Lassa fever as a metaphor for failure

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Apart from portraying the poor state of Nigeria’s health care system, the rising incidence of Lassa fever in the country reveals an enduring characteristic of the Nigerian government — the customary failure to act on time and decisively. This characteristic is reproduced from government to government with every government typically struggling to fight back only after it has been beaten on an issue several times over. Even where it lies within the government’s power to act, such as preparing a budget and getting it passed, it takes forever to do the right thing, year after year.

True, this has been the culture of governance in Nigeria since independence; it must be admitted that this culture has grown into an obsession. That’s why, as Jiti Ogunye put it last Sunday on Sunday Politics, hosted by Seun Okinbaloye on Channels TV, it is like waiting for a calamity to happen before taking action. What is worse, such action often is neither effective nor is it the right thing to do.

This culture of failure is revealed in the haphazard fight against corruption, which has taken more money from the treasury than the government has spent on the people; in the handling of the Boko Haram insurgency, which has killed thousands of people, and continues to kill and abduct people with impunity; in the ongoing conflicts between herdsmen and farmers, which have led to the wanton destruction of lives and property; and in kidnapping for ransom and armed robbery, which have also led to loss of lives and property.

In every case, successive governments have been so slow and late in their responses that enough room was created for the problems to grow out of hand. What is worse, little or no attempt was ever made at a holistic solution to be encapsulated in an enduring policy. Rather, ad hoc solutions were often proffered, which applied in one particular situation and not in others, even when faced with the same problem.

Unlike the other four problems listed above, which involve human agency, Lassa fever is caused by rats. Not all rats, but a particular kind of rat, known as the natal multimammate mouse. It is distinguished by the female’s multiple and prominent mammary glands. These rats carry the Lassa fever virus and pass it on to humans through their saliva, urine, faeces, and other body fluids. Once infected, a human can also pass it on to other humans, including healthcare workers taking care of an infected person.

The history of this virus and its migration pattern across the country is a sorry case of government neglect. When Lassa fever was first discovered in 1969 in the village after which it was named in Borno State, the government did nothing to educate the public about the deadly virus nor did it take necessary steps towards exterminating the carrier rat.

Indeed, the virus probably would not have been discovered then but for the deaths of two infected missionary nurses, who were infected in Lassa village in 1969.

Ever since that time, the number of deaths from the virus has been growing steadily, reaching a peak of 62 deaths recorded in 2012. That was the time that the test kit for detecting the virus should have been ordered at least for every state capital in the country. Instead, between 2012 and now, only three centres have been equipped with the appropriate testing capacity for Lassa fever in the country, namely, Lagos State University Teaching Hospital, Irrua Specialist Teaching Hospital, and the National Reference Laboratory in Abuja.

To complicate matters, the 2012 peak has now been surpassed. According to the Nigerian Centre for Disease Control, 90 deaths occurred from 1,081 suspected cases of Lassa fever between January 1 and February 25, 2018, that is, within a mere two-month period!

Today, the Lassa fever virus has spread across Nigeria and, indeed, across the West African region, including Liberia, Ghana, Sierra Leone, and Guinea. The number of reported cases ranges from 400,000 to 500,000, resulting in about 5,000 deaths a year.

What is significant about the Nigerian case is that rats were once a delicacy for many a youth in many parts of the country.  When I was growing up in the 1940s and 50s, killing rodents with traps or catapult was a pastime for the youths in various farming villages. The main targets were rats and squirrels. Traps were set in the rats’ dens in the bush near the village, while squirrels were targeted on trees or on the ground with catapults loaded with small pebbles or stone chips. The resultant harvest would be roasted on open log fire and devoured with relish.

Over the years, however, rats have gradually infested the domestic sphere, feeding on stored grains and other food items. This is especially true of the multimammate rat, which carries the Lassa fever virus. That’s why it is now a life-or-death decision to store food and other household items away from rodents and other pests.

Food items should be stored in air-tight containers, while cooking utensils, including pots, frying pans, knives and spoons as well as plates, dishes, glasses, and silverware should be kept away from pests.

The ultimate safety precaution, however, is to maintain clean households and a sanitary environment and to dispose of garbage far away from the house, rather than just in the backyard.

To be sure, the NCDC is trying its best by working in collaboration with the World Health Organisation and local hospitals in minimising the outbreak. Nevertheless, the resources and necessary facilities needed to cope with millions of potential patients are just not there.

What is even worse is the near absence of nationwide public enlightenment about the virus, how to prevent infection, and how to manage it after infection. Yet, this is very important because there may be more unreported cases, especially in the rural areas, than reported cases.

It is necessary to educate the rural illiterate population, especially in the farming villages throughout the country, using, for example, properly illustrated brochures, which could be distributed by Local Government Council staff.

By whatever means, Nigerians need to know that this virus can kill within two to three weeks of infection. However, if detected early, it can be treated with ribavirin, which is the only available drug for treatment at this time. Unfortunately, no vaccine has been developed for the virus.

It is also important to know the symptoms of the infection include fever, headache, abdominal pain, diarrhoea, nausea, vomiting, cough, and many more. The symptoms manifested by each infected patient depend on the severity of the infection and the patient’s immune system.

The problem with the symptoms is that they can lead to wrong diagnosis, because they could be conflated with the symptoms of other infections, such as malaria and typhoid. That’s why if these two infections are ruled out, then care must be taken to test the patient for Lassa fever.

The bottomline here is that federal, state, and local governments should act fast to arrest the developing outbreak of Lassa fever in the country. As usual, Lagos State has taken the lead in this regard by educating the public and ensuring that homes, offices, markets, motor parks, bus stops, and parks are regularly fumigated. Even rat killers were distributed to households and market women. Environmental sanitation is also vigorously encouraged.

It will be very unfortunate to keep losing human lives, when tomatoes were saved from tomato Ebola and efforts are in top gear to save cattle. If so much energy and resources are being invested in establishing colonies for cows, then needed attention and resources should be devoted to saving humans from the Lassa fever virus. The government’s human face is sorely needed at this time by all citizens.

Source: Punch newspaper

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