Ebola: keep calm and follow Nigeria’s lead

Interview with senior Lagos State health  officials from October edition of NewsAfrica magazine

Interview with senior Lagos State health officials from October edition of NewsAfrica magazine

Now here’s an unexpected headline: ‘Nigeria provides salutary lesson for west in battle against Ebola’. It appeared in the Financial Times on October 14 above a front page story explaining how swift action by the Nigerian authorities following its first Ebola death in July managed to contain the spread of the virus. While more than 4,000 people have died in Sierra Leone, Liberia and Guinea, the figure in Nigeria is only eight thanks to strictly enforced control measures.

The trouble is, this news only appeared in the FT. Elsewhere, it is an entirely different story, of ‘West Africa’ being engulfed by a disease whose rapid spread is threatening the rest of the world, as if this huge region comprised only Sierra Leone, Liberia and Guinea, and Nigeria, Africa’s most populous nation, was insignificant.

The US and UK have jumped in to help but those leading the effort are in the ministry of defence not in the ministry of health as the old colonial order reasserts itself. Our boys fly in to help the hapless natives, who cry out, thank you, massa. It is not a pretty sight.

Western politicians are now so hardwired into war that they seem to see Ebola as a new battlefront, all the more urgent now that a few cases have emerged outside of Africa. But boots on the ground are no substitute for efficient state health systems.

It’s no surprise that the worst affected countries are also the poorest. Poverty and disease have always gone together and it is often the simplest of measures that prove to be the most effective – like soap and water and three square meals a day. Despite the evidence of history, you wouldn’t know this, judging from the news coverage about Ebola. As the headlines become daily more alarming, the race is on to find a magic bullet for the virus, fast tracking trials for a vaccine that will make billions for the pharmaceutical companies involved. It takes time to work out whether or not a drug is safe and, in the rush to bring a ‘cure’ to the market, who knows what might happen?

The money and effort would be better spent in re-building the battered public health systems of Liberia, Sierra Leone and Guinea, countries struggling to emerge from years of conflict and political instability. In Nigeria doctors, nurses and facilities were mobilised as soon as the first Ebola death occurred (via a lone traveller from Liberia), tracker teams were set up to monitor those who had contact with the infected, full protective clothing was readily available for health workers (obtained during the bird flu outbreak in 2006), and disease control centres were opened to quarantine patients.

There was no evidence of the poor organisation that often hampers Nigerian operations, no troops were involved and medical personnel were not provided by overseas NGOs. And all this in a country where the public health service leaves a lot to be desired – if you have the money you go private, even if it means flying overseas. The authorities there must have correctly concluded that Ebola is no respecter of people’s wallets. Let that be a lesson for the privateers.

Nigeria’s calm and measured approach has worked. Since September 5 there have been no new cases of Ebola there and no deaths. Yet hardly anyone knows about it.

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