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A Country Against All Odds

February 20, 2015

 

How Nigeria Beat Ebola


Dr. Stella Ameyo Adadevoh, a respected physician in Nigeria, contracted Ebola while trying to restrain an infected patient from leaving her private Hospital. In her determined effort to fight diplomatic and public health pressures to protect her country from an epidemic, she left Nigeria with the perfect blueprint. This blueprint is a comprehensive log of every Ebola case dating back to its original transmitter, Patrick Sawyer. 

On October 20th, 2014, the World Health Organization officially declared Nigeria “Ebola-free no” after a 42 day period. Based on an interview we conducted over the phone with Niniola Soleye, Dr.  Adadevoh’s niece, she described first-hand how her aunt contained Ebola within her private hospital and prevented it from reaching a population of over 170 million. Now having returned from her September trip to Nigeria for her aunt’s burial services, Soleye continues to share the heroic story of her deceased aunt. 

Impressively, her aunt, Dr. Adadevoh was not a physician in infectious disease and never witnessed a case of Ebola. Before the 2014 case, she had spent 21 years in the First Consultant Hospital as their lead endocrinologist physician and was very popular among numerous patients. Known for her compassion, she would regularly buy medicine for patients who lacked the finances, follow-up with discharged patients, and provide religious services to those with limited mobility. She also earned a highly-ranked British Council Scholarship (where she earned her degree in Endocrinology) at London’s Hammersmith Hospital of the Imperial. Soleye spoke of how her aunt’s medical expertise granted her many opportunities in the United Kingdom, but her passion for her homeland trumped all abroad opportunities. Her extraordinary intuition led to the discovery and initial diagnosis of H1N1 in Nigeria. This same intuition would ultimately crown her as a heroine in Nigeria’s medical field. 

When people tell stories of Dr. Adadevoh’s heroism, they recognize that heroism is a tradition deeply embedded in the lineage of her family. Her paternal great-grandfather, Herbert Samuel Macaulay, was the founding father of Nigerian Nationalism and the creator of Nigeria’s first political party. His face is shown in the Nigerian naira coin. Although Ebola claimed the life of Dr. Adadevoh, her exquisite accomplishments and her family’s distinguished legacy endure. Throughout Niniola’s interview, she stressed how she wanted her aunt to be remembered for her kind heart and passion for helping others. Dr. Adadevoh’s amicable presence is noticeably shown through the countless testimonies and narratives of her patients and colleagues. Yet, these acts of altruism are what tragically led to her death on August 19th, 2014.

On Sunday July 17th, 2014, 40 year-old Ebola-symptomatic Patrick Sawyer left quarantine in Liberia against medical advice in a CDC report. He later flew from Monrovia, Liberia to Ghana, Togo, and then to Lagos, Nigeria. When he reached Lagos, he collapsed in an airport terminal after vomiting on the plane. Soleye states that “under normal circumstances” Sawyer would have been transmitted to a federal hospital facility. However, because Nigerian doctors were conducting a nation-wide strike, Sawyer was placed in Dr. Adadevoh’s hospital later that night. According to a statement co-authored by Dr. Adadevoh and her colleague Dr. B.N. Ohiaeri, before her untimely death, Sawyer was diagnosed with malaria upon arrival that night. The statement continues to declare that Sawyer’s body did not respond to the malaria treatment and started to experience “hemorrhagic symptoms.” This prompted further questioning in which Sawyer denied having any contact with anyone exposed to the Ebola virus. Despite the fact that Sawyer had knowingly taken care of his sister infected with Ebola before he arrived at hospital. She later died from the virus. 

The following day, Dr. Adadevoh conducted her ward round and discovered Sawyer. Immediately, she went against her colleague’s judgment and Sawyer’s story, diagnosing the first case of Ebola in Nigeria. Wasting no time, Dr. Adadevoh sent blood samples to the World Health Organization and distributed flyers on Ebola to her nurses, doctors, and ward maids. She built an isolation facility in the hospital where she held Sawyer. 

Pressure mounted quickly against Dr. Adadevoh on Wednesday when she received a call from the Liberian ambassador, condemning her for holding their senior Liberian delegate against his will. Before Sawyer collapsed in the airport terminal, he was on his way to an economic convention in Calabar, Nigeria (over 9 hours away from Dr. Adadevoh’s hospital). Liberian officials accused her of violating Sawyer’s human rights, but Dr. Adadevoh adamantly pushed against the ambassador’s request. Sawyer, displeased with her motion, “pulled his intravenous [tubes] and spilled the blood everywhere,” (Yahoo News). Somewhere along this scuffle, Dr. Adadevoh and nineteen others at her hospital contracted Ebola, and nine (including Dr. Adadevoh) died as a result. Patrick Sawyer died five days later on July 25th.

“Nigeria was not prepared for this, and nothing was put in place,” Soleye stated. According to Soleye, Ebola appeared last November and between March and July, there was no plan of action put in place to stop it. This was most apparent from their lack of protective gear, equipment and protocol, leaving many health workers openly exposed to the virus. “They were fighting off this disease with gloves and whatever they had”, Soleye emphasized. The only isolation center available was a run-down facility that was not equipped for treatment. “This was where they placed my aunt”, and due to the meager conditions of the facility, Dr. Adadevoh was ultimately relocated to a former tuberculosis ward. This is where she passed. 

Soleye, a 26 year-old Communications Specialist at Management Sciences for Global Health Organization, now aims to help reinforce health systems in developing countries. She now stresses the importance of strengthening health systems to “give countries the ability to properly respond to unexpected health challenges like Ebola.” In her blog, located under Management Sciences for Health, she details how the fatality of Ebola strongly correlates with the power and preparedness of the health system and its employees. Her aunt’s legacy now lives in a non-profit trust fund to immortalize her name. Drasatrust dot-org is an endowment fund devoted to providing high-quality healthcare to Nigeria. 

What ultimately led to the confinement of Ebola to only 20 cases instead of thousands was Dr. Adadevoh’s detection, her resilience towards diplomatic threats and the hospital’s swift action after Sawyer’s encounter.  A statement released by Sahara Reporters shows that after the Sawyer incident, there was a temporary shutdown of the hospital and immediate evacuation of all patients. 

 Decontamination efforts and removal/incineration of bodies all followed the W.H.O guidelines.  These procedures limited the Ebola virus to the First Consultant Hospital Centre, and spared the lives of many Nigerians nearby.  Dr. Adadevoh’s keen imperative intuition and historic diagnosis allowed for the possibility of all Ebola cases in the region to be linked and tracked.  The Center of Disease Control reports how Nigeria was able to track every case and identify 894 subjects and conduct 18,500 face-to-face visits through contract tracers. This detailed tracing system led to no new cases of Ebola in Nigeria since August 31st, 2014. “Many other countries do not know the source, and are chasing [it] instead of containing it.” Soleye points out that West Africa can learn from Nigeria by implementing a strong health system to combat health emergencies, such as Ebola, early on. 

The work of courageous doctors such as Dr. Adadevoh and her staff who risked their lives to contain Sawyer stresses to the rest of Africa the importance of being prepared. “This is a serious virus that needs more supervision such as surveillance across borders and more up-to-date facilities”, Soleye urges. Many remain thankful for Dr. Adadevoh and her admiration is shown through pins worn across the chest of many Nigerians. Soleye ended the interview with a warning and some guidance to those battling Ebola. This was just a miraculous success story inside an ongoing struggle. Soleye concludes, “My aunt won’t be there next time to catch the [next] person”. 
 

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