Ebola: Counting the Cost
Months after Nigeria was declared Ebola-free by the World Health Organization, the World Bank and the World Economic Forum in collaboration with the Boston Consulting Group gathered stakeholders at a forum in Lagos to discuss lessons learnt from the crisi
ust as Nigerian government and its health sector continue to share the success story of how Ebola Virus Disease (EVD) was defeated in the country despite the volatile nature of the spread of the dreaded disease, experts have said the first step in preparing for future outbreaks is to have a retrospect on how the battle was fought as well as mistakes made before and during the outbreak and then proffer ways to better tackle future occurrence.
Hence, stakeholders from various sectors in the country gathered recently to brainstorm on the past, present and future of disease control in Nigeria.
Clearly, stakeholders were unanimous in their verdict that Nigeria is not yet prepared to tackle any future outbreak of EVD since the necessary facilities and heath care system needed to achieve it were not yet in place.
They specifically stressed that only a strong health care system, good diagnostic facilities, robust decentralisation of informations, strong research and training culture, unprecedented forms of public-private cooperation are ways that can show that the country is moving towards preparation to tackle another Ebola crisis should it arise again.
While speaking at the forum, the former Chief Medical Director, Lagos University Teaching Hospital, Prof. Akin Osinbogun told the participants that to be able to effectively tackle future outbreak, Nigerians, especially health professionals must be well informed on protocols involved in diagnosis, management of the virus as well as treatment.
He said: “Nobody can contain an outbreak that he/ she knows nothing about. That is why we must continuously train health personnel on how to identify diseases of this nature and how to contain them.”
He said prior to EVD outbreak, little was known about the virus and the various protocols to be taken to avoid its spread. “I believe this is one of the reasons other Nigerians who were in contact with the index case, Patrick Sawyer were infected. Lesson learnt from this is that we must not wait till we have outbreaks before we train health personnel on the disease. Once they are aware first hand on what to do, it would greatly minimise the rate of spread,” he added. He also called for establishment of diagnostic centres in the country and within Africa, as this would go a long way in identifying diseases on time and tackling it before it spreads to other people.
“We need to keep strengthening the health care system through the building of laboratories that can diagnose molecular viruses, like Ebola. Though, the facilities are expensive to establish, the government has all it takes to set them up. I know if we ex-ray the lessons we have learnt from the Ebola outbreak, we will know that one of the issues we encountered was lack of diagnostic facilities,” Osinbogun explained.
On area of research, he decried the continuous lack of recognition for research and researchers in the country saying, “researchers are poorly celebrated in this country. Even with all Dr. Ameyo Adedevoh did for this country, the least government could have done was to name a street after her,” he stated.
For Dr. Ama Adedevoh, the younger sister to the heroin of the Ebola crisis in Nigeria, late Dr. Ameyo Adedevoh, the reasons why the lessons learnt from the EVD crisis was important was so that what happened to her sister and other victims affected by the outbreak will not happen again.
Adedevoh, who said the country was not yet prepared to tackle any EVD crisis, also stressed that if necessary protocols were put into consideration, her sister would not have died from the virus. “I believe my sister died because we were not proactive enough. We became more active some days after the outbreak, and by then it was already late because some persons, including my sister were already infected.
“The government had no reason keeping Patrick Sawyer in First Consultant Hospital after they were informed of his case, because the hospital at that time had no facilities and the capacity to handle it, and more so because it is privately owned. It was the responsibility of the government to take him out of a private hospital and place him in government facility,” she added.
Adedevoh, explained that this was what gave room for more people to be infected in the hospital, which was also a very big risk for the privately owned hospital.
She said she believed one of the ways forward was for the country’s health care system to be strengthened so that further disease outbreaks would be better managed.
In his remark, the Lagos State Commissioner for Health, Dr. Jide Idris, told the participants that even though the country may not be fully prepared to tackle another outbreak, mistakes from the previous outbreak has been highlighted and the lessons learnt has made Lagos State Government to be more prepared to handle EVD crisis better in the future. Idris said: “Though we are not fully prepared to tackle another EVD crisis, one thing is certain, we are no more where we used to be, we can tackle Ebola crisis better now because of the experience garnered from the last outbreak. But we still have a long way to go in reaching the point where we can fully say we are well prepared. And this point requires not just the government but collaboration with all stakeholders.”
In discussing the lessons learnt, the commissioner said it was important he shared highlights on why Lagos state was able to tackle the disease the way it did. “We were able to respond faster without having to depend on the federal government because we already had established health care system. This system was not established because of Ebola. They were already there, so when Ebola came, we didn’t have to first put these establishments on ground before tackling the crisis.”
He explained that among the established systems were; “emergency disaster response of the government, good transportation system, housing, robust health care system, among others. All these contributed to the swift tackling of the crisis. “For us to say we can effectively tackle another outbreak in the future, we must continue to do more than providing the establishments we already have. We need to start strengthening those establishments the more.”
He said to guarantee a safer Nigeria, such establishments must be replicated in other states of the federation, as one may not know where the next outbreak would come from.
Also lending his voice, a leading private sector donor to the Ebola response and Chairman, Heirs Holdings, Tony Elumelu, stressed the importance of private sector involvement in the post-Ebola phase, while noting that a problem anywhere is a threat to mankind everywhere.
Elumelu noted that in the post-Ebola phase, the private sector needs to think about how to help the affected countries’ economies bounce back after the crisis. He said that poverty was one of the major reasons why certain people were more susceptible to infections.
Citing lessons for Nigeria’s successful response to the Ebola scourge, Elumelu said that transparency in the process was an important strategy. “The fact that Nigeria acknowledged the existence of Ebola early aided good communication, prompt mobilization of resources which led to public enlightenment”.
He also noted that the involvement of the private sector was more than just funding and logistics, the private sector stepped up to really boost the awareness of the disease with the public. “It showcased the nation’s ability to provide solutions to such events from within as it rose to the occasion and most importantly made sure businesses stayed open,” he added.
For the Chief Medical Director, First Consultant Hospital, Dr. Benjamin Ohiaeri, his dissatisfaction over lack of strategies in dealing with stigmatisation of Ebola victims was made known. According to him, some of his staff who were survivors of the disease had at various times complained of being stigmatised.
“For instance, one of my doctors that survived EVD complained of how her children were thrown out of their rented apartment. This is just one example. There are several other horrible scenarios which these survivors experience, just because they put in their all to save this country.
“These same survivors as well as First Consultant Hospital were not compensated even in the face of stigmatization. How can such people be motivated again to put their life in line to contain any outbreak?” He questioned.
He also said those who laid down their lives, including Adedevoh deserved to be compensated
Responding, Idris said the issue of compensation for First Consultant Hospitals, and the survivors were discussed but the council however agreed not to tow that line because it would form precedence, which the government may be unable to handle in future as other patriotic Nigerians who have done one good deed or the other for the country (or state) would also want to be compensated.
“We also discussed about Adedevho, but if we single her out, what would happen to others, especially the poor and unknown ones who also gave their lives for the cause,” he added.
After the brainstorming and deliberations, the stakeholders however agreed to forge a common cause in preparation for future outbreaks of diseases.