EBOLA: AS COMPLACENCY HAS TAKEN OVER!

The introduction of Ebola to Nigeria by Patrick Sawyer was a wake up call to all healthcare workers in Nigeria. I still thank and strongly recommend that the management and staff of First Consultants hospital, Lagos be compensated for the patriotic role they played which ensured that the index case was contained even when they later paid dearly with the lives of some of their staff for that patriotic act.

Now that Nigeria has been 'allegedly' declared Ebola free ,do our experts really take into consideration that another 'Patrick sawyer' can easily fly into the country anytime and any day? Do we still have direct or indirect flights to and from Liberian? How prepared and vigilant are our health officials in our ports of entry? This is because it was when Patrick Sawyer came that the moribund Infectious Disease units in our ministries of Health were revamped .Believe you me,there are officials in that segment of the ministries of health,receiving salaries at the end of the month,threatening the governments with industrial actions concerning their promotions and other allowances but it was when Ebola came into the country that they dusted their chairs and removed the cobwebs in their offices,a piece of evidence that they had not been working. Why was it impossible for the laboratory at LUTH(Lagos University Teaching Hospital ) to run a confirmatory test on the Patrick Sawyer's sample sent to them initially and why must we wait till a confirmatory result was done outside the country?

It should be noted that the laboratory at LUTH showed that Patrick Sawyer's sample had an Ebola virus but the strain of the virus( which may be Zaire,Bundibugyo,Sudan,Reston or Tai forest species) that infected him and it was outside the country that it was confirmed that the strain of the virus that infected him was the Zaire species. Although I am not an expert in Infectious Disease Control and Prevention hence I may be pardoned if the gold standard was that the sample must be confirmed outside Nigeria(possibly in a WHO reference laboratory),all I am saying is that as a giant of Africa,the 26th best/largest economy in the world and the much-taunted largest economy in Africa, we are supposed to start and finish everything here(including all medical tourisms abroad). This is because South Africa,the immediate past largest economy in Africa, was able to hospitalise their own Nelson Mandela in their own hospital and their own doctors managed him but in this part of the world, we embark on private trips to Germany to check our blood pressures. The south Africa that we collected the largest economy in Africa from, pays their health workers almost three times what we pay our health workers here and the south African government can boast that their roads are free of pot holes but our own roads are mortuary annexes.

Many hospitals and public places that installed health measures at the outbreak of the index case of Ebola in Nigeria have since abandoned them since the country has been declared Ebola free. To an average Nigerian,we remain Ebola free forever. I think the current index case of Ebola virus disease that was diagnosed recently in Dallas ,Texas USA will really tell us that we can be hit again by this deadly virus disease. If the United States of America can be hit with this deadly virus despite all sensitization and their preparedness,how much more a developing country like ours,where some officials manning our ports of entry prefer dying for their pockets and stomachs to dying for their country ? The current index case in America was said to have travelled from Liberia to America to visit the family. In view of this,another 'Patrick Sawyer' may surreptitiously come into our own country and this time,it will be more disastrous than that of original Patrick Sawyer. This is because the victim will be rushed to the Emergency section of our government owned hospital where the same sphygmomanometer used for the patient will be used to check other patients' blood pressures hence almost all patients brought into the accident and emergency unit that day will be infected.

Also,all the health workers in the section will be infected. The health workers will now serve as vectors carrying the infection after 'culturing' it between 2 to 21 days to their colleagues,family members,church/mosque members etc. This is why I have been shouting that the management of First Consultants Hospital should be compensated and be awarded the national honorary awards because they saved this country from a very big calamity. Had they succumbed to pressures mounted on them by Patrick Sawyer and other diplomats in discharging Patrick Sawyer as requested without notifying the appropriate authorities,Nigeria must have been locked down by now because while the Lagos contacts would be busy spreading the virus ,the calabar(the meeting place for the convention that brought Patrick Sawyer to Nigeria) contacts would also be spreading the infection while the late Dr Sam Iyke Enemuo would be in Port Harcourt contributing his own quota to the 'nation building'.This is why at times I think that the last NMA strike was a blessing in disguise because if not the strike,Patrick sawyer might have landed in the LUTH's emergency section and the rest would be history by now.

Meanwhile, I am not comfortable with many of these our infrared thermometers because I know that some dubious business men must have gone into the importations and productions of the said thermometers the same way they were into the productions and importations of fake and substandard drugs into the country before the late Professor Dora Akunyili became the director of NAFDAC. This is because,there was a day I was checked by somebody with the infrared thermometer and the reading was 34.1degrees centigrade .I was not comfortable with the figure since I knew that the normal body temperature varies between (about) 36 and 37 degrees Centigrade,I quickly rechecked my body temperature with my own conventional clinical thermometer and i got 36.6 degrees centigrade . What a big difference of 2.5 degrees centigrade? Also,recently a colleague complained that a patient managed by his team was first checked with the infrared thermometer at the entrance and the result was normal(about 36 degrees centigrade) but on physical examination,it was found out that the patient was febrile to touch hence the temperature was rechecked with our conventional clinical thermometer and it was found out that the patient's actual temperature was above 38 degree centigrade.

In view of the above observations,it is now clear that something must either be wrong with the readings given by some of our infrared thermometers or that we may not have understood how to use and interpret the readings . This is because I know that before a temperature reading raises any concern with respect to Ebola virus disease,the measured temperature will be as from 38 degrees centigrade (core) or 37.5 degrees centigrade (axillary) .It follows that if these infrared thermometers can give readings about 2 to 3 degrees centigrade below what our conventional clinical thermometers can give us,it calls for immediate investigations as Ebola patients with body temperatures of about 38 or 39 degrees centigrade may erroneously give readings such as 36 and 37 degrees centigrade respectively with the infrared thermometers hence they will pass this initial and very crucial screening exercise. I do not know the agency that regulates,approves and certifies the importation of these so called infrared thermometers ,they should immediately brace up with the challenges of ascertaining the qualities of these thermometers imported into the country especially this time that the prices have skyrocketed from N5000 to about N25000 and for the fact that most of the unscrupulous drug dealers who held the country at the jugular before Dora Akunyili came on board are still very much around. I don't want to talk about the hand sanitizers because dubious business men have taken over the productions as Dry Gin , Aromatic schnapps,locally- made beers and all other alcoholic products are now packaged inside the bottles as hand sanitizers.

We should not relax yet as the battle is not over. Just like any other diseases(eg cholera,influenza etc ) that come as epidemic,Ebola can pay us an unscheduled visit anytime and it will be easily through our ports of entry. When I see big arms and ammunition plus heavy military equipment recovered from Boko Haram insurgents,I always ask how do these fighting instruments get into the hands of the insurgents in the first place even when it is extremely difficult to smuggle a car into the country from Beni republic. It then follows that there must be either a mole in the regulatory agency or the officials were negligent hence health workers manning our ports of entry must be patriotic since any further incidence of Ebola virus disease in Nigeria now will have multiplier effects as we are currently complacent having been declared Ebola free.

Dr PAUL JOHN
08083658038
[email protected]
Port Harcourt,Rivers state.