© 2019 - International Centre for Investigative Reporting
INVESTIGATION: Health minister exaggerated, Nigeria not prepared to combat Coronavirus
THE Minister of Health, Dr. Osagie Ehanire, announced weeks ago that Nigeria is prepared to handle Coronavirus, a deadly virus that originated from Wuhan, China, which has killed over 1,800 and infested 73,325 persons.
But evidence from major hospitals in Abuja, the Nigerian capital, indicate that the minister’s claim is not entirely true as none of the facilities is equipped to handle a Coronavirus case.
The hospitals visited by our reporter include the National Hospital and the University of Abuja Teaching Hospital, UATH.
The ICIR can authoritatively report that Nigeria’s National Hospital located in the Federal Capital Territory has only a makeshift two-bed isolation ward for likely victims of the deadly Coronavirus, also known as Covid19.
The same ‘ward’, set aside for Covid19 is also dedicated to patients of other serious ailments such as Lassa Fever and Ebola virus, according to a health worker in the hospital.
Findings by The ICIR reveal that the isolation area located at the Female Ward Centre of the hospital is in fact, a makeshift holding space, located at the end of a corridor with easy access to visitors to the hospital.
Indicated with a hand-written sign that reads ‘isolation holding area,’ the section is screened from the rest of the corridor by movable hospital curtains, void of any visible machine/equipment found in a hospital ward dedicated to treating patients infected with deadly diseases.
The ICIR reporter was able to move close enough to this area to take photographs without being questioned by hospital staff.
“That’s the problem, what is here is only a two-bed isolation ward to manage patients with deadly viruses like Coronavirus and Lassa Fever. That’s all but the government has plans for an Isolation Centre somewhere,” a highly placed source, who sought anonymity, told The ICIR.
While the National Hospital has a makeshift, two-bed isolation space, the University of Abuja Teaching Hospital (UATH), Gwagwalada, has nothing.
Ranked highly as a reference hospital, with a 360-bed-capacity, as at the time of filing this report, UATH had no facility in place to handle cases of Coronavirus.
It was discovered that the Isolation Centre designed for the purpose of handling infectious diseases is still largely under construction.
In fact, the Isolation Centre project first began during the Ebola outbreak in 2014 but was abandoned after the virus was contained and eliminated from the country.
“During the time of Ebola, space was there but there was no building. They only created a temporary structure with canopies, trampolines and the rest but now they’re urgently constructing the centre because of Coronavirus and this only started after the Minister of Health visited,” a hospital staff told The ICIR.
The minister paid a visit to the hospital on February 4, few days before he declared Nigeria’s readiness to deal with the deadly disease.
During the minister’s visit, the Chief Medical Director (CMD) of UATH, Prof. Bisallah Ekelea, pledged to use a section of the newly-completed Accident and Emergency Department for the handling and treatment of suspected cases of Covid19.
“I will not only make the yet to be completed Isolation Centre available but also to offer the newly completed Accident and Emergency department for temporary use until the completion of the Isolation Centre,’’ he said.
However, the temporary building ear marked for the purpose of combating Covid19 sighted by The ICIR is placed under lock and key and lacks any furniture or equipment.
Dr. Yunusa Tahiru, team lead on preparedness of infectious disease at the UATH, told The ICIR in an interview that if a Coronavirus case is to be handled at the hospital, the patient would be treated at the Intensive Care Unit (ICU) pending when the temporary Isolation Ward would be furnished and when the Isolation Centre would be completed.
According to him, there exists a Memorandum of Understanding (MOU) with the ICU and any case of Coronavirus can be managed there successfully.
Tahiru claims that treating a patient with an infectious disease such as Covid19 or Lassa Fever at the ICU of the UATH, would only inconvenience the regular capacity of the hospital but not its overall performance.
However, Dr. Ifeanyi Nsofor, a public health physician and graduate of the Liverpool School of Tropical Medicine, stated that such a practice only shows that UATH and is not prepared for epidemics.
According to him, the hospital should have a dedicated ward for treating infectious diseases as opposed to risking the lives of other patients who might be receiving treatment at the ICU.
He, however, noted that the ICU is dedicated to critical cases; and using the area for treating infectious diseases in the absence of an Isolation Ward is not out of the ordinary.
“The best option for treatment in absence of an Isolation Ward would be the ICU because that’s the place to handle emergencies but that also means that every other patient in the ICU is at risk and the area would need to be effectively disinfected to prevent transmission,” he said.
These realities in the FCT certainly bely the health minister’s claim that Nigeria is ready to handle the deadly disease which has killed so many people and has spread to more than 25 countries.
Considering her estimated population of 200 million, a challenged health care system, and a high volume of travel to China, the World Health Organisation (WHO) listed Nigeria as one of the high-risk countries most susceptible to importing Coronavirus and suffering an outbreak.
Epidemics and safety measures
It has been determined that Covid19 can be transmitted from human to human. This finding has made many countries including the UK, US and Germany shut their borders to visitors from China – to prevent importing the virus.
Countries have also moved to extract their citizens in the broader Hubei province and provided a measure to quarantine evacuees by isolating them for at least 14 days before letting them back into the country.
So far, many countries have opted for the standard safety precaution to ensure that anyone who has been in the epicentre of the virus is quarantined for a minimum of 14 days regardless of symptoms they may or may not display.
In Nigeria, the safety measures being carried out are different.
For one, travellers from China are still freely coming into the country given the trade relations between the two countries.
In arresting the virus at the point of entry, the Nigeria Centre for Disease Control (NCDC), in partnership with the ministry of health has invested in thermal cameras that are placed at international airports in the country.
Thermal cameras are designed to capture and record temperature variations on the skin for medical diagnostic purposes, in that, a rise in body temperature serves as a red flag for health workers designated to work at the airports.
Other tests, including quizzing travellers about their health status and travel history are also carried out.
However, unlike some other countries, travellers arriving in Nigeria are released into the country after the basic checks and they are advised to self-isolate in their homes if they suspect any symptoms.
But it is hard to determine if such measures would be adhered to by travellers who must have come from China since the outbreak of Covid19, in the absence of a dedicated monitoring system.
A medical doctor who pleaded for anonymity criticised the safety measure being carried out by the government. According to him, it is safer for the government to quarantine travellers from Wuhan through the incubation period of the virus, which is 14 days.
” The Nigerian government asking travellers from China to self-isolate is wrong. If there is no one to monitor them, they might not corporate and that can be dangerous,” he told The ICIR.
However, Dr. Nsofor, stated that the self-isolation advisory is a standard procedure. He, however, expressed concern that the government had no way of monitoring the travellers after releasing them into the country.
According to him, it would be alarming if anyone displaying symptoms at the airport was identified and there are no facilities to quarantine them.
The ICIR tried to reach out to the Lagos State health commissioner, Akin Abayomi, who in several tweets has updated the public on the government’s preparedness level for coronavirus in the state, but he didn’t respond to messages sent to his social media platform.
To observe the method in which travellers are checked at the airport and to determine the effectiveness of the self-isolation advisory method employed by the federal government, The ICIR wrote to the Federal Ministry of Health asking for access to the arrival terminal of the Nnamdi Azikwe International Airport.
The request was submitted on January 30 to both the Permanent Secretary and the Minister of Health but at the time of filing this report, it was discovered that while the letter has been approved, the Director of Port Health Services, who is in charge of granting approval, has been absent from the office.
Meanwhile, the minister has revealed that N71 million was released to the Port Health Services Division of the ministry to handle and manage cases of Coronavirus.
The minister also announced that Nigeria would spend N620 million special intervention fund to monitor, detect and contain the deadly Coronavirus. He stated this when he appeared before the Senate Committee on health, Punch reported.
Porous land and sea borders
While the government has worked to ensure that the international airports are manned to an extent, Nigeria’s land and sea borders are still porous – an indication that the preparedness against coronavirus is weak, at best.
Controller-General of Nigerian Immigration Service (NIS), Mohammed Babandede once affirmed that the porous borders in the country pose security risks.
While speaking at a function in Kano, Babandede lamented the inability of Immigration to render maximum control of the 140 recognised land borders in the country.
“There is no country or institution without challenge. Our major challenge at the Immigration presently is the inability to control the 140 borders in the country. We still have unsecured borders and this administration is trying to manage that.
“The borders are so porous and we need to have more border patrol bases and posts and again, enough border patrol vehicles to monitor all border axes,” he said.
To this day, the reality remains unchanged and the rising insecurity levels are a testament.
Dr. Tahiru of UATH confirmed to The ICIR that the porosity that characterises the Nigerian borders is worrying. According to him, if Covid19 were to enter any African country, it would easily be transported into Nigeria given the stream of unmanned borders scattered around the country.
“Because of our porous land and sea borders, Coronavirus can actually come into the country and cause a lot of trouble. This presents a level of susceptibility. It is unfortunate that we have a scenario where people can actually come into the country anyhow, that’s one area we have a problem with but the NCDC is on top of their game.
“But the porous land borders put us at risk and all this wasn’t included in the risk assessment by the World Health Organisation (WHO),” he said.
Re-echoing the words of Tahiru, Dr. Nsofor, stated that porous borders weaken the prevention of importing deadly viruses into the country.
“There are thermal cameras at international airports but let’s not be deceived by that because we have very porous land and sea borders that are not well manned,” Nsofor said in an interview with The ICIR.
He advised that Nigeria must learn to invest in epidemic preparedness before major outbreaks.
In the area of preparedness against Coronavirus or other infectious diseases, Nsofor, said that no country in Africa is fully prepared. He, however, highlighted that NCDC has done a lot in the past three years to create a system for epidemic preparedness in the country.
According to Dr. Nsofor, the NCDC led the coating of epidemic preparedness through the National Action Plan for Health Security (NAPHS) and from that plan it would cost about $80 million to prevent pandemics for Nigeria’s estimated population of 200 million.
He warned, however, that if not done, a study has shown that Nigeria could lose about $9.6 billion in GDP annually if a major pandemic were to occur in the country.
WHO has reported that Covid19 has spread to 25 countries with a total of 73,000 confirmed cases.
With evidence showing the unpreparedness of the country to fully handle coronavirus cases, The ICIR reached out to Mrs. Bob-Manuel Enefaa, the spokesperson of the Minister of Health, to clarify the statement of the minister on Nigeria being prepared for the deadly virus and in response, she reiterated the words of the minister.
When presented with some of the evidence, she said: “That’s is what the minister has said,” ignoring details of the findings contradicting the submission of the minister.
On its part, the NCDC has advised Nigerians not to panic. According to Dr. Olaolu Aderinola, Assistant Director, head preparedness and response, infectious disease at NCDC, a risk assessment on the importation of the virus has been carried out.
It was found that the risk of the virus entering the country is high because of frequents travels between China and Nigeria
He, however, noted that enhanced surveillance is being carried out.
“Every traveller from China is screened with thermal scanners. There are also health officers at the airport to identify sick travellers and if any case is noticed, the person is isolated,” Dr. Aderinola said during an interview with The ICIR.
NCDC has also announced that it has the capacity and reagents to diagnose Covid19.
However, diagnosis is just a part of the whole. There still needs to be facilities in place to handle and manage suspected cases and that is evidently lacking in the Federal Capital Territory.