EBOLA OUTBREAK: WHOSE FAULT?

by Ogundimu Omolabake

Until the entry of Patrick Sawyer, the Liberian Ebola victim, into Nigeria, most Nigerians who rely on the local media to educate them about the news of the wider world did not know about the existence of Ebola, the everyday Nigerian person knew next to nothing about Ebola, its symptoms, ways of detecting it and preventing it or the contagious rate of the virus. The death of Patrick in Lagos, Africa's most populous city, had health workers scrambling to trace those who may have been exposed to him across West Africa, including flight attendants and fellow passengers and with the help of the unprepared Nigerian government they sought to curtail the spread of the virus and educate Nigerians about the deadly virus.

The risk of contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say. Patients are contagious only once the disease has progressed to the point they show symptoms, according to World Health Organization (WHO). And the most vulnerable are health care workers and relatives who come in much closer contact with the sick. Most Nigerians didn't know this in the early days of the detection of the virus and they made false assumptions and passed wrong information about the virus believing that Ebola could be spread like flu through casual contact or breathing in the same air and some even devised homemade remedies; such as bathing with and drinking hot water and salt to reduce their susceptibility to the disease, others refused to shake hands, hug or engage in any sort of body contact with people around them.

Patrick Sawyer died after becoming noticeably ill on a flight from Liberia, where the worst ever outbreak of Ebola is gathering pace, to the city of Lagos in Nigeria. His case sparked alarm across the globe because he was able to board an international flight while carrying the incurable disease, potentially infecting other passengers who could fly across the world in a nightmare scenario for health experts.

Questions have being raised over whether the Liberian government could have prevented the entry of Ebola into Nigeria, if they had knowledge of Patrick Sawyer's condition they could have seized his international passport to prevent the further spread of the Ebola outside the borders of their country. Some see their negligence as a mischievous attempt to spread the virus to Nigeria and believe that the Nigerian government should take sanction against them.

The Nigerian government have also being blamed based on their level of unpreparedness for the entry of the deadly virus into the country. Ebola had first being detected in the 90's but came into Nigeria june, 2014 and it had caused almost a thousand deaths in countries including Liberia and Sierra Leone. Prior to the entry of Ebola into the country, the Nigerian government didn't make any move to educate its citizens and prepare its health sector for an emergency situation despite the presence of the deadly virus in West Africa.         

Presently the front page of Nigerian newspapers are filled with different stories on Ebola while the television I'd filled with campaign after campaign to educate Nigerians and separate myths from facts. If all this had being done prior to the entry of the virus into the country maybe it would have gone a long way in preventing casualties. The media's efforts to educate and sensitize the nation can easily be dismissed as 'Campaign after election'.

Nigerians has been banned from entering countries because of this deadly virus, what is required now is that government focus seriously on the disease instead the government has chosen this time to fire up to 16,000 doctors. The government needs to upgrade its public enlightenment and education programme about Ebola disease as many ignorant Nigerians have killed themselves quicker than the virus itself as they scramble for salt-water bath and drinking “remedy”. The government should not only provide laboratory and testing facilities for people who have contacted this virus but should also equip the place properly both with doctor and quarantines, and also reduce the spread of disease by encouraging Nigerian citizen to always sanitize themselves and report to hospitals if symptoms of this virus shows rather than hide it to avoid stigmatization.

The government should also curtail the information dissemination of the local media as most information disseminated by them has only heightened the fear about this Ebola outbreak.

Jonathan Sacks 16,000 Resident Doctors in Nigeria

The President, Goodluck Jonathan, has ordered the sack of all resident doctors in Nigerian hospitals.

 

The sack was contained in a directive by Mr. Jonathan to the Federal Ministry of Health to suspend all residency training programme for Nigerian doctors.

 

The directive was stated in an internal memo dated August 13 and signed by the Permanent Secretary, Federal Ministry of Health, L.N. Awute, to federal hospitals.

 

Mr. Awute said the president's directive was given following an appraisal of the challenges facing the health sector.

 

"Mr. President, Dr. Goodluck Ebele Jonathan, GCFR has suspended the Residency Training Programme for Doctors in Nigeria indefinitely for the purposes of appraising the challenges facing the health sector," Mr. Awute said.

 

He said the Minister of Health, Onyebuchi Chukwu, has also directed that "letters of termination of residency training" be issued to all affected resident doctors in hospitals immediately.

 

The memo asked the management of all public hospitals to take necessary measures to restore full medical services in the hospitals, even without the resident doctors.

 

In what appears to show the reason for government's action, the permanent secretary said the hospital could employ part time doctors who must be of 'good behaviour.'

 

"Note however, this is without prejudice to the employment of Locum Physicians on six (6) months renewable contract tied to productivity and good behaviour," Mr. Awute said.

 

Such recruitments must, however, be "be approved by Mr. President through the Honourable Minister of Health."


Doctors react

 

In his reaction, the President, National Association of Resident Doctors, NARD, Jubril Abdullahi, told PREMIUM TIMES that the president's directive is illegal.

 

He said the decision shows that Mr. Jonathan yielded to the demand of the Joint Health Workers Union, JOHESU.

 

"The action of Mr. President is illegal because there are several Acts that recognize Residencies in Nigeria and his action speaks volume of the government's decision to follow the dictates of the Joint Health Workers Union. This is one of the issues the union is asking for.

 

"Whatever the government have done in their reaction to the NMA's strike means they are not ready for dialogue because while we are engaging them, they have resorted to this," Mr. Abdullahi said, saying members of his association nationwide were about 16,000.

 

A resident doctor, who spoke on anonymity to avoid persecution, condemned the decision saying he was now officially unemployed.

 

The doctor, a staff of a teaching hospital, said a colleague of his had just sent him another circular ordering all resident doctors to surrender hospital property in their possession.

 

The circular, seen by PREMIUM TIMES, said the doctor's salaries and allowances for one month has been paid in lieu of the notice as they ordinarily are not entitled to any salaries for the period they have been on strike.

"In compliance with this order, I am to regrettably inform you that your appointment in this hospital is hereby terminated forthwith," the letter issued residents doctors in a teaching hospital in the South South region of Nigeria stated.

The Nigerian Medical Association, NMA, of which the resident doctors are members, has been on strike since July 1.

One of the demands of the NMA was that the Federal Government through the Ministry of Health should formalize and implement the report of the inter-agency committee on residency training.

The NMA also asked the FG to release a uniform template on the appointment of resident doctors and a funding framework for residency training established while overseas clinical attachment be fully restored and properly funded.

Resident doctors are doctors being trained to become specialists/ consultants in different fields of medicine. During their 4 to 5 years training to become consultants, they work in different government hospitals and make up the majority of doctors in teaching hospitals.

"Let's see how this will work. Except they want to kill the teaching hospitals and the health sector in general," another resident doctor told PREMIUM TIMES.

He explained that he believed the incessant strike by resident doctors and the NMA was what influenced the government's decision but doubted that it would be effective.

 

"In our own teaching hospital, about 90 per cent of the doctors are resident doctors, there are few medical officers. So how can you sack 90 per cent of doctors in a hospital?" he asked rhetorically.

 

Presidential Directives Suspendng Residency Programme in Nigeria

HEALTH: PRIVATE HOSPITALS FAIL TO ADMIT PATIENT WITH FEVER SYMPTOMS

Some private hospitals in Lagos yesterday Tuesday August 12th rejected treating patients who visited them with symptoms of fever as part of measures being taking to prevent contracting the Ebola Virus. 
 
A visit by the News Agency of Nigeria to some hospitals in Lagos Metropolis showed that nurses and other health workers, including cleaners were seen wearing face mask and gloves while attending to patients.

Also, some of the health facilities were compelling patients to wash their hands and apply sanitisers before proceeding into their building. 
 
Some of the hospitals visited included Jaycee Hospital, Prime Hospital, Lifeline Children’s Hospital and Providence Hospital. 
 
A Neurologist at Jaycee Hospital, Dr. Francis Ojini, told NAN that his hospital did not attend to patients who had with fever. 
 
Ojini said that it became necessary as health workers were at greater risk of contracting the virus. 
 
“Health workers are the first to be in contact with patients who visited the hospital and so it is necessary we take precautions. 
 
“For now, any illness that has to do with fever is not being attended to as we are trying to be careful because of the new development of the Ebola disease. 
“If there is need, we refer patients we feel we cannot treat. We hope we are able to curtail the spread in order to save lives,” he said. 
 
A nurse at the same hospital, who pleaded anonymity, said that nurses wore facemask and gloves when any patients visited the facility. 
 
He said: “We are protecting ourselves from contracting a deadly disease that has no drug or vaccine at the moment.” 
 
Allso speaking, the Medical Director, Lifeline Children’s Hospital, Dr. Uche Owowo, said that his hospital was making hand sanitisers available for patients. 
 
Owowo urged the Federal Government and other civil organisations to intensify awareness programmes to educate the masses about the disease. 
 
“Many people still need to know more about the disease, how it can be contracted and how to prevent being infected. 
 
“I believe educating people and making the facilities available and accessible will encourage people to be cautious,” he said. 
 
Efforts to speak with the medical directors and other health workers of Prime Hospital and Providence Hospital proved abortive as they refused to comment.
 
Source: NAN