by Adedayo Ademuwagun

Everyone panicked when the first Ebola case in the country was reported in July, and people thought the disease would spread like wildfire.

Ebola has killed over 1500 people in Liberia, Guinea and Sierra Leone and it still looks to be spreading beyond control in those countries. But there have been only eight deaths in Nigeria, and the government has effectively restricted the spread.

The question is, why is Nigeria winning its fight against the disease while the other affected countries are struggling and in a worse situation?

There are five relative advantages that have put Nigeria in this ‘favourable’ position.

1. Border advantage

Nigeria doesn’t share a border with any of the other countries affected by this outbreak. To bring in Ebola by land, a person in Liberia would have to travel 2,000 kilometres across four countries.

This border advantage is what Liberia and Sierra Leone didn’t have. The outbreak originated from a Guinean town near the border with Liberia and Sierra Leone, and people continued to pass to and fro freely several months after the epidemic began.

Despite the high risk, Sierra Leone and Liberia left their border with Guinea open, and soon there were more fresh cases being reported in each of Liberia and Sierra Leone than in Guinea itself. By the time Guinea finally seized the initiative and shut the border to save its neighbours further trouble, the virus was out of control.

2. City advantage

Ebola got into Nigeria when a man who had the virus arrived in Lagos.

Lagos is more populous than Freetown, Conakry and Monrovia put together — six times. So it would have been far more disastrous if the virus got out there in the city without being contained.

This didn’t happen for various reasons. First, Lagos is one of the most efficient state governments in Nigeria. Once the first case was detected, the Lagos government responded speedily, setting up an isolation centre and moving to trace people who likely had contact with the man. The proactive response made a great deal of difference. But for fresh cases in Port Harcourt lately, the fight was almost over in Lagos one month later.

Some people feel that the resistance Lagos mounted averted a national disaster, and that maybe if the virus entered through another state, the epidemic might not have been as well managed.

3. Financial advantage

Nigeria is a lot richer than the other affected countries, and unlike them, it has petrodollars to spend.

After the first Ebola case in Lagos, the federal government promptly declared a national emergency and put in about $12 million to beef up the health system nationwide. Lagos, which is a megacity, also dipped into its treasury.

On the other side, Guinea, Sierra Leone and Liberia have struggled to initiate and sustain their drive against the disease. Government response has been severely hampered by financial constraints, and the governments have relied heavily on support from medical charities.

Two months ago, the US Peace Corps pulled out of the three countries because of the increasing risk to their volunteers. The medical charity, MSF, has also appealed to the international community for help, citing government incapacity.

4. Circumstantial advantage

Before Patrick Sawyer, the first Ebola case, came into Lagos, there was no screening going on at the airports and land borders. The Nigerian government didn’t seem to bother, nor did the people.

When Sawyer came into Nigeria through the Lagos airport, there was no medical check and he was on his way into the city when he slumped at the airport and had to be whisked straight to a hospital. He died there two days later, having only had contact with people on his trip, those who welcomed him at the airport, and few staff at the hospital.

If the circumstances were different, if he had got out there and mixed with lots of unsuspecting people at meetings, the situation would certainly have been more difficult to control.

In Port Harcourt, a doctor secretly treated an Ebola patient at a hotel room, went back to his family and business and later even threw a house party, putting a lot more people at risk. Over 200 people were quarantined because of that situation, and if not for that, this outbreak would be nearly finished in Nigeria by now.

5. Chronological advantage

Until recently, Nigeria was the last country hit by the virus, and this is a good thing from a chronological angle.

Epidemiologists have established that the first Ebola case happened in Guinea last December. But even the Guinean authorities didn’t know until two months later when the disease was confirmed to be Ebola. So there was no immediate action from the government or WHO.

Further, the medical charities and others helping out didn’t arrive until March. By the end of the month when the Centre for Disease Control and Prevention team arrived in Guinea to
help mount a defensive, it was three months into the epidemic and the virus had entered the capital and crossed the border.

The advantage for Nigeria was that the outbreak had happened in three other countries already and had been on for over six months. So the world and health bodies were on high alert by the time it entered Nigeria. Consequently, the response was rapid.

Last week, there were various local media reports that someone in the northern city Kaduna had caught the virus, causing further anxiety. It turned out the lad had not even been tested, and when the test came out, it was negative.

The Nigerian media have been very dramatic in covering the epidemic’s progress in the country, thereby causing a good deal of hysteria among the people.

Timeline

March 22 – First case of Ebola case is confirmed in Guinea, with a study tracing the original source to a 2-year-old boy in the town of Gueckedou. Cases are also reported in the capital, Conakry.

March 30 – Two cases of Ebola are reported in Liberia, with suspected cases also in Sierra Leone.

April 1 – Medical charity Medecins Sans Frontieres (MSF) sounds a note of warning about the spread of the Ebola virus, but a World Health Organization (WHO) spokesman calls it “relatively small still”.

April 4 – Health workers in Guinea, Sierra Leone and Liberia are attacked by hostile local citizens due to fear of being infected. An Ebola treatment centre is attacked by an angry mob in south-east Guinea.

May 26 – First Ebola death is confirmed by the World Health Organisation in Sierra Leone.

June 17 – Liberia confirm first Ebola case in the capital city, Monrovia.

June 23 – West Africa records over 350 deaths, indicating the worst outbreak in the region.

July 25 – First case of Ebola death is reported in Nigeria, after Patrick Sawyer, a Liberian citizen who is infected with the disease dies at First Consultants Hospital in Obalende, Lagos, after travelling from Monrovia.

July 29 – Leading Sierra Leonian doctor, Dr. Sheik Umar Khan, dies of the virus.

July 30 – Schools are shut down in Liberia. The government orders the quarantining of the worst-affected communities, using troops to enforce it.

July 31 – Due to fears of Ebola, the U.S. Peace Corps withdraws all volunteers from Liberia, Sierra Leone and Guinea.

August (Aug) 2 – Kent Brantly, An American missionary aid worker, who has been infected with Ebola in Liberia, is flown to the United States for treatment at Emory University Hospital.

Aug 4 – The World Bank announces $200 million grant by to help fight the disease in Liberia, Sierra Leone and Guinea.

Aug 5 – A Second U.S. missionary, Nancy Writebol, is infected with Ebola and flown from Liberia to Atlanta hospital.

Aug 8 – Ebola is declared an “international public health emergency” by the WHO.

Aug 12 – Spanish priest infected with Ebola dies in Madrid hospital, as death toll rises above 1,000.

Aug 14 – WHO says reports of Ebola deaths and cases do not justify the danger it poses.

Aug 15 – MSF says the West African Ebola outbreak will take about six months to control.

Aug 20 – Fracas in the capital city of Liberia as local security forces fire tear gas to disperse crowd trying to break out of Ebola quarantine. A teenager reportedly dies of gunshot wounds.

Aug 21 – An experimental drug, the ZMapp, is used to treat two American missionary aid workers in Atlanta. They are released from the hospital free of the virus.

Aug 24 – Ebola outbreak is reported in the northern Equateur province of the Democratic Republic of Congo. A British medical worker is infected in Sierra Leone and flown to the UK for treatment.

Aug 28 – Death toll rises above 1,550. WHO warns outbreak could infect more than 20,000 people. The U.N. health agency announces says $490 million is needed over the next six months to fight the disease.

Aug 29 – The first case of Ebola is reported in Senegal.

Aug 30 – World Food Program says $70 million is needed to feed 1.3 million people who are at risk in Ebola-quarantined regions.

September (Sept) 2 – Ebola outbreak is reported to be spreading out of control. The MSF President, Joanne Liu, tells United Nations members the world is “losing the battle” against the outbreak. Liu accuses “a global coalition of inaction”.

Sept 3 – The United Nations declares that $600 million will be needed to fight the outbreak in West Africa. Death toll rises to 1,900. Officials say there were close to 400 deaths in the past week. An experimental Ebola vaccine developed by a Canadian reserve team is stuck in the lab that developed it because officials cannot figure out how to transport it without endangering its viability.
A third U.S. doctor, Rick Sacra, is infected with the Ebola virus in Liberia.

Sept 5 – Rick Sacra is flown to a special isolation unit at The Nebraska Medical Center in Omaha, US for treatment.