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Ebola Contaimment: A Rare piece of Good News from Nigeria

BusinessDay (19:08:2014):
In the midst of the gloomy news that Nigeria is often associated with comes a ray of hope that the country can indeed get things right when its officials and people put their hearts to work.This is the story emerging from the handling of Ebola outbreak in West Africa, where Nigeria’s officials have been able to contain its spread in Africa’s most populous country with over 168 million people.

This response has received huge commendations from the United Nations Population Fund (UNFPA) and the international community.
Following fear and anxiety the lethality of the Ebola outbreak has generated since it came into the country through late Patrick Sawyer, a Liberian-American, on July 20, 2014, Nigeria is racing to halt Ebola Virus Disease (EVD) from spreading, including tracing individuals known to have had contact with confirmed cases, training health care professionals to identify EVD, and raising public awareness of symptoms.
This cheery news comes as contact tracing in Nigeria has resulted in a range of between 94 percent and 98 percent of contacts of EVD cases being identified and followed up, according to the World Health Organisation (WHO).

With Nigeria recording 12 confirmed EVD cases, this development comes as a relief and provides a window to wipe out the disease before it gets out of control, as it has in Guinea, Liberia and Sierra Leone, claiming 1,066 lives, with 1,963 EVD cases confirmed since the outbreak began in December 2013. Onyebuchi Chukwu, minister of health, had announced yesterday that four additional confirmed cases of EVD who had been managed successfully and were now disease-free had been discharged.
“The four persons include two male medical doctors and one female nurse. The three participated in the treatment of the index case, while the fourth person was a female patient at the time the index case was on admission,” a statement from the ministry said.
This brings to five the total number of patients diagnosed with EVD who have now been discharged from hospital.

On the Federal Government’s containment efforts, Chukwu told BusinessDay that state governments were urged to institute a communication strategy to ensure mass awareness creation and sensitisation for individuals and communities on EVD in a bid to halt the spread of the disease. Federal and state ministries of health and the human services secretariat of the FCT administration were also directed to provide adequate incentives to health workers participating in the management of EVD patients, he said.

Chukwu said Nigeria’s partnership with WHO, UNICEF, the United States Centre for Disease Control and Prevention (CDC), local authorities and international partners in the area of technical capacity, health facilities for isolation of EVD patients and other containment efforts was aimed at halting EVD spread.
“The Ministry of Health is procuring isolation tents to quicken the pace of providing isolation wards in all states of the federation and the Federal Capital Territory. We are also setting up a special team to provide counselling and psychosocial support to patients, identified contacts and their families,” Chukwu explained.
“189 persons are under surveillance in Lagos and six persons under surveillance in Enugu. All the persons under surveillance were secondary contacts. All the patients under treatment have now moved to the new 40-bed capacity isolating ward provided by the Lagos State government. Additional equipment has also been made available to the new isolating ward by the Federal Government,” he said.

Chika Mordi, CEO, National Competitiveness Council of Nigeria, said Nigeria has done creditably well in containing the spread of EVD in the country. While Nigeria is perceived in the international community not to have functional institutions, Mordi said the case management of EVD in Nigeria has proven that the nation has functional institutions.
He said “If you compare the way Nigeria have handled the case of EVD outbreak when compared to other Ebola affected countries within the West-African sub-region, you will agree that we have done an excellent job. We can also improved upon the success.
“You may remember that the outbreak started in Guinea and then spread to neighbouring Sierra Leone and Liberia. Remember that the index case who brought EVD into Nigeria was visibly ill when he stopped over in Togo and yet Togo said they dont have any case of EVD. Ivory Coast which borders Guinea say they dont have EVD cases.
Don’t forget that in the last few months, Nigeria has been on the front burner on CNN and other news channels in the area of insecurity, suggesting that we don’t have functional institutions. The way we have effectively managed EVD in Nigeria suggests that the country has functional systems in place which could be improved upon.”
Another impressed observer of Nigeria’s handling of the Ebola outbreak narrated his experience at the Murtala Muhammed International Airport, Lagos yesterday. He said, “I was at the airport this morning (yesterday) to see off a relation and as she went in to board, she and other passengers were screened by health officials who not only checked their temperature but asked questions like how they felt, where they had been and it was damn effective. A rare case of us doing the right thing. I was so impressed and it shows how far we can go if we do the right things.

Babatunde Fashola, Lagos State governor, said the government was not shying away from its primary purpose of protecting and saving lives, as the state House of Assembly had approved additional expenditure to fund efforts at containing the spread of the disease. “My view of the fact that we are gaining control is informed by verifiable facts that I receive daily from our health workers that all the cases of those who have either unfortunately died, or those who are sick, and those who are contacts under surveillance are directly traceable to the imported case. This is encouraging news from which our containment strategy can profit greatly; because it means that we do not have any case of unknown origin, which will raise the risk of an epidemic,” Fashola said.

Adebayo Onajole, director of communication and community mobilisation for Ebola in Nigeria, said the country had been able to contain the spread through increased surveillance at the country’s borders (air, land and sea), increased awareness and less of disinformation of the disease in the country.
Onajole, who is also a consultant public health physician, noted that universal health precautions and personal hygiene were currently being encouraged, a situation  that would halt the spread of the disease.
“Efforts are currently ongoing to scale up and strengthen all aspects of response, including contact tracking, public information and community mobilisation, case management and infection prevention and control, and coordination,” he said.
“There is now increased disease surveillance system in a bid to monitor, control, and prevent any occurrence of the disease,” he added.
Five committees have been put in place in the country to halt the spread of the disease, BusinessDay investigation reveals. These committees include contact tracing (responsible for tracing contacts of infected person), case management unit (responsible for managing established cases), and point of entry unit, which is charged with the responsibility of examining persons entering Nigeria from various borders.
Besides the Federal Government’s N1.9 billion Ebola Intervention Plan announced by President Goodluck Jonathan, Aliko Dangote, chairman, Dangote Group, announced the donation of over N150 million from Dangote Foundation for the establishment of a National Ebola Emergency Operations Centre (EOC) at Yaba, Lagos.
The EOC is a key part of Nigeria’s response to the outbreak of Ebola on its shores. Headed by Faisal Shuaib, a US-trained public health expert with extensive international experience, the centre serves as the engine room of national response, providing a coordinating mechanism for prevention, surveillance, patient care, tracking, data analysis and containment of the spread of the virus.
It also facilitates coordination of partners, serves as a platform to link to the medical community across the country and also internationally, especially with countries also battling the virus in West Africa.
Public health experts believe EVD can be stopped through maintaining high effective control mechanism and communication within communities on proper hygiene practice.
“We do know how to stop Ebola. Its old-fashioned plain and simple public health: find the patients, make sure they get treated, find their contacts, track them, educate people and do infection control in hospitals,” said Thomas Frieden, director, United States Centre for Disease Control and Prevention.

By Alexander chiejina

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