In the wake of the outbreak of the Ebola Virus Disease, EVD, in Nigeria, numerous experts on the local and international scene have commented on the immediate and long-term implications of the outbreak in the country.
Okhria who manages a health care consultant group called Victoria Universal Technologies Limited in Texas, USA shares from his extensive clinical and administrative experience in the health care industry, to speak on the reality of Ebola survivors in the country. Excerpts:
Some survive, others don’t.
Ebola is a deadly virus with a high mortality rate of about 90 percent of people who are infected. Timely detection or diagnosis of the disease is essential because early treatment may increase the chance of survival.
Perhaps the reason why some survive and others don’t is because the average time between contracting the infection and the start of symptoms varies.
It is usually eight to 10 days, but it can vary between 2 and 21 days. Early symptoms of EVD may mimic those of malaria, dengue fever or other tropical fevers which may mislead the healthcare providers and delay appropriate treatment. Furthermore, the disease challenges the immune system, depletes the blood clotting-cells, and damages the body organs.
These subsequently results into disseminated intravascular coagulopathy (DIC) and multiple organ failure which increases death rate. Hence, the survival rate of infected people who are already immune-compromised may be reduced.
If an infected person survives, recovery may be quick and complete. However, Ebola virus may be able to persist in the semen of some survivors for up to seven weeks, which could give rise to infections and disease via sexual intercourse.
There should be no stigmatisation of EVD survivors. They should return to the community and successfully perform their usual activities of daily living.
There are indications that prolonged EVD cases are often complicated by occurrences of long-term problems, such as inflammation of the testicles, joint pains, muscle pains, skin peeling, or hair loss. Eye symptoms, such as light sensitivity, excess tearing; iritis, iridocyclitis, choroiditis, and blindness have also been described.
It is unwise for the Lagos State Government to unveil Ebola survivors publicly. Patients’ privacy and confidentiality should take precedence over the aim of the government to toot its horn when it is providing its citizens healthcare services which is their rightful entitlement.
The government should quietly savour its successful outcome in controlling the outbreak, while it exacts more efforts to consolidate the gains and up surveillance for improved protection.
We are not completely out of the woods with the EVD outbreak. EVD survivors who want to share their ordeal with the public may come forward on their own accord or give interested second party an informed consent to act on their behalf.
Short term/long term effect
The short term effect of EVD outbreak is the immediate realization that the disease is not a hoax. It is obvious that our healthcare facilities were not readied for such outbreak and it may over burden the healthcare system in terms of the availability of trained personnel, equipment and fiscal solvency.
We are a society that is quick to forget and we are apt to let down our guard once we have a little reprieve from a situation.
There may be a shortage of healthcare workers due to their hesitation to provide care to the EVD patients and the fear of getting infected may pose a long term effect of the EVD outbreak on the healthcare system which is already inadequate and weakened to begin with.
Preventative or therapeutic vaccine?
Most vaccines provide active preventative immunisation. Vaccines prevents the occurrence of a specific target disease for which it was produced, it may not be therapeutic post infection. The development of vaccines to prevent EVD is more desirable, however, none yet exists.
Therapeutic treatment of people infected with EVD is supportive care which may include giving either oral hydration therapy or intravenous fluid to maintain the body’s electrolyte balance and skin turgor. And of course, the isolation of the patient from the public to prevent further spread of the disease..
Ebola spreading beyond Lagos
The implication of the spread of the EVD beyond Lagos indicates that our assumption that the outbreak is localised is false and the government may lose the battle to contain it. This portends that new cases of the infection could be lurking around in some other states of the country.
More so that it has become evident that some healthcare providers are not diligent in the triage of new onset cases, problems of under reporting, perhaps lack of surveillance in many states, compounded with the hidden cases of infected of infected persons who may choose to seek traditional healing.
EVD outbreak may also pose a public health threats because of its effects on healthcare providers. Failure to observe universal precautions in healthcare facilities may impact on the entire healthcare system.
The government should enforce its quarantine (enforced isolation) law, and/or enact one for the EVD emergency.
Pros and cons of response
The pros of the government response to the EVD has been the ability to seriously view the outbreak as detrimental to human lives, the economy and the stigmatisation of the world community as a clueless entity. The cons of the response validate the belief that the government has no long term strategic plan towards major casualty or natural disaster should it occur.
This is true in all aspects of governance, be it human services or basic social amenities. More proactive plan rather than reactive would be advantageous, and it enable less chaotic handling of emergencies.
We do not have to wait until the last minute when disaster occurs before a campaign of its probability of occurrence is set in motion. There should have been a drum beat about the disease prior to now.
By so doing, the community would have been well informed and educated about the disease. Suffice is to say that Nigerians have been moderately sensitised about the disease.
Plugging the gaps
A gaps analysis of the EVD strongly suggests lack of preparedness and non-sophistication of the healthcare system.
Nigeria is still years away to catch up with modern technology and advances in the delivery of healthcare. Some of our healthcare providers are unethical, healthcare facilities are antiquated and the entire healthcare system is non-responsive to the well-being of the people.
The healthcare system in Nigeria requires the infusion of funds, ultra-modern technologies, staff development and culture change.