Boots on the Ground
Posted by Ann Lee Hussey
Boots on the Ground – Success against Ebola in Nigeria
In late July, Nigeria received their first Ebola case. Everyone froze in fright, except Dr. Faisal Shuaib, but he was concerned since it was in Lagos. Of all the places in Nigeria, Ebola entered the city of Lagos, with a population of over 21 million.
Dr. Shuaib is the Deputy Incident Manager of the National Polio Emergency Center and worked to set up the Ebola Operation Center, with health leaders from WHO, CDC, UNICEF and Médecins Sans Frontières. These leaders met frequently to strategize a unified defense against Ebola. It must be pointed out that it was set up similarly to the Emergency Operation Center already established in response to the 2012 WHO declaration, that polio eradication was a global public health emergency. This EOC is focused on polio eradication and is made up of leaders from the government, WHO, CDC, UNICEF, Rotary, and the Gates Foundation, and is responsible for taking Nigeria from hundreds of polio cases to just six cases this year, all within two years time.
In response to the strategies suggested, a ward approach was set-up to contain the outbreak of the Ebola virus, which included a dedicated team; a team that emphasized team work, strict guidelines, and accountability, never letting a team member down.
But the “Boots on the Ground”, the use of our polio program, already established throughout the country, is what provided the essential contact tracing. Over 800 people were traced and over 18,000 homes were visited. Doctors, nurses and other medical professionals searched for people who may have had any contact whatsoever with those infected with Ebola. When a contact case was discovered, teams educated the contact cases to distance themselves socially from others; the teams then monitored temperatures and symptoms and visited each contact case daily. In this way, when symptoms developed the person was quickly evacuated and placed into isolation immediately.
In order to reach Ebola contacts, vehicles were donated for use by partner agencies and the government supplied funding for the large amount of resources being utilized. Some contacts even had to be reached by boats. The same GPS mapping utilized in finding homes in the polio eradication efforts were utilized in the Ebola contact search.
When asked what are the lessons learned that could benefit other countries, Dr. Shuaib replied, “I think overall, with rapid, cohesive action, it is possible to defeat Ebola. It requires leadership. It requires preparedness. Those countries that do not have cases right now, it is important to move rapidly with the first single case, to isolate the case, and investigate the individual. It is dangerous. This is one situation where you cannot afford to delay. One thing that we have come to realize is that panic does not help. Panic and fear slow the response. So health-workers need to be very clear in their minds about what kind of messages are sent to communities.”
The lessons learned in containing the Ebola virus in Nigeria are being shared with other African countries, with Nigeria helping to set up operational centers replicating the success achieved in Nigeria. Volunteers from Nigeria are also traveling to infected countries to assist in the outbreaks, “Boots on the Ground”.
As long as Ebola outbreaks continue in Sierra Leone, Liberia and Guinea, Nigeria will continue to be at risk for Ebola outbreaks. They do not plan to let their guard down and today screening at all airports, seaports, and land crossings continue in an effort to find symptomatic travelers.
Throughout containment of the Ebola virus, polio immunizations have continued. Today Dr. Shuaib has returned to Abuja and continues his work with Polio eradication along with all the dedicated members of the EOC, health workers and Rotarians. We are winning the battle against Polio with “Boots on the Ground”.