In the city of Lagos where Ebola Virus Disease (EVD) was first reported in Nigeria on July 2014, posters and billboards containing educational messages about the disease are seen pasted visibly in public places. There is a high sense of awareness among the populace.
“So you mean this Ebola has no cure?” a hair-stylist asked me a couple of months back, when the news about the virus began to gain momentum in the country. I could sense the fear in her voice. All attempts to allay her state of apprehension were futile.
She reclined into a shell and hesitated before touching a new customer’s hair.
Ebola case in Nigeria
Ebola came into our psychic when Patrick Sawyer, an infected Liberian-American, flew into Nigeria and spread the virus through contact. Before now we have been reading about Ebola, Dengue fever, and some other kinds of strange fever. We just saw it as something happening to some other countries and not within our country here. So when it hit us, people got scared. People are still scared, narrates Dr. Richard Adebayo, a clinical psychologist based in Lagos.
Ebola virus disease is a fatal infection that has no cure. But it can be medically managed to recovery. Since the outbreak of the disease in West African region, scores of death has been recorded while a handful were managed back to full recovery. For example, in neighboring Liberia, over one thousand people have been infected with the virus and about six hundred have died, according the World Health Organization. Many people are still in quarantine centers in the region, under medical and security surveillance to reduce the spread of the virus across border.
“We are in a state of apprehension,” Dr. Adebayo chirps. “That is (why) mental health issues are involved now.”
The psychologist says the infectious nature of the disease has created a sense of apprehension in the minds of people. Many avoid large gatherings. Some organizations provide hand-sanitizers for clients and customers who come into the place for business. There is an increased effort to enforce healthy habits that will reduce the spread.
“It has created a state of apprehension. A state of anxiety. People are concerned. And the fears are real. They are not just misplaced. Honestly, they are real. So you get to an institution or any organization, you are told to go and wash your hands, wash your hands, apply sanitizer. Despite that, people are still afraid.”
Interventions marred by misconceptions
Lagos is described as the commercial hub of Nigeria. But Dr. Adebayo says although public enlightenment is high in the city, the control and eradication efforts depend on how effective campaign messages are in the suburbs.
In addition, while the use of technology and its fast-paced nature of information dissemination in our society is said to have contributed to the increased awareness created to curb the spread of the virus, it also enabled effortless spread of misconceptions.
Dr. Adebayo recalls the incident in August where an individual started a rumor about the use of salt as a protective solution against Ebola. The message went viral within a few hours. Some Nigerians diluted their bathing and drinking water with salt before use. “We got report of two people (who) died and twenty-two others who were hospitalized as a result of that,” he said.
Although the source of the rumor was not known, the message went viral. Some states in north-central and northern parts of Nigeria that had no recorded case of Ebola were proactive in taking the salt-water solution.
“My mother woke us very early in the morning to drink and bathe with salt water,” Happy Titus, a young lady based in Kaduna recounts quietly, during a visit to Lagos.
She said many people complied with the message because they wanted to protect themselves from the virus by all means.
“You can imagine someone who is hypertensive drinking salt water. That will aggravate the blood pressure of course,” Dr. Adebayo noted.
“Why is it that people are taking those things when they have not even had Ebola?” he asked, “That explains what I described earlier on- state of fear and anxiety.“
Ebola raises health consciousness, poses mental strain
Dr. Adebayo points out that Ebola outbreak in Nigeria has left a positive mark in the country because people have become more health conscious, taking into cognizance personal hygiene that is usually ignored.
“But beyond that it may lead to a state of compulsion,” the psychologist warns.
People can become obsessed with routines or suffer obsessive-compulsive disorder, he says.
“They may wash their hands now, something can touch their hands- maybe they handle newspaper and they go and wash their hands again.”
The doctor points out that fever is not something that is new in a tropical environment like West Africa, and Nigeria in particular. “People can run temperature, have headache and complain of other conditions like malaria, typhoid, upper respiratory tract infection or some other viral infection that the body will overcome.”
However, since the outbreak of Ebola, any case with feverish condition is labeled as a suspected Ebola virus infection even when it is not Ebola.
“I heard of a hospital where a suspected case of Ebola was reported and people ran away. When the person has not even been diagnosed.”
Nigeria is Ebola-free, what next?
International support to eradicate Ebola has been very strong in the region. Bill and Melinda Gates foundation recently announced a donation of fifty million dollars to help organizations working to control the disease.
While other affected countries still struggle to eradicate the disease, Nigerian government has been commended for its efforts in curbing the spread.
Nigeria’s Minister of Health, Prof. Onyebuchi Chukwu recently confirmed that there were no new cases of Ebola infection in the country. In a report published in one of the national dailies, Professor Chukwu revealed that out of nineteen Ebola cases that were confirmed, seven deaths were recorded while twelve suspected cases were successfully managed to recovery.
According to the report, a total of 350 contacts that were previously on surveillance have been discharged. However, doctor Adebayo cautions against discharging people without providing enough psycho social support for those affected.
“We need psychologists to take care of them, to continue to have discussion with them,” said Dr Adebayo.
He said that those who have lost family members to the diseases should be provided with psycho social support.
“It is not just enough to now say go home, thank God, thank your star that you are not positive.”
Without any psycho-social support, those discharged will continue to suffer in silence and might come down with all types of mental disorder when we have long forgotten about Ebola outbreak, the doctor warns.
More health interventions needed in rural communities
With the recent call for schools to resume the new session that was earlier postponed, things are gradually returning back to normal. But Dr. Adebayo says there is still need for more enlightenment.
The government leaders are doing well in creating awareness through the mass media. But there is a need to go beyond that, he said. Preventing the spread of Ebola is not just about washing of hands alone but keeping a healthy environment.
“We need to reach out to grassroots through religious leaders and traditional leaders in our communities. We need to reach out to them more so that they can explain this to their people in their local dialect, in their local languages rather than relying on the advert on the newspaper or television.
“People are afraid because they think Ebola is a death sentence but it is not a death sentence. But people need to know what to do. We need a lot of enlightenment than what we are doing now.
“And then we need to empower and strengthen our health systems.”
Most rural communities in Nigeria lack access to government health centers due to poor road network, he said. People in these areas sometimes rely on small private hospitals that lack equipment and manpower.
To bridge this gap, Dr. Adebayo suggests that more efforts should be channeled towards training community health workers for underserved communities.
“If somebody is having a suspected case of Ebola in a remote area like Ikorodu or Epe (a suburb of the commercial city), do they have resources they can call upon to take care of them (on) time? How soon can they get response?”
The psychologist said solving the health challenges in Nigeria is not something to leave to government leaders alone.
“I was delighted when I heard of (an) Oil Company donating vehicles and protective gears to Lagos state government. Other private organizations should imbibe that,” Dr. Adebayo said.
He called for more collaboration between government institutions, private healthcare organizations as well as corporate companies, not only to eradicate Ebola from Nigeria but also to improve the health sector in general.
Ehidiamen is a published author and a tech-savvy journalist based in Lagos.
