LAGOS, NIGERIA - When the consultant for the Liberian ministry of finance, Patrick Sawyer, collapsed at the Nigerian airport on July 20, he was rushed to the private First Consultants Medical Centre in Obalande, a crowded suburb of Lagos.
Dr. A. S. Adadeveoh was in attendance and noted the patient had a fever and felt extremely weak, but he was fully conscious. His symptoms suggested malaria. The staff began testing him as he gave his clinical history.
Tests came back: the malaria was confirmed, but HIV and hepatitis B and C tests were negative. However, he failed to respond to treatment and developed symptoms of hemmorhagic fever.
Adadeveoh and a colleague asked if Sawyer had been in contact with any person with the Ebola Virus Disease at home, in any hospital or at a burial. According to the statement dictated and signed by Adadeveoh and her colleague, Sawyer said no.
That was the beginning of a series of events in which Nigeria hopes that it has stopped the Ebola virus in its tracks. Time will tell if the virus has been stopped. But some warn that the government needs to help the people face up to the dear of Ebola, as well.
Nigerian hospital does not bow to pressure
In her recorded testimony, Adadeveoh wrote that there was great pressure to release Sawyer, a Liberian American who was supposed to attend an Economic Community of West African State in Cross River State. Instead, the doctors isolated and quarantined the patient, initiated barrier nursing and asked the state ministry of health about further lab tests. Sawyer was, after all, a Liberian citizen, from a country where hundreds had already died of the virus.
Sawyer died on July 25. Dr. Adadeveoh died on August 19. Eight Nigerians have died of the virus. It is not clear if Adadeveoh is counted as one of those deaths; she was member of the Nigerian Medical Association, but her requiem mass was held at Christ the King parish in Accra, Ghana, where she was born.
Another doctor at the hospital, Ada Igonoh, contracted the virus but she survived. Igonoh says officials of World Health Organization picked her up from her parent’s home after her blood test came out positive for the Ebola virus. She was taken to a quarantine centre in Lagos where she was kept in isolation along with others who were also infected. Daily medication was provided.
Preparing for isolation and medication
Officials of World Health Organization provided pre-counseling to help the staff understand what to expect during the isolation period and from drug interactions. Some NGOs offered further counseling. A member of a team of medical volunteers who started a helpline called Ebola-Alert says the team provides psycho-social support for patients during isolation.
“We need a kind of psycho-social support for these people who are now left, who are bereaved,” says Dr. Richard Ademola Adebayo, a clinical psychologist in Lagos. Adebayo says psycho-social support for all patients should be mandatory – and should also extend to families of patients.
“We need a lot of support for them thereafter. It is not just enough to now say, ‘Go home. Thank God. Thank your star that you are not positive.’”
He warns that without support, those who have been discharged will suffer in silence and likely experience mental disorders long after the Ebola outbreak has disappeared from the headlines.
Dr. Adebayo says public enlightenment campaigns should also be expanded.
Already, those efforts can be seen on billboards recommending good practices for avoiding the virus. They include washing your hands with soap and water and not touching sick people who may have Ebola. The campaigns also include the telephone numbers of government agencies people can call for additional information.
Nigeria’s fears about Ebola are real
Many countries have offered help in the hope of eradicating Ebola. The Bill and Melinda Gates foundation recently announced a donation of $50 million to organizations working to control the disease. The United States and the European Union and international agencies are spending over a billion dollars in the effort to get the virus under control. But the fight promises to be a long one for most countries.
Among four countries fighting this strain of the Ebola virus that has killed more than 3,800 people, the Nigerian government has been aggressive in mounting early campaigns to create awareness about Ebola, how to avoid it, and how to help contain it from spreading.
But Adebayo says the fear of contracting the virus is still a large concern among the public.
“It has created a state of apprehension,” Adebayo says. “A state of fear, a state of anxiety, that people are worried, people are concerned. And the fears are real. They are not just misplaced. Honestly, they are real.
“So when you get to an institution or any organization, you are told to go and wash your hands, wash your hands, apply sanitizer. Despite that, people are still afraid.”
Lagos is the commercial hub of Nigeria. Dr. Adebayo says much of the public is knowledgeable about the Ebola virus, but the success of control and eradication efforts depends on the effectiveness of campaign messages in the suburbs.
“The government should reach out to the community leaders so that this information will percolate down to real people, grassroots people … especially those that are not very educated so that they will understand things very well.
“I am also saying that government should move fast beyond mere rhetoric and put a lot of things in place now.”