Combating Ebola: Can Nigeria’s health system withstand the challenge?

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By most accounts, public health has become an integral element of any nation’s national security.

This explains why structured efforts are always made to provide adequate and timely medical care for the citizens of a nation, while tracking, monitoring and controlling disease outbreaks in the country.

The focus of global health concern is now on Ebola virus, which is currently ravaging some West African countries, as the deadly disease has the propensity to spread across national borders in epidemic proportions which can be very catastrophic.

Ebola, a devastating viral disease transmitted via contact with infected persons, has ravaged Guinea, Liberia, Sierra Leone and most recently, it surfaced in Nigeria, which has recorded two Ebola-induced deaths.

The World Health Organisation (WHO) says that at least 1,013 deaths in the four countries have been attributed to Ebola virus disease (EVD) or Ebola hemorrhagic fever (EHF), out of 1,868 reported cases.

The global health agency adds that 52 persons died of Ebola virus in the four countries between Thursday, Aug. 7 and Saturday, Aug. 9

Observers note that the number of Ebola infections is growing by the day, adding that the disease has become an international health emergency.

Patrick Sawyer, a Liberian national, was the first person to die of EVD in Nigeria and the disease has also claimed the life of one nurse, while five other Nigerians have been confirmed to be infected with the virus and consequently quarantined.

When Ebola virus surfaced in Nigeria via Sawyer, the Nigerian Medical Association (NMA) was on strike and thus, government hospitals across the country were not fully functional because of the absence of medical doctors.

Observers describe the situation in government hospitals at that point in time as a blessing in disguise, saying that the magnitude of the spread of the Ebola virus would have been greater if Sawyer had been taken to a government hospital.

A major question in the minds of many concerned citizens now is: “Is Nigeria’s healthcare apparatus well primed to handle Ebola epidemic?’’

Dr Jibril Abdullahi, the National President, National Association of Resident Doctors (NARD), said in a recent write-up that the Ebola virus had come to meet dilapidated health system in Nigeria.

He stressed that over the years, the Nigerian health system had crumbled into a state of disrepair, as factors such as brain drain, corruption and dearth of modern facilities had reduced the quality of the country’s health system.

“And alas under this new health threat, one must x-ray the state of Nigerian hospitals.

“Indeed, most government facilities are not equipped to handle such a crisis; biohazard suits are not available, protocols for treatment and referral of Ebola cases are nowhere to be found.

“Test kits are in short supply, even simple ancillaries like gloves and syringes are a premium in Nigerian hospitals.

“The current system obtainable in most government hospitals where patients are obliged to wander from one pay point to another in a bid to access care is only a harbinger of doom, likely to precipitate the spread of the virus en-masse by a potential sufferer who is striving to access care.

“Indeed, providence has smiled on Nigeria for if not for the ongoing doctors’ nationwide strike; it is highly likely that the Liberian, Mr Sawyer, would have been taken to one of the teaching hospitals.

“And before one could say Jack Robinson, scores of doctors, medical students, nurses and even laboratory scientists would have contracted the deadly disease with the exponential spread to their families, friends and other patients.

“Ebola is, indeed, the game changer for the Nigerian health sector whether the government likes it or not, and it calls for urgent action,” he said.

Abdullahi said that doctors were willing shelve their strike and go back to work, in efforts to contain the virus, adding, however, that they would not do so without the provision adequate protective gear and health insurance.

He urged the Federal Government expedite action on the resolution of the issues that led to the doctors’ strike, while forestalling the recurrence of such strikes by revamping the health sector and meeting the doctors’ valid demands.

Abdullahi argued that if the government could spend trillions of naira to equip the military to fight insecurity; then, it should be willing to spend a few billions to save the health sector from an imminent collapse in the event of an Ebola outbreak.

However, since the unfortunate Sawyer saga, the Federal Government has been making concerted efforts to contain Ebola virus and forestall the onset of an epidemic, while reaching out to the doctors to call of their strike.

President Goodluck Jonathan moved quickly and decisively to arrest the spread of the Ebola virus by approving the acquisition of additional protective equipment for health and border officials.

The special gear will reduce risk of infection among those who, by virtue of their occupation, may come in contact with persons who are infected with Ebola virus.

Jonathan said that the gear would be distributed to all federal hospitals across the nation; beginning with border states like Lagos, Cross River, Kano, Rivers, and Borno.

Following the presidential directives, health workers and border officials will also be educated on the use of the gear; they will also be equipped with adequate information about the Ebola virus and how to handle suspected cases of Ebola infection.

According to the Federal Ministry of Health, government officials have started to screen passengers coming into the country for symptoms of Ebola.

Besides, workers of various agencies operating at the Murtala Muhammed Airport, Ikeja, and the Nnamdi Azikiwe International Airport, Abuja, have been sensitised to the dangers of Ebola virus and how to prevent its spread.

The Minister of Health, Prof. Onyebuchi Chukwu, also said at a recent meeting with diplomats that the government would begin the screening of outbound passengers at the country’s borders, as a way of curbing the spread of Ebola virus.

Moreover, Chukwu said that the Federal Government had declared the Ebola disease as a national emergency, while briefing the House of Representatives’ Committee on Health.

The minister said that everyone in the world now was facing the risk of Ebola infection, adding that the Nigerian experience had further opened the “eyes” of the world to the reality of Ebola.

Although Nigeria has yet to close its borders, the Federal Government has banned the repatriation of dead bodies from Guinea, Liberia and Sierra Leone into the country.

As a proactive measure, the health ministry wrote to the U.S. government, asking for the experimental serum “Zmapp” which is reportedly efficacious in the treatment of two U.S. citizens, Nancy Writebol and Kent Brantly, who contracted the Ebola virus.

Although indications suggest that the U.S. may not be forthcoming with regard to the drug, the Jonathan-administration is still relentless in efforts to partner with the U.S. in curbing the spread of the virus and save Nigerian citizens.

Meanwhile, all the states in the country have gone ahead to set up isolation units for those who have contracted Ebola virus, while embarking on the training of health personnel on how to manage the disease.

In Enugu State, for instance, the Commissioner for Health, Dr George Eze, disclosed the preparedness of the state in efforts to fight the epidemic.

“We have an epidemiology unit in the Ministry of Health, with experts who are saddled with the responsibility of fighting epidemics like this,’’ he said.

In Lagos State, the state government has moved swiftly to secure the state’s borders and scrutinize all persons coming into the state through the Seme axis of the Nigeria-Benin border.

Indeed, Nigerians are now more cautious of the risks of contracting the Ebola virus – the world’s deadliest virus — as people now avoid handshakes and contacts with others.

All the same, the health ministry has advised the citizens to adopt precautionary measures like hand washing to guard against infection.

It also advised health workers to use protective gloves while handling patients. (NANFeatures)

By Oladayo Komolafe

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