by Kolapo Olapoju
As of the designated time of 0900 local time, Nigeria was officially deemed Ebola free by the World Health Organisation having survived for 42 days, or twice the incubation period, of the virus. YNaija in this analysis, takes a look at how the country against all odds managed to stop the spread of the deadly Ebola virus disease in its tracks within our borders.
WHO country representative Rui Gama Vaz said in Abuja, “The virus is gone for now. The outbreak in Nigeria has been defeated. This is a spectacular success story that shows to the world that Ebola can be contained.”
On 20 July, a Liberian finance ministry official Patrick Sawyer, who was ill flew on a commercial plane from the epicentre of the Ebola epidemic in Liberia to Lagos, Nigeria’s largest city with a population of over 20 million, poor sanitation and insufficient health facilities.
It was a cause for alarm, as Sawyer became Nigeria’s first Ebola case, ‘the index patient’. He would succumb to the virus five days later on 25 July, amidst reports that he knowingly brought the virus into Nigeria. He was scheduled to speak at an ECOWAS event in Calabar, and despite external pressures on the officials of First Consultants Hospital, to allow him travel for the event, Late Doctor Stella Ameyo Adadevoh stood her ground and refused him exit, a decision which went a long way in stopping what could have been a potential epidemic.
Over a month after Sawyer’s importation of the virus into Nigeria, some 20 people across Lagos and Port Harcourt were diagnosed with the disease, most of which were health officials who treated the index case. Eight people would eventually die from the infection, one of which was the heroine, Dr Adadevoh, whose actions helped the nation curb the spread of the virus.
She passed away on Tuesday, 19 August, at an isolation centre where she had been quarantined along with other doctors and nurses who treated Sawyer when he was admitted at First Consultants Hospital, Obalende, Lagos.
Just when it seemed Nigeria had gotten the spread of the virus under control, it appeared in Port Harcourt, through another infected ECOWAS diplomat, Koye Olu-Ibukun, who travelled to the state to meet Dr Iyke Enemuo for treatment.
Olu-Ibukun was placed under surveillance in Lagos but he escaped to Port Harcourt where he checked into a hotel and contacted Enemuo for treatment. He recovered from the ailment and returned to Lagos, but not after having infected the doctor who treated him.
While other West African countries continue to grapple with the disease, Nigeria has not recorded a single case of the virus since 5 September, and as at 24 September, the country’s Ebola isolation and treatment wards have sat empty. Consequently, after the stipulated 42-day period, barring any recurrence, Nigeria would be declared Ebola free the apex health body in the world.
How did Nigeria do it?
Despite not being fully prepared to handle the menace of the virus, the Lagos state government, wwith the help of health organisations and the Federal government took the best possible reactionary steps to tackle the virus and curtail its spread by sensitizing the public and putting in place necessary facilities and deploying adequate personnel to work the victims.
Public health campaigns, including a giant electronic billboard warning about Ebola just outside the hospital where Sawyer died, have helped raise awareness.
It must also be taken into cognizance that doctors were on strike at the time over pay and conditions in the public health sector, where many state hospitals lack running water, let alone soap and other basic equipment. In spite of the strike, extra efforts were made by the government to make available the needed number of personnels.
One of such steps was by offering to pay outrageous amounts to doctors and health workers to work at the Ebola quarantine and isolation centres in Lagos.
The security level at the country’s entry ports was also increased, with compulsory screening of travellers and passengers becoming a regular feature. The necessary personnels were trained and equipped to carry out their tasks.
Meanwhile, every Nigerian at all levels did their part, by acquiring hand sanitizers, maintaining optimum hygiene and following the guidelines of the health ministry once the virus came into the country through Liberian/America, Patrick Sawyer.
Most importantly, Nigeria was able to avert a possible disaster and vast spread of the virus through the sacrifice of Late Dr Stella Ameyo Adadevoh, who did not allow Sawyer leave the premises of the hospital, despite intense pressure from external forces to allow him travel to Calabar.
The Emergency Operations Centre, having worked on the eradication of the polio virus two years ago, employed the same strategy in responding to the outbreak of the Ebola virus disease. In fact, many of those chosen to work on the Ebola outbreak, were picked based on their prior experience in working on polio eradication.
The general consensus of observers, health experts and analysts is that Nigeria got rid of the virus by acting aggressively and quickly, in tracing all the secondary and primary contacts of the index case.
John Vertefeuille, of the US Centres for Disease Control and Prevention (CDC) recently told AFP that the prompt reaction of the country was a major factor in the halting the virus’ spread.
He said, “Nigeria acted quickly and early and on a large scale. They acted aggressively, especially in terms of contact-tracing.”
The Ebola Emergency Operations Centre (EEOC) prioritised contact-tracing and twice-daily monitoring of those at risk, with experts aware that every Ebola case is in contact with about 50 people.
In total, close to 900 people were monitored in Lagos and Port Harcourt, while about 1,800 people were trained to trace and monitor the primary and secondary contacts of the index case.
Many, however, believe that luck played a major role in Nigeria’s quick halting of the virus’ spread. This school of thought highlights the fact that prior to the virus’ importation, Lagos state lacked personal protective equipment for medics, which could have had serious implications in any rapid spread.
While luck can be said to have played some part, credit should also be given to the actions of the Lagos state and Federal government, the citizenry’s compliance with government directives and maintenance of optimum health, coupled with the efforts of the doctors who prevented Sawyer from discharging himself into an area of the state frequented by thousands of people.
As Nigeria awaits the World Health Organisation’s declaration of Nigeria being free of Ebola, it goes without saying that a joint effort by everyone across board that led to the stop of the spread of the virus.