Case study: How Nigeria contained the Ebola outbreak

By Edwin Ikhuoria, Nigeria Country Representative, ONE

A hospital in Lagos, Nigeria stocks up on Ebola supplies. Photo credit: Bryan Christensen/ CDC

A hospital in Lagos, Nigeria stocks up on Ebola supplies. Photo credit: Bryan Christensen/ CDC

Nigeria’s response to the Ebola epidemic raging in West Africa has so far been robust and decisive – attracting commendations from several international partners.

As of October 13, 2014, the World Health Organization declared Nigeria free of Ebola, a victory in a region where Ebola has claimed the lives of more than 5,000 people.

For a country to be declared Ebola-free, it must go 42 days with no new cases, double the incubation period. It must actively seek out all possible contacts, and show negative test results for any suspected cases.

Of the 19 confirmed cases in Nigeria, 7 infected persons have died and there are 12 survivors. While the continent’s most populous nation is not out of the woods yet, there are already notable lessons worthy of emulation by other countries at risk.

So how did Nigeria contain the Ebola outbreak?

A crucial first step in the Nigerian response was the vigilance of aviation and health authorities in Lagos who identified and promptly isolated the first case in Nigeria.

Following the isolation of that first case, the Nigerian government moved swiftly to approve a special intervention plan to contain and prevent the spread of the Ebola outbreak. The plan was propped up with the release of USD $11.5 million to support implementation.

An additional USD $1.2 million was also provided by the federal government to support an already very aggressive and successful response from the Lagos State Government and its emergency operation center.

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Map of the Ebola outbreak as of October 15, 2014. Source: CNN & WHO

Effective coordination of Ebola containment and prevention interventions has remained vital in Nigeria’s war against outbreak in the country.

The Nigerian Center for Disease Control has worked in close partnership with state governments, the World Health Organization, UNICEF, Médecins Sans Frontières and the US Center for Disease Control and Prevention to establish the Emergency Operations Center at the Central Public Health Laboratory in Yaba, Lagos and another in Rivers State.

This partnership and coordinated effort has led to increased awareness of Ebola by the general public and markedly improved case management centers, underpinned by an aggressive and successful contact-tracing program.

State governments have also acted swiftly – establishing emergency coordination offices, identifying isolation centers in readiness for potential outbreaks, sensitizing their populations, and working with federal authorities.

Additionally, there have been other specific Ebola containment interventions by the Nigerian government and its partners. These include:

  • Banning transportation of corpses – both international and interstate
  • Establishment of an Ebola Treatment and Research Group with a mandate to carry out an extensive research into the Ebola virus
  • Establishment of 6 testing centers nationwide with plans to expand this further
  • Training of Nigerian health workers in Ebola containment related courses
  • Delaying the reopening of schools, subject to the status of the Ebola epidemic
  • Private sector players like the Dangote Foundation have made significant contributions towards the Ebola eradication efforts. The Emergency Operation Center in Lagos have received about a $1 million from the Dangote Foundation towards its operational costs
  • Ensuring adequate provision of protective gear and resources to field personnel
  • Providing support for isolated patients or suspected cases
  • Promoting an anti-stigmatization campaign to protect Ebola-free victims – most especially given that stigmatization may further make contacts and suspects to go underground – because such contacts and suspects may not come out and if they don’t come out, they jeopardize the life of those they come in contact with, including their families

Social media, SMS platforms and radio have also played a key role in the sensitization of the public.

While having an irrefutable reach, these publicly controlled media have already highlighted the dangers of having “free for all” communication conduits – particularly when it comes to specific public health messaging, as it is with the Ebola outbreak.

In a tragicomic incidence that had national repercussions, a university student, playing an innocent prank, announced that bathing and drinking salted water prevents Ebola infections. A significant number of people fell for this prank that unfortunately caused a few fatalities, particularly for people who went overboard in their implementation of the hoax message.

The prank was exposed by national public health agencies, albeit after a few fatalities. By and large, Nigerians in both rural and urban communities seemed to have gotten the message that Ebola is real and lethal.

While Nigeria is not out of the woods yet with regards to the Ebola epidemic, the national effort so far has been purposeful, It is hoped that the demonstrated efforts towards containment and prevention of the Ebola outbreak is sustained till the logical end.

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