We must change the way we handle Ebola threat or prepare for disaster
What you need to know:
- When patients go for prayers rather than to hospital, and there is all that laying on of hands, when patients, including doctors, hide facts about their illness, when patients break out of quarantine, knowing well that they are contagious, then you have a bad, unpredictable situation.
- First, we need a multi-disciplinary task force, a big one. It should have some armed component so that quarantines can be enforced and some kind of order maintained. If you are going to use troops, it makes sense to train them to keep safe and treat patients with respect.
- Secondly, I think doctors and nurses in all district hospitals should be trained and drilled on Ebola management. They should be provided with protective gear and medical equipment for the support, isolation, and transportation of patients.
A woman has died in Port Harcourt, the large city of 1.4 million people in the Niger Delta.
She was killed by Ebola, which has so far taken 1,900 lives and which the World Health Organisation expects will put 20,000 in their graves before it is brought under control — if everything works according to plan. And Ebola is spreading because nothing works according to plan.
The woman contracted the disease because she was in the same hospital with Dr Samwel Enemua, who was infected by his patient, Mr Koye Olu-Ibukun, a Nigerian Ecowas diplomat who was, in turn, infected by Mr Patrick Sawyer, the Liberian-American man who brought the death to Nigeria on 20 July.
Mr Ibukun was in quarantine with other persons who had been in contact with Mr Sawyer.
However, he left quarantine, took a flight to Port Harcourt, and generally lay low, including switching off his phone. Mr Olu-Ibukun has recovered, but not Dr Enemua.
TAKE A DEEP BREATH
The behaviour of the two shows why Africa needs to take a deep breath and compose itself, otherwise it is going to get wiped out one of these days.
Dr Enemua knew he was dealing with an Ebola case. He reportedly took some precautions, including washing his whole clinic with disinfectant when Mr Ibukun was finally tracked down and taken back to Lagos. But when he fell ill, he did not disclose his suspicion that he had probably contracted the disease. He approached a colleague for treatment.
The colleague is reported to have been puzzled by his symptoms but was also careful. When Dr Enemua tested negative for the obvious ailments — malaria, typhoid and so on — he suspected that he was not being given the whole story and so he did what all good doctors should do: he called in more doctors. Dr Enemua died.
Dr Enemua’s wife has symptoms. His sister, Chinyere, ran away to Abia State when her brother died. She has since overcome her fears and come forward and is showing symptoms.
BAD SITUATION
About eight or so patients have been treated and discharged in Nigeria and 320 have been quarantined for the regulation 21 days and discharged. In Lagos, 41 people are under observation, in Port Harcourt 255.
Ebola in West Africa is beginning to go like a freight train. In the past week alone, 3,500 people have fallen ill and 400 have died. If you look at how it moved from Liberia to Nigeria and from Lagos to Port Harcourt, you begin to appreciate why doctors’ confidence that Ebola is easily controlled because it is not airborne is a bit brave.
When patients go for prayers rather than to hospital, and there is all that laying on of hands, when patients, including doctors, hide facts about their illness, when patients break out of quarantine, knowing well that they are contagious, then you have a bad, unpredictable situation.
Kenya is in a situation similar to a football match when the game is being played around your penalty area, your goalkeeper is making save after desperate save, and you are conceding corner after corner. It is just a matter of time.
After weeks of campaigning, I find the Ministry of Health strangely unresponsive and defensive. Someone important, perhaps the President himself, should take an interest in this emergency.
MULTIDISCIPLINARY APPROACH
First, we need a multidisciplinary task force, a big one. It should have some armed component so that quarantines can be enforced and some kind of order maintained. If you are going to use troops, it makes sense to train them to keep safe and treat patients with respect.
Secondly, I think doctors and nurses in all district hospitals should be trained and drilled on Ebola management. They should be provided with protective gear and medical equipment for the support, isolation, and transportation of patients. The lesson from West Africa is that patients, when they are provided with good care, can actually beat the virus.
The overarching priority is public information. Tell the people what Ebola is, how it is transmitted, how to stay safe, what the symptoms are, what to do when you have those symptoms, how to respond to family members and other loved ones who show symptoms, how to keep a cool head and a caring heart in the face of danger.
It can all be avoided, of course, by throwing everything we have at keeping out the virus, something we seem to be doing a good job of lip service to.
