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The International Writers Magazine: Africa

Ebola Virus: How Prepared Is Nigeria?
• Odimegwu Onwumere
Disease claims *660 lives in Africa so far this year and rising fast.


Ebola continues to spread in Sierra Leone, Liberia and to a lesser extent in Guinea, with a combined 44 new cases and 21 deaths between July 6 to 8, the World Health Organization said on Friday.

* This brought the total in West Africa's first outbreak of the deadly viral disease to 1093 cases including 660 deaths since February, the United Nations agency said. *July 24th 2014

After a Federal Executive Council (FEC) meeting in Abuja in April, the Nigeria's Minister of Information, Labaran Maku declared that there had not been any testified case of Ebola Virus outbreak in Nigeria. This was a follow-up to the information the honourable minister said that the Federal Ministry of Health briefed the FEC on the believed outburst of Ebola Virus in Nigeria.

Continuing, Maku reassured that the health ministry was ever ready to control the virus in the dawn of an outbreak in the country. Maku counselled that, "Citizens are reassured that there is no Ebola fever in the country and all the checks so far undertaken declare clearly that we don't have it. The ministry has assured that should there be anything like that within our boundary it will be quickly tackled."

Nigerians were warned to always be concerned about their health statuses. The Ministry of Health had also admonished those citizens with symptoms such as high fever, headache, severe abdominal pain, diarrhea and bleeding to report to the health authorities.

The warning was on-the-cards for Nigerian citizens who had travelled to Guinea, Sierra Leone, and Liberia, countries that have had well over a thousand infections so far.

Health professionals around the world are worried over the disorganized medical infrastructure to deal with the epidemic, which according to the World Health Organisation, WHO, is novel to western Africa. It is believed that the virus had claimed over two-thirds of the infected patients in the areas that the killer bug had been noticed.

According to a report by WHO in Guinea - by 3rd July 2014 it brings the cumulative number of cases reported from Guinea to 413 confirmed and 303 deaths. The number of contacts currently being followed-up countrywide is 1147 +++

Commenting on the danger of the disease, Keiji Fukuda, assistant director-general, WHO, had said: “This is one of the most challenging Ebola outbreaks we have ever faced.”

With a population of over 1.5 million, Conakry, the capital of Guinea was reported to be worst. Senegal had shut her border with Guinea, with presupposed patients with the disease reported in Sierra Leone.

In Sierra Leone: The cumulative number of cases reported from Sierra Leone to 239 with 99 deaths from confirmed cases.

The number of contacts currently being followed-up countrywide is 37 from Kailahun. Community health workers are being trained to do follow-up and contact listing is continuing in Kenema, Kailahun, Kambia, and Port Loko.

In Liberia between 19 and 3 July 2014, brings the cumulative number of cases reported from Liberia to 107 and 65 deaths and rising.

*The total number of cases is subject to change due to reclassification, retrospective investigation, consolidation of cases and laboratory data, and enhanced surveillance

ebola treatment How prepared the Federal Government of Nigeria is against this backdrop is left for time to tell. Eva Marie Coll Seck, Senegal’s health minister, was quoted as saying by AFP: “We have everything in place to take measures against Ebola. We have a well-oiled system, which we are perfecting daily.”

While the Nigerian Government was reassuring its citizens of an Ebola Virus-free country, seven out of nine suspected patients were confirmed in Mali. The neighbouring Ghana also has feared that the virus had entered the country even though she discounted the presence of the virus in the country, just like her neighbouring Nigeria.

But while the Federal Government was with high hopes and giving gratuitous hopes to its citizens, Stephane Hugonnet, a WHO medical officer, reportedly said: “Obviously there is a risk that other countries might be affected, therefore we absolutely need to remain vigilant.”

National Health Bill
The Nigerian Senate had recently passed what was regarded as “the highly controversial National Health Bill 2014” into law. This followed its third reading in the house. How this law would assist the country in being vigilant about the Ebola Virus cannot be ascertained, even though that it has been said that the bill was targeted to establish a support for the directive, supervision and development of the country's health system.

It’s an acknowledged fact that before the bill was passed into law it suffered numerous hiccups since Sen. Ifeanyi Okowa (PDP-Delta), who was the sponsor, submitted it. Although, the senator on one occasion had said that the bill that was once regarded as controversial, would help the country to realize the Universal Health Coverage and meet the Millennium Development Goals (MDGs) target.

"We all know that the primary health care is within the purview of the local government councils, the states and the Federal Government actually do give support programmes apart from technical support.

“This bill also seeks to provide one per cent of the consolidated revenue fund for the purpose of the development of the primary health care. The bill is also for the purpose of providing health care insurance to certain class of people who are deprived. The 50 per cent of the one percent fund that is provided for in clause 11 under a Basic Health Care Fund will be utilised by the NHIS for providing health coverage.
This will cover pregnant women, children who are under five and the elderly and physically challenged persons," Okowa had said.

Okowa was of the belief that part of the funds would be used to endow the Primary Health Centres (PHCs) as well as train and re-train health experts, adding that the country needed PHC dearly with at least each ward having one PHC; but he feared that the country was yet to have well trained personnel. He added that the country needed to train such experts and have the effective drugs, facilities and equipments in place.

One of the suggestions that Okowa gave that could help in the fight against the arrival of the Ebola Virus in the country and other diseases was that states could also partake in civilizing primary health centres through a complementary fund that would enable them to profit from the combined revenue fund.

In his words: "Fifty per cent of the fund shall be used for the provision of basic minimum package of health services to citizens in eligible primary or secondary health care facilities through the NHIS. Twenty per cent of the fund shall provide essential vaccines and consumables for eligible primary healthcare facilities. Fifteen per cent shall be for the provision and maintenance of facilities, equipment and transport for PHC facilities.”

Investigations revealed that one of the benefits of the National Health Bill was to put an end to the incessant squabbles that had existed among professional bodies in the health sector, making a roadmap for the duties and responsibilities of each of the professional body.

No Restrictions To The Affected Areas
According to a source, Ebola Virus first had its presence in the Democratic Republic of Congo in 1976. In 2012, about 29 people died of the virus in Guinea. It was an inspirational experience in Guinea, when experts said that they saw victims that recovered from the virus, even though that it’s believed that the outbreak is not over in that country, just as Nigeria should not rule out the outbreak of the virus in the country someday, as long as it’s not earnestly being controlled in the country.

Dr Marie-Claire Lamah from Medecins Sans Frontieres in Conakry, and MSF spokesperson Sam Taylor, were among the persons who had expressed enchantment at seeing patients hale and hearty again from the disease. This was on the hill that in 2000, about 224 people died out of a total of 425 inveterate, contaminated patients in Uganda, making it the year that the country witnessed the largest-known Ebola scourge.

In all of this, reports nonetheless, were that WHO had not suggested any travel or trade constraints to Guinea, Liberia, Mali or Sierra Leone, even though that the world health body had not stopped showing great concern about it. Even though that Nigeria had not recorded any case of the virus, on April 9 2014, the Federal Government did not shy away from owing up that Nigeria was at risk.

“Ebola has been moving eastward towards Nigeria as well and we are already facing danger from the Central African Republic, even with what is happening in Congo, people are also migrating to Chad and, Cameroon are also in our borders. So, Nigeria is in danger, but we have recently said that in addition to the leaflets that we are producing for Lassa and other fevers, we will now emphasise Ebola fever,” said Onyebuchi Chukwu, minister of health, after the Federal Executive Council (FEC) meeting.

Connoisseurs had advised that the Federal Government had to secure the country’s borders and make sure that those coming into and going out of the country are well monitored. In a statement apparently by Osahon Enabulele, President, Nigerian Medical Association (NMA): “Anywhere you have movement of people from one location to the other. The likelihood of having the virus spread is high. That calls to attention the need for us to check our borders.”

Enabulele continued: “More often than not, when there are movements of people from the affected countries, especially when you have a very defective, weak surveillance system at the entry points – land, air and sea – people from infected regions or localities can be given access into your country. That leads to the possibility of having it spread into new territories, especially if there is contact with those infected persons.”

He added: “If those surveillance mechanisms are not on ground and if the level of suspicion is not high, then you could have an infected person coming into your environment. An Ebola patient will start manifesting the symptoms no more than 25 days after he contracts the virus.”

The director-general, Nigerian Institute for Medical Research (NIMR), Yaba, Lagos, Innocent Ujah had suggested to the country and the citizens to maintain a high level of hygiene and sanitation, since there is nonexistence of qualitative treatment and human vaccine for the virus.

He maintained that there should be severe awareness in the country about the dreaded virus in the areas of sensitization, for people to go for medical checkups regularly. Adding, he said that in the event of the virus, citizens should be attended to by professionals wearing protective equipments such as gloves, since the disease is highly contagious.

© Odimegwu Onwumere, a Poet/Writer, writes from Rivers State. July 2014

WHO FACTS July 3rd 2014:

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