The Ebola Next Time
Ayo Olukotun
‘Viruses have a biological desire to stay immortal. One day we will witness again the emergence of a terrible virus spread via the respiratory system, highly contagious, with a high mortality rate. We need to use the current Ebola outbreak to take steps now, so we aren’t panicking later’ Carolyn Crist August 2014
‘Once Nigeria overcomes a challenge, it forgets about it until another problem comes’ Oyewale Tomori, August 2014
On Monday, the World Health Organization (WHO) through its Regional Office for Africa affirmed that Nigeria and Senegal had ‘pretty much contained’ the Ebola Virus Disease (EVD). Provided we do not throw away the qualification ‘pretty much’ by relapsing to our old negligent habits, so soon after our rescue from the frightening borders of a breakaway epidemic, Nigerians can for now breathe a sigh of relief.
As the two opening quotes warn us however, it is fundamental to harness our takeaways from Nigeria’s combat with EVD, employing them to prepare for the next medical emergency. Generals preparing for the last war have long been scoffed at; but they are at least a step ahead of Generals who are not preparing for any war at all. If we refuse to learn our lessons, they will return to haunt us in ways we cannot for now imagine.
As several commentators including the eminent scholar and regional virologist for the World Health Organization, Professor Oyewale Tomori, have remarked, proactive manning of the Nigerian embassies in Liberia and Sierra Leone would probably have averted the entry of Patrick Sawyer into Nigeria, sparing us the recent trauma. It is possible that the embassies sent warnings concerning the ravaging EVD and the need to tighten control, and they were discountenanced or treated with levity. We may never know; but having paid such a steep price for our happy-go-lucky ways, it will be interesting to see what changes we make, if any with any respect to information sharing in periods of emergency.
A related point is the laxity with which our borders are policed. Even when we take into account the inevitable porosity of our international borders, which in any case are colonial artifices, the description of border security as ‘a joke’ by Channels Television following an investigative report ought to send wake-up signals to a people who are willing to learn from their omissions and tragedies.
There is also the issue of prioritizing medical research, basic and applied, which I raised in ‘Ebola: The absence of Nigerian Science’ (Punch August 22, 2014). In a thoughtful rejoinder to that piece, Iruka Okeke, Professor of Molecular Microbiology at Haverford College, in the United States suggested better funding for diagnosis, care and clinical research in order for Nigeria to be adequately equipped to handle scourges like Ebola. She went on to sketch the possibility of breakthrough findings on EVD and cognate diseases by our scientists through increased funding for virologists working on influenza and Lassa fever. In her words, ‘Had the Nigerian government invested in more widespread resources for diagnosis, care and clinical research on Lassa fever those resources could have been adapted to deal with the next, unpredictable outbreak of hemorrhagic viral disease like Ebola’.
What we have today, however, is the ironic circumstance whereby the countries at the forefront of EVD research such as Canada, Japan and the United States are not the ones threatened by Ebola. They do this because they have built a buoyant scientific infrastructure for carrying out bio-medical and other researches; and because their governments and societies are far-sighted enough to appreciate the immediate and long-term spin-offs of such researches.
There is a related point mentioned by Tomori that he will not feel safe to work in a laboratory devoted to finding a cure for Ebola unless the necessary safety precautions were in place. Maintaining these safety precautions is a function of a certain level of infrastructural investment in areas such as regular electricity which for the moment are lacking in Nigeria.
A more fundamental problem relates to the status of health care in Nigeria and the rating of Nigeria’s health sector by W.H.O as weak. The Health minister Professor Onyebuchi Chukwu once listed the problems of government hospitals as those of environmental hygiene, out-of-stock syndrome in pharmacies, long waiting time for patients, as well as the quality of services. To Chukwu’s list can be added the worsening quality of doctors trained in Nigeria, scandalous errors of diagnosis, frequent strikes by doctors and the shortage of medical personnel.
To dwell, for example, on lapses on diagnosis, it would be recalled that the late human rights crusader, Gani Fawehinmi was wrongly diagnosed by hospitals in Lagos for pneumonia. Fawehinmi leant too late in a London hospital that his ailment was cancer. There was the reported case of a lady who had her two breasts cut off for what was diagnosed as breast cancer only to discover in the course of a trip to United States that she did not have cancer at all.
One should not be unduly alarmist but several cases such as those cited have led to the loss of credibility by our health institutions and growing medical tourism which cost to Nigeria is estimated at $5oo million annually. Similarly, the quality of doctors trained in our medical schools has deteriorated to a point where some countries no longer allow them to practice. This of course is related to the downhill slide in the quality of Nigerian education recently corroborated by our bottom league position in the 2014 global ranking of universities by the web-based International Colleges and Universities.
True, and as the recent anti-Ebola medical efforts showed, our health institutions are not as disheveled as is often feared. Nonetheless, one of the apprehensions entertained by Nigerians in the wake of the EVD onslaught is that of rickety health institutions with demoralized medical personnel becoming overwhelmed were the crisis to have reached epidemic proportion. This is mainly what has happened in Liberia, where inadequate and undermanned heath institutions have been virtually overrun by snowballing EVD cases.
Preparing for another medical emergency of the scale of an Ebola outbreak would mean that we begin to pay close attention to the status of health care in Nigeria with a view to revising the decay. The current situation where less than six percent of national budget is allocated to health with 80% spent of that amount on salaries and emoluments is clearly unsatisfactory. Several African countries such as Rwanda, Botswana, Zambia and Burkina Faso spend up to 15% of their yearly budgets on health and yet they neither have Nigeria’s exploding population or disease profile.
Obviously, therefore, the recent Ebola scourge should be seen as a yellow card on the vulnerability of human existence in the context of decadent health institutions. Interestingly, if a thorough going epidemic breaks out, Nigerian citizens, the political elites especially, may find that they cannot travel outside the country. This sobering fact should serve as an additional incentive to concentrate on the re-vitalization of our health institutions as well as focus on contingent and long term initiatives that would better prepare us to tackle medical emergencies such as Ebola.
· Professor Olukotun is the Dean, Faculty of Social Sciences, Lead City University, Ibadan
--
No comments:
Post a Comment