WHO DID IT BETTER; LAGOS AND TEXAS: RESPONDING TO A CASE OF EBOLA

 

On 20th July 2014 Nigeria was thrown into commotion, Lagos state particularly as the country recorded its first victim of Ebola diagnosed in a private hospital in Lagos. The index case was a Liberian, the late Patrick sawyer who evaded authorities in his country to seek care in Nigeria; haven suspected that he had been exposed to the deadly virus. His arrival caused a lot of panic with resultant loss of lives and several people contracting the illness. Though Patrick Sawyer died five days after being diagnosed with the disease, Nigeria was able to do a splendid job of containing the spread of the illness. Through contact tracing and active surveillance we have been able to rid the country free of Ebola.

But in a similar twist of fate another Liberian Thomas Duncan, has been diagnosed with the Ebola virus in Texas United States of America, making the second Liberian to have taken the disease through the air route to a country in which the disease is not natural. The index case arrived the United States from Liberia on 20th September 2014 haven had contact with an Ebola victim while in Liberia. He marked the first case of EVD to be diagnosed in the US and since then up to eighty people have been put on a watch list.

There seems to be so many similarities in the two events, but through a critical look we can analyze the two events and compare the ways both have been managed. But before we go into critical analysis we should have at the back of our minds that the United States has a functional health system with adequate funding and a motivated work force against the backdrop of a robust economy. The situation in Nigeria is completely the reverse, a poor health system; indeed some would say no system exists, but the health workforce is far from motivated against a backdrop of poor socio economic conditions.

Mr Patrick Sawyer travelled to Nigeria from Liberia arriving at Muritala Muhammed International Airport on the 20th of July. The purpose of his visit was to attend a conference in Calabar although hand site report revealed that he sneaked into the country haven suspected that he had contracted the deadly virus. He came down with the sickness at the Airport and he was transferred to first consultant hospital Lagos.

At that time there was practically no protocol existing in the country on handling of suspected Ebola cases, indeed there was little expectation by Nigeria and even the western world that the deadly virus could be transmitted to a country that did not share contiguous border with Sierra Leone, Liberia and Guinea; the three countries in which the virus had already assumed an epidemic proportion.

However, through the heroic effort of members of staffs of First consultant hospital lead by the late Dr Stella Adadevoh whom so many now consider a national hero,  saved the day. It would have been unthinkable the overwhelming effect the disease would have had on our health system if those people had not taken pain to do their job diligently. Through their heroic efforts and an appropriate response by authorities of the Lagos State government it was possible to effectively carry out efficient contract tracing and active surveillance which made it easier for the country to contain the disease.

The case in Texas seems a little different. Even though the patient arrived from Liberia at a time when the attitude of the whole world was trigger ready to fish out any suspicious case of Ebola especially with the slightest inkling of contact with an infected person or region, the patient presented at a hospital in Dallas (Texas health Presbyterian) with symptoms of fever and even after giving information that he just returned from Liberia he was asked to go home with antibiotics prescribed. He returned to the hospital two days later haven spent time with close family and friends while exhibiting symptoms of EVD and it was until the second visit that he was then put on a watch list and eventually diagnosed of EVD.

Thomas Duncan who is presently in a bad shape had contacts with dozens of people and therefore puts up to eighty people into the surveillance zone for EVD. This list includes five school children who have put much fear in the minds of many parents whose children attend the same school with these pupils.

There is no doubt that the United State health system is ready to cope with the challenge of curtailing the disease but that does not obviate the error that has now put many people in harm’s way. One would have thought that with already perceived danger of a global spread the health system in the United State would have been so much ready that such a case should not have been missed.

I must however clarify that such errors are not beyond any health system for as long as humans interact in any system there are bound to be errors. The point that is being made however is that Nigerian doctors need to be appreciated. They have been working in a no system environment, poorly motivated in a harsh socio-economic environment, yet he puts up his best to deliver service best that he could.

Though so many regard the Late Adadevoh a hero of the country; I quite agree with that clamour, but the late doctor was actually just doing her job. She did it in a manner in which she has learnt, not minding the fact that the society had next to nothing to offer in return. So many Nigerian doctors are daily giving their all and a couple of times their lives to saving patients lives. They do it without expecting so much from the society yet the Nigerian doctor seems to be the most bashed by the public more than any other society that I have learnt about.

Even before EVD, Nigerian doctors face the daily threats of HIV, Hepatitis and many other communicable diseases. They also face harassment by the patient who they care for. They do this and only receive a wage too paltry to take care of a quarter of their needs. With or without Ebola the risk of communicable disease is rife amongst health workers, yet the doctor receives a paltry sum of five thousand Naira as hazard allowance.

We need to think deeply and give to the Nigeria doctors what they truly deserve. The doctors deserve to work in a virile and well funded health system with the capacity to improve upon the practice of medicine and consequent improved service delivery. The Nigerian doctor deserves encouragement and support, not frequent strikes as a need to demand for basic means of sustenance. It’s time to change the social ethos, lets support our doctors for all the work they do. Health is wealth, and remember an unhappy doctor is a dangerous doctor.