Ebola outbreak: Anger in Lagos infectious diseases hospital
Jide Idris, Lagos State Commissioner
for Health
Members
of staff of the Infectious Disease Hospital, Yaba, Lagos, have
expressed anger over the impending removal of the hazard allowance
component of their September salary. Sources within the hospital told
our correspondent that the Lagos State government has excised the
allowance, which has been paid for years in the September payroll.
“We
have sighted the payroll for September already and there is no
provision for this allowance which has been paid to us for more than
four years. This is really terrible. If government wants to remove
anybody’s allowance, should it be from us workers at the IDH? What kind
of problem is this?” one of the workers of the hospital lamented.
Earlier, volunteers at the isolation ward had protested the non-payment of their daily allowance since August 30.
“We
learnt they want to send us away because there are no cases of Ebola
again. But they should at least pay us our entitlements even if they
will do that,” a volunteer confided in our correspondent on Thursday.
While
the Lagos State Government has not disclosed the cost it has incurred
in containing the Ebola Virus Disease so far, it has received cash
donations from some sources, including the Federal Government.
Governor
Babatunde Fashola recently confirmed the receipt of a N200m assistance
from the Federal Government, while officials of Seplat company also
donated N20m to the state to help contain the virus, among other
material and financial donations.
In
the wake of the outbreak, which occurred during the nationwide strike of
the Nigerian Medical Association, the state government had called for
volunteers. It paid daily allowance of N30, 000, N40, 000 and N50, 000
respectively to attendants, nurses and doctors working at the isolation
unit but the payment of the allowances had been stopped since August 29.
While
the volunteers still report to the isolation centres daily, many of
them said they were aware that the government would soon ask them to go
away “because there are no more cases of Ebola in the state.”
As
of Thursday, only the female student of the Obafemi Awolowo University,
who was brought to the centre late on Tuesday, remained in the Lagos
Ebola isolation ward. The student was said to have confessed that she
had contact with the late Port Harcourt doctor, Iyke Enemuo, who died of
the EVD after treating an ECOWAS diplomat in a hotel.
The
student, who was rushed to the centre from Ile Ife after she fell ill
and manifested symptoms similar to EVD, however, has tested negative to
the Ebola virus, the OAU authorities said on Thursday.
The
Lagos State Commissioner for Health, Dr. Jide Idris, did not answer his
call when our correspondent called for his confirmation of situation at
the IDH.
Meanwhile, in a paper
released Wednesday afternoon titled “Ebola Then and Now”, two doctors on
the frontlines of the 1976 outbreak in Zaire recall the meticulous
procedures that kept the climax of the outbreak to 318 people. While the
piece offers valuable information for those fighting the current Ebola
outbreak, it underscores just how dangerous it has become. That was
then, this is now. Here, juxtaposed with the New England Journal of
Medicine’s report, is today’s response.
Delayed Response Time
1976
The
study’s authors, Dr. Joel G. Breman and Karl M. Johnson, arrived in
Zaire in 1976 equipped with new virologic and immunologic tests that
helped them immediately identify the (then new) agent. “In Zaire, we
became, respectively, the chief of surveillance, epidemiology, and
control and the scientific director of the International Commission for
the Investigation and Control of Ebola Hemorrhagic Fever in Zaire,” they
write. Immediately upon arrival, five commission members were sent to
the village of Yambuku—the original site of the outbreak—to map the
extent of the outbreak. The other 70 members remained at the hospital
base.
Now
On
March 23, 2014, the World Health Organisation (WHO) reported what they
called a “rapidly evolving outbreak” of Ebola in West Africa, where 49
cases and 39 deaths had been recorded. One month later, the number of
cases had quadrupled, with WHO showing more than 208 cases and 130
deaths. It wasn’t until August 6, with 1,779 cases and close to 1,000
deaths, that WHO began discussing whether or not the outbreak
constituted an international health emergency. By the time it did a few
days later, which made it nearly six months after the initial outbreak,
it was too late.
Infective Quarantine
1976
When
Breman and Johnson arrived on the scene, the government had already
quarantined 275,000 people in the Bumba Zone. Planes, boats, cars,
strangers—all were banned from entering the cordoned off area. At first,
the doctors write, the villagers were “fearful and agitated,” lacking
the basic necessities needed to survive. When members of the
International Commission arrived to help, the community was wary. But
with an electron micgrograph to illustrate what was fueling the
outbreak, they were able to gain the trust of the people. “People along
the road from the town …were relieved when we said we’d come to stop the
disease’s spread, treat patients, and meet their families,” the paper
reads. Inside the quarantine zone, even more specific procedures were
outlined to keep those within the bounds of it safe.
Now
Attempts
to quarantine during the current outbreak, led by the local armies and
police, have been catastrophic. When the Liberian government attempted
to contain the outbreak in Liberia through a quarantine in West Point—an
exceptionally impoverished area near Monrovia—they did the opposite.
With anywhere from 70K to 120K residents living in tiny shacks without
running water, sanitation, or electricity, they left a struggling
demographic without the means to protect themselves—many, without
knowledge of what it was that necessitated protection. With people
fighting for food, violent outbreaks between Liberians and the army
began to heat up at the 10-day mark. When four were injured and one
killed, President Ellen Johnson Sirleaf officially lifted the
quarantine.
Mistrust from Communities
1976
For
those outside of the quarantine zones, Drs. Breman and Johnson laid out
specific guidelines to community members to help reduce the risk of the
infection’s spread. Family members who became infected with the disease
were placed in “huts outside their villages,” a procedure that allowed
victims to be isolated outside of a hospital. The doctors then suggested
one family member, “preferably someone who had recovered from the
illness,” deliver food, water, and medicine to the patient each day
until a medical professional could arrive on the scene. With the help of
other community members, the doctors successfully educated the families
of those who died about the dangers of handling the body in typical
ritual fashion. “Credibility was gradually restored, especially when we
began visiting villages accompanied by the three remaining nuns,” the
authors write.
Bodies were covered
with bleach and buried, and isolation huts burned. An already-local
tradition of shaving one’s head in mourning for a lost family member
became dual purpose—used to flag potential carriers of the disease.
Now
With
the virus already widespread when international relief began pouring
into West Africa, spending individual time in affected communities was
not an option. Without this crucial period of trust building, many in
the communities spent months under the impression that Ebola was either a
hoax or a disease brought to West Africa by American nurses and
doctors. The fallout of this loss of trust has had an enormous impact on
the outbreak. Without a clear understanding of how Ebola is spread and
when it is contagious, family members continued to bury their loved
ones—who, at that point, are the most contagious—with typical burial
rites such as washing, touching, and even kissing the corpses. While
doctors in West Africa now report success educating the communities and
persuading them not to perform burials, the amount of burials already
performed have infected hundreds, if not thousands of people.
At
the end of the report, which highlights stirring images from the
original 1976 outbreak, the authors offer suggestions for where the
international community should focus their support. “We believe the main
priorities should be adequate staff for rigorous identification,
surveillance, and care of patients and primary contacts. Strict
isolation of patients, good clinical care, and rapid,
culturally-sensitive disposal of infectious cadavers,” they write.
“Breman, who got wind of the current outbreak when a CDC officer
stationed in Guinea called him for advice in March, is still optimistic.
Most of his positivity rests on the news that people in the villages
have finally begun to trust that the outbreak is real, and that the
health workers are there to stop it. And with the announcement that the
U.S. plans to send a “surge” of workers into West Africa armed with $22
million from the Pentagon, America now looks poised to fight back
against Ebola.
“These are the darkest
days, they know what they’re doing,” Breman tells the health care
workers in the field. “They know the dangers. There are dangers at the
front lines. It’s a war zone, and Ebola is the enemy.”
The first son of Gov. Theodore Orji of Abia State, Chinedu Orji, an
engineer, has sued The Sun Newspapers Limited, owned by a former
Governor of the State, Dr. Orji Uzor Kalu, claiming N5bn damages fo
