FEATURE ARTICLE

Temple Chima UbochiThursday, October 23, 2014
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Bonn, Germany

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NIGERIA’S STOPPING OF EBOLA DEAD IN ITS TRACKS: A NO MEAN FEAT (1)


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Nazareth! Can anything good come from there? Nathanael asked.“Come and see,” said Philip (John 1:4)

Nigeria's success "is a first-class effort. There's a lot here for other countries to learn, including the United States (Downie)

Stand up to your obstacles and do something about them. You will find that they haven't half the strength you think they have (Norman Vincent Peale)

Nigeria’s globally-acclaimed success against Ebola is a testimony to what Nigerians can achieve if they set aside their differences and work together (President Goodluck Jonathan)

oday, Nigeria is making world headlines, for a positive reason, and that should be a source of joy for all. This is a cause for celebration. The World Health Organisation, on Monday, October 20, declared Nigeria Ebola-free after 42-day period with no new cases in the country. That day marked three months after widespread fear that Ebola virus could spread through Nigeria. According to AFP, the WHO declaration is premised on the fact that Nigeria has not had a confirmed case of Ebola for 42 days or two incubation periods of 21 days. “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." With the above words, Country Representatives of the World Health Organisation (WHO) in Nigeria, Dr Rui Vaz, officially declared Nigeria free of the Ebola Virus Disease. The achievement is being welcomed, in view of the no end in sight to the disease that has claimed more than 4,500 lives this year, most of them in West Africa, and mounting fears about cases around the world. But how did Nigeria win this Ebola war in such a short time, while the advanced countries are struggling to contain the disease? The advanced countries are even learning how Nigeria handled this issue so as to apply same in their respective countries. They say that close attention is being paid to how Nigeria, with an under-funded and ill-equipped health system, managed to contain the virus, as specialists look for a more effective response to control its spread. Nigeria led a very effective fight against Ebola: There was pragmatic set of measures put in place by the government which involved the federal, states and international organizations.

No one, in this world, thought that this can ever happen in Nigeria! The World Health Organization (WHO) has declared Nigeria Ebola Free! How did the country pull this one off? All of a sudden, Nigeria turns from a good-for-nothing-country to a new bride being courted by the world to know how it handled its Ebola cases. While the developed world is struggling, not knowing how to handle Ebola, Nigeria blazed the trail, by defeating the scourge. For instance: The Texas hospital that cared for the first patient to be diagnosed with Ebola in the United States, has apologized over its mishandling of the case. In its words: “We did not correctly diagnose his symptoms as those of Ebola. For this, we are deeply sorry. Our facility “did not live up to the high standards that are the heart of our hospital’s history, mission and commitment.”

The whole world is tackling Ebola together, because, if not well handled, it would go on for decades, and no one knows where and when it would end. The US President, Barack Obama, is just naming attorney Ron Klain as the new White House “Ebola czar”, to coordinate the US response to the outbreak. The European Union is still deliberating on how to handle the situations in the Union, with the European Union foreign ministers agreeing, on Monday, October 20, in Luxembourg, to appoint an Ebola coordinator to bring together resources and funding to tackle the deadly disease before it becomes a global disaster. The coordinator will be named in the coming days and will be based at the EU’s Emergency Response Coordination Centre in Brussels. We are told that appointing an EU coordinator is an important step “because everybody has to be on board to fight this epidemic. In the words of the French Health Minister: “The mounting death toll in Liberia, Sierra Leone and Guinea is cause for grave concern, with the “figures rising… exponentially”. The leaders of the 28 EU nations will also meet on Thursday, October 23, and, Friday, October 24, at a summit in Brussels, to discuss on Ebola. From all the desperation, one can see that world leaders are rushing to get ahead of Ebola before it can establish a foothold outside Africa. While world leaders are still looking for ways to handle Ebola, Nigeria has been certified Ebola-free, because of the speed and decisiveness employed by the federal government and all the relevant health authorities, showing what can be done, if action is taken promptly. What to learn here is that we can defeat any of our problems, if we have the will and commitment to face them.

Nigeria’s success story here involved commitments on the part of the leadership and health care personnel involved, and a bit of luck, as the virus was stopped dead in its tracks, with only 20 cases and 8 deaths. Nigeria also used an effective communication system, such as facebook, voice messages, twitter and the social media, to get the citizens informed about the precautionary measures to be taken to keep the disease at bay. There were Public health campaigns, including a giant electronic billboard warning about Ebola just outside the hospital where Sawyer died, which helped raise awareness. Airports and seaports introduced compulsory screening on arrival and departure; temperature checks and hand sanitizer use for the public become the norm. Then, two treatment centres only (Lagos and Port Harcourt) were created in the country as that streamlined things down, so that any case of Ebola in any part of Nigeria was either referred to Lagos or Port Harcourt, and no other place. Everything was well organized: At these two treatment centres, for every two medical personnel, there was a third (personnel) supervising, and once a mistake was made, treatment would stop and the affected medical personnel would be disinfected immediately. There was the effective use of local ingenuity, local materials and local personnel and these paid off handsomely. For instance: polythene bags, water proof sheets, dettol and bleach from local stores were all used when there was shortage of materials. The survival strategies Nigerians have learned in the midst of wants, needs and adversity help out here, as bleach was used to disinfect the hospitals, polythene bags and water proof sheets were used to sow protective gears, hand gloves, disposal bags etc.

The World Health Organization says that Nigeria handling of the Ebola Virus Disease was a spectacle success story; calling it a tremendous day for Nigeria, showing that with the will, the fight against Ebola can be won. Nigeria was effective from the beginning, as an existing plan for a mass outbreak of polio and heath surveillance system for polio was converted and adapted for the fight against Ebola. Dr Rui Vaz, WHO’s Representative in Nigeria, said that “the Nigerian experience had become a huge reference point for Ebola curtailment in the world. We need to continue sharing the Nigeria's experience and country's expertise to help other countries to urgently contain the epidemic and support others in their preparedness to the response plans”. We also learnt that about 600 volunteers had been trained and ready to be dispersed to support West African countries that are still Ebola endemic. The Coordinator, Nigerian Centre for Disease Control (NCDC), Prof. Abdulsalami Nasidi, said “over 600 Nigerian doctors, nurses, laboratory scientists, field epidemiologists and other categories of experts, including journalists, have registered to join the international team on Ebola. This strong team is an indication that Nigeria is committed to leading the fight against Ebola in West Africa.’’ According to Elombah, the NCDC coordinator said that the Federal Government’s Treatment and Research Group had helped in developing a national response plan. He stressed that implementation of the plan, which was conceived to help Nigeria to prepare in the event of an outbreak of the disease in any part of the country, would soon commence. The coordinator said that the plan put together was in acknowledgement of the fact that Nigeria was still at risk of another outbreak of the disease. He added that until the last reported case of Ebola in the world was brought under control, Nigeria would not relent in its efforts to combat the disease. Also, the Lagos state Governor, Babatunde Fashola, on Sunday, October 19, said his government was finalizing arrangements to deploy some health workers, who had helped in the containment of the Ebola Virus Disease (EVD) in his state, to Sierra Leone. The Governor said the health workers are to replicate the efforts used in containing the virus in Lagos, with a view to helping Sierra-Leone contain same. Sierra Leone accounts for a substantial number of the over 4,000 global Ebola deaths. According to Fashola, sending health workers there is not only to assist the country but to contain further spread of the deadly disease. “Lagos is free from Ebola; Nigeria is free from Ebola. But that does not mean there cannot be another case. For as long as people are moving from countries to countries, the risk of infections is still there. That is why I appeal to the Federal Government to continue to scrutinize people travelling into Nigeria from land, sea and air from regions where the problem is still ravaging. That is why some of the things the commissioner for health will be announcing very soon is the arrangements we are making to send some of our health workers and volunteers to go and help out in Sierra Leone. That is the only way we, the whole of Africa and the World can be safe.” Fashola expressed optimism that the EVD will soon get a cure, hence called on Nigerians not to live in fear but take preventive measures against the virus. Fashola stated that among his strategies to prevent return of the virus include, the deployment of screening equipment to schools and hospitals and the construction of sanitary facilities in schools. Others are training and retraining of personnel on infectious diseases diagnosis and the sensitisation of residents on how to be safe from the problem.

Nigeria has mesmerized the world, even if it was luck that played the major part here. When the index case was discovered in Lagos, it raised such national and international concern that government, at all levels, brought to the fore the primary importance of fighting the spread of the virus. Many feared the worst when Sawyer died on July 25 in a private hospital in Lagos, which is home to more than 20 million people, with poor sanitation and inadequate health facilities. Doctors were on strike at the time over pay and conditions in the public health sector. In Nigeria, many state hospitals lack running water, let alone soap and other basic equipment. Yet the doomsday scenario of rapid spread among a 170 million population did not materialize. Nigeria acted quickly, early and aggressively when Sawyer arrived, especially in terms of contact-tracing. There was a perfect contact tracing system put in place in which anybody who had any form of contact with Sawyer, whether directly or indirectly, was monitored for any sign of the disease. Faisal Shuaib, the head of Ebola Emergency Operations Centre (EEOC), said there was prioritized 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 all, nearly 900 people were monitored in Lagos and Port Harcourt; where one contact of Sawyer travelled to, after slipping surveillance, and infected another doctor. Some 1,800 people were trained to trace and monitor those at risk, as well as decontaminate infected places and care for the sick. Luck cannot be discounted in Nigeria's first brush with Ebola. Sawyer was taken straight to hospital after arriving from Monrovia visibly ill, keeping him off Lagos' teeming streets. Doctors also prevented him from discharging himself into an area of the city frequented by tens of thousands of people. The EEOC, in the early days of the outbreak, highlighted concerns such as a lack of personal protective equipment for medics, which could have had serious implications in any rapid spread, but, there was improvisation when the need arises.

The American government was so worried that Nigeria would not handle the situation that they were almost “weeping more than the bereaved”. But today, Nigeria has defeated the disease while the United States is still contemplating how best to tackle the disease. The Acting Director of the United States Centre for Disease Prevention and Control, Dr Pauline Harvey, was in Nigeria on Monday, October 20, saying that she was there to learn from Nigeria, and would take Nigeria's experiences very seriously in managing the situation with the confirmed cases in America. She said: "We take great pride in joining the federal republic of Nigeria and its partners, stakeholders, communities including private sectors across the country to recognize this remarkable achievement". David Francis, in a report, captioned “Ebola: Nigeria Got Right Everything America Got Wrong“, published by Scruples on October 20, wrote: “When the first case of Ebola was discovered in Nigeria this summer, Jeffrey Hawkins, the U.S. Consul General in Lagos, said that an outbreak there could become an "apocalyptic urban outbreak. The last thing anyone in the world wants to hear is the two words, 'Ebola' and 'Lagos,' in the same sentence," Hawkins said in July.

Americans yawned, assured that if Ebola did somehow make it to their shores, the world's richest country would swiftly and easily eradicate it from its borders. "The United States had overconfidence in their ability to stop it," said David Dausey, a Yale-trained epidemiologist who works on controlling pandemics and who is dean of the School of Health Professions and Public Health at Mercyhurst University. However, Hawkins and others had plenty of reason to worry about Africa's most-populous country, Nigeria, which had 20 Ebola cases and eight deaths. Lagos, with some 21 million residents, is the continent's biggest city. In addition, 49 percent of Lagos state's population lives in poverty in slums with little sanitation. Making matters worse is that doctors discovered an Ebola case in Port Harcourt, another extremely poor area where the majority of people live in shanties with almost nonexistent sanitation (keep in mind, the disease is spread by bodily fluids).

And it was not just lives at risk. As FP reported in August, an outbreak in Nigeria had the potential to devastate West Africa's economy. Nigeria seemed like the ideal petri dish for the virus to grow. That's what makes the World Health Organization's announcement that "Nigeria is now free of Ebola virus transmission" a massive relief in the fight to stop the pandemic that began in December 2013. That WHO announcement reveals an organization that seems to be in disbelief. In a situation assessment, the WHO called it a "spectacular success story" that prevented "potentially the most explosive Ebola outbreak imaginable."

So how did Nigeria, a country with poor public-health infrastructure and a GDP of $510 billion, manage to contain the disease when the United States, a country with sophisticated public-health infrastructure and a GDP of $17.3 trillion, could not? First, a bit of luck: Nigeria's "patient zero," a man from Liberia, collapsed in a Lagos airport, making it easier to identify those exposed to the disease."What helped Nigeria is that they quickly traced the source of the virus," said Richard Downie, an expert on Nigeria at the Center for Strategic and International Studies. "The fact that he collapsed in the airport was good luck in a good way." However, Downie credits Nigeria, a country not known for coordinated or effective action at the national level (see the fight against Boko Haram), for what came next. "What impressed me the most about the response, and somewhat surprised me given Nigeria's track record in dealing with other crises, is that they were so thorough about it," Downie said. "They quickly amassed a list of anyone who may have come into contact with the index case. They hit the streets. They had a fast response, came up with a plan, and did the legwork on the ground." According to the WHO, the public-health community knew an outbreak in Nigeria was a potential disaster. As soon the first case was discovered, the WHO, the CDC, and other government officials "reached 100 percent of known contacts in Lagos and 99.8 percent at the second outbreak site, in Port Harcourt, Nigeria's oil hub."

Isolation wards were then created, followed by treatment facilities. People who tried to escape were digitally tracked and returned to isolation. Doctors Without Borders and the WHO quickly trained local doctors to treat the disease. And while Nigeria's public-health system is poor, it's not nonexistent; aid groups have been working to eradicate polio there for years. In an interview with Time Magazine, Faisal Shuaib, a doctor at Nigeria's Ebola Emergency Operation Center, also said that stopping public panic was instrumental. "People began to realize that contracting Ebola was not necessarily a death sentence," Shuaib said. "Emphasizing that reporting early to the hospital boosts survival gave comfort that [a person] has some level of control over the disease prognosis." Shuaib added that keeping Nigerian borders open -- the opposite of a strategy being thrown around in Washington right now -- helped to contain panic.

On the other hand, the United States has done almost the complete opposite of Nigeria. It took 11 days to diagnose Thomas Eric Duncan with Ebola after he was turned away from a hospital six days after the Liberian's arrival in Dallas. Amid questions about whether medical personnel were properly trained to treat the disease, two nurses who treated Duncan, Nina Pham and Amber Joy Vinson, contracted it. Vinson was allowed to travel round-trip to Cleveland, despite reporting a fever to the CDC, which has been on its heels since Ebola arrived in America. Meanwhile, the political efforts to reassure the American public have been inconsistent; on Friday, President Barack Obama appointed Ron Klain, a political operative with no public-health experience, to coordinate the government's response. The Pentagon created a 30-person medical personnel team to train people to treat the virus. Politicians continue to call for a travel ban, while cable news covers the three cases as if they represent a national outbreak“.

To be Concluded!

TIT BITS

https://www.youtube.com/watch?v=YiUQE5bJKFU

https://www.youtube.com/watch?v=ZX0ywZ-ot1I

https://www.youtube.com/watch?v=ehw2Vhcfv4M

THE THANX IS ALL YOURS!!!

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