WHEN Dennis Akagha’s fiancée, Justina Ejelonu, contracted Ebola in Lagos two months ago, Nigeria’s health-care workers had little experience in dealing with the disease. A hospital nurse, she had been infected while caring for Patrick Sawyer, a Liberian-American, who flew into the country carrying the infection in July. He was the first known case of Ebola in Nigeria, and all of the country’s cases since then can ultimately be traced to him.
At first medical staff did not know what they were dealing with—Mr Sawyer claimed to be ill with malaria—so they did not take precautions against the virus. Nine doctors and nurses became infected. Four died, among them Ms Ejelonu and her unborn child (she had been two months pregnant).
Within a fortnight, Mr Akagha was also displaying symptoms of Ebola. By then, fortunately, Nigeria had already started to mobilise against the illness. Throughout the crisis, epidemiologists’ great fear has been that the Ebola virus would make the jump from relative small west African countries—Guinea, Liberia and Sierra Leone—into larger neighbours. Lagos, Nigeria’s commercial capital with its sprawling slums, has been the subject of particular concern. Yet Nigeria’s effort to contain the outbreak of Ebola—along with Senegal it was declared to be free of the virus in recent days—is a story of success that experts at the World Health Organisation think should be emulated, even by wealthy countries.
Health-care systems and methods developed to combat polio (nearly eradicated in Nigeria, after the defeat of Guinea worm) were quickly turned to use in fighting Ebola. People who had been in contact with Mr Sawyer, directly and indirectly, were traced, monitored and isolated if displaying signs of illness. The process involved personal interviews and the use of mobile-telephone data in real time.
Mr Akagha was among those to whom a “communicator” had been assigned to conduct daily health checks. When he became sick, the response was quick. “I was taken to an isolation ward, and by then they had upgraded the facilities, there were volunteers, there was proper equipment,” he recalled. “I was well cared for.”
Can other countries learn from the success of Nigeria and Senegal? Unlike Sierra Leone, Liberia and Guinea, the wealthier governments in Nigeria and Senegal were able quickly to impose strict measures to quarantine the ill and monitor contacts. Senegal’s response was so effective that it appears there was not a single transmission in the country, suggesting better infection controls in its hospitals than of those in America and Spain. In Nigeria, the government was quick to declare a national emergency and close schools. Health experts also highlight the fact that it channelled all resources through a single body—the Emergency Operation Centre for Ebola—which allowed for better co-ordination than that displayed in Liberia and Sierra Leone.
With elections coming up in February 2015, Nigeria’s government is milking its success in containing Ebola for political advantage. In Lagos, the mood has lifted. People are shaking hands again. Yet continued vigilance may be more appropriate than self-congratulation. There is every chance more carriers of the virus will cross west Africa’s porous borders. Officials in Nigeria say that they are trying to control that risk by screening at land, sea and air borders. They add that trained surveillance teams are ready to respond quickly if new cases pop up anywhere in the country.
A new outbreak would put what is still a weak health service under serious pressure. But Nigerians are taking comfort in the fact that health care teams now have experience handling the disease. “The resources are there,” says Dr Morenike Alex-Okoh, director of port health services at Lagos airport. “Even with several new cases, the previous outbreak has given us a practice run, and we will meet the challenge”.
Despite his bout with the illness, Mr Akagha is heartened. “In Nigeria,” he told your correspondent, “we have proved that Ebola is not a death sentence.”
