28 July 2014

Liberia: Letter From Lagos - Wish Liberia Had Done This Much to Curb Ebola

Photo: Samaritan's Purse
Dr. Brantly makes chlorine solution for disinfection at the case management center at ELWA Hospital in Monrovia before he was infected with the virus.

Lagos — On the day my country, Liberia turned 167, I touched down in Lagos, Nigeria to see for myself what really happened to Patrick Sawyer and how he died.

Sawyer, a WASH Consultant, at the Ministry of Finance, who was quarantined since falling ill after arriving here for a conference last Sunday, was pronounced dead as a result of Ebola, the first casualty here.

The speculations have been endless: That upon concluding he had the virus, Nigerian authorities forcefully ended his life to prevent the deadly outbreak from spreading into its 168 million population. Truth or false, fact or fiction: Few would argue that if what the Nigerians feared or had ample medical evidence, they had to do what they had to do to avert or avoid what is already wreaking havoc in Liberia, Sierra Leone and Guinea, killing, according to the latest World Health Organization numbers, more than 670 people with more than 1000 cases reported. The worst previous outbreak, in 2000 in Uganda, saw 425 people infected, of which just over half died.

Local newspapers quoting some of the passengers on the flight reported that many agree that it was unfair for Sawyer to have been allowed to go away without ensuring their health had not been compromised. Others are demanding that screening of people should have been adopted earlier to stop the spread of the disease.

In Liberia those casualties have included Dr. Samuel Mutooro, a Ugandan doctor, who lost his life trying to save a peer, Esther Kesselly, several other healthcare workers, including Dr. Samuel Brisbane, head doctor at JFK. Two Americans working with the medical humanitarian group, Samaritan Purse have also been infected.

Dr. Kent Brantly, 33 and Nancy Writebol are in Liberia helping to respond to the outbreak that has killed 129 people nationwide when he fell ill, according to the North Carolina-based medical charity, Samaritan's Purse. Writebol is said to be gravely ill and in isolation at the ELWA facility, now being used as a major Ebola containment center.

Others on various social networks and chatter rooms have pointed to Sawyer's own carelessness as having played a role in his death.

I spoke to Sawyer via phone some three weeks ago to express my sympathy upon hearing of his sister's death. He had explained to me that the sister's husband had fled after her death and that he had gone in search of him, in hopes of bringing husband to test for Ebola.

I even spoke to him the night before he died - and he sounded fine, tried calling back later but the phone rang endlessly. By 6am I received a call from a senior government official with whom I had discussed the situation the night before, that Sawyer had expired, even though the conclusive test was still due. It was announced shortly after his death that he died of Ebola.

Local media reported here Monday that Sawyer's body was cremated a few days ago.

What I forgot to ask Patrick then, was whether he had made contact with his sister? Whether he himself had been tested?

More importantly, I keep wondering how much it would have taken health authorities in Liberia to quarantine Sawyer and all those he came in contact with before his death: The usual crew with whom he ran regularly with on Saturday mornings at the Samuel Kanyon Doe Sports Complex; His immediate family and most importantly, those with whom he worked at the Ministry of Finance?

I would like to think that the answer to all the above were all in the affirmative, that authorities took precaution by doing all those things, but having seen and reported stories about suspected-Ebola patients carried on the backs of friends and relatives who just dropped them off at the Cholera Unit and went back in their communities without being tested or quarantined, hope remains slim and skepticism at an all time high.

The sad reality is, all Liberians are guilty of overlooking a deadly virus and taking it for granted.

We're talking about a country where citizens have attacked an Emergency Room at the country's largest hospital demanding the body of a relative who had just been diagnosed with Ebola, a country where a nurse was stabbed on her way to work in her nursing uniform, a country where some relatives are determined to hold regular funeral for relatives who have died from Ebola even though they have been told that it is dangerous, a country where some medical facilities are still without protective gears. Mind you, people have contracted the virus after coming in contact with dead and living chimpanzees, gorillas, monkeys, forest antelope, porcupines and humans.

More importantly, doctors and nurses in the line of fire are dying in the droves even as the World Health Organization have declared that testing blood specimens for the disease presents "an extreme risk", and must be done only under the strictest containment conditions.

Even those foreign doctors on the front line at the only facility capable of dealing with the outbreak, the Samaritan Purse at ELWA are putting their lives at risk.

Despite the danger, these Samaritan Purse doctors continue to press on, against dissent from ELWA community residents who have resisted the doctors' attempt to open more centers to cater to more suspected cases out of fear that the disease will spread to them. As a result, the good Samaritans are no longer taking new cases. So much for trying to do good to a nation that does everything to show their ignorance, intolerance and naivety.

This brings me back to Lagos and my mission here. Gauging between how my own country handled the outbreak in the initial stages and what I have seen and experienced since I arrived here, I think it is pretty fair to say that my country "F... .ed up.

One could argue that authorities in Lagos where the federal government has issued an alert, canceled flights to Liberia and IMPLEMENT, not just DECLARED stringent measures are doing so because of its large population, with millions of peoples' lives at stake and at risk.

Here, authorities are actually scrambling to contain the threat since Patrick Sawyer's death.

International airports in Nigeria are screening passengers arriving from foreign countries for symptoms of Ebola, Health officials are also working with ports and land borders and giving out information in terms of enlightenment, what to do? what to look out for? More importantly, airports are setting up holding rooms to be ready in case another potential Ebola victim lands in Nigeria.

In Liberia, a long-debated border closure have finally been 'DECLARED' and the President has again declared yet another state of emergency.

To understand the magnitude of Patrick Sawyer's death, one has to weigh a series of possible complications. Besides those he may have come in contact with in Monrovia, the SKD Sports Complex and his peers at Finance Ministry, the plane carrying Sawyer, stopped in Lome, Togo, according to the World Health Organization. There have been some reports that he vomited a few times among friends prior to making his trek and even vomited on the plane; that he argued with a Deputy Minister over the delay in getting his travel per diem and unanswered questions over how forthcoming Patrick was to his family, his friends, the government he worked for and his country.

Authorities announced Friday that blood tests from the Lagos University Teaching Hospital confirmed Sawyer died of Ebola earlier that day.

"Several potential vaccines are being tested but it could be several years before any are available," according to the WHO. "A new drug therapy has shown some promise in laboratory studies and is currently being evaluated." In Monrovia, shutdowns have been announced at several government buildings: The General Services Agency, the National Oil Company of Liberia, the Ministry of Finance. In setting up her task force to deal with the Ebola threat, President Sirleaf says: "We must come together as never before despite of our political, religious and social persuasions, we must show a deep sense of nationalism. We must reach across borders and join our brothers and sisters in other neighboring countries that are affected to ensure continuing common response." Upon the declaration of Ebola as a National Emergency, the task force headed by President Sirleaf, has announced the closure of all border entry points."

I hope that this time, the president means it, I hope this time eye-servant Cabinet ministers and government officials, notorious for waiting for the President to move before they move will take this Ebola madness more serious than they have. While the setting up of a task force and late measures to curb Ebola is commendable, the president must take steps and action to dismiss someone over the poor handling of this, particularly, whoever was responsible for not quarantining Patrick Sawyer and whoever allowed him to leave Liberia.

As a result of incompetence, Nigeria has suspended flight operations to Liberia and Sierra Leone even as it advised that all inbound flights into Nigeria from any of the Ebola affected countries be immediately suspended by the Federal Government. This is a major embarrassment for Liberia and could set a precedence for others to follow. In Monrovia, airline offices are jamming with those who can afford to leave. It is more than likely that most government officials will try to leave. What President Sirleaf should do, is order all those senior officials already out to return home and demand that they all stay in Liberia and deal with this madness. If possible, President Sirleaf should designate Vice President Joseph Boakai to represent her at President Barack Obama's White House meeting with African leaders next week.

Liberia survived more than a decade of war and enduring a corrupt system. I hope and pray that we survive Ebola and that those foreign powers contemplating leaving Liberia reconsider and help us fix the mess health authorities have made. My diplomatic sources in Monrovia tell me that a town hall meeting of U.S. citizens in the country is being planned for Tuesday and U.S. embassy staff are meeting to ponder what's next. We must all hope it doesn't come to what many are dreading. At JFK, sources tell me that an emergency meeting was held Monday and that the staff has given the hospital management an ultimatum to shut the facility down between today and Wednesday for a 21-day incubation period, so that the entire facility can be sprayed. Both the Emergency Wing and OPD have already been shut down. Perhaps, it wouldn't be a bad idea to quarantine all the healthcare workers.

Sadly, 21 days would mean a living hell for pregnant mothers awaiting delivery or accident victims in need of urgent care. But nurses and doctors' lives are at risk. "If the American doctors wearing masked and the best gears are getting infected, what about us," a health worker told FrontPageAfrica via phone Monday, shortly after the meeting with management.

In hindsight, I hope those at the helm of power learn a hard lesson from this. Nigeria is taking these steps not because it does not consider Liberia a friend, not because it does not want a fellow ECOWAS nation to feel offended or bad, it is taking these measures because it wants to stop the spread, and keep Ebola out of reach of its 168 million population. My country of a little over four million, according to 2012 estimate, still has a long way to go. But leadership is about taking hard decisions, making tough choices -even at the expense of losing popularity or making someone feel bad.

I strongly believe that if our leaders had taken the steps they are 'declaring' now, we would not be in the situation we are today. But the damage is already done, the onus is on all of us to work within the reach of what we have to keep more people from dying, to give health care workers hope that the broken system will be restored so they can return to work, to bring hope to all and believability to many still harboring doubts about Ebola.

As I end on this note, Arik Airlines which flew me into Lagos, has suspended flights to my homeland, passengers arriving here are being screened and the country is on Red Alert. I have to find another way out and hope and pray that this Ebola thing will pass over soon so that Liberia can return to normalcy from the state of uncertainty and fear now creeping and lurking behind the shadows of incompetence and failure. For those still in doubt? Ebola is for real. We must all work the clock and spread the word before we all end up dead.

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