Ebola, an epidemic or a symptom?

Ebola, an epidemic or a symptom?

Thursday, September 4, 2014 12:16 pm

By Gbenga Olorunpomi

September 4, 2014Lagos – By now, the initial scramble to purchase hand sanitisers and similar health products has settled. So has the reluctance to shake hands receded since it became apparent that the Ebola Virus Disease (EVD or Ebola) is mostly infectious in clinical settings or to care givers for already ill patients. Our experience in Nigeria has merged with the largest Ebola outbreak in history that has been making headlines for months in West Africa. Health officials and government leaders from West Africa and well beyond have all tried to grapple with a disease still boasting a mortality rate near 90 percent. 

 Many have labeled Patrick Sawyer, a public health terrorist, for his role and status as the index case within Nigerian territory.  For us, the narrative must focus on the capacity of our public health and governance systems to prevent and attend to any threats to the public health.  Essentially, can your government defend and protect you against disease and/or insecurity?

 Sawyer came into Nigerian territory, a visibly sick man from Liberia.  Obviously, we had no government measures in place to address the entry of an Ebola sick person in our territory and minimize contact.  For a disease that has ravaged three West African countries since March of this year, there was an imminent risk that a traveller with the Ebola symptoms may turn up within our borders. Without question, the Federal Government failed in its immigration and civil aviation responsibilities. Ghana, within close proximity to Sierra Leone, Liberia and Guinea, seems to have managed its prevention measures better.  We now know that Ebola has travelled outside of Lagos, as Rivers State has reported its first Ebola death.

 To contain EVD, the Lagos State Government, among other containment measures, set up isolation centers and also implemented a quarantine programme.  The Federal Government followed suit, announcing a state of emergency and a special intervention fund of N1.9 billion. This fund is meant to be utilized to intensify measures to contain the disease by the establishment of more isolation centers, case management, contact tracing and recruiting additional personnel among other things. Many Nigerians share a sense of déjà vu about the Federal Government’s policies.

 First, the declaration of an emergency is not an end in itself. This is proven by the Federal Government’s declaration of a state of emergency in Borno, Yobe and Adamawa States, that has only aggravated the state of insecurity in those states.  One thing is clear- more critical thinking and sincere action are required to make such declaration worthwhile. For the sake of us all, we hope the ingredients of critical thinking and sincere action would be available for the Ebola emergency. In related terms, Nigeria’s public health has been in an emergency ward for years.  Ebola is just a symptom of what has become an epidemic.  Ebola, as ravenous as it appears, has accounted for no more than a score of infections. Meanwhile, since 2009, we have lost a total of 3,954,084 children between 0-5 to infant mortality. In 2010 alone, 810,000 children in this age grade died prematurely from preventable health reasons. Women that die on account of childbirth related causes, amount to 55,000 annually, or 150 every day. Malaria still kills 300,000 Nigerians annually.  To put this in context, preventable diseases have taken more Nigerian lives since 2009, than the Syrian, Liberian and Nigerian civil wars joined together. How can a Nation thrive when less than 3% of its population have health insurance? Let’s be clear here, these are not just emergent issues that could be wished away.  These are governance issues that must be addressed by a thinking government that sincerely acts for the people’s benefits.

 Secondly, we, as many other Nigerians, have a genuine fear that the Ebola Intervention Fund would not be judiciously and transparently utilised by the Federal Government.. And there is probable cause for this fear. Judging by this administration’s demonstrated propensity for hurtling critical funds for urgent public purposes elsewhere, only a vigilant citizenry can ensure that the Ebola Fund does not follow the wasteful path of other public funds. The Minister of Health has all but confirmed this apprehension as he has recently been quoted as saying that the release of the N1.9 billion is not for the management of Ebola, but instead, for the procurement of new vehicles to aid in working and purchasing more drugs. This statement is in contrast to the alleged use of the funds as stated in a press release authorized by the Special Adviser to the President.

 Add this to the long and growing list of other missing funds and wasteful spending, and you discern a pattern. $US 20 billion in oil proceeds disappeared between December 2012 and June 2013. A total of approximately $US14 billion appropriated for security in three years, cannot secure the homeland. This government has presided over a scarcity of helmets, guns and a winning strategy against Boko Haram, but instead, engages in a vociferous media propaganda war against the opposition to deflect from its failure. The government’s failure has seen wide scale desertion in the army, a rising of mutiny within the ranks in the army, a direct emboldenment of the Boko Haram devil-incarnates, while ostracising the local population.  Only a few weeks ago, the Office of the Presidency engaged in a nationwide campaign to mobilise and aggregate all local campaign groups for the Goodluck Jonathan Re-election Bid.  This blatant use of public resource to pursue partisan gain is the latest testament to institution-destruction by this administration. As citizens, we must ensure that the Ebola Fund is not a slush fund.  Investment is required for fluid resistant jumpsuits, face masks, gloves, leg coverings, eye protection and industrial autoclaves to better equip caregivers and reduce the risk of transmission. The Government must establish more isolation centers and more importantly, ensure proper screening of immigrants from risk prone countries at all points of entry into the country.

 Governance is at the centre of defending a nation from disease and insurgents.  What we see today in Nigeria are symptoms of weak and insincere governance and leadership. Moving Nigeria forward requires a combination of proactive and critical thinking with sincere action.  For far too long, Nigeria has grappled with mediocre leadership that has not defended or advanced our individual and collective dreams.  The quest for a government that would lead sincerely and govern must continue to dominate our thinking and action.

.Olorunpomi is a public affairs analyst

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