Humbling The Ebola Virus Disease In Lagos: Heroes Of The Containment


By Mac Durugbo

September 18, 2014, will remain a memorable date in the history of Nigeria in general and Lagos State in particular. It was on that day that the dreaded Ebola Virus Disease which was imported into the State by the Liberian-American, Patrick Sawyer was finally contained. But before Sawyer landed at the Murtala Mohammed International Airport bringing his deadly cargo on July 20, 2014, the disease had claimed over 3,000 victims across the West African sub-region. According to World Health Organization (WHO) report as at September 28, 2014, 3,330 people had died across four countries of the sub-region, Guinea, Sierra Leone, Liberia and Nigeria with Nigeria recording the least cases. WHo says close to 5,000 victims have died by November.

However, before July 20, 2014, little was known of the devastating effect of that disease by Nigerians except, perhaps, some fairy tale and distant stories of infected victims bleeding from all parts of their bodies before they eventually died and the fact that it was highly contagious. But that knowledge alone was enough to scare the hell out of Lagosians when it was announced that the virus had, indeed, landed in the state. That scare was enough to spur Lagosians to take proactive steps to protect themselves and members of their families. It is noteworthy that even before the State Government began the public enlightenment to sensitize them on the precautionary measures to take to avoid infection, residents had started digging into the Ebola history seeking such information on internet and other sources including rumours. It helped check some excesses of residents which would have, perhaps, adversely affected the containment efforts of the government.

Everything about the EVD case in Lagos was exceptional. First, it was the first time in world history that a disease of that magnitude would be breaking in an urban setting, in this case a state populated by over 20 million people. That, perhaps, was what made the containment a feat worth commendation, especially, if it is factored in that the State Governor, Mr. Babatunde Fashola, was away in Saudi Arabia observing the Lesser Hajj when the “Life Bomb” fell. Secondly, the man, Patrick Sawyer, could not be diagnosed as Ebola virus carrier until few days later by which time he had directly infected over 20 people, including the staff of First Consultants Medical Centre, Obalende, who came in direct contact with him. Thirdly, the First Consultants Hospital is a private health institution. Now this is very significant to the containment feat for several reasons.  First, while the result of the blood test carried out on the patient was being awaited, the hospital was pressured by Sawyer himself and the Liberian Ambassador to Nigeria to let him go. But, according to the Chief Medical Director of the Hospital, Dr. Benjamin Ohiaeri, “the hospital refused on the grounds that public good must be considered above all else”. Secondly, the Liberian Ambassador was said to have threatened to invoke international law against Nigeria should Sawyer come out negative of the disease.  So, by insisting to detain Sawyer the hospital also risked legal action.  Any other hospital could have taken the easy way out and let him go which would have been a disaster let loose on 20 plus million people.  And, perhaps, finally without a previous experience, the State Government was able to rise up to the occasion by putting up a defensive strategy in record time to cordon off the deadly virus and contain its spread.

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The whole containment story started with Dr. Ibeabuchi Morris, a staff of the First Consultants Hospital, Obalende, the first to receive the late Sawyer into the hospital. According to him, since the patient did not disclose that he collapsed at the Lagos Airport, he was first treated of Malaria. He said after the patient continued to manifest high temperature, he contacted Dr. Stella Adadevoh, a Consultant Surgeon at the hospital who was off duty, and she advised him to take the blood sample of the patient and send it to the laboratory and continue attending to him pending the arrival of the test result. Let me spare you the details of what the doctor went through, but when the blood test result finally arrived it was confirmed that he was EVD positive. Sawyer died exactly five days after he was admitted. Dr. Ibeabuchi himself started manifesting symptoms of the disease 12 days later as his body temperature continued to rise beyond 38.5 degrees Celsius. His body temperature got to an all time high of over 40 degrees at which point the Medical team from Lagos State came and took him to the isolation centre after decontaminating his house.  He survived.

But Dr. Stella Adadevoh, a Consultant Physician at the Hospital, was not that lucky. When she was contacted by Dr. Ibeabuchi, she cut short her off-day and went back to the hospital to attend to the patient. She had already gone to work on the patient and was far gone into it before the laboratory report arrived showing that the man Sawyer was actually an EVD carrier. Even when she knew, she continued to attend to the patient. She was the one who informed the Lagos State Government. Dr. Adadevoh unfortunately died some days later at the Isolation Centre quickly set up by the State Government to quarantine suspected victims of the disease.  The swiftness with which the State Government raised the team of both local and international health experts to confront the disease has since become a subject of international discourse. Mobilizing experts in the health ministry to team up with officials of the National Disease Control Centre, the World Health Organization (WHO) and other partners was not a mean feat. The team began with the tracing of all contacts with the index case and initially identified 59 of the primary contacts. This number later expanded to over 200 contacts consisting of both primary and secondary contacts. The contacts included the doctors that treated the index case and ECOWAS officials who came with him and those he met with on arrival at the Lagos Airport. It also included all those who arrived the airport in the same aircraft with the index case, the staff of First Consultants Hospital and those who had contacts with them including members of their families. However, it was only primary contacts that were quarantined at the isolation centre. All secondary contacts were kept under observation in their localities with the directive to restrict their movement and contact with other people until after the mandatory 21 days which is the gestation period of the virus.

The State Governor, Mr. Babatunde Fashola, had to re-order the state’s 2014 budget to make provision for emergency funds to tackle the problem. The Federal Government later released N200 million to assist the state. Also the State Government embarked on massive enlightenment campaigns on the need to keep safe from the Ebola Virus Disease. Aside the numerous handbills promoting personal hygiene, especially regular washing of hands, restriction in handshakes, avoidance of crowding and discouraging consumption of bush meat, among others, the Governor met with different segments of the society such as traditional rulers, religious leaders, Organized Private Sector, market women and men, community leaders and others where he spoke of the efforts of government to contain the disease and what they, the citizens, were expected to do, while television and radio stations aired anti-Ebola campaigns. While Lagosians complied with feverish enthusiasm, corporate organizations tried to march Government’s efforts by setting up hand sanitizers, water taps and wash basins in front of their offices compelling their customers to wash and sanitize their hands before entry. Some had thermo-scanners for testing temperature of visitors before admitting them into their offices or into public gatherings. Others like MTN Nigeria, donated protection kits and other relevant materials for the containment of the disease.

•Durugbo, humanrights activist wrote from Lagos

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