Nigeria: 2014 - Ebola, Strikes Dominate Health Sector By Sola Ogundipe, Chioma Obinna and Gabriel Olawale FOR the Nigerian health sector, the outgoing year 2014 was eventful in several respects. It was a cocktail of the good and the bad. The year was marked by gloomy health stories that elicited fear, sadness and death, as it was illuminated by events that gave reason to cheer and remain hopeful. The year 2014 will never be forgotten as the year the dreaded Ebola Virus Disease, EVD, came to Nigeria. Much more reported than any other health event, the historic Nigerian Ebola incident topped the list of medical and health stories even though the year saw quite a few other memorable moments. The first ever Ebola outbreak that occurred in Lagos, and the nations ultimate victory over the deadly virus, have gone down as two of the most important events of the year. Even in the face of significant strides in preventive healthcare and near eradication of polio, the Ebola saga took the limelight. The major minuses included the inhibiting health sector strikes, sustained high infant, child and maternal mortality and morbidity; increasing cases of Non-Communicable Diseases, NCDs, etc. Like the previous year, 2014 opened with a strike threat, and is closing with a health workers strike. The outgoing year was consecutively punctuated with protracted strikes in the health sector that effectively paralysed healthcare delivery activities. Indeed, the story about health sector strikes this year is no different from previous years. There was good news in polio eradication. Indeed, among the most glaring assessments of the sector in 2014 was perhaps the commitment and leadership shown by the Federal and State governments to stop the spread of the dreaded Ebola virus and the fact that the country is close to eradicating polio. President Goodluck Jonathan assented to the National Health Bill, the Pneumococcal Conjugate Vaccine, PCV, was also adopted into the National routine immunisation schedule. These were the landmarks. The honest assessment of the year is captured in a statement by the American billionaire and Microsoft giant and philanthropist, Bill Gates, when he observed in his official twitter handle that the media coverage about Nigeria this year was Ebola and terrorism, adding that from a global health perspective, Nigeria actually had a pretty good year. Good Health Weekly chronicles the failures and successes in the health sector in 2014. Excerpts: The Ebola outbreak The outbreak of the Ebola Virus Disease brought fears, pains, death and losses to businesses in the country. The outbreak in Lagos followed importation by late American-Liberian, Patrick Sawyer. Also affected was Rivers state. A total of 19 cases were reported of which seven died while 12 survived. Laboratory confirmation of the first case, in Lagos on 23 July, rocked public health communities across the country. There was panic not only because of the virus but because of the countrys population. Lagos alone was 18 million. The Lagos State government was worried about carrying out successful contact tracing in such a congested area. With assistance from the World Health Organisation, WHO, the US Centres for Disease Control and Prevention, CDC, and other health officials reached 100 percent of known contacts in Lagos and 99.8 percent in Port Harcourt. Federal and State governments in Nigeria provided ample financial and material resources. Exactly 42 days after the last Ebola contact undergoing treatment was discharged from the Isolation Centre in Lagos, the WHO declared Nigeria Ebola free. The declaration was a landmark event acknowledged by the entire world, on the basis that Nigeria could defeat Ebola despite challenges of insecurity and poor health system among others. The Nigerian government received accolades for the leadership it provided during the Ebola outbreak. To put an end to Ebola in West African countries and the world at large, the Federal Government sent 250 Ebola volunteers to Sierra Leone, Liberia and Guinea, to help contain the outbreak. The Nigerian Centre for Disease Control, NCDC, is sending 250 more volunteers by January 2015. The outstanding performance the country recorded in the eradication of polio despite the insecurity in some parts of the country which hampered immunisation in those areas was another milestone that received accolades even from outside the country. Nigeria is one of the only three countries that have never been free from polio (Pakistan and Afghanistan are the other two), but with a decrease of 50 cases to six cases in 2014, the country would soon be declared polio free. In the words of Bill Gates, the fact that Nigeria is now Ebola free is a great example of how doing the work to fight things like polio also leaves countries better prepared to deal with outbreaks of other diseases. Also according to the Special Assistant to President Jonathan on New Media, Reno Omokri, Nigeria has not recorded a single new case of the wild polio virus since July. Only six cases have been recorded in Nigeria this year - a dramatic 90-per-cent decline from last year. This is crucial progress, since Nigeria has been the sole reservoir for the spread of the virus to dozens of other African countries. It would leave Pakistan and Afghanistan as the only remaining countries in the world where polio is still endemic. A decade ago, the campaign was in serious trouble, as northern politicians and religious leaders spread rumours that the polio vaccine caused AIDS and infertility. In February, 2013, disaster struck again when gunmen killed nine vaccination workers in the northern city of Kano. Other milestones The National Health Insurance Scheme, NHIS, in collaboration with mobile networks in Nigeria launched a mobile health insurance scheme. With the launch every Nigerian who owns a phone will now have access to health insurance with as low as N250.00 per week. The Mobile effective networks include MTN and Airtel, Nigeria. The Lagos University Teaching Hospital, LUTH, opened the N100 million Molecular Biology Research Laboratory built and equipped by Chevron Nigeria. The lab was key to the quick confirmation of late Sawyers infection status with Ebola Virus Disease. To boost lab services in the country, the Nigerian Institute of Medical Research, NIMR, commissioned its Human Virology Laboratory. Also, during the year, President Goodluck Jonathan launched a programme on Prevention of Mother to Child Transmission of HIV, PMTCT, where it was declared no Nigerian child should be born with HIV. Another event was the commissioning of Dental Therapist Development Centre in Lagos. The centre which is first of its kind in Nigeria will help to check quackery in the dental profession. The resignation of the former Minister of Health, Professor Onyebuchi Chukwu towards the end of the year to contest the gubernatorial seat in Ebonyi state led to appointment of the Minister of State for Health as the supervising Minister of Health. Incessant strikes The year began with a threat by the Nigerian Medical Association, NMA that Nigerians should prepare for the mother of all strikes precisely on January 5th, 2014. But the timely intervention of President Goodluck Jonathan caused the strike to be shelved after he agreed to appoint the first ever Surgeon - General in the country. But six months later, NMA executive led by its President, Dr Kayode Obembe resumed a nationwide indefinite strike despite all appeals by Nigerians over its 24 - point demands. The strike which began in July 1, 2014 dragged on even when Ebola broke out in the country. The strike apparently caused the striking doctors to lose public sympathy when they failed to call off their strike in the face of the Ebola outbreak. The NMA President finally suspended the strike in August 25, 2014. The Medical Guild, group of doctors by the Lagos State government had their two months salaries withheld as the state government decided to implement its no work no pay policy. The year is winding up with another nationwide strike by members of Joint Health Sector Union, JOHESU. The Union had since November 16, embarked on a nationwide strike abandoning their duties to doctors alone. Philanthropy, corporate sponsorships and partnership The year witnessed improved partnership between public hospitals, Private facilities, and corporate institutions, politicians as well as religious organisations. This came in form of donations, rebuilding, and reconstruction and for improved health care services. The philanthropy shown by organisations, particularly in the fight against Ebola deserves mention. Mobile companies like Airtel Nigeria provided phones, free airtime amongst others. MTN donated treatment equipment, while organisations donated funds. Chevron Nigeria Limited also donated a N100 million laboratory to the Lagos University Teaching Hospital, LUTH, Idi Araba Lagos. Also, the private hospitals this year showed more understanding in terms of data collection. According to the Lagos State Commissioner for Health, Dr. Jide Idris, there are improved data collections from the private facilities unlike before. The outbreak of Ebola also brought a lot of changes in the way patients are assessed in the hospitals. It brought about for example the introduction of hand - held non contact thermometers. Also worthy of mention, is the fact that many religious organisations in 2015 launched various programmes on health and lifestyle. Some churches dedicated some of their time to educate their members on health education particularly during the Ebola saga.
Posted on: Tue, 30 Dec 2014 09:29:54 +0000