The African Continent has seen the worst outbreak of the Ebola virus disease (EVD) formerly known as the Ebola Hemorrhagic fever. This disease cause fatal illness in humans. The virus is transmitted to people from wild animals and spreads to the human population trough human to human transmission. In Ebola virus disease fact sheet released by the World Health Organization (WHO), the fatality rate is around 50% initially, however, case fatalities varied from 25% to 90% in the past outbreaks. During the first outbreak of EVD, remote villages were affected in Central Africa near tropical rain-forest but recently most rural areas were affected.
A team of medical professional from Ghana were sent by WHO to these centers affected by this misfortune namely Guinea, Liberia, Serra Leone and some surrounding countries in the region. A senior scientist amongst the team spoke to the Medical Journalists Association of his experiences and the preparedness of the Ghanaian community.
Mr. Augustine E. Sagoe is an Immuno- virologist and a Chief Biomedical Laboratory Scientist at the Central Laboratory of the Korle Bu Teaching Hospital in Korle Bu, Accra. He was the former Laboratory manager of the Central Laboratory Services, Medlab Services and has served on various institutional boards across the African continent. He has been on call since the 70’s when this deadly disease appeared in Central African. He has had many experiences in this area.
Mr. Augustine Sagoe started by saying that the experience he had in the countries he visited was a worry to him and therefore Ghana is not ready at all for this misfortune or any other outbreaks for that matter. He says “Ghana do not have the facilities to curb and manage this disease once it hit us and to worsen the case our borders are porous”. He further said “I have seen the worst of this disease and I can tell you its nothing to be joking with. I tell you today, Ebola will come again and I pray it does not hit Ghana or any country for that matter, we are not prepared”.
“When we first got to Monrovia, it was terrible in fact it was a terrible sight. People were dying here and there, on the road, the streets were virtually empty. Lots of lives were lost due to this outbreak”. Mr. E Sagoe with one scientist, BMS Agyemang, traveled to Liberia when the outbreak was at its peak. Their first travel was to train some health workers how various ways of managing the disease.
A team of medical professionals was sent by the World Health Organization, West Africa. The team was made up of 39 individuals of various health background. Mr. Augustine happens to head the medical team from Ghana. The “Manhyia” had its first group of the medical team dying (“Laboratorians”). “My first encounter in Liberia was with a lady who joined the medical team from Liberia was told she lost a close relative of hers a day before made him throw up” says Mr. Sagoe.
“Africans cultural diversity was one major challenge that the team face” Say Mr. Sagoe. There are certain rites that needs to be performed when one loses a relative. This was a major hurdle for the team that was sent to these centers. Locals around the areas sometimes refuse to give up dead bodies of affected persons to be taken care of by the professionals. They claim, some funeral rites have to be performed before these relatives are buried. Most often than not, these funeral rites involve handling the corpse which makes it difficult to handle or contain the disease. “We have a particular group of persons who will wash the corpse with water and sprinkle it on any outsider who will come and pay his or her last respect to the dead. Well you see, Africans are very particular and strict when it comes to their customs and practices. It was a difficult task but we have to do our work and our work was to contain the spread. Obviously, this was not helping. We had to involve the government and other stakeholders. I must confess this was our major hurdle. There was yet another group who came to hold hostage our place of work and demanded that we release a corpse who was a royal. They needed a ring from this individual who was wearing it when he died of the Ebola virus. We explained to the group that it is not possible to give it out but they still insisted. It was hell. I was away from our place of operation after I have worked for some long hours but I was called to come. Hmm, how we resolved that issue still remains a mystery” Says Mr. Sagoe.
One other thing that affected their work as a team was the fact that those doing the burying the affected individuals sometimes had to bury their whole family. “How would you feel if you find out your whole family died of Ebola? I remember once the team was called to quarantine a house that was affected by the disease, not knowing one of the team members has his relatives in that particular house. I was really saddened by what I saw. The next day most of the team members left their work and I understood why they left. Because it is a difficult work to do, burying your own family whiles taking care of others. These were a few experiences” Says Mr. Sagoe. Most of their colleague refused to work with them because of stigmatization and discrimination. Locals from those centers refuse to associate themselves with them. “Even when we got back to Ghana after our first trip, it was not easy associating with our fellow Biomedical Laboratory Scientists in the laboratory let alone our family members. It took some time. There was stigmatization everywhere” narrated by Mr. Sagoe.
After their first trip, the authorities at the Airport allowed them in even though they had indicated where they are coming from. No checks were done on them. He had to go to Cape Coast to quarantine himself for 21 days, after which he narrated everything that happened to some authorities. “This was my deepest fear being manifested” Says Mr. Sagoe. His narration forced the Ministry of Health to purchase three walk- through temperature detector machines. These machines are able to bring out the heat signatures of the virus in humans thereby making it easy to locate any one effected with the disease. The Ebola Virus strives well in heat. These machines were placed at the Kotoka International Airport, Aflao Border (Volta Region in Ghana border with Togo) and Eluba (Western Region shares border with Cote d’Ivoire).
The team was quarantined in La Cote d’Ivoire for 21 days after their second trip. The government offered nothing to the team. Mostly the team relied on some donations that they were given. They worked selflessly to manage the situation in Liberia. “It is on record that my team was the only team who had no incidence of infection or deaths, other teams, example American soldiers team Centre for Disease Control, Cuban team, Chinese team, Swedish team etc had an incident of infection” Says Mr. Sagoe.
“I will recommend to the Ministry of Health and all agencies to put in much in terms facilities and modern equipment, a level three bio-safety laboratory and well built infectious disease centers. Nuguchi cannot do all the work” Says Mr. Sagoe. He concluded by appreciating the efforts of his team members and admonish the government to put in structures to monitors these outbreaks. He went on to say that various training programs must be organised at least every six months for various health professionals to show our preparedness in case there is any out break of that sort.