Femi Ajayi's Outlook

Thursday, September 4, 2014

Prof. Femi Ajayi



he importation of Ebola to Nigeria, through Government recklessness at the ports of entry, is a wake up call to an average Nigerian, who lives in an unhealthy environment, coupled with unhygienic practices, or habits that have reduced life Nigeria's life expectancy at birth to 48.4 years from the United Nation's Human Development Report.

It has not been proved the natural reservoir of Ebola virus, or the manner in which the virus first appears in a human when the outbreak became unknown. However, researchers have procured an hypothesis that the first patient becomes infected through contact with an infected animal. In effect the virus can be spread through direct contact, through broken skin or mucous membranes, with a sick person's blood or body fluids - urine, saliva, faeces, vomit, and semen; objects, such as needles, that have been contaminated with infected body fluids; or infected animals. In effect, Healthcare workers and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids. Please contact your Physician if and when you, or, any noticeable individual, has Fever (greater than 38.6°C or 101.5°F), Severe headache, Muscle pain, Weakness, Diarrheal, Vomiting, Abdominal (stomach) pain, or Lack of appetite.

On Aug 29th 2014, it was reported that Ebola has officially spread to Senegal, joining Liberia, Sierra Leone, Guinea, and Nigeria. The news came only a day after World Health Organization officials announced that they expect to see, perhaps, as many as 20,000 cases before the current outbreak is quelled, which is nearly seven times as many as reported so far (September 2014). As of the time of this piece, WHO reported that there were 84 reported deaths between 14 and 16 August. As a matter of fact the Ebola outbreak has killed more than 1,300 people across West Africa. The death toll is rising, most quickly in Liberia, according to WHO. At least 2,473 people were infected with Ebola virus in West Africa.

As reported again, August 28, 2014, two Guineans and one Nigerian have been placed under surveillance at Imeko Afon, Imeko Afon Local Government, border area of Ogun State.

In Nigeria, the Government is working to control the spread of Ebola, as done by several organizations in protecting their staff against the spread of Ebola. Two patients, who had initial contact with late Mr. Patrick Sawyer, were discharged, August 25, 2014, free of Ebola Virus. It was also reported that, Nigeria, out of thirteen reported cases of EVD, five did not survive; seven were successfully managed at the isolation Ward in Lagos and have been discharged.

An American Survivor of Ebola August 2014

In the United States, the two Ebola victims were evacuated from Liberia Aug. 2, 2014, with a specially equipped jet; in another specially equipped Ambulance, with Police escort, to Emory University, Atlanta, Georgia. They were in the isolation unit, behind glass and many people treating them wore protective bulky medical suits. The victims received an experimental drug; and after three weeks of intensive care, survived, and returned to their families. It is believed that generally patients do not relapse and are not contagious once they have recovered.

Protection from Ebola

Emory University Hospital only had to treat two people. In addition, it had better infrastructure and testing capabilities available to it. There were five physicians and 21 nurses dedicated to helping these two patients, in addition to the support of hundreds of others.

Meanwhile, still in the United States, Universities and Colleges have begun to screen students coming from West Africa as a precaution to help prevent the disease from spreading to the United States. Babcock University is currently (September 2014) screening its Students, Staff and all guests into the University.

Despite the Government measures on Ebola; screening at the ports of entry; closing down Public Schools; and by the private organizations; Nigerians, in their private life, need to take care of their environments and drastically deviate from their contaminated ways of life.

The use of hand sanitizer which has been part of the Citizens handbag is not enough. That is not a big deal to women as they always turn their bags into mobile cabinet. Men have begun to mess up their dresses by sitting on the hand sanitizer in their pockets. Some are refusing to shake hands, talk less of hugging, which is alien to the Nigerian culture anyway.

Regardless the use of the hand sanitizer, running water is of importance in our homes, and in the medical facilities. Hand-washing, under running water in the Medical facilities, using mounted dispensing soap in the public facilities should be encouraged. Carrying sanitizer in pockets does not totally solve the unhygienic daily practices of an average Nigerian. Definitely, hand sanitizer does not reduce the spread of viruses and would not work on dirty hands. The sanitizer does not even reach about 95% of the Nigerian population.

In most of Nigerian Hospitals, from my experience, on my various Medical Missions to Nigeria, we observed Health workers attending to patients without any protective gloves. With the Ebola awareness, the Health workers must attend to patients with protective gear, not selling, or keeping them in their drawers and shelves.

One of the reasons for the death of one of Health workers Nigeria, who contacted Ebola virus through contact with Patrick Sawyer, Dr. Ameyo Stella Adadevoh, a Senior Consultant Physician, and Endocrinologist with First Consultant Medical Centre in Obalende, Lagos, Nigeria, was partially attributed to lack of basic amenities, especially running water. Water is of essence in our daily life. Accessible sanitary water is the single most essential component to living a healthy life.

Unfortunately, over half of Nigeria lacks sustainable access to safe water supplies and sanitation; which seriously affect their life expectancy. Water supply is not constant in the Medical facilities. Nigeria government should speed up provision of running water, in each of Nigeria Medical facilities across the country. Considering medical facilities, Hospitals, Clinics, and Health Centers, where individuals receive treatment, the poor unhygienic conditions of the environment, structure, and equipment in such facilities, would add more to the illness of the patients. This is worse in rural communities where majority of the Nigerian population dwell. The Medical facilities, environment, the equipment must be very clean, not rot, discouraging the breeding space for germs.

Survivors of Kaduna Blasts lying helpless on the unhygienic hospital floor: www.morenikejiblog.com

Nigerians should be very cautious of consuming food sold by roadside vendors, motor parks, and traffic holdups; most especially in the manner in which such food, were prepared. Ironically in that part of the world, there is no consistent regulation in the food sector, which gives room for sellers to prepare their food anyhow, anywhere and with anything.

A typical Bukateria in Nigeria in an open environment

Most of these foods and consumables are prepared in filthy environments with contaminated tools and water; and flies perch on them anyhow. The packaging and presentation of these foods are also insanitary and a major threat to life. Nevertheless, people buy and consume them either because they are in a hurry, ignorant, or do not have alternatives.

Roasted Chicken Being Sold Openly Vegetable traders conduct their business in very unhygienic conditions in various locations across the country.

Nigerians eat moin-moin, Akara-Idanre, roasted corn, fried yam, pounded yam, pap, plantain, and other food items from these unclean places. As a matter of fact, the average Nigerian goes for quantity instead of quality. Unfortunately, food vendors have a very low frequency of hand washing and personal hygiene, when they have to ration the amount of water available to use, sometimes using their wrapper to clean their hands. Food handlers with poor personal hygiene and knowledge of health education are potential sources of infections.

In the personal practices, homes must be kept clean preventing domestic germs from striving and causing havoc to human life. The kitchen, most especially, must be spotless before, during, and after each cooking to prevent house germs. A filthy kitchen that was filled with discarded food, containers in the house with no hot water, could be vulnerable.

A Filthy Kitchen

THE habit of open urination and defecation by an average Nigerian, regardless the status in the community, is one of the unhygienic acts that could jeopardise people's life. While Nigerians should not defecate or urinate anyhow anywhere, the government should endeavour to encourage the public toilets where those pressed with nature could easily take care of their natural desires, most especially at the Cities, Towns, and even Villages. That goes with the approval of all business or even private buildings for the provision of toilets.

A man defecates in a canal at Oshodi. Photo by Akinbuli Oluwatobiloba

In a report, in some Nigerian Cities, like Dustbin Estate in the heart of Ajegunle, Ojo, Ijesha and adjoining residential areas in Lagos; the little playground within residence is used to play soccer, perform acrobatics, often times without footwear, (Jonathan School days with no shoes) in a place that does not have the green playground, or a beach sandy playground, possibly filled with heaps of garbage. Residents have adapted so well they hardly fall sick of the germs they constantly interact with.

Inside a Lagos community where residents build and live on garbage ...www.premiumtimesng.com

On food production, in Ikosi-Isheri Local Council Development Area, LCDA, an individual takes pleasure in using baked bread as a source of relaxation bed. He has the moral justification to sell the products to the public for consumption. This is an unhygienic practice over various environmental offences most food producers commit.

See how unhygienic Agege bread is prepared with an innocent consumer December 2013, www.bomapeters.blogspot.com

The Government is campaigning against the consumption of bush meat; uncontrollably migrate from place to place; while some sellers and consumers insist that Ebola Virus is only in Liberia, Sierra Leone and not in Nigeria. The ways they are processed is sufficient to raise the red flag on the consumption of Bush Meat.

It is a known fact that some tropical hunting species are medicinal, as snail contains almost all the amino-acids that the human body needs. Its shell is a source of gum, and its colorless blood is useful locally for the treatment of hypertension. Since they are not under any protection, it is still necessary to restraint from the consumption of these delicacies, at least for now, and even in the future. At any rate they must be thoroughly cooked before consumption.

Fresh Bush Meat

In Line with the bush meat, is the locally prepared meat processing. The unhygienic ways they are processed need some Government and individuals' intervention. My visit to an open market when I first returned to Nigeria was very shocking with the amount of flies dancing over the raw meat on display in a filthy market place. The amount of flies on top of the displaced meat is enough for someone to throw up. Even transporting the meat, from the abattoir to the distributing centers and retailers, is unhealthy.

Roasted goat meats are placed in a wheelbarrow at the Swali abattoir in Yenagoa

Despite the campaign by the Lagos State government against handling meat in an unhygienic way, some meat sellers still defy the campaign and do their things their way. As people still operate illegal and unhygienic abattoirs across the country; the way and manners these consumables are transported are unhygienic. These people should constantly be reminded of Ebola virus among other viruses.

Unhealthy transportation of meat products

It is appalling some various unhygienic, unhealthy practices that shorten an average Nigerian life. Nigerians should desist from their bad habits, especially their unclean environments. Regardless what the government does or organizations enforce, individuals' ways of life matter, in averting any spread, or outbreak of any diseases in all areas. Hygienic living prolongs human life, beside the natural causes or accidents.

Once again, Nigerians should stay away from most of their unhygienic practices controlling the spread of Ebola and some other viruses. According to the United States President, Barack Obama, "…affected countries should focus on building a "strong public infrastructure". …… The Ebola virus, both currently and in the past, is controllable if you have a strong public health infrastructure in place."

Hello! Bawoni! Kedu! Sannu!

As there is no more hand shade, or hugging in Nigeria, which is alien to Nigerians anyway, citizens could go by way of greetings in Asian Culture: close your palms with simple bow. You can say Hello (English), Bawoni (Yoruba), Kedu (Igbo), or Sannu (Hausa). Make it simple. Regardless, most of Nigerian life styles must change. Nigeria and Nigerians have to wake up and clean up their environments, and stop unhealthy practices.

Health is Wealth!!!