Ebola virus

Stories of resilience in the midst of Ebola

Reposted from globaluminary.wordpress.com.

Most of the international stories surfacing deal with so much of the negative it seems hope is lost in the fight against Ebola. Well, I am here to bring you a new perspective. One I hope will inspire during this time of loss, uncertainty and fear. May this post shine brightly in the midst of the fight to contain Ebola.

Allow me to introduce you to some local survivors, who have now committed themselves to educating communities and working in Ebola facilities to comfort both families and patients. Please meet a few overlooked Ebola Fighters.

Mohamed and Zena are Ebola survivors from Guinea. Both became infected with the virus while caring for Mohamed’s older brother, who at the time, they were not aware had Ebola. The virus hit their family hard, with 9 becoming infected and 6 dying.

After recovering, Zena, a 24 year old school teacher and Mohamed, a 34 year old civil servant both lost their jobs from the stigmatization attached to the disease. Even with facing so much loss in their lives both knew they wanted to become more active in stopping the transmission of the virus so other families could survive and not endure the same pain they suffered from. They wanted to work to keep villages in tact and safe.

Medecins Sans Frontieres and other NGOs saw this as an opportunity and have deemed both Zena and Mohamed, Ebola Ambassadors. They go around communities contributing their personal stories to share knowledge, save lives and ultimately control the outbreak.

Then there is Salome Karwah of Liberia. Salome, her parents, fiance, sister and niece all became infected after her uncle contracted the virus by taking another infected woman to the hospital. Shortly after his death, Salome and her entire family, found themselves at an Ebola treatment center for care.

Salome Karwah

She describes her experience as:

“Severe pains were shooting inside my body. The feeling was overpowering: Ebola is like a sickness from a different planet. It comes with so much pain, and it causes so much pain that you can feel it deep in your bones.”

After 18 days, and following the loss of her parents, she tested negative for the virus and was able to go home with her fiance, sister and niece. After arriving home to fearful neighbors, she knew she needed to do more to educate and fight the stigma attached to Ebola. Currently Salome is back at the same treatment center who provided her care working as a mental health counsellor. She treats patients as family and shares her story to inspire them through it all.

Dr. Ada Igonoh a Nigerian doctor, takes you on an emotional rollercoaster as she recounts her experience surviving the deadly Ebola virus. A story so powerful, it has spread across the world like wildfire. Now as a survivor she uses some of her time to educate the world on her experience. She discusses her fears, the realities, thoughts and the tools she used to pull through the hardest of her days.

Stop_Ebola_0Sadly, Ebola continues to threaten the lives of millions. However, even through the storm, can light be seen. I found these stories to be inspirational aswe work to #EndEbola. We all have a part to play. To understand the magnitude of loss experienced by Mohamed, Zena and Salome and yet to see the passion blazing through them, now all working to care for their communities is a selfless act and one we should all aim to recognize. In fact,  Time Magazine has deemed such actions as Heroic naming a few as ‘Person of the Year.

Let’s not further the stigmatization or lose sight of what it takes to end such a deadly virus. Instead educate yourself on the virus and take time to hear more stories of survivors and how they too change the tide of this current epidemic. Write a governmental official. Blog. Whatever positive action you chose to take could make the impact necessary to perhaps… just  perhaps… #EndEbola.

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Grassroots organizations fighting ebola in Liberia

 

Fighting Ebola from the grassroots | By David Norman and Saran Kaba Jones of FACE Africa | Oct 9 2014

Image: A health worker checks the temperature of a man at a roadside health checkpoint outside Ganta October 7, 2014. REUTERS/Daniel Flynn

As a global community, our ability to respond to the Ebola crisis gripping West Africa and to future crises will depend on how much we effectively learn from past interventions, and how best we adapt our practices to improve on coordination, mobilization, impact and long-term outcomes.

When responding to crises and disasters of this magnitude, we can benefit tremendously from local, grassroots organizations and their ability to operate in complex environments, to aid in more timely assessments, and to quickly disseminate information and critical services in the wake of a global crisis. Due to the very nature of their proximity to a potential disaster, community-based organizations become the de facto first responders, witnessing the situation as it begins to emerge. Their knowledge on the ground can play a critical role in assessing the severity of the problem and more accurately projecting its impact.

The first cases of Ebola in West Africa were reported back in September of 2013 and went through a lull before finally resurfacing in early 2014. We can ask ourselves what if, during that period, we had made use of on-the-ground reports by local organizations? Could we have come to learn earlier what we now know about the disease? Would epidemiologists have been able to better predict the capacity of health systems in the region to cope with this new Ebola virus? Could local groups have been able to warn others that the lack of local containment of the disease could pose a serious threat to attempts at intervention?

Unfortunately, as has happened far too often in the past, by the time the world acknowledged the potential consequences of the current epidemic, it was already too late to avoid a completely overwhelmed and unprepared response lagging far behind the spread of the disease.

However, even at the current phase (with a recent CDC estimate suggesting that the virus could infect anywhere from 500,000 to 1.4 million people across the region over the coming months), identifying and empowering local groups as the foundation of intervention could have a significant impact on efforts to contain the spread of the Ebola virus.

Organisations with strong local ties have long understood the importance of engaging with communities in a meaningful, equitable way. Liberians teaching Liberians. Guineans treating Guineans. Sierra Leoneans empowering Sierra Leoneans. In the case of our organisation, FACE Africa, our track record of community engagement in Rivercess County, Liberia allowed us to launch an Ebola awareness campaign far more quickly than a major international player would have been able to. The effectiveness of our campaign was enhanced by the local ties and level of deep-rooted trust we already had within communities. An international team parachuted in would likely not have received the same level of receptiveness from local communities (indeed, there have been numerous cases where health workers and response teams have been met with outright hostility).

Engagement is the pathway to empowerment and when communities are empowered to take control of a situation for themselves, you see meaningful change. They may not have all the expertise, but they have the ability to learn, take charge and even put in place their own solutions. Ian Smillie in the book Patronage or Partnership states that, “supporting the work and strengthening the capacity of local organizations can not only be instrumental in dealing with the situation at hand, but also increase resilience to future humanitarian emergencies. Sending in international emergency teams can help, but is not enough. It is important for the international response to move from a culture of patronage to a culture of partnership.”

We only have to look at the catastrophic 7.0 magnitude earthquake that devastated Haiti in 2010 to understand the importance of local response and long-term planning. As the world’s attention was focused on Haiti after the earthquake, billions of dollars of emergency relief flooded into the country from international donors, supplies were mobilized and doctors and nurses were parachuted in to perform lifesaving medical procedures and care. UN soldiers were deployed to coordinate efforts and governments pledged billions to reconstruct the country so that it was “stronger and more prosperous than ever before”. Four years on, and Haiti is still reeling with nearly a million homeless, the worst cholera outbreak in recent history and an insecure future.

We cannot allow the mistakes in Haiti to happen in Liberia, Sierra Leone and Guinea. As the world rushes in to help eradicate Ebola in West Africa, now is the time to start thinking beyond the current crisis. Now is the time to focus on ways to sustain our efforts and build infrastructure that will last long after the current crisis has subsided. Because in strengthening the infrastructure and capacity of these countries well into the future, we are not only limiting a potential recurrence, but we are tackling the myriad of other health problems from malaria, to diarrhea, to cholera and typhoid that continue to kill far more people every day.

But any efforts at sustainable development cannot be achieved in the absence of local organisations and community groups. These groups must be at the forefront and lead any long-term development efforts. They must be recognized and supported because they represent the long-term health and strength of African communities; they have been on the ground, are currently on the ground and will still be there when everyone else has left.

Authors: Saran Kaba Jones is the Founder & CEO of FACE Africa and a World Economic Forum Young Global Leader. David Norman is the Business Development Officer at FACE Africa.

Ebola: 1,332 Nigerian Soldiers Quarantined in Liberia

The Nigerian Army has revealed that about 1332 of its peace keeping troops in Liberia have been placed under surveillance following their contact with a Sudanese who later died of the Ebola Virus Disease (EVD).

They reportedly came in contact with an infected Sudanese man who was in the soldiers’ camp to lead them in prayers during the Sallah celebration.

The development was disclosed by the Director of the Nigerian Army Medical Corps, Major-General Obashina Ogunbiyi in Abuja on Thursday October 9.

Ogunbiyi reportedly added that Nigeria is still at risk of the disease as any of the soldiers could choose to come back home at any time.

He also said that the quarantined soldiers are part of the reason “…why the military had to be totally involved in the fight against the Ebola virus.”

Nigeria has contained the Ebola outbreak and is set to be officially cleared by the World Health Organization on October 20.

Voices from the epicentre of the Ebola epidemic

As Ebola spreads across west Africa, we talk to the medical and humanitarian professionals scrambling to contain the spread of the disease

Reposted from  – Guardian Professional, Monday 14 July 2014 12.17 EDT

Ebola clinic Guinea
Medics enter an Ebola isolation tent at Donka Hospital in Conakry, Guinea. Photograph: Sylvain Cherkaoui/Cosmos/Médecins Sans Frontières

The outbreak of Ebola in West Africa is unrelenting: according to the World Health Organisation there have now been 888 cases and 539 deaths across Guinea, Sierra Leone and Liberia since the virus was first reported in March this year. The epidemic is unprecedented and the global health community has been left scrambling to contain the disease, for which there is no vaccine or cure.

In a bid to boost the response to the disease, the World Health Organisation (WHO) convened a special meeting on 2-3 July in Accra, Ghana, with health ministers from 11 West African countries and partners involved in tackling the disease.

Here, professionals involved in fighting the deadly virus share their experiences of what it’s like to be at the epicentre of the epidemic.

Dr Ibrahim Bah, medical supervisor at the isolation centre of Hôpital National de Donka, Conakry, Guinea

I work in the department for infectious and tropical diseases so I am used to working on epidemics but this is the first time I have dealt with Ebola. It is a new disease in Guinea. Before Médecins Sans Frontières arrived, we had no specific training on dealing with the virus. At the beginning, I was scared: I saw people haemorrhaging to death. The experience is traumatising for patients too: they know we don’t have a vaccine or a cure, and they think: “I have Ebola, my life is over.”

The earlier patients seek treatment however, the higher their chances of survival. We have had more recoveries than deaths on the ward. The first recovery was a real celebration – it gave us strength to continue working.

Safety is paramount but working with the protective clothing is exhausting in the heat. On very hot days, you sweat so much that you can’t keep the equipment on in the ward for more than 30 to 45 minutes.

It has been very hard for us: there is a lot of stigma attached to working with the virus and some people have been rejected by their families. But as people become more aware and realise Ebola need not be fatal, things will change.

Dr Jacob Mufunda, World Health Organisation representative, Freetown, Sierra Leone

One of the positive outcomes of the emergency ministerial meeting is that it aligned our actions. Until then, each country had been dealing with the disease individually. Yet the epicentre of the disease is the border area triangle between Sierra Leone, Liberia and Guinea. The people living in this region are the Kissi. They speak the same language in each country and they move across borders along traditional routes.

So WHO is very clear on this issue: closing borders would make no difference. What is crucial is that we keep focusing on surveillance and that we harmonise our approach across countries because if you use different languages and different practices to tackle the disease and approach these people, who should they believe?

We want to encourage countries in West Africa to send their medical staff to affected countries so that they get hands-on experience. That way, if the virus spreads, they’ll be better equipped to tackle the epidemic.

Mohamed Fofana, training manager with ActionAid, Kono District, Sierra Leone

We have just finished training 24 community outreach workers to raise awareness about Ebola. A key consideration in recruiting participants was that they are influential in their community so that when they go back, people listen to them.

The training focused on the origins of the disease, its transmission, the signs and symptoms and what to do if you suspect a case of Ebola. We heavily emphasised the fact that transmission can happen through a dead body because in Sierra Leone, it is customary to pay your respect to the dead, to wash the body, touch it or keep clothes or sheets of the deceased, but these practices do not conform with Ebola prevention.

If they suspect that someone is infected or has died from Ebola, outreach workers know that they should immediately notify the authorities. They must also refer the patient to the nearest health facility or make sure that no one comes into contact with the corpse if the person is dead. A specially-trained burial team will intervene instead.

Dr Bernice Dahn, deputy minister for health services, Monrovia,Liberia

Our biggest challenge is denial. People do not believe that Ebola is happening. There is a lot of fear and panic too and we’re struggling to get people to come into hospital when we suspect they are infected. The key for us is to align our traditional leaders with medical and health ministry officials: our society holds them in high esteem so if they are on board, they can educate their communities.

Dealing with Ebola is labour intensive. Case detection is a door-to-door process; once identified, patients have to be taken to isolation wards; and then we need to trace all the people they have been in contact with. We also need special burial teams to handle dead bodies. Sorting out the logistics for all these interventions has stretched us.

The difficulty is that the situation keeps evolving so we’ve had to modify our response needs: our initial strategy cost was $1.2 million but as the epidemic has progressed, we estimate we’ll now need $6.5 million. We’re still working within the constraints of the initial budget but the international community has been very supportive, so I am hopeful that we’ll be able to tackle this epidemic within the shortest possible timeframe.

Woman saves three relatives from Ebola

CNN – By Elizabeth Cohen, Senior Medical Correspondent, Fri September 26, 2014 – suggested reblog by How-Matters.com

Fatu Kekula has cared for four of her family members with Ebola, keeping three alive without infecting herself. Fatu Kekula has cared for four of her family members with Ebola, keeping three alive without infecting herself.

For more from Elizabeth Cohen on the ground in West Africa, watch CNN Saturday at 3 p.m. ET.

(CNN) — It can be exhausting nursing a child through a nasty bout with the flu, so imagine how 22-year-old Fatu Kekula felt nursing her entire family through Ebola.

Her father. Her mother. Her sister. Her cousin. Fatu took care of them all, single-handedly feeding them, cleaning them and giving them medications.

And she did so with remarkable success. Three out of her four patients survived. That’s a 25% death rate — considerably better than the estimated Ebola death rate of 70%.

Fatu stayed healthy, which is noteworthy considering that more than 300 health care workers have become infected with Ebola, and she didn’t even have personal protection equipment — those white space suits and goggles used in Ebola treatment units.

Instead Fatu, who’s in her final year of nursing school, invented her own equipment. International aid workers heard about Fatu’s “trash bag method” and are now teaching it to other West Africans who can’t get into hospitals and don’t have protective gear of their own.

Every day, several times a day for about two weeks, Fatu put trash bags over her socks and tied them in a knot over her calves. Then she put on a pair of rubber boots and then another set of trash bags over the boots.

She wrapped her hair in a pair of stockings and over that a trash bag. Next she donned a raincoat and four pairs of gloves on each hand, followed by a mask.

It was an arduous and time-consuming process, but Fatu was religious about it, never cutting corners.

UNICEF Spokeswoman Sarah Crowe said Fatu is amazing.

“Essentially this is a tale of how communities are doing things for themselves,” Crowe said. “Our approach is to listen and work with communities and help them do the best they can with what they have.”

Two doctors for 85,000 people

She emphasized, of course, that it would be better for patients to be in real hospitals with doctors and nurses in protective gear — it’s just that those things aren’t available to many West Africans.

No one knows that better than Fatu.

Her Ebola nightmare started Juy 27, when her father, Moses, had a spike in blood pressure. She took him to a hospital in their home city of Kakata.

A bed was free because a patient had just passed away. What no one realized at the time was that the patient had died of Ebola.

One woman walked in, and the Ebola nightmare began

Moses, 52, developed a fever, vomiting and diarrhea. Then the hospital closed down because nurses started dying of Ebola.

Fatu took her father to Monrovia, the capital city, about a 90-minute drive via difficult roads. Three hospitals turned him away because they were full.

She took him back to another hospital in Kakata. They said he had typhoid fever and did little for him, so Fatu took him home, where he infected three other family members: Fatu’s mother, Victoria, 57; Fatu’s sister, Vivian, 28, and their 14-year-old cousin who was living with them, Alfred Winnie.

Guilty of Ebola until proven otherwise

While operating her one-woman Ebola hospital for two weeks, Fatu consulted with their family doctor, who would talk to her on the phone, but wouldn’t come to the house. She gave them medicines she obtained from the local clinic and fluids through intravenous lines that she started.

At times, her patients’ blood pressure plummeted so low she feared they would die.

“I cried many times,” she said. “I said ‘God, you want to tell me I’m going to lose my entire family?’ “

But her father, mother, and sister rallied and were well on their way to recovery when space became available at JFK Medical Center on August 17. Alfred never recovered, though, and passed away at the hospital the next day.

“I’m very, very proud,” her father said. “She saved my life through the almighty God.”

Now he’s working to find a scholarship for Fatu so she can finish her final year of nursing school. He has no doubt his daughter will go on to save many more people during her life.

“I’m sure she’ll be a great giant of Liberia,” he said.

Ebola patients left to lay on the ground

CNN – By Elizabeth Cohen, Senior Medical Correspondent – Tue September 23, 2014
Watch this video

Ebola overwhelms new hospital in Liberia

Editor’s note: CNN senior medical correspondent Elizabeth Cohen is in Liberia to report on the largest Ebola outbreak on record.

Monrovia, Liberia (CNN) — On the day the new Ebola clinic in Liberia opened, ambulances waited outside. Inside the ambulances were desperately ill patients who had come for treatment but instead would be left to lie on the ground as others walked by.

The Island Clinic and its 120 Ebola treatment beds opened to fanfare Sunday afternoon, with a ceremony attended by international health officials and Liberian leaders. But the clinic, located on Bushrod Island near Monrovia, the capital, did not appear to be ready for the number of patients that quickly flooded its doors.

Some lay motionless on the floors of the ambulances outside the center, too weak to get out. They had traveled for hours after being turned away from other hospitals in the area. No one from inside the hospital arrived to offer assistance.

Photos: Ebola outbreak in West AfricaPhotos: Ebola outbreak in West Africa

“Try to come down and walk a little,” a worker told him.

“I’m too tired,” the man said.

But he summoned his strength and got out of the ambulance — and immediately collapsed on the ground.

A little boy tried to walk out of another ambulance, but he too collapsed.

The two lay on the rocky ground just a few feet apart. The boy was completely naked and the man was naked from the waist down — Ebola patients often don’t wear pants because of the intense diarrhea caused by the virus.

“Get up and go inside,” workers told the boy. “You’ll only get food if you go inside.”

“Let him rest,” another worker said, and they agreed to let him stay where he lay.

When asked why no one from the hospital was helping them get inside, a hospital worker said staff was inside suiting up in protective gear. Ebola spreads through contact with bodily fluids from an infected patient.

More than 2,800 people have died over the past six months in West Africa. Five countries have reported Ebola cases, but Liberia, Guinea and Sierra Leone have carried the largest burden.

Deadliest outbreak: What you need to know

Island Clinic is supported by the government of Liberia and the World Health Organization. When shown CNN’s video of the patients collapsing, a WHO representative was horrified, but said the patients shouldn’t have waited until they were so sick to seek help.

“I think the lesson here is that people come too late,” said Peter Graaff.

But many Ebola patients don’t wait by choice — there’s an estimated shortage of 700 Ebola beds in Monrovia alone, and patients often wander from hospital to hospital, only to be turned away.

“I know, I know,” said Graaff, WHO’s country representative in Liberia. “That’s why we need to increase capacity.”

Graaff said he would try to find out why hospital workers didn’t come help the patients. He said he hopes any opening-day difficulties won’t discourage patients from seeking help — he doesn’t want them to stay home.

“It’s shocking,” he said. “This is exactly what we should try to avoid in the future. It’s horrible.”

***

John Bonifield, Orlind Cooper, Orlando Ruiz and Jacque Wilson contributed to this story.

Fighting the Spread of Ebola in a Weak and Poor Governance Structure: A Liberian Peacebuilder’s Perspective

TEST

As the Ebola virus spreads throughout Liberia, the effects of bad governance, weak health infrastructure, mismanagement, and greed are manifest as death rates continue to surge. On September 23, the Center for Disease Control estimated that cases of Ebola in West Africa will double every 20 days — and in an absolute worst-case scenario without any intervention, the disease could infect 1.4 million by January. The government has lost control of the situation and is now dependent on the goodwill of the international community for both manpower and basic supplies.  For example, hospitals and government-run Ebola centers are plainly unable to handle the caseload — many suspected victims have been asked to return home due to lack of beds and unavailability of staff to care for them. At the same time, local organizations are engaging in awareness activities hoping to reach out to populations in Monrovia and beyond, but with little or no support from the government.

The Ebola virus epidemic started in Gueckedou, a city in Guinea near Voinjama in Liberia’s Lofa County. The index case of Liberia is suspected to have been a health worker who became infected while treating two suspected cases of Ebola in Liberia’s Foya Hospital near the country’s border with Guinea. This nurse was further alleged to have travelled to relatives in Margibi County, about an hour drive away from Monrovia and subsequently sought treatment at the Liberia’s Firestone Hospital in March 2014. The Liberian government declared the Ebola epidemic in middle of March when two out of four samples sent to Guinea for testing came back positive. The numerous further contacts  apparently among those that had interactions with the first victims and additional cases from Guinea to Liberia resulted in the first wave of the epidemic, which was mostly confined to Lofa County running from March to June. After a period of lull, there came a second outbreak in July which spread at a faster rate and engulfed the capital city of Monrovia.

Fighting the Spread of Ebola Nat B. Walker Building Peace Forum

The government reacted slowly. It appeared to expect the international community to do for Liberia what it should have done for its people during the early stage of the crisis. For instance, when international organizations mobilized to control the situation at the borders, senior government officials made pronouncements dismissing the claims that the outbreak was Ebola. When Médecins Sans Frontières (MSF) and Samaritan’s Purse fought to contain the virus, the government was unable even to support the establishment of a testing center. It took days to get test results from the only testing facility in the country and even as the virus spread, confirming results was a challenge as it remained the only testing facility for months. With the help of the international community, there are now three active testing centers.

Much later, in July of 2014 in an attempt to contain the situation, Liberia’s President Madam Ellen Johnson Sirleaf announced the formation of a national Task Force on Ebola, to be headed personally by her. But the Task Force idea appeared like another political decoration: it had no clear mandate, a very weak coordination structure.  It was a rapid response team with little or no logistical support and no involvement of local people.  The ineffectiveness of the government institutions on the task force and the overall poor and inadequate response to the crisis ultimately led to violence.

The virus spread and continued to claim lives daily, yet for almost three months, only two ambulances served the 1.5 million citizens of Montserrado County (the area around Monrovia). A popular Liberian politician aimed to help by providing a third ambulance, but it was instructed only to pick up sick people. The dead were left to rot, accumulating at alarming rates and contributing to infection.  Vehicles were quickly donated to government agencies by international organizations when government officials declined to contribute their luxurious, government vehicles to the urgent need. Community dwellers were forced to expose themselves to the virus by removing the bodies from their homes to the roadside because the response team had no logistics to respond to the many calls for help. For them, placing the bodies in the streets made their homes safer while urging the government to clear the streets, but many contracted the virus from the contact.

As the government continued to demonstrate inefficiency in containing the situation and failed even to communicate in a coordinated fashion, distressed and marginalized citizens took to the streets.  These attempts to spur government attention led to outbursts of violence. In late July, I witnessed residents of the St. Paul Bridge Community in Montserrado County block a major highway connecting the western region with the capital, demanding that the government remove five dead bodies from their community. Only then did the government-coordinated Ebola response team respond. More recently, on the capital by-pass road, less than two miles from the Executive Mansion, a similar situation occurred. In the meantime, angry citizens called in to radio shows (the most popular form of mass communication in the country) to narrate how they were forced to sleep in streets while waiting for the government to remove dead bodies from their homes. The authority and legitimacy of the government are constantly being questioned by the citizens because of how inadequately they have addressed the virus.

The government instituted a curfew from 9:00 PM to 6:00 AM, intended to prevent people from coming out at night to throw bodies in the streets or to secretly bury their dead. Later adjusted to 11:00 PM to 6:00 AM, the curfew still remains active, but for many, the official justification is not logical. If intended to prevent people from taking actions to remove dead bodies from their homes, why not focus on strengthening the capacity of the agencies responsible for gathering the sick and deceased?  Instead, armed robbers have taken advantage of the curfew by attacking homes at night, since the government-imposed curfew now prevents community dwellers from organizing community watch teams and security agencies lack the capacity to patrol communities at night.

A health worker at Island Clinic in  Monrovia, Liberia checks on a patient. (Photo Credit: Morgana Wingard, USAID via Flickr)

At the moment, there is better coordination with the arrival of international experts and the much-delayed appointment of a national coordinator to the government task force. Much of what the task force is now doing, it should have begun months ago and undoubtedly would have saved many lives. But serious challenges remain. The biggest of these is how to address the virus outside of Monrovia. Beyond the capital, there is no clear support to empower health workers and social mobilization committees to carry out community-driven response activities.  Allegations of bribery are also on the rise, indicating continued state inefficiency.  A member of a recent civil society team confirmed that he paid 400 Liberian dollars (less than five United States dollars) to security personnel at the checkpoint between Grand Bassa and Rivercess in order for his colleagues to pass through since one was traveling without identification. It is even alleged that members of the government response team are requesting bribes to pick up dead bodies from communities.

In the government’s fight against Ebola, there is also suspicion of financial mismanagement. Nurses and doctors, whose lives are most at risk, are still not receiving adequate compensation and have no life insurance or medical insurance. There have also been fears of abuse and waste when handling Ebola funds. The Head of the Anti-Corruption Commission recently warned that his agency is monitoring the flow of cash and that corrupt officials will be prosecuted. Unfortunately, a lot of skepticism remains about the political will of the commission — since its formation over eight years ago, it has not closed a single case of corruption in the interest of the Liberian citizens. It remains a toothless bulldog to the excitement of the establishment.

Unless the fight against the spread of Ebola is fully decentralized to the county, district, and community levels, and adequate support is provided to caregivers including health practitioners, we should expect many more people to die. This is a sad reality. The government and its partners should take keen note of this and consider identifying, strengthening, and supporting community-led structures, especially in counties not yet overpowered by the virus.

President Barack Obama’s pronouncement of 3,000 US troops to help contain the situation is highly welcomed, but I recommend  that, as a matter of policy, U.S. troops and other international actors be directed to exercise caution. Liberians are already disenchanted with the government’s poor handling of the crisis.  If care is not exercised, the anger of the citizens could easily be transferred from the government to international actors. Involving local civil society actors, especially grassroots organization is an essential factor to any international intervention. This will help address the negative perceptions and mistrust the public has in the government’s handling of the crisis. This critical step must be implemented at the very beginning of the process if the desire result is to be achieved swiftly.

Nat B. Walker is a development and peacebuilding consultant working in Liberia. Hired on a long-term basis by Humanity United and TrustAfrica, he is currently supporting the development and expansion of a community-based conflict early warning and response system in Liberia. Nat is also a Liberia correspondent for Insight on Conflict, a UK-based project of Peace Direct and has previously worked for international organizations including the Catholic Relief Services, Mercy Corps and Conservation International. He is also an adjunct faculty member at the Kofi Anaan Institute of Conflict Transformation at the University of Liberia.

Dr. Igonoh describes her treatment of ebola patients

Reprinted from nanaaweredamoah.wordpress.com – who pulled it from Bellanaija.com

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As Nigeria battles with the outbreak of Ebola, we consistently commend the dedication and selflessness of the doctors, nurses and other healthcare professionals.

Lives have been lost, and families have had to undergo the trauma of isolation. The fear of the unknown even very crippling. We read about the numbers in the news, but when we put a face to the news reports, it brings it home. Dr. Ada Igonoh of First Consultants Hospital is one of the doctors who attended to Patrick Sawyer. She was infected by the virus and miraculously, she survives to share her story with BellaNaija.

It is a long read but definitely worth reading as Dr. Ada details her experience. It’s a really gripping read which shows the story of strength, faith and dedication. We are grateful to Ada for sharing her story with us.

***

On the night of Sunday July 20, 2014, Patrick Sawyer was wheeled into the Emergency Room at First Consultants Medical Centre, Obalende, Lagos, with complaints of fever and body weakness. The male doctor on call admitted him as a case of malaria and took a full history. Knowing that Mr Sawyer had recently arrived from Liberia, the doctor asked if he had been in contact with an Ebola patient in the last couple of weeks, and Mr. Sawyer denied any such contact. He also denied attending any funeral ceremony recently. Blood samples were taken for full blood count, malaria parasites, liver function test and other baseline investigations. He was admitted into a private room and started on antimalarial drugs and analgesics. That night, the full blood count result came back as normal and not indicative of infection.

The following day however, his condition worsened. He barely ate any of his meals. His liver function test result showed his liver enzymes were markedly elevated. We then took samples for HIV and hepatitis screening.
At about 5.00pm, he requested to see a doctor. I was the doctor on call that night so I went in to see him. He was lying in bed with his intravenous (I.V.) fluid bag removed from its metal stand and placed beside him. He complained that he had stooled about five times that evening and that he wanted to use the bathroom again. I picked up the I.V. bag from his bed and hung it back on the stand. I told him I would inform a nurse to come and disconnect the I.V. so he could conveniently go to the bathroom. I walked out of his room and went straight to the nurses’ station where I told the nurse on duty to disconnect his I.V. I then informed my Consultant, Dr. Ameyo Adadevoh about the patient’s condition and she asked that he be placed on some medications.

The following day, the results for HIV and hepatitis screening came out negative. As we were preparing for the early morning ward rounds, I was approached by an ECOWAS official who informed me that Patrick Sawyer had to catch an 11 o’clock flight to Calabar for a retreat that morning. He wanted to know if it would be possible. I told him it wasn’t, as he was acutely ill. Dr. Adadevoh also told him the patient could certainly not leave the hospital in his condition. She then instructed me to write very boldly on his chart that on no account should Patrick Sawyer be allowed out of the hospital premises without the permission of Dr. Ohiaeri, our Chief Medical Consultant. All nurses and doctors were duly informed.

During our early morning ward round with Dr. Adadevoh, we concluded that this was not malaria and that the patient needed to be screened for Ebola Viral Disease. She immediately started calling laboratories to find out where the test could be carried out. She was eventually referred to Professor Omilabu of the LUTH Virology Reference Lab in Idi-Araba whom she called immediately. Prof. Omilabu told her to send blood and urine samples to LUTH straight away. She tried to reach the Lagos State Commissioner for Health but was unable to contact him at the time. She also put calls across to officials of the Federal Ministry of Health and National Centre for Disease Control.

Dr. Adadevoh at this time was in a pensive mood. Patrick Sawyer was now a suspected case of Ebola, perhaps the first in the country. He was quarantined, and strict barrier nursing was applied with all the precautionary measures we could muster. Dr. Adadevoh went online, downloaded information on Ebola and printed copies which were distributed to the nurses, doctors and ward maids. Blood and urine samples were sent to LUTH that morning. Protective gear, gloves, shoe covers and facemasks were provided for the staff. A wooden barricade was placed at the entrance of the door to keep visitors and unauthorized personnel away from the patient.
Despite the medications prescribed earlier, the vomiting and diarrhea persisted. The fever escalated from 38c to 40c.

On the morning of Wednesday 23rd July, the tests carried out in LUTH showed a signal for Ebola. Samples were then sent to Dakar, Senegal for a confirmatory test. Dr. Adadevoh went for several meetings with the Lagos State Ministry of Health. Thereafter, officials from Lagos State came to inspect the hospital and the protective measures we had put in place.

The following day, Thursday 24th July, I was again on call. At about 10.00pm Mr. Sawyer requested to see me. I went into the newly created dressing room, donned my protective gear and went in to see him. He had not been cooperating with the nurses and had refused any additional treatment. He sounded confused and said he received a call from Liberia asking for a detailed medical report to be sent to them. He also said he had to travel back to Liberia on a 5.00am flight the following morning and that he didn’t want to miss his flight. I told him that I would inform Dr. Adadevoh. As I was leaving the room, I met Dr. Adadevoh dressed in her protective gear along with a nurse and another doctor. They went into his room to have a discussion with him and as I heard later to reset his I.V. line which he had deliberately removed after my visit to his room.

At 6:30am, Friday 25th July, I got a call from the nurse that Patrick Sawyer was completely unresponsive. Again I put on the protective gear and headed to his room. I found him slumped in the bathroom. I examined him and observed that there was no respiratory movement. I felt for his pulse; it was absent. We had lost him. It was I who certified Patrick Sawyer dead. I informed Dr. Adadevoh immediately and she instructed that no one was to be allowed to go into his room for any reason at all. Later that day, officials from W.H.O came and took his body away. The test in Dakar later came out positive for Zaire strain of the Ebola virus. We now had the first official case of Ebola virus disease in Nigeria.

It was a sobering day. We all began to go over all that happened in the last few days, wondering just how much physical contact we had individually made with Patrick Sawyer. Every patient on admission was discharged that day and decontamination began in the hospital. We were now managing a crisis situation. The next day, Saturday 26th July, all staff of First Consultants attended a meeting with Prof. Nasidi of the National Centre for Disease Control, Prof Omilabu of LUTH Virology Reference Lab, and some officials of W.H.O. They congratulated us on the actions we had taken and enlightened us further about the Ebola Virus Disease. They said we were going to be grouped into high risk and low risk categories based on our individual level of exposure to Patrick Sawyer, the “index” case. Each person would receive a temperature chart and a thermometer to record temperatures in the morning and night for the next 21 days. We were all officially under surveillance. We were asked to report to them at the first sign of a fever for further blood tests to be done. We were reassured that we would all be given adequate care. The anxiety in the air was palpable.

The frenetic pace of life in Lagos, coupled with the demanding nature of my job as a doctor, means that I occasionally need a change of environment. As such, one week before Patrick Sawyer died, I had gone to my parents’ home for a retreat. I was still staying with them when I received my temperature chart and thermometer on Tuesday 29th of July. I could not contain my anxiety. People were talking Ebola everywhere – on television, online, everywhere. I soon started experiencing joint and muscle aches and a sore throat, which I quickly attributed to stress and anxiety. I decided to take malaria tablets. I also started taking antibiotics for the sore throat. The first couple of temperature readings were normal. Every day I would attempt to recall the period Patrick Sawyer was on admission – just how much direct and indirect contact did I have with him? I reassured myself that my contact with him was quite minimal. I completed the anti-malarials but the aches and pains persisted. I had loss of appetite and felt very tired.

On Friday 1st of August, my temperature read a high 38.7c. As I type this, I recall the anxiety I felt that morning. I could not believe what I saw on the thermometer. I ran to my mother’s room and told her. I did not go to work that day. I cautiously started using a separate set of utensils and cups from the ones my family members were using.

On Saturday 2nd of August, the fever worsened. It was now at 39c and would not be reduced by taking paracetamol. This was now my second day of fever. I couldn’t eat. The sore throat was getting worse. That was when I called the helpline and an ambulance was sent with W.H.O doctors who came and took a sample of my blood. Later that day, I started stooling and vomiting. I stayed away from my family. I started washing my plates and spoons myself. My parents meanwhile, were convinced that I could not have Ebola.

The following day, Sunday 3rd of August, I got a call from one of the doctors who came to take my sample the day before. He told me that the sample which was they had taken was not confirmatory, and that they needed another sample. He did not sound very coherent and I became worried. They came with the ambulance that afternoon and told me that I had to go with them to Yaba. I was confused. Couldn’t the second sample be taken in the ambulance like the previous one? He said a better-qualified person at the Yaba centre would take the sample. I asked if they would bring me back. He said “yes.” Even with the symptoms I did not believe I had Ebola. After all, my contact with Sawyer was minimal. I only touched his I.V. fluid bag just that once without gloves. The only time I actually touched him was when I checked his pulse and confirmed him dead, and I wore double gloves and felt adequately protected.

I told my parents I had to go with the officials to Yaba and that I would be back that evening. I wore a white top and a pair of jeans, and I put my iPad and phones in my bag.
A man opened the ambulance door for me and moved away from me rather swiftly. Strange behavior, I thought. They were friendly with me the day before, but that day, not so. No pleasantries, no smiles. I looked up and saw my mother watching through her bedroom window.
We soon got to Yaba. I really had no clue where I was. I knew it was a hospital. I was left alone in the back of the ambulance for over four hours. My mind was in a whirl. I didn’t know what to think. I was offered food to eat but I could barely eat the rice.

The ambulance door opened and a Caucasian gentleman approached me but kept a little distance. He said to me, “I have to inform you that your blood tested positive for Ebola. I am sorry.” I had no reaction. I think I must have been in shock. He then told me to open my mouth and he looked at my tongue. He said it was the typical Ebola tongue. I took out my mirror from my bag and took a look and I was shocked at what I saw. My whole tongue had a white coating, looked furry and had a long, deep ridge right in the middle. I then started to look at my whole body, searching for Ebola rashes and other signs as we had been recently instructed. I called my mother immediately and said, “Mummy, they said I have Ebola, but don’t worry, I will survive it. Please, go and lock my room now; don’t let anyone inside and don’t touch anything.” She was silent. I cut the line.

I was taken to the female ward. I was shocked at the environment. It looked like an abandoned building. I suspected it had not been in use for quite a while. As I walked in, I immediately recognized one of the ward maids from our hospital. She always had a smile for me but not this time. She was ill and she looked it. She had been stooling a lot too. I soon settled into my corner and looked around the room. It smelled of faeces and vomit. It also had a characteristic Ebola smell to which I became accustomed. Dinner was served – rice and stew. The pepper stung my mouth and tongue. I dropped the spoon. No dinner that night.

Dr. David, the Caucasian man who had met me at the ambulance on my arrival, came in wearing his full protective ‘hazmat’ suit and goggles. It was fascinating seeing one live. I had only seen them online. He brought bottles of water and ORS, the oral fluid therapy which he dropped by my bedside. He told me that 90 percent of the treatment depended on me. He said I had to drink at least 4.5 litres of ORS daily to replace fluids lost in stooling and vomiting. I told him I had stooled three times earlier and taken Imodium tablets to stop the stooling. He said it was not advisable, as the virus would replicate the more inside of me. It was better he said to let it out. He said good night and left.

My parents called. My uncle called. My husband called crying. He could not believe the news. My parents had informed him, as I didn’t even know how to break the news to him.
As I lay on my bed in that isolation ward, strangely, I did not fear for my life. I was confident that I would leave that ward some day. There was an inner sense of calm. I did not for a second think I would be consumed by the disease. That evening, the symptoms fully kicked in. I was stooling almost every two hours. The toilets did not flush so I had to fetch water in a bucket from the bathroom each time I used the toilet. I then placed another bucket beneath my bed for the vomiting.
On occasion I would run to the toilet with a bottle of ORS, so that as I was stooling, I was drinking.

The next day Monday 4th of August, I began to notice red rashes on my skin particularly on my arms. I had developed sores all over my mouth. My head was pounding so badly. The sore throat was so severe I could not eat. I could only drink the ORS. I took paracetamol for the pain. The ward maid across from me wasn’t doing so well. She had stopped speaking. I couldn’t even brush my teeth; the sores in my mouth were so bad. This was a battle for my life but I was determined I would not die.

Every morning, I began the day with reading and meditating on Psalm 91. The sanitary condition in the ward left much to be desired. The whole Ebola thing had caught everyone by surprise. Lagos State Ministry of Health was doing its best to contain the situation but competent hands were few. The sheets were not changed for days. The floor was stained with greenish vomitus and excrement. Dr. David would come in once or twice a day and help clean up the ward after chatting with us. He was the only doctor who attended to us. There was no one else at that time. The matrons would leave our food outside the door; we had to go get the food ourselves. They hardly entered in the initial days. Everyone was being careful. This was all so new. I could understand, was this not how we ourselves had contracted the disease? Mosquitoes were our roommates until they brought us mosquito nets.

Later that evening, Dr. David brought another lady into the ward. I recognized her immediately as Justina Ejelonu, a nurse who had started working at First Consultants on the 21st of July, a day after Patrick Saywer was admitted. She was on duty on the day Patrick reported that he was stooling. While she was attending to him that night, he had yanked off his drip, letting his blood flow almost like a tap onto her hands. Justina was pregnant and was brought into our ward bleeding from a suspected miscarriage. She had been told she was there only on observation. The news that she had contracted Ebola was broken to her the following day after results of her blood test came out positive. Justina was devastated and wept profusely – she had contracted Ebola on her first day at work.

My husband started visiting but was not allowed to come close to me. He could only see me from a window at a distance. He visited so many times. It was he who brought me a change of clothes and toiletries and other things I needed because I had not even packed a bag. I was grateful I was not with him at home when I fell ill or he would most certainly have contracted the disease. My retreat at my parents’ home turned out to be the instrumentality God used to shield and save him.

I drank the ORS fluid like my life depended on it. Then I got a call from my pastor. He had been informed about my predicament. He called me every single day morning and night and would pray with me over the phone. He later sent me a CD player, CDs of messages on faith and healing, and Holy Communion packs through my husband. My pastor, who also happens to be a medical doctor, encouraged me to monitor how many times I had stooled and vomited each day and how many bottles of ORS I had consumed. We would then discuss the disease and pray together. He asked me to do my research on Ebola since I had my iPad with me and told me that he was also doing his study. He wanted us to use all relevant information on Ebola to our advantage. So I researched and found out all I could about the strange disease that has been in existence for 38 years. My research, my faith, my positive view of life, the extended times of prayer, study and listening to encouraging messages boosted my belief that I would survive the Ebola scourge.

There are five strains of the virus and the deadliest of them is the Zaire strain, which was what I had. But that did not matter. I believed I would overcome even the deadliest of strains. Infected patients who succumb to the disease usually die between 6 to 16 days after the onset of the disease from multiple organ failure and shock caused by dehydration. I was counting the days and keeping myself well hydrated. I didn’t intend to die in that ward.

My research gave me ammunition. I read that as soon as the virus gets into the body, it begins to replicate really fast. It enters the blood cells, destroys them and uses those same blood cells to aggressively invade other organs where they further multiply. Ideally, the body’s immune system should immediately mount up a response by producing antibodies to fight the virus. If the person is strong enough, and that strength is sustained long enough for the immune system to kill off the viruses, the patient is likely to survive. If the virus replicates faster than the antibodies can handle however, further damage is done to the organs. Ebola can be likened to a multi-level, multi-organ attack but I had no intention of letting the deadly virus destroy my system. I drank more ORS. I remember saying to myself repeatedly, “I am a survivor, I am a survivor.”

I also found out that a patient with Ebola cannot be re-infected and they cannot relapse back into the disease as there is some immunity conferred on survivors. My pastor and I would discuss these findings, interpret them as it related to my situation and pray together. I looked forward to his calls. They were times of encouragement and strengthening. I continued to meditate on the Word of God. It was my daily bread.

Shortly after Justina came into the ward, the ward maid, Mrs Ukoh passed on. The disease had gotten into her central nervous system. We stared at her lifeless body in shock. It was a whole 12 hours before officials of W.H.O came and took her body away. The ward had become the house of death. The whole area surrounding her bed was disinfected with bleach. Her mattress was taken and burned.

To contain the frequent diarrhea, I had started wearing adult diapers, as running to the toilet was no longer convenient for me. The indignity was quite overwhelming, but I did not have a choice. My faith was being severely tested. The situation was desperate enough to break anyone psychologically. Dr. Ohiaeri also called us day and night, enquiring about our health and the progress we were making. He sent provisions, extra drugs, vitamins, Lucozade, towels, tissue paper; everything we needed to be more comfortable in that dark hole we found ourselves. Some of my male colleagues had also been admitted to the male ward two rooms away, but there was no interaction with them.
We were saddened by the news that Jato, the ECOWAS protocol officer to Patrick Sawyer who had also tested positive, had passed on days after he was admitted.

Two more females joined us in the ward; a nurse from our hospital and a patient from another hospital. The mood in the ward was solemn. There were times we would be awakened by the sudden, loud cry from one of the women. It was either from fear, pain mixed with the distress or just the sheer oppression of our isolation.

I kept encouraging myself. This could not be the end for me. Five days after I was admitted, the vomiting stopped. A day after that, the diarrhea ceased. I was overwhelmed with joy. It happened at a time I thought I could no longer stand the ORS. Drinking that fluid had stretched my endurance greatly.

I knew countless numbers of people were praying for me. Prayer meetings were being held on my behalf. My family was praying day and night. Text messages of prayers flooded my phones from family members and friends. I was encouraged to press on. With the encouragement I was receiving I began to encourage the others in the ward. We decided to speak life and focus on the positive. I then graduated from drinking only the ORS fluid to eating only bananas, to drinking pap and then bland foods. Just when I thought I had the victory, I suddenly developed a severe fever. The initial fever had subsided four days after I was admitted, and then suddenly it showed up again. I thought it was the Ebola. I enquired from Dr. David who said fever was sometimes the last thing to go, but he expressed surprise that it had stopped only to come back on again. I was perplexed.

I discussed it with my pastor who said it could be a separate pathology and possibly a symptom of malaria. He promised he would research if indeed this was Ebola or something else. That night as I stared at the dirty ceiling, I felt a strong impression that the new fever I had developed was not as a result of Ebola but malaria. I was relieved. The following morning, Dr. Ohiaeri sent me antimalarial medication which I took for three days. Before the end of the treatment, the fever had disappeared.

I began to think about my mother. She was under surveillance along with my other family members. I was worried. She had touched my sweat. I couldn’t get the thought off my mind. I prayed for her. Hours later on Twitter I came across a tweet by W.H.O saying that the sweat of an Ebola patient cannot transmit the virus at the early stage of the infection. The sweat could only transmit it at the late stage.
That settled it for me. It calmed the storms that were raging within me concerning my parents. I knew right away it was divine guidance that caused me to see that tweet. I could cope with having Ebola, but I was not prepared to deal with a member of my family contracting it from me.

Soon, volunteer doctors started coming to help Dr. David take care of us. They had learned how to protect themselves. Among the volunteer doctors was Dr. Badmus, my consultant in LUTH during my housemanship days. It was good to see a familiar face among the care-givers. I soon understood the important role these brave volunteers were playing. As they increased in number, so did the number of shifts increase and subsequently the number of times the patients could access a doctor in one day. This allowed for more frequent patient monitoring and treatment. It also reduced care-giver fatigue. It was clear that Lagos State was working hard to contain the crisis

Sadly, Justina succumbed to the disease on the 12th of August. It was a great blow and my faith was greatly shaken as a result. I commenced daily Bible study with the other two female patients and we would encourage one another to stay positive in our outlook though in the natural it was grim and very depressing. My communion sessions with the other women were very special moments for us all.

On my 10th day in the ward, the doctors having noted that I had stopped vomiting and stooling and was no longer running a fever, decided it was time to take my blood sample to test if the virus had cleared from my system. They took the sample and told me that I shouldn’t be worried if it comes out positive as the virus takes a while before it is cleared completely. I prayed that I didn’t want any more samples collected from me. I wanted that to be the first and last sample to be tested for the absence of the virus in my system. I called my pastor. He encouraged me and we prayed again about the test.

On the evening of the day Justina passed on, we were moved to the new isolation centre. We felt like we were leaving hell and going to heaven.
We were conveyed to the new place in an ambulance. It was just behind the old building. Time would not permit me to recount the drama involved with the dynamics of our relocation. It was like a script from a science fiction movie. The new building was cleaner and much better than the old building. Towels and nightwear were provided on each bed. The environment was serene.

The following night, Dr. Adadevoh was moved to our isolation ward from her private room where she had previously been receiving treatment. She had also tested positive for Ebola and was now in a coma. She was receiving I.V. fluids and oxygen support and was being monitored closely by the W.H.O doctors. We all hoped and prayed that she would come out of it. It was so difficult seeing her in that state. I could not bear it. She was my consultant, my boss, my teacher and my mentor. She was the imperial lady of First Consultants, full of passion, energy and competence. I imagined she would wake up soon and see that she was surrounded by her First Consultants family but sadly it was not to be.

I continued listening to my healing messages. They gave me life. I literarily played them hours on end. Two days later, on Saturday the 16th of August, the W.H.O doctors came with some papers. I was informed that the result of my blood test was negative for Ebola virus. If I could somersault, I would have but my joints were still slightly painful. I was free to go home after being in isolation for exactly 14 days. I was so full of thanks and praise to God. I called my mother to get fresh clothes and slippers and come pick me. My husband couldn’t stop shouting when I called him. He was completely overwhelmed with joy.
I was told however that I could not leave the ward with anything I came in with. I glanced one last time at my cd player, my valuable messages, my research assistant a.k.a my iPad, my phones and other items. I remember saying to myself, “I have life; I can always replace these items.”

I went for a chlorine bath, which was necessary to disinfect my skin from my head to my toes. It felt like I was being baptized into a new life as Dr. Carolina, a W.H.O doctor from Argentina poured the bucket of chlorinated water all over me. I wore a new set of clothes, following the strict instructions that no part of the clothes must touch the floor and the walls. Dr. Carolina looked on, making sure I did as instructed.

I was led out of the bathroom and straight to the lawn to be united with my family, but first I had to cut the red ribbon that served as a barrier. It was a symbolic expression of my freedom. Everyone cheered and clapped. It was a little but very important ceremony for me. I was free from Ebola! I hugged my family as one who had been liberated after many years of incarceration. I was like someone who had fought death face to face and come back to the land of the living.

We had to pass through several stations of disinfection before we reached the car. Bleach and chlorinated water were sprayed on everyone’s legs at each station. As we made our way to the car, we walked past the old isolation building. I could hardly recognize it. I could not believe I slept in that building for 10 days. I was free! Free of Ebola. Free to live again. Free to interact with humanity again. Free from the sentence of death.

My parents and two brothers were under surveillance for 21 days and they completed the surveillance successfully. None of them came down with a fever. The house had been disinfected by Lagos State Ministry of Health soon after I was taken to the isolation centre. I thank God for shielding them from the plague.

My recovery after discharge has been gradual but progressive. I thank God for the support of family and friends. I remember my colleagues who we lost in this battle. Dr. Adadevoh my boss, Nurse Justina Ejelonu, and the ward maid, Mrs. Ukoh were heroines who lost their lives in the cause to protect Nigeria. They will never be forgotten.

I commend the dedication of the W.H.O doctors, Dr. David from Virginia, USA, who tried several times to convince me to specialize in infectious diseases, Dr. Carolina from Argentina who spoke so calmly and encouragingly, Mr. Mauricio from Italy who always offered me apples and gave us novels to read. I especially thank the volunteer Nigerian doctors, matrons and cleaners who risked their lives to take care of us. I must also commend the Lagos State government, and the state and federal ministries of health for their swift efforts to contain the virus. To all those prayed for me, I cannot thank you enough. And to my First Consultants family, I say a heartfelt thank you for your dedication and for your support throughout this very difficult period.

I still believe in miracles. None of us in the isolation ward was given any experimental drugs or so-called immune boosters. I was full of faith yet pragmatic enough to consume as much ORS as I could even when I wanted to give up and throw the bottles away. I researched on the disease extensively and read accounts of the survivors. I believed that even if the mortality rate was 99%, I would be part of the 1% who survive.

Early detection and reporting to hospital is key to patient survival. Please do not hide yourself if you have been in contact with an Ebola patient and have developed the symptoms. Regardless of any grim stories one may have heard about the treatment of patients in the isolation centre, it is still better to be in the isolation ward with specialist care, than at home where you and others will be at risk.

I read that Dr. Kent Brantly, the American doctor who contracted Ebola in Liberia and was flown out to the United States for treatment was being criticized for attributing his healing to God when he was given the experimental drug, Zmapp. I don’t claim to have all the answers to the nagging questions of life. Why do some die and some survive? Why do bad things happen to good people? Where is God in the midst of pain and suffering? Where does science end and God begin? These are issues we may never fully comprehend on this side of eternity. All I know is that I walked through the valley of the shadow of death and came out unscathed.

***

We’d like to thank Dr. Ada Igonoh for sharing her inspirational story with BellaNaija.

We’re hoping the spread of Ebola Virus is curbed soon, and we’re thankful for all the health workers and medical researchers around the world, who are working tirelessly to achieve this goal.

Ebola headlines and local report wrap up, Sep 8 2014

African Union says efforts to stop Ebola are creating sense of siege

MONROVIA, Liberia – The United States and Britain will send medical equipment and military personnel to help contain West Africa’s Ebola outbreak, as the World Health Organization warned Monday that many thousands of new infections are expected in Liberia in the coming weeks.

The current Ebola outbreak is the largest on record. It has spread from Guinea to Sierra Leone, Liberia, Nigeria and Senegal and killed more than 2,000 people. An “exponential increase” in new cases is expected in the hardest-hit countries in coming weeks, the U.N. health agency warned.

“As soon as a new Ebola treatment facility is opened, it immediately fills to overflowing with patients, pointing to a large but previously invisible caseload,” WHO said in a statement about the situation in Liberia. “Many thousands of new cases are expected in Liberia over the coming three weeks.”

Military personnel will set up a 25-bed field hospital in the Liberian capital, Col. Steven Warren, a Pentagon spokesman, said Monday. The clinic will be used to treat health care workers, a high number of whom have become infected in this outbreak.

Once set up, the centre will be turned over to the Liberian government. There is no plan to staff it with U.S. military personnel, Warren said.

Liberia welcomed the news.

“This is not Liberia’s particular fight; it is a fight that the international community must engage very, very seriously and bring all possible resources to bear,” said Information Minister Lewis Brown.

In addition, Britain will open a 62-bed treatment centre in Sierra Leone in the coming weeks. It will be operated by military engineers and medical staff with help from the charity Save the Children, Britain’s Department for International Development said Monday.

The clinic will also include a special section for treating health care workers, offering them high-quality, specialist care, the statement said.

Currently, there are about 570 beds in Ebola treatment centres in Guinea, Sierra Leone and Liberia, the hardest-hit countries, and the World Health Organization says nearly 1,000 more are needed, the vast majority of those in Liberia.

Doctors Without Borders welcomed both the American and British announcements, but warned even the latest surge in efforts may not be enough, saying the disease was moving “catastrophically through the population much faster than new facilities are being created.”

And experts say it’s not just beds, but that more international and local health workers that are needed. Doctors Without Borders also urged Washington to not simply set up clinics but also to staff them.

Many health workers, however, have been reluctant to respond to the crisis out of concern that there isn’t enough protective equipment to keep them safe.

A fourth American who contracted Ebola in West Africa was expected to arrive in the U.S. for care Tuesday, Emory University Hospital — where two other aid workers successfully recovered from the disease — said Monday in a news release.

Ebola is spread through the bodily fluids of people who show symptoms, and doctors and nurses are at high risk of infection because they work closely with the sick. The WHO doctor whose infection was announced Monday is the second health care worker with the agency to catch Ebola. The doctor is in stable condition and will shortly be evacuated, the agency said.

In Liberia alone, 152 health care workers have been infected with Ebola and 79 have died, WHO said, noting that country had too few doctors and nurses even before the crisis.

“Every infection or death of a doctor or nurse depletes response capacity significantly,” it said.

U.N. Secretary-General Ban Ki-moon called several world leaders over the weekend, including the British prime minister and French president, to urge them to send more medical teams and money to fight the outbreak.

Officials have said flight bans and border closures — meant to stop the disease’s spread — are slowing the flow of aid and protective gear for doctors and nurses to the region.

At an emergency African Union meeting Monday, members agreed to open borders that have been closed and lift bans on flights to and from affected countries, according to Nkosazana Dlamini Zuma, chair of the AU’s Commission. But it was unclear how quickly those promises would be kept.

Earlier, Senegal, which has shut its borders and blocked flights, said it was planning to open a “humanitarian corridor” to the affected countries.

Liberia: Govt. Suspends Poro, Sande Activities

The Ministry of Internal Affairs through its Bureau of Customs and Culture and in collaboration with the National Council of Chiefs and Elders has announced the immediate suspension of all Poro and Sande activities throughout Liberia.

Sande, also known as zadεgi, bundu, bundo and bondo, is a women’s association found in Liberia, Sierra Leone andGuinea that initiates girls into adulthood, confers fertility, instills notions of morality and proper sexual comportment, and maintains an interest in the well-being of its members throughout their lives. In addition, Sande champions women’s social and political interests and promotes their solidarity vis-a-vis the Poro, a complementary institution for men. The Sande society masquerade is a rare and perhaps unique African example of a wooden face mask controlled exclusively by women – a feature that highlights the extraordinary social position of women in this geographical region.

The ministry says its attention has been drawn to reports of the continued operation of Poro and Sande societies in several parts of the country in violation of the moratorium placed on the operation of Poro and Sande Societies on June 2, 2014.

In a press release issued here, it said the decision then, and now, was intended to ensure that there is no outbreak of the Ebola virus in any Poro or Sande grove in Liberia.“This would be a disaster and it must be prevented in the interest of saving additional lives of our fellow citizens”, the release read. However, the ministry notes that in spite of its demonstration of understanding and accommodation, some individuals have continued to operate Poro and Sande Groves and conduct cultural festivals.

According to the press release signed by Minister Morris Dukuly, such practices in the face of the Ebola epidemic exposes citizens to increased incidents of the virus and untimely death. The ministry therefore directs that all such practices must cease and be seen to have ceased by September 17, 2014.

MIA warns that any grove which operates or reopens its doors to initiate persons will be seen to be in defiance of its General Circular No. 13 and its most recent statement, reaffirming the provisions of the General Circular.

The Ministry says, the two-week extension it is granted under this statement is to allow the smooth closure of all Poro and Sande Societies operating in the country, and should not be viewed as an extension of the term of existing graves.

It said any grove or society found operating beyond the September 17, 2014, date would be ordered immediately closed in keeping with cultural, traditional practices, and its guidelines and regulations, while persons operating such groves will be prosecuted under the laws of Liberia.

Meanwhile, the Minister of Internal Affairs is authorizing all county Superintendents, District Commissioners, County Inspectors, and other appropriate local government officers ensure full compliance with this directive, and to close uncooperative Sande and Poro Societies upon the expiration of the two-week extension period.

The release said the Minister of Internal Affairs has written to inform Chief Zanzan Karwor, Chairman of the National Council of Chiefs and Elders, of the directive, and requested the full cooperation of the council.

Monrovia – The deadly Ebola virus is spreading in Monrovia and beyond, touching the security sector as 18 Police officers have been quarantined in Bloc C at the Police Barracks in Monrovia.

According to sources, one Police officer serving the Police Support Unit (PSU) contracted the virus and is currently undergoing treatment at the ELWA Ebola center.

One senior Police source confirmed to FrontPageAfrica that the officer is in critical condition at the Ebola treatment center. The Police officer is said to have contracted the virus from his wife who is a nurse, who transferred the virus to her husband after also getting infested from work.

The health of the PSU officer prompted the quarantining of Bloc C of the Police barracks where accordingly the 18 Police officers are residing. Located at the intersection of Camp Johnson Road and Capitol By-pass the Police Barracks is home to several Police officers and their dependents.

According to one member of the Ebola Task Force, several items have been supplied the quarantined Police officers including chlorine, biscuits and other materials. Police officers are used in protecting clinics and other medical facilities also accompanying various medical teams, including burial, collection of sick patients and others.

The officers are usually not seen wearing protective gears including gloves and other PPEs while providing protection in medical facilities and carrying out other duties closely related to Ebola. Police officers are also used to implement quarantine in several communities as they were recently deployed to ensure the quarantine of the West Point community and some are now in Dolo’s Town, Margibi County performing similar duty.

United States based Centers for Disease Control has warned that up to 20,000 people will get infested with the virus before it is brought under control, but it seems the Liberian government does not agree with such prediction as President Ellen Johnson Sirleaf has publicly declared disagreement with the CDC’s prediction.

Despite disbursement of funding from the Ebola fund to the security sector including the Police, Police officers are not adequately catered for as some officers have complained that they do not receive daily per diems and other protective materials, thus making vulnerable to contracting the virus.

Story of the first ebola survivor (1972)

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In 1972, a full four years before the Ebola virus even had a name, Dr. Thomas Cairns was a young doctor doing missionary work in the dense jungles of Zaire — a sprawling central African nation now known as the Democratic Republic of Congo.
A very sick patient came into Cairns’ clinic and died before doctors could offer a diagnosis. This was not particularly extraordinary, given the panoply of exotic infectious diseases native to the region. The local authorities requested an autopsy to see if they couldn’t figure out what killed this person so quickly. During the procedure, Cairns nicked himself with a scalpel, drawing blood. It was that moment that he became, quite possibly, the first non-African Ebola patient — and would become, almost certainly, the first non-African Ebola survivor.

“Twelve days later I became acutely ill,” Cairns said. “I had a very high fever, intense aching, headache, vomiting, diarrhea, rash. My skin was peeling. I lost hearing in one ear for weeks. My hair turned white. We didn’t know what was happening to me.”

The illness that was ravaging Cairns’ body was unlike anything any of the local medical staff had ever seen. “We thought it was going to kill me,” he said. “That was a real possibility.”

But, instead — inexplicably — Cairns began to feel better. It took weeks, but he was eventually able to get back on his feet, and even began practicing again, part-time at first and then back to a normal schedule. He didn’t travel back to the U.S., opting instead to continue his work in the small villages that dotted the western and central African landscape. For four years, the illness that nearly took his life remained a mystery.

Then, in 1976, two nearly simultaneous outbreaks of a similar deadly virus in Sudan and Zaire took hundreds of lives in a short period of time. It flagged the attention of the Center for Disease Control, which began intensive epidemic research in the region, alongside the World Health Organization. As officials looked for the source of the virus that was decimating those who came in contact with it, they coined a name for it: Ebola, after the river that ran near the village of Yambuku, ground zero of what was becoming a serious epidemic.

At the time, Cairns recalled, epidemiologists had fanned out across the region to collect blood samples from the indigenous population. They also took samples from about 50 expatriates working and living in the area. Cairns was included in the sample, and stood out immediately: He was the only one who carried a large amount of antibodies resistant to the Ebola virus.

That antibody level implied to doctors that Cairns had at one time been exposed to Ebola and had successfully fought it off. He was, effectively, immune to one of the most lethal diseases nature has ever produced.

“That’s when we knew: I was, in all likelihood, the first non-African survivor of the Ebola virus,” he said.

Cairns, 71, now semi-retired and working at an urgent care facility in a suburb of Minneapolis, did more than just survive. Health officials were so enamored with the level of Ebola antibodies they discovered in his blood that they took samples to store in the CDC freezers in Atlanta, to study and to use to help treat those who may come in contact with the virus in the future. (Over those initial years, Cairns gave several specimens to health workers but his antibody levels eventually lessened as he grew older, making his blood less immune to the disease than it once was.)

With the latest Ebola outbreak among the most deadly in the virus’ 40-odd-year lifespan, Cairns remembered those weeks in ’72 for the lack of information he and his colleagues had to work with. “We knew this thing was really bad, but that was about it.”

Yet, decades later, even modern medicine and pathology have limits: Ebola’s kill rate remains stubbornly high. In past outbreaks, as much as 90 percent of those who contract the disease have died from it. In the current outbreak, the rate appears to be about 60 percent.

Cairns credits his faith for not becoming one of those statistics. “It was literally the grace of God that brought me around back then,” he said.

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First published August 5 2014, 8:16 AM – Reposted on September 3, 2014