- We need more than ritualistic response to a perennial public health problem
Lassa fever has broken out in Ebonyi and Kogi states. So far, the infection had killed four citizens, including two doctors. As at the time of writing, there are already nine persons receiving treatment and 139 others under active surveillance. As expected, the Federal Ministry of Health has alerted WHO about the outbreak of Lassa fever and has provided support to states with cases of confirmed infection.
Already, the disease has led to the closure of public and private schools in Ebonyi for seven days in the first instance, to prevent spread of the disease among school children. And patients receiving treatment not related to Lassa at the National Obstretic Fistula Centre (NOFIC) in Abakaliki have been evacuated to prevent being exposed to Lassa infection. Further, patients diagnosed with Lassa fever in Kogi have been taken for treatment to Irruain, Edo State.
Expectedly, both federal and state governments have embarked on the usual response to outbreak of Lassa in the country: reminding medical staff of precautionary measures required for attending to those diagnosed with the fever; repeating the symptoms to which individuals should seek immediate diagnosis; sending medications to states experiencing Lassa fever. In addition, citizens in affected states are being reminded about how to avoid future occurrence: refraining from burning bush to avoid forcing rats to run into houses for protection; advising citizens to store their food, especially grains, gari, powdered food in securely covered containers; and avoiding bodily contact with rats and their urine and faeces. But the pattern of response is not different from that of past years.
Between mid-May 2015 and August 2016, 289 citizens were infected by Lassa fever, which caused the death of 154 patients. And in January of 2017, six states were affected by Lassa fever: Plateau, Nasarawa, Ogun, Ondo, Taraba, and Edo, and about 20 patients died. The fast spread of the infection and loss of lives pushed the National Centre for Disease Control (NCDC) to create Lassa Fever Eradication Committee to provide clues on how to prevent future outbreak of the disease. The committee had made recommendations to the government well ahead of this year’s dry season. This 2018 outbreak of Lassa fever exactly a year after the last outbreak should spark curiosity about the progress of the Lassa Fever Eradication Committee.
We fully agree with complaints of University Graduates of Nursing Science Association (UGONSA) about the ritualistic nature of response in the country to Lassa epidemic since 2013, especially in Ebonyi where over 40 had died of the disease since 2013. We find the observation of UGONSA that the outbreak in Ebonyi would have been avoidable if the government had lived up to expectation in the health care delivery system to be apt: “What we see each time we experience the avoidable death of health workers from Lassa fever is that government officials rush to the press to commiserate with the victims….Hypocritically, they resume the supply of basic Personal Protective Equipment (PPE) and hand sanitisers to hospitals.But as soon as the tension dies down, hand sanitisers, PPE, electricity and running water disappear and become essential commodities in our hospitals, leaving our nurses and physicians with the pathetic option of treating patients largely unprotected.”
We implore both federal and state governments to pay more attention to quality and regularity of health care in the country, particularly in terms of preventive medicine which is universally much cheaper than curing people after they are diagnosed with Lassa and other infectious diseases. If nurses and other health workers cannot trust the government on regular supply of sanitisers in hospitals, why would government expect non-medical citizens to heed advice from health workers about importance of personal and public hygiene? Ministries of health all over the country need to obey their own rules at all time.
In the short run, both federal and state governments should ensure that all forms of intervention necessary to stop spread of Lassa and prevent infection of medical staff attending to patients are put in place immediately. Losing three doctors in one week to a treatable disease is, to say the least, worrisome. In the long run, the government needs to collaborate with international organisations on research towards production of Lassa vaccine. A country without potable water for over 80% of its population and with erratic supply of electricity for proper storing of food, and erratic public health education cannot afford to delay further on production of vaccine against Lassa fever.