus can indeed learn from Africa. Without in any way claiming that Africa has the best expertise or structures for disease control, it should be noted that the experience of Nigeria and Senegal can serve as a template for charting the path for the control of the disease globally. The efforts of various governments both within and outside Africa to control the spread of Ebola in countries like Sierra Leone, Liberia and Guinea even though inadequate is still worthy of commendation. Without doubt, if efforts are increased and adequate machineries are put in place very soon the world will be Ebola-free.
* Gregory Nnam, studies at the University of Nigeria, Nsukka