“It is regrettable that proactiveness eludes Nigeria. However, this is the end game; once confirmed several cases of Ebola reach our shores, it will not matter whether or not it has been transmitted to others. The damage that a disease like this can do is not limited to just illness and death, it will most likely kill far greater numbers of people through the resulting panic and collapse of just in time delivery and infrastructure brought about by widespread disproportionate panic“. 

PRECAUTIONS have been taken in Nigeria on several occasions only after heavy calamities have befallen the country. Unfortunately Nigeria has failed to learn from her past mistakes. While still contending with the issue of Boko Haram activities that aimed at mass annihilation of Nigerians, the dreaded Ebola Hemorrhagic Fever Virus is now the brand new threat to the nation.

   The threat of this tropical pathogen that can turn people into de facto corpses recently popped up on the global radar when an infected American-Liberian son travelled via airplane from Liberia to Lagos, a city with over 21 million bullet-moving people in search of competitive survival. This fellow was on two different international flights and would be heading back to the United States.   The flight to Nigeria unloaded, some connected to their on-going international flights, the rest walked out and mingled into a city of over 21 million Lagos-dense population. Lagos being a city with international airport, Ebola virus could just be a plane ride away from many other nations.

   As recently reported, the porosity of Nigeria’s illegal borders of over 1,400 makes Nigeria more vulnerable to the Ebola epidemic. If there should be spread of the virus from these borders, it means that Nigerian residents might basically be walking dead because of its high 90 per cent mortality rate upon 21 days incubation period that scientist say. Zoonotic diseases like Ebola should now modify the perception of patronising bush meat in dare cuisine preferences. Research has shown that about 75 percent of recently emerging infectious diseases affecting humans are diseases of animal origin, and approximately 60 per cent of all human pathogens are zoonotic. Emphasis has been that, it comes mostly from bats, yet I am surprised to learn recently that many Nigerians admitted eating bats but refuted the emergence of Ebola virus from wild animals.

   Nigerians being rather reactive in nature will always act on issues when situations have gone beyond control. For example, Emab Plaza in Abuja has been barricaded with thick bricks and rods and visitors are seriously been screened, that is the kind of Nigeria we have; Nigeria of “Medicine after death”. I still recall the PHCN started mass sensitization against trading under high tensions cables after a high tension cable loosed up and fell on people in Port Harcourt in February, 2010. That’s Nigeria of “Medicine after death”. It was after Nyanya blast by terrorists that Nigeria government began to ask questions about who did a sham of the Closed-Circuit Television (CCTV) and swindled the government of a fat sum of $470 million (N76 billion) that could have rehabilitated a health facility in a village like “Otuoke” at least. That is the kind of Nigeria we have, “Nigeria of medicine after death”, and a lot more instances like that.

   It is regrettable that proactiveness eludes Nigeria. However, this is the end game; once confirmed several cases of Ebola reach our shores, it will not matter whether or not it has been transmitted to others. The damage that a disease like this can do is not limited to just illness and death, it will most likely kill far greater numbers of people through the resulting panic and collapse of just in time delivery and infrastructure brought about by widespread disproportionate panic.

   Liberia got herself into this mess because it took a lot of things for granted. Even upon learning about the outbreak of Ebola in Guinea and Sierra Leone, their borderless frontier with Guinea had allowed free movements of their respective people even to trade bush meats that scientists claimed bore the deadly Ebola virus. Most of them were even Ebola deniers including Mr. Patrick Sawyer who eventually became a victim and as a high ranking government official, sparked off national and global concerns that today, developed countries like USA are taking proactive measures against the outbreak of Ebola in their “God bless American” country.  Though Liberia’s President Ellen Johnson Sirleaf has made a national broadcast announcing the closure of all borders, schools and offices and burning of bush meats etc, but that came a bit too late, the deed had been done. If a country like Liberia with a sparse population of about four million could not contain this menace, you can imagine what will be the fate of the “Giant of Africa” with 170 million inhabitants if strategic actions are not taken now which has not been depicted from the National Health Bill. The responsibilities for the provision of care are poorly delineated by the Nigerian constitution. A National Health Bill that will solve this has been pending between the National Assembly and the President for over eight years.

   With Nigeria’s 2014 budget on health of N264,461 billion and 81.38 per cent goes to recurrent expenditure, it spells a mockery doom for Nigeria to fight Ebola outbreak in Nigeria. It is often assumed that the poor state of healthcare delivery in Nigeria can be attributed to inadequate public funding of the sector. For example, total spending on health in the country is low; it is about 5 per cent of the GDP. The total health expenditure is dominated by household out of pocket expenditure. Since 1999, the average annual budgetary allocation to the sector by the Federal Government of Nigeria is about seven per cent which is less than 15 per cent, the benchmark recommended for developing countries like Nigeria by the World Health Organisation.

   Besides improving the health fiscal policies, there are other non-budgetary obligations that Nigeria government, her institutions and the citizens can do to help halt Ebola including shelving power tussles aside and mending fences with the Nigerian Medical Association. This is the time the Federal Government and NMA should strike a balance to achieve a cordial and harmonious working relationship. Should an outbreak of Ebola erupt while Nigeria doctors sit at home in order to drive their points and demands home, the nation will be in a messier situation. Though some international researches have proven that, doctors’ strike increases mortality rate, nevertheless, we cannot overlook to project the consequences that come as a result of doctors’ strike; untimely death of patients, prolongation of suffering of patients in severe cases. Breach of international code of ethics that doctors themselves have sworn to uphold is not ethical in its nature since it involves humans’ life.

   On the other side, as though the strike is not scary enough to health sector in Nigeria, the Federal Government is over reacting by recently going ahead to “suspend” the residency programmes in all its teaching hospitals in Nigeria leaving little or no sufficient capacities to help fight Ebola. In Nigeria, the term “democracy” is just a name. Government is not for the people, but for the politicians. The people do not have a say and are always intimidated and coerced into succumbing to the bullies of those in power and the recalcitrance of the NMA to the bullies of Federal Government will end up in horn-locking fiasco to the detriment of Nigerian masses that are faced with the Ebola monster.

   For the sake of humanity, the Federal Government should consider shifting a little. They cannot win all the time. It is regrettable that the doctors are already seeing the agitation as a blessing in disguise since they are most likely the initial prey that Ebola is seeking to devour. Therefore, a little stroking of the doctors’ back could make them give “their life to all of us”. However, the doctors should not use their ongoing agitation as a lame excuse to shy away from their sworn responsibilities in this critical moment of their service delivery. They should also remember that the Nigerian soldiers are risking their lives fighting insurgency in Sambisa forest. That is the oath they both took for service to humanity and fatherland.

  To avoid Nigerian contributing to the spread of Ebola internationally, too much international travel should be curtailed. Just because we can jet around to the other sides of the planet in 24 hours, does not mean we should. Bacteria and viruses being what they are will gladly hop on board for a free ride. On the national level, it is advisable that hunters in the country refrain from hunting and saturating Nigeria’s meat market with bush meat. If it is true that bats are eaten in Nigeria, this is the time to stop and find their nest to destroy as much as possible.

   It is now “Health is everybody’s business”. Therefore, all sectors of Nigeria’s economy must be engaged in the spread of Ebola prevention and not infection. Anything worth doing is worth doing now. The crusade against Ebola has to start now.

   Nigeria’s tele-density is now over 92 per cent, according to the NCC’s fact sheet. Therefore, with the combination of all service providers, it is imperative for all of them to engage in aggressive dissemination of information on Ebola prevention as part of their corporate social responsibilities through unsolicited SMSs to “market this Ebola product”. It is now that the religious leaders should get involved and insert Ebola messages in their sermons to their congregations. This is the time to shelve religious sentiments and resentments between diverse religious entities but demonstrate the “one Nigeria” we claim to have, by preaching Ebola messages in their churches and mosques. This is the time our schools from primary to tertiary should take advantage of their mass gathering to sensitize pupils and students about Ebola.

To be continued.

• Amaefula is a senior programme/research assistant at Centre for Social Justice, Abuja.

Culled from http://risenetworks.org/2014/09/18/ebola-virus-and-nigerias-medicine-after-death-approach1/

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