REMEMBERING ADADEVOH; THE NIGERIA'S EBOLA STORY

About a year ago, Ebola came to Nigeria and the experience, for most Nigerians, was like embarking on a trip to Golgotha, the proverbial place of the skulls. For 93 days, Nigeria grappled with the ominous challenge of the deadly Ebola incursion, and eventually contained it, but at a huge cost of eight precious lives. Sunday July 20, 2014 will always be remembered because it was the day the nation’s Ebola patient “zero” , or index (first) case – the late Liberian-American, Patrick Sawyer, imported the Ebola virus into Nigeria, setting off a chain reaction of unprecedented magnitude. Tuesday, August 19, 2014 will also not be forgotten because it was the day Nigeria’s Ebola heroine – Dr. Ameyo Stella Adedavoh, passed on. She was one of the hospital staff at First Consultants Hospital, Obalende, Lagos, that lost the battle for survival as a result of Ebola infection through primary contact with Sawyer. Following her encounter with Sawyer, Adadevoh, a medical consultant and endocrinologist, died after she was infected with Ebola by the index case. Her last days were spent in isolation at the Ebola Operations Centre in Yaba, Lagos. Sawyer has infamously gone down in history as the harbinger of Ebola in Africa’s most populous nation, while Adadevoh is being remembered as the nation’s Ebola heroine. Her death made it much more obvious that dying without the benefit of the comfort of loved ones is all part of the debilitating nature of the killer virus. Dr. Ameyo Adadevoh She was not the first or only Nigerian to succumb to the dreaded virus, but Adadevoh’s personal involvement and role in helping to contain the Ebola epidemic was unprecedented. It was she who first suspected that Sawyer was infected with Ebola and her quick intervention and firmness helped limit spread of the infection. On the day he was admitted to the hospital, Sawyer was first treated for malaria, and Adadevoh was at home spending the weekend with her family. It was the next day she went to the hospital that she saw him (Sawyer) who appeared to have blood seeping through his skin. Adadevoh immediately knew his ailment was more serious than malaria. She was quite disturbed, and when Sawyer confirmed he was from Liberia, she immediately suspected it could be Ebola. She was not a virologist or epidemiologist, but was experienced enough to know it was a probable case of Ebola. Months before Ebola came to Nigeria, the disease was trending in Guinea, Liberia, and Sierra Leone. Mali and Senegal also recorded cases. Also, long before the Sawyer episode, Adadevoh already had the conviction that Nigeria was not prepared for an Ebola outbreak. But realising that Nigeria needed to be prepared in the event of an outbreak, she began to research privately on Ebola. She established that the Ebola virus is an infectious agent and one of the viruses that can cause haemorraghic fever, a severe infectious disease characterised by high fever and bleeding, in humans and some other primates, such as monkeys. Adadevoh knew infection with the Ebola virus causes severe illness in humans, and after an incubation period of 3 to 21 days, patients initially present with general flu-like symptoms before a rapid progression to advanced disease characterised by haemorrhage, multiple organ failure and a shock-like syndrome. From her research, she knew that there was yet to be an approved vaccine or treatment, and that Ebola outbreak management was limited to palliative care and barrier methods to prevent transmission. It was a proactive move that paid off because when she saw Sawyer, she immediately suspected he had a haemorrhagic disease which was infectious. Her sharp-eyed diagnosis and high level suspicion didn’t immediately identify the virus, but it was her suspicion that pointed state and Federal health officials in the right direction. Were it not for her quick thinking, it is widely believed that that the story would have been completely different altogether. Adadevoh had practiced at First Consultants for 21 years, in fact, she was synonymous with the hospital, so when Sawyer insisted on being allowed to leave the hospital, Adadevoh was not intimidated. She had the mien and clout to muster enough authority that ensured he did not leave and with the cooperation of other hospital staff successfully kept him isolated. This singular action saved the nation from what could have been a catastrophic situation. From Adadevoh’s perspective, the Nigeria Ebola story is worth telling over and over. Ebola came like a thief in the night and caught everyone unawares. It was not the apocalyptic outbreak most people feared, but Sawyer’s death spontaneously set off a chain reaction, in addition to further raising fears that the dreaded virus could spread. Before being declared Ebola-free on October 20, 2014, there were a total of 19 cases and 11 survivors. Local and international health officials and responders made a total of 894 identified contacts in the affected states of Lagos, Rivers, and Enugu. They also made and estimated 18,500 face-to-face contact visits. Although the whole world held its breath as the Ebola saga played out in Nigeria, the World Health Organisation, WHO, waited one month before declaring that the West African Ebola virus disease outbreak merited the status of a public health event of international concern. In the meantime, there was conscious nationwide alert to mobilise against the disease, while the apex health Ministry worked closely with the West African Health Organisation, WAHO, and the WHO, to deploy experts to strengthen its response capacity. All entry ports into the country were placed under surveillance even as a Presidential special information committee for Ebola was set up. Vigilance became the watchword. However, Nigeria’s Ebola story can never be complete without mentioning the part played by the well-loved senior consultant at First Consultants Hospital – Dr Stella Adadevoh. In her lifetime, Adadevoh never hid her passion for her career as a medical doctor. She had options of remaining abroad for her practice, but chose to return to Nigeria where she wanted to make an impact on the health care system. Even in death, her selflessness and devotion to her professional calling continue to stand her out.