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Ebola? Close The Borders… Now!!!

August 10, 2014

Then there was the position taken by the Minister of Interior, Comrade Abba Moro, when he was reported to have stated that an isolated case is not enough to shut the nation’s borders against its neighbors.

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Watching the news clip of the Minister of Health, Professor Onyebuchi Chukwu speaking at an interactive meeting between the Nigerian government and diplomats on measures to contain the outbreak of one of the world's most lethal infectious diseases, I was frustrated and incensed.

As the Minister spoke of the processes that the government had adopted in order to contain Ebola; including, intense training and public awareness of the disease and screening of outbound passengers at the ports, he also announced that the Nigerian government had no intention of closing its borders.

The Minister stated that there was no plan for the government to, at this time, take such a measure but would not hesitate to do so when and if the need arose. In his words (I quote), “If we did close (the borders), what we have only done is to alienate the people to go underground… And if they go underground, it means that people are not on our radar… And if they are not on our radar, we are not screening them.” It was reported that the Minister then went ahead to advise the public that there was no need to use gloves… as it may further aid the spread of Ebola.

Now, call me acerbic but, after living for decades with a clear understanding of what common sense is, I am ‘not’ prepared to loose rationality to the Honorable Minister’s rhetoric when that rhetoric challenges reason and makes absolutely no sense. I am not prepared to follow that rhetoric like a fool at logic's expense… at least not when the subject matter is a deadly virus epidemic of a magnitude never before seen! Are you serious Mr. Honorable Minister? Are you seriously trying to say that the effect of closing the Nigerian borders will only result in people going underground and out of your radar rather than containing the virus? Are you really trying to convince the public that wearing gloves may further aid the spread of the disease?

Listening to the words of the Health Minister took me back to a speech by Guinea’s president, President Alpha Condé, in April when he appealed to his citizens for calm at the panic raised by the initial spread of the virus. “My government and I are very worried about this epidemic,” he said and he went ahead to assure Guineans that the government had taken strict precautions to avoid the further spread of the disease.

Similarly, back in April, Sierra Leone’s chief medical officer, in order to calm the panic raised by Sierra Leoneans, spoke about the extensive screening processes that had been introduced in the country’s borders.

Looking back at the declaration of the Guinean and Sierra Leonean leadership about restrictions to travel and cross border exchanges, appeal for calm and assurances that every precaution to ensure that the disease stays contained had been taken by the authorities, it is safe to say that the measures they put in place weren’t altogether successful; considering the fact that the outbreak eventually found its way out of those countries and has infiltrated and alarmed a number of governments across the West African region, including Nigeria.

Then there was the position taken by the Minister of Interior, Comrade Abba Moro, when he was reported to have stated that an isolated case is not enough to shut the nation’s borders against its neighbors.

At this stage, I’m going to have to take a break; because I’m going to need the Minister of Interior, Comrade Abba Moro, to take five solid seats at the back left hand corner of the hall and the Minister of Health, Professor Onyebuchi Chukwu, to take a full stadium of seats for the ‘perilous, imprudent, negligent and deficient’ position they have taken on this biggest threat to humanity!

Correct me if I’m wrong, but we are talking about one of the most challenging outbreaks of a deadly haemorrhagic fever, which can wipe out the whole of humanity, aren’t we? Please remind me again; the subject matter ‘is’ a virus with the ability to move faster than human scientific communications and control capacities, right? Now just incase anyone missed it, the disease that both Ministers are speaking about is one that has been described as, ‘the deadliest in recorded history!’ …That is what we are playing “The Sinking of the Titanic” with, Ladies and gentlemen!

To get straight to the point; this issue is about death! Point, blank and period! Indeed, if this was Russian-Roulette loaded with a blank, as opposed to a real bullet, then going with the flow, in the manner we oft do in Nigeria, would be an option, despite what logic dictates. But this Ebola business is the real deal. It is not about party politics, or an insurgency by raving lunatics; it is not about ‘my interest’ against ‘your interest,’ culture religion or tribe. This issue is about a deadly, deadly, ferocious disease, of which the outcome cannot be predicted. So, by way of advise, both Minister’s, perhaps, need to fully comprehend that this is not the time for the government, for the opposition, for devil’s advocates or anyone else, for that matter, to tender only paying lip-service to such a threat from an extreme danger, the likes that we have never, ever seen before!

While one wouldn’t advocate for people to give into panic, irrationally act out of alarm or stigmatize mildly sick people, there is undoubtedly a need for the government to order the complete closure of all Nigerian borders; land, sea and air with immediate effect! Putting checks on all airports across the country is just not good enough, not in this instance. Unless one is a bird or a mosquito, no human being, dog, sheep, cattle, cat, ram, goat or horse should be allowed to come in or go out of Nigeria until the cases of Ebola within our shores have been detected and those who have come in contact with victims have been quarantined.

Initially, the spread of the current outbreak seemed to have slowed down, but has unfortunately picked up pace again in the past couple of weeks.  Now it is apparent that the virus is progressing faster than all the work done to try and contain it. If the condition gets any worse than it is now, the effects could become cataclysmic. The tragedy of Ebola is that, just one undetected infected person can provoke a global epidemic.

Certainly it is difficult to disagree with the Chairman of TIEMS, Nigeria (The International Emergency Management Society), West Africa, Muhammad Audu-Bida, who advised the government to close all Nigerian borders until the virus is contained. This view is predicated on the notion that the isolation of individual cases is too much of a weak measure in comprehensively ensuring the containment of the disease.

We should be able to learn from the haphazard manner in which Guinea and its border countries of Liberia, and Sierra Leone failed to contain and curtail the spread of the deadly virus. The government of, especially, Guinea, where the virus originated from, has done an abysmal job in trying to curb or curtail the spread of the lethal virus within its own borders and to other countries in the region. Perchance, if the country has closed its borders from the onset and the virus had been curtailed, the world wouldn’t have to be facing such a quandary that the virus is currently posing.

All the countries that have been affected with this virus need to seriously reflect on their lax response to the Ebola situation. Every single country in the world has had ample warning about Ebola. Since the first outbreak in Guinea back in March and the first case of a woman going into Liberia from Guinea, all countries should have taken preventive measures. It is a crying shame that it is only now, 5 months on and almost 1,000 deaths later, that governments are declaring an Ebola emergency.

The emergency declared as a result of the Ebola virus in Nigeria is a step in the right direction, but that step is really not enough. I mean, think about it; the measures that the Nigerian government have taken now are not so much different to those taken and announced by the Guinean, Liberian and Sierra Leonean governments before the disease spilled onto the Nigerian shores. And even now, as we observe the emergency declared, already news reports state that Benin has reported two cases of the deadly Ebola virus. The Health Minister of Benin announced the death of one suspected case and the quarantine of another who had, incidentally, returned to Benin from Lagos.

The closure of Nigerian borders until the disease is contained is not just for the purpose of protecting Nigeria from infected people coming into the country, it is also to protect the rest of the world from what Nigeria is taking out. Since Mr. Patrick Sawyer made the conscious decision to come into Nigeria, after knowingly having contact with a family member who died from Ebola, he placed on Nigeria a burden, which has got to be completely offloaded. The Liberian government’s sheer incompetence and ‘uselessness’ in failing to stop the movement of Mr. Sawyer and allowing him to travel abroad, having known he was taking care of his sister, who was infected and later died of the virus, is astounding. The Liberian authorities have admitted to being aware of Mr. Sawyer’s medical condition. He had, apparently, been put under surveillance by Liberian health authorities but escaped quarantine and managed to book and board a flight heading out of the country. Unbelievable!!!

In addition to the apology that the Liberian president has issued to Nigeria for her government’s incredible ‘inability’ to manage even the simplest of tasks of keeping ‘one’ man in quarantine, there should be an official apology and possible compensation for the families of the doctors, nurses and all those who have lost their lives or have contracted Ebola as a result of the direct selfishness and recklessness of both late Mr. Patrick Sawyer and the Liberian government. And if we later learn that the reason for Mr. Patrick Sawyer’s haste to travel to Nigeria in his condition was because of a directive from his employers at ECOWAS, and not because he personally wanted to fulfill the condition of collecting ‘estacode’ (money provided to pay for travel expenses for corporate officers), then ECOWAS should be held ‘vicariously liable’ for any tort committed while he was conducting his official duties. Under Tort law, a strict liability has been imposed on ECOWAS for any wrongdoing of Mr. Sawyer while ‘in the course of his employment,’ so if it turns out that he was merely carrying out his duties, one would hope that the families of those directly affected would explore the possibility of filing a legal suit. Not that anything can bring back the family’s deceased loved ones back or repair the damage already done, but the only crime of those who came into direct contact with Mr. Sawyer was to help a very sick man. Therefore some accountability should be taken for the risk that was ‘wickedly’ imposed on them.

So, as we continue to groan and moan about the late Patrick Sawyer’s lack of good judgment in deciding to travel to Nigeria despite his infection and the Liberian government’s ‘worthlessness’ of letting a man who had been known to have contact with a victim of Ebola travel out, Nigeria’s lack of full-proof preventative measure is now posing, to other countries, the same threat Liberia posed to us.

The arrival of Ebola in Nigeria should be of great concern to every nation in the world. No country deserves the curse of Ebola, but the one country in Africa that Ebola does not need to find a base is Nigeria. With a population of approximately 170 million people, with a community so overcrowded and clustered, with an environment so overwhelmed with pollution, with borders so porous that insurgents navigate it at will, with hundreds of International flights leaving the country weekly, Nigeria would be a most dangerous hub for Ebola to fester.

The Nigerian authorities must understand that, with such an epidemic, the domestic and global situation cannot be kept separate because any lapse we have domestically can have dire global implications. Nigeria must appreciate the weight of the world to ensure the complete eradication of Ebola from within its borders that is presently resting on its shoulders. The very nature of Nigerian communities and family structures, the overcrowding, lack of access to health care and our over imaginative superstition, all provide a viral breading ground for a disease like Ebola.

Nigeria has a responsibility to its citizenry, the same duty Guinea failed its people, the same duty Liberia failed its people, and the same duty Sierra Leone failed its people, by shutting its borders, not only to protect our country from Ebola-prone countries but also to protect other countries from us, until the epidemic can be controlled. Failure to carry out this preemptive and decisive action would further render the world vulnerable and susceptible to a global pandemic.

Similarly, Lagos, the ground zero of Ebola in Nigeria, should also shut its borders for the duration of the stipulated incubation period and set up effective awareness campaigns enlightening the populace of the effects of the Ebola virus and the importance of reporting any suspected case within the period that lives can be saved. Once people understand that the only way to stop the virus is to prevent it and the only way to save the life of an infected person is to treat the symptoms early after infection, one would believe that people would cooperate and come forward when symptoms occur. If the virus is not contained and eradicated within Lagos and is allowed to get out of the state, the consequence would be extremely colossal for a population of 170-million people and, by extension, for the world.

For the future, African countries have got to try and improve the capacity of its various hygiene and medical systems to respond to all these health emergencies, whether it is Ebola, Lassa fever, Marbug, Cholera or any other disease. However, for now, sanitary gloves, disinfectants, sanitizers and face-masks (the likes of which I am displaying) should be made available to people in Lagos and other part of Nigeria in sensitive environments such as hospitals and laboratories to further help in curbing the spread of the virus. The basic protective gear displayed will primarily benefit those in high-risk environments but it’s not necessary for every day or domestic use.

Also, decisive action has got to be taken on some very worrying and emerging elements of this disease. Since news of Ebola broke, government authorities and medical experts have been battling misinformation and folktales with the capacity to worsen the situation. In one such incident a prank about ‘salt’ having the ability to kill Ebola was started by an attention seeking young woman who later sent a ‘salty’ confession to the media, if only to reinforce that desperation for attention. (Her gloating confession can be read on the following link: http://ynaija.com/site/this-lady-says-she-started-the-salt-and-water-ebola-joke-read/). ‘But-for’ the fact her antics allegedly lead to the death of, at least two people and 20 others being hospitalized for consuming an excessive quantity of salt in order to protect themselves from the virus, she could have been known as the giggling fool. But now, she is something much worse. And one would hope that she understands the high price that has been paid and the shocking tragedy that has come from her quest for her ‘five minutes!’

Government must clamp down on those promoting false theories on, not just salt, but bitter kola as well. Equally, authorities must vehemently warn Muslim and Christian clerics and traditionalists from utterances that suggest an alternative to conventional medicine. Faith and spirituality is, no doubt, the most important component of any struggle and challenge, but we must ensure that it is channeled in a way that will help our communities follow the instructions of medical experts to contain and eradicate the disease as opposed to hindering efforts to try and get it under control. All religious leaders and herbalists must be given the explicit order not to make public statements on Ebola that may have dire results.

Another necessary target group for the authorities to clamp down on are the people who continue to insist on hunting and eating bush meat, despite the stern warning of the danger it may carry. Handling uncooked bat with the virus strain and eating bush meat are some of the ways experts suspect that the Ebola virus has been transmitted from the animal world to the human one, after which human-to-human contact then becomes possible.

Since the outbreak of the disease, several countries have banned the hunting or trading of bush meat. But unfortunately in most of those countries, many have ignored the ban and continued to expose themselves and the larger community to the risk of contracting the virus through their ingestion of bush-meat. In an Al Jazeera news interview (which can be seen on the following link, https://www.youtube.com/watch?v=xZohUJXRECQ *recommended to watch*)

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Meat-Eating continues despite Ebola scare

, the chairman of the Nigerian National Association of Hunters, Olasehinde Afolabi, insists that he will continue eating bush meat. In the clip, when the reporter interviews him, Mr. Afolabi lividly declares, “It’s a lie… It’s a beyond lie! If they don’t want bush meat, they should not eat it, but we the hunters… they cannot say we should not eat it and they cannot tell the public not to be eating it.’

…Now, wait, wait, what? Did Mr. Afolabi just allude to the fact that he will continue hunting and eating bush meat, no matter the threat posed? Wow! One is inclined to think that this reprehensible attitude that Mr. Afolabi is displaying may somehow constitute a weak link in the national effort to contain and overcome Ebola! Maybe if he could, just for a minute, put his seemingly insatiable avarice for, ‘poached monkey’s brain pepper soup,’ ‘smoked bat and armadillo orishirishi’ or anything even remotely edible aside, he would understand that the struggle to protect and save the world population is much more important than satisfying his ‘over active’ taste buds and filling his stomach!

Here we are, in a race against time, trying to get under control a ginormous threat to humanity and there is the chairman of the Nigerian National Association of Hunters, risking the lives of every single one of us just so that he and his hunters can enjoy a piece of unidentifiable animal part. At this point the Nigerian authorities should take the threat that is posed by the actions of every gluttonous, carnivorous, bush-meat-eating biped very seriously and completely ban the hunting, trade and congestion of bush meat, until further notice. And in the mean time, the relevant people in the black suits and black ray bans from the relevant authorities might just consider paying a visit to this overzealous meat eater and having a wee word with Mr. Olasehinde Afolabi! Maybe if he saw the images of the pain and suffering of Ebola victims or heard the tears of the families of those who have died, he would know how serious this issue is and how reckless his actions are. It is advisable for us to be cautious.

We have already partaken in the blunder of the century by allowing Ebola to come onto Nigerian shores. Back in March and April, as soon as it was widely publicized that there was an Ebola virus outbreak in the West African region and had begun spreading to other countries other than Guinea, where it originated from, the Nigerian government should have closed all air and land borders from affected countries or just screened all the people coming into Nigeria from those locations. And the blame does not only lie on the government. Nigerian citizens have also failed to spread awareness and learn about this disease till now.

I have followed this Ebola story religiously since May of this year and I often speak about the disease on my social media pages. Some weeks ago, when I learnt that there was a suspected case of Ebola in Ghana, I wrote a full op-ed on it. The feedback that I received from readers on my e-mail and social media pages were very negative and shocking to me. A lot of readers suggested that I had ‘misplaced priority’ by writing and speaking out extensively about the Ebola virus and the Gaza situation, which were not problems that Nigerians were dealing with. They believed that I should have concentrated all my efforts solely on writing about the return of our Chibok girls because that was the domestic issue that was plaguing us. I was quite disappointed with the response and although I could understand where they were coming from, I could honestly not appreciate their rationale. With this epidemic, one hopes that we all realize the irrationality and danger of separating certain catastrophes with the faculty of affecting every one of us and pigeon-holing them as domestic and global; because one catastrophe can have a dire effect on the other.  Issues such as disease, natural disasters, war and genocide can all have a global domino effect. As part of the human race, we have a responsibility to collectively speak about them all; wherever they occur in the world.

Curiously though, despite the widespread report of a lack of vaccine or cure for the deadly Ebola virus, two American health workers who contracted Ebola, seem to have swerved death after being given a "mystery serum" made with tobacco leaves known as ZMapp, which appears to have improved their condition.

Nancy Writebol and Doctor Kent Brantly were both diagnosed with Ebola after being in West Africa as part of Charity organization, Samaritan’s Purse, to help with the aid effort following the outbreak of the disease. When it was learnt that they had become infected, they were immediately flown back to America, where the Ebola secret serum was administered to them, albeit without FDA approval. Ordinarily, before an experimental drug can be used in America, the FDA would have to give its approval but in this instance, that requirement was waived because it was an emergency situation and due to a loophole that was created because the American health workers become infected in Africa, not America.

Reports suggest that the United States Army; Department of Defense is partly responsible for some of the funding going to the research of this serum. If that is the case, then the American government was very much aware of its existence and progress and it was not some dark secret kept in the corridors of private pharmaceutical conglomerates. But America never said anything about a possible serum when African governments were being overwhelmed and victims of Ebola were being ravaged… Until two Americans became infected with the disease.

Facing widespread criticism, by way of information as to how the two American health workers were able to have access to a mysterious serum, the American National Institute of Health released a statement saying, “Samaritans Purse contacted CDC officials in Liberia to discuss the status of various experimental treatments that they had identified via a search from the literature…CDC officials referred them to an NIH scientist who was on the ground in West Africa assisting with outbreak response efforts and broadly familiar with the various experimental treatment candidates…. The scientist was able to informally answer some of the questions and referred them to appropriate company contacts to pursue their interest in obtaining experimental product. She was not officially representing NIH and NIH did not have an official role in procuring, transporting, approving or administering the experimental products administered to the two US patients.” Now, if one didn’t know any better, one could have sworn this sounded like excuses, as if the Institute of Health was trying to distance itself… Ummm!

This is indeed food for thought. From the get go, the speed at which America transported the two health workers back to the United States seemed very strange. It just didn’t add up. From all that we had heard about Ebola, with its high contagious and mortality rate, for American to introduce Ebola infected patients onto its shores and potentially endanger the uninfected population in America, just didn’t make sense! And even when we learnt that a mystery serum, never before used on humans had been tried on the two health workers, it didn’t add up that America would be willing to use its two nationals as Guinea pigs. If America maintains that it had no idea what the effect of the experimental drugs would be on humans, one questions whether they really would have risked using an experimental drug on its citizens without ascertaining its potency first? Even if the serum was experimental, why wasn’t the experiment done on the hundreds of African Ebola patients who had been infected and succumbed to the disease? There is no doubt, Nancy Writebol and Doctor Kent Brantly are global heroes and they deserve to live but also, so do the hundreds of Africans who have fallen victim to Ebola.

The only plausible explanation of the haste in which America flew the two American doctors back to the United States to give them ZMapp, despite the danger it posed to its citizenry and the administration of the mystery serum, is that the American authorities had enough confidence in the drug to actually administer it, as a first resort, to the American patients.

Serious questions need to be asked about the availability of this Ebola serum, ZMapp. But unfortunately, the opportunity presented by the just concluded US Africa summit, was not fully utilized by the African leaders. As their countries continue to cower under the threat of Ebola, the African leaders failed to vigorously demand for a valid explanation from the Americans why the serum wasn’t and hasn’t been provided for Africans infected with the virus.

If anything, this Ebola mystery serum saga should be food for thought for Africa. A ferocious disease is devouring Africa and killing at an unprecedented rate; a potential cure is being developed in America but is never mentioned until the point that Americans become infected. It is indisputably clear; Africa has got to get its act together… if only for its future survival!

If Americans can make the serum, then why cant Africans? Typically with every Pharmaceutical Company, there has to be a financial incentive to invest in manufacturing new drugs. Owing to the drawn-out process and repeat trials that go into developing and manufacturing drugs, Pharmaceutical companies have to invest an incredibly huge amount of money for each product. With a malaria drug, for instance, the high incidence of the disease and demand for the drugs provides an incentive for Pharmaceutical companies to manufacture and produce it. But with a new illness such as Ebola, which is, at present only in parts of West Africa, the manufacturers are not prepared to invest the huge amount of money needed for the clinical trials that would guarantee and manufacture the serum. With only a handful of ‘low income’ countries stricken by Ebola and by the theory that, once the disease is contained, there would be very low demand for the expensively manufactured drug, the Pharmaceutical Companies just don’t have a financial incentive to produce the serums. And that may just be the mystery behind why the mystery serum has not been made available to Africa yet!

In the short term, all affected countries have got to put necessary and comprehensive measures in place. And the countries most affected, ECOWAS or the African Union might think of putting enough funding together to approach the Pharmaceutical company in charge of manufacturing the ZMapp serum in order to try and get the serum produced and delivered to Africa as soon as possible.

In the longer term, all African countries must focus on strengthening the capacities of continental and national health and sanitation systems so that we can respond to such emergencies, whenever they do arise. Every African country has enough indigenous scientists or can employ foreign expertise to build its scientific capability in drug development. In Nigeria, we have the Nigerian Institute for Pharmaceutical Research (NIPRD) and the Nigerian Institute for Medical Research (NIMR). Government should enhance the support for these institutions in the experiment and manufacture of drugs.

This terrible plague has already ravaged enough countries and claimed enough lives. Decisive action must be taken in order to contain the spread of the virus. Ebola, having an incubation period of up to 21 days, means that the symptoms do not necessarily show before then. Once transmitted through contact with the bodily fluids of infected persons, meat or surfaces, a fever quickly degenerates into internal and external bleeding, vomiting and diarrhea, which all contain vast amounts of the pathogen. If the incubation period goes up to 21 days, then the government should consider closing the borders for, at least, the full duration of that period. That way authorities will be able to have a clearer idea of the true number of cases and an assurance that Nigeria has not played a part in the link of passing the disease on.

Undoubtedly, if the government were to consider momentarily closing the borders, there would be harsh economic consequences felt across the board. The economic effect would be similar to what Nigerians have experienced in the past during strikes, natural disasters, curfews imposed by sectarian violence and the state of emergencies. And despite the difficult effect of such a decision, were it to happen, Nigerians would need to keep in mind the alternative; the deadly consequence of giving Ebola an opportunity to spread.

Now that the Nigerian government has increased surveillance at all entry points to the country and set up a committee to deal with any potential escalation of the disease, there really is an urgent need to consider closing the borders, especially if more cases of Ebola are confirmed or suspected. In addition, hospitals, clinics and laboratories should be provided with the necessary protective gear, required apparatus and needed chemicals for diagnostic tests. Quarantine, security, medical, custom and immigration officers (if the borders aren’t closed) should be equipped with thermal body monitoring cameras to monitor the temperature of suspected victims or passengers arriving into Nigeria. And a vigorous awareness campaign has to be launched throughout Nigeria.

The real paradox of Ebola is that the same element that makes it so vicious and so much of a threat happens to also be it’s failing. The disease kills a high percentage of victims within a very short period of time. This makes it too potent to effectively extend itself broadly. However, that being said, unless we are able to completely eradicate it, the danger of it adapting to its host and mutating to become less virulent is a real scary possibility. The very nature of the survival of viruses is constant mutation and adaptation. So, the longer Ebola is allowed to hang around, the more it will become the long-term public risk that the world cannot afford or control. It has got to be stopped.

As Nigeria comes to terms with the arrival of Ebola, every single one of us has to exhibit a stanch sense of urgency by being aware, taking precautions and following the proper instructions. And as part of a coordinated international response, the government should act carefully and conscientiously.

Yeah, Ebola ‘has’ arrived in Nigeria. Shut the borders…NOW!

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