Ebola, Nigerians and Getting It All Wrong

By IndepthAfrica
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Aug 26th, 2014
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By Nze Anizor

Since the Ebola virus docked in Nigeria through a Liberian diplomat, Patrick Sawyer, it has been a frenzy of information, panic, misinformation, sickness, survival and death. Lives have been lost and heroines have been made. The Lagos State Government and the Federal Ministry of Health have been working to contain the virus within the boundaries of Lagos, and thus stem its possible spread to the other parts of the country. The Chibok girls have been forgotten, and even the Boko haram seemed to have deferred to the virus and relented in their blood – letting, until recently that is. Nigerians agreed on one issue and signed a petition to compel the government of the United States of America to release the experimental drug, ZMAPP, for the use and possible cure of our Ebola patients. Never mind that as of that time, the drugs record was two out of three which was not really significant considering the very small number of samples.

Within that same period, we got to know of a drug called Nano Silver which our Federal Ministry of Health was on the verge of ordering for our patients until the US FDA raised an alarm that it was actually a pesticide. Suddenly, we were told that the National Drug Research Council failed to grant approval for the use of the drug, and it was withdrawn.

Within this same period, we awoke one morning to text messages urging us to bath with ‘salt mixed in warm water before 6.30am’ as a vaccine against the Ebola virus. We were told that the ‘drug’ originated from a Pastor in Lagos, a Pastor in Anambra, or a traditional ruler in Kogi, depending on who was telling the story. News reports had it that a number of people lost their lives to that misadventure.

Within that same period, a Professor who really should know better publicly announced that bitter kola showed some efficacy against the virus, and those of my friends who ordinarily liked kola are now complaining that the commodity has become very scarce. People have bought it up as a preventive measure against Ebola, after all a Prof said it.

Last week, we were told how the late Dr. Stella Adadevoh, a doctor in the hospital which attended to Patrick Sawyer was actually a hero having ‘prevented the patient, Sawyer, from leaving the hospital despite intense and repeated pressures from many sources including the Liberian Embassy to release him to attend an ECOWAS meeting in Calabar.’ We were told that if she hadn’t been firm, the man would have travelled to Calabar and infected more Nigerians. Our gratitude goes to the good doctor who unfortunately succumbed to the virus and lost her life along with some other personnel of that same hospital. According to news reports, the Federal Government is already mulling over possible ways to honour her. All I can say is that such honour must necessarily include every staff of the hospital that contacted the virus from Sawyer and died from it.

This then brings us to a few questions regarding that Sawyer matter or what I like to call, ‘The Case of the Infected Diplomat.’ How could a deathly ill Sawyer have been able to make it from his hospital bed in Lagos to the ECOWAS meeting in Calabar? This is more perplexing when one considers he lasted only five days in the hospital before death did him part. Where were the government health officials when ‘intense pressure’ was being mounted on Dr Adadevoh from quarters known and unknown to release Sawyer? Ordinarily, a case of Ebola, and the first one in our country for that matter, should be a matter for the federal authorities to take immediate charge of and implement necessary quarantine measures. This is the point at which those talking about ‘pressure’ lose me. I have a friend who made it a point of duty to post daily updates on his Facebook timeline asking about our preparedness for the virus. He has done this for past five months. Unfortunately, Ebola still caught us napping which was why nobody could flag Sawyer as a suspect even though he came in from Liberia and was near death as of the time the aircraft bearing him touched down in Lagos. He was so sick he had to be rushed to hospital straight from the airport. And we still missed it.

The Catholic Church leadership in Nigeria have stopped the habit of shaking hands as a sign of peace during mass. This is part of the Church’s new anti – Ebola stance. Another stance is that during Holy Communion, the priest should place the host in the palm of the communicant who would then feed himself. The normal practice in these parts is for the priest to place the wafer directly on the communicant’s tongue. I said in these parts because in many other parts of the world, the priest usually places the wafer on the communicant’s palm.

The Catholic Church has a rich history and invests lots of resources on the training of her priests. The church runs educational institutions and is known for erudition. One would have expected her to know that in the matter of Ebola, placing the wafer on the palm of the communicant is a recipe for disaster. It infinitely makes more sense and is safer for the priest to continue the former practice because it is very rare for his finger to touch the tongue of the communicant. A lot of anti – Ebola campaign focuses on regular hand washing because one would have to get Ebola or any other virus or bacteria – infected hand into his mouth, nose or eye to become infected.

How then does the Church encourage people to pick the communion wafer with an unwashed hand and from an unwashed hand, which has already touched different surfaces in the church, and put it into their mouths? Does the Church intend to create receptacles where communicants would wash their hands before proceeding to receive communion? One of our problems as a nation is engaging in knee – jerk responses to serious situations without adequate thought. The Church should not make a change just so that it will be said to have done something. We must not also always copy things from abroad. The Chinese were having daily baths long before Europeans and Americans accepted that regular bath is not injurious to health. The latter could go for weeks without a bath and believed head lice to be a normal part of life. In terms of hygiene, placing the wafer in the tongue by the priest is safer than placing it on the communicant’s palm. Hopefully, the Church may rethink this whole matter.

This brings us to the other matter of handshake. We are suddenly dwelling on discouraging handshake instead of educating our people on regular hand washing which will take care of any virus or bacteria one may have picked up in the course of daily living. It is a scientific fact that regular hand washing reduces orally contacted bacteria and viruses by more than fifty percent. We are relegating this very important public health tool to the background while concentrating on whether or not people should shake hands. This is irrespective of the fact that we know, or ought to know, that a habit ingrained in our genes over centuries cannot easily be stopped within a few months.

Rather than teach our hunters how to safely prepare their bush meat, we are asking them to stop hunting, and encouraging people to stop eating bush meat. We ought to know that since we are not providing an alternative to the hunter, he will most likely scoff at us and simply find a way to circumvent our laws or instructions, and continue his business at great risk to himself and the rest of the society. I admit that it is more difficult to teach him safe ways of preparing or butchering his bush meat than simply asking him to stop hunting. But I also know that short cuts normally have a price higher than the alternative path forsaken.

A friend insisted that Ebola has come to stay in Nigeria, after all we are still polio – endemic, but I prefer to believe we can lick Ebola if we just get our acts right.

Some companies have added body temperature check to the procedures visitors must go through before accessing their premises. It will be interesting to observe how the company would have react to somebody with a higher than normal body temperature. Quarantine him or deny him entrance? Or arrest him? Just one of those publicity stunts we invest in during serious national emergencies. I won’t be surprised if workers and visitors start popping anti – pyretic before approaching the gate. I doubt that anybody with a slight fever will be happy to be treated as an Ebola suspect. Perhaps they are going for the psychological effect.

One grave danger of passing the wrong information about Ebola and scaring the public is that hospitals may stop attending to patients who present with a fever. We should know the calamity that entails since many illnesses we encounter in these parts have elevated body temperature at the early stage.

Our public awareness messages should concentrate on encouraging people to wash their hands regularly; avoid touching body fluids of sick persons without protection; bury dead Ebola victims quickly and with minimal contact; practice safe preparation of animals known to transmit the virus; and most importantly, get sick persons to the hospital as quickly as possible.

The fact that ZMAPP’s record is presently 50% should encourage us to look away from it and concentrate on realistic preventive measures, more so when we have patients who have survived Ebola without being administered the drug.

Our people should know that Ebola virus disease does not have a 100% case fatality rate and that neither ZMAPP nor any other experimental drug is a silver bullet. That way, we shall focus on prevention and early reporting to a hospital in case of ill – health.

A FEW OTHER MATTERS

Boko Haram and The ‘Caliphate’ Foretold

News reports have it that the Boko haram have taken over Gwoza in Borno State and declared it their ‘Caliphate.’ Naturally, our Defence Headquarters have denied it as they are wont to do. And naturally, very few people believe them. The United Nations was reported to have confirmed that Gwoza is under ‘rebel’ control. Note the change in nomenclature from ‘terrorist’ to ‘rebel.’ In my article, ‘Boko Haram: The Genie We Let Out of The Bottle’ which was widely published by different online media on April 25, 2014, I said, ‘If we continue to toy with this insurrection as we are currently doing, we may end up at a conference room in Geneva negotiating for a cease fire with the Boko Haram, part of the conditions for which might be forming a ‘government of national unity’ with Shekau as Vice President and the members of the BH assimilated into the Nigeria Army. This will be the assured outcome once they declare themselves as the legitimate government of the North East.’ The chicken is gradually coming home to roost, to our utter chagrin. I knew the game has changed when they sacked what may pass as the top Police Academy in Nigeria which is located in Gwoza. Reports have it that at least thirty five policemen, including trainees, are still unaccounted for after the Boko haram attack. Many of us remember seeing mobile policemen preening and being very proud of having been trained at Gwoza. That seems to be coming to an end. The surprise is that the terrorists were able to take the Academy so easily. One would have thought that based on the recent history of Gwoza, all federal institutions, especially security ones, should be under maximum guard. Well, I will believe the Defence Headquarters while looking forward to credible evidence of the area still being under the control of the Federal Government of Nigeria.

The currently trending news about hundreds of our soldiers voting with their feet to Cameroon is not helping matters.

NMA and the Embarrassment Foretold

That the Nigeria Medical Association have called off their ill – advised strike is no longer news. What is news is that may have thrown the resident doctors whose employment was brought to an abrupt end as government’s response to the strike under the bus. The doctors should learn never to start a fight they lack the mental constitution to sustain and win.

Mr. President’s ‘Private Trip’

Something is still not right about the President’s information management team. Just imagine the way they have managed to mess up his visit to Germany and give room for needless speculation. So what if the President went for a medical check – up? So what? It is not as if Nigerians will see it as an affront. The NMA did not even know enough to exploit it to their own benefit. Presidents of countries do not just get up and make sudden ‘private visits’ to foreign countries. Their vacations are publicly announced, and the location known. But this is Nigeria.

You may follow the writer, Nze Anizor, on Twitter: @Okenze

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