Nigeria Struggles to Cope With Ebola Outbreak
Ebola, one of the world’s most fatal diseases, has surfaced in Africa’s most populous country.
Nigerian
health officials have announced 10 confirmed cases and two deaths in
the country from the Ebola outbreak that is sweeping West Africa,
including a nurse and a man from Liberia whom the nurse had been caring
for.
The
man, Patrick Sawyer, a naturalized American citizen, had flown to
Nigeria in late July and died soon after. He had infected at least eight
other people, including the nurse, who died on Tuesday, officials said.
By
Friday, President Goodluck Jonathan had declared a state of emergency,
officially adding Nigeria, home to more than 160 million people, to the
list of nations struggling to control one of the largest public-health
emergencies in recent history. More than 900 people have died.
Gulf of Guinea
Atlantic Ocean
“Rapid
epidemic transmission has been with us a long time, but my guess is
that it’s accelerating, with the number of people on the move and
intensity of air travel, global trade and the numbers of displaced
people we have globally,” said Jeffrey D. Sachs, an economist and the
director of the Earth Institute at Columbia University.
Climate
change, population growth and an increase in displaced populations mean
that people are pushing into previously uninhabited places, creating
new vulnerabilities and bringing humans into closer contact with animal
populations, where many of the diseases have begun, he said.
At
the same time, globalization means that people are mixing more, trading
more and handling more farm animals in industrial settings — all of
which facilitate the emergence and spread of infectious diseases.
“This
ought to force a reflection,” Mr. Sachs said, adding that establishing a
basic network of community health workers across the developing world
was an urgent priority.
Health
officials emphasized that Nigeria still had only a few confirmed Ebola
cases and that its government had mobilized substantial forces to try to
stop the spread of the disease.
David
Daigle, a spokesman for the Centers for Disease Control and
Prevention’s effort in Nigeria, said the ministers of health and
information were on hand Friday for the opening of an emergency
operation center in Lagos, a sign that the government was treating the
situation seriously.
“The
Nigerians understand the magnitude of the problem here,” said Dr. Frank
Mahoney, an epidemiologist who has been leading the C.D.C.’s Ebola
response in Lagos. Still, he said, international health officials are
undertaking a substantial effort in Nigeria, motivated by what might
happen if the disease, which had been confined to remote forests and
villages in decades past, starts to spread in one of Africa’s most
densely populated countries.
“We
are very worried about this,” Dr. Mahoney said, pointing out that
Nigeria’s health care system could easily become overwhelmed. “Lagos is
such a huge city with such a mobile population.”
Lagos,
a city of nearly 20 million, the most populous in Nigeria, is also home
to a large contingent of religious healers, such as Temitope Balogun
Joshua, a popular Christian minister and televangelist known as T. B.
Joshua. Health experts are concerned that sick people will flock to
Lagos to seek his advice.
Dr.
Mahoney said health experts were reaching out to such leaders, and Mr.
Jonathan called on churches and religious leaders to halt large
gatherings that could encourage the spread of the disease.
Almost
all of the suspected Ebola cases involve people who had direct contact
with Mr. Sawyer — either in the airport, where he was helped into a car,
or in the hospital where he was treated, the First Consultant Medical
Center.
Newspapers
in Liberia and Nigeria were brimming with accounts of the strange tale
of Mr. Sawyer’s sickness, which began in Liberia, where the disease is
exploding.
According to a report
in The National Chronicle, a Liberian newspaper, Mr. Sawyer’s sister,
who died of Ebola in early July, had arrived at a hospital bleeding. But
when doctors and nurses tried to put her in isolation, the report said,
Mr. Sawyer refused to allow it, demanding that she be given a private
ward. He undressed her, put her into a wheelchair and offered the
hospital workers cash, the paper said.
And in an account
in another Liberian newspaper, The New Dawn, which cited footage from a
security camera in the airport in Monrovia, Mr. Sawyer behaved
strangely as he waited for his flight out of Liberia. He sat alone,
avoiding physical contact with people, including an immigration agent
who tried to shake his hand, and even lay flat on his stomach on the
floor of a corridor of the airport, the paper reported.
The
episode prompted the president of Liberia, Ellen Johnson Sirleaf, to
publicly apologize to Nigeria about Mr. Sawyer, who she said had sneaked
out of Liberia, where he was being tracked as a potential Ebola case, according to The Daily Independent, a Nigerian newspaper.
The
number of suspected cases has continued to tick up slowly. Nigeria’s
state oil company announced on Friday that it had closed its clinic in
Lagos after a patient suspected of having Ebola was admitted there. The
patient had visited the First Consultant Medical Center, which has since
been closed.
In
a strange twist, a doctors’ strike in Nigeria may have saved lives by
reducing the number of medical workers who came into contact with Mr.
Sawyer.
“It
would have been a disaster,” said Babajide Saheed, a doctor and the
secretary of the Lagos State chapter of the Nigerian Medical
Association. “At the time, nobody was prepared for it.”
About
70 people are believed to have had contact with Mr. Sawyer, Nigerian
health officials said. Dr. Mahoney said teams of people were working to
call those people and to try to persuade them to stay at home and watch
for symptoms, such as a rising temperature.
Just as concerning was what would happen if the disease began to spread inside the health care system, Dr. Mahoney said.
“The health care system in Nigeria would have a really difficult time responding to a communitywide outbreak,” he said.
Correction: August 10, 2014
An earlier version of this article reversed the given name and surname of the secretary of the Lagos State chapter of the Nigerian Medical Association. He is Babajide Saheed, not Saheed Babajide.
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