A friend of mine on Facebook posed an interesting question: “Say someone infected with Ebola landed at JKIA. How do you reckon our government would respond?” It is a legitimate question currently bedevilling African nations as Guinea, Liberia, Sierra Leone, and now Nigeria, struggle to manage the epidemic. There are direct flights from the three affected nations to 36 airports in 35 countries, most of them African. Among these is the Jomo Kenyatta International Airport, East Africa’s busiest airport.
The recent spread of the Ebola virus to Lagos, Nigeria, showed just how easy it is for the disease to spread. A consultant for the Liberian government, Patrick Sawyer, was travelling with a high fever that had first been thought to be malaria. He began vomiting during the flight and should have been quarantined during the flight and on arrival to Lagos. Instead, he came into contact with about 59 people on the flight, and was moved to a private hospital before he was eventually quarantined.
This sad state of affairs points to the lethargy of most national health and security systems to the dangers of the Ebola epidemic. Despite the fact that the virus has been known since 1975, African countries are still slow to respond and hardly ever act in concert to stem its spread. The result has been the confirmed infections of over 1300 people, the highest in recorded history of the Ebola virus among human primates. The previous record was held by the 2001-2002 outbreak of the Sudan ebolavirus in three Ugandan districts. There were 425 confirmed cases, 224 of whom died.
The current species of the virus is the highly infectious Zaire ebolavirus (EBOV), which was also the first to be detected in 1976. EBOV was first diagnosed in Mabalo Lokela, a 44-year old schoolteacher from Yambuku, Zaire (now Democratic Republic of Congo) and was then detected in 284 people, 151 of whom died. The new disease, then thought to be a haemorrhagic fever, was named after the nearby Ebola River. It is now known to be a virus disease with haemorrhagic symptoms. 1976 was the same year that a different but less lethal species, the Sudan ebolavirus, was diagnosed in Nzara, Sudan. The question remains how many of these deaths were preventable through early screening and sufficient barrier nursing. In countries such as Uganda that have suffered several phases of different species of the virus, management time has reduced and practices are continually improving.
The 2007-2008 Ebola outbreak in Uganda took about four months to manage, for example, although these were still four months too many. Although Kenya has been lucky so far, it is only a flight away from having the virus passing through one of its newly-renamed terminals. It would be interesting to see how such a case would play out, given the current lethargy towards public safety and security. In December 2011, a 29-year old waitress called Gladys Muthoni was rushed to the Kenyatta National Hospital. She was haemorrhaging profusely, leading first responders at the hospital to suspect it was the dreaded Ebola virus. What followed was a spectacle that should send a shudder down the spine of every Kenyan.
Muthoni’s body was left in the taxi that ferried her there for six hours as the healthcare system scrambled to respond. Her would-be saviours, who included her father, were quarantined in a secluded section of the hospital and guarded by a mean-looking Administration Police officer wearing a face mask. What’s even more interesting is that one of Muthoni’s sisters, seemingly distressed, tried to breach the barrier despite the speculation that her father too could be infected by whatever had killed Muthoni.
The three quarantined patients were later transferred to the City Council Hospital in Dandora for the night. From here, Muthoni’s father, Gibson Kagoi, sneaked out and went home to get a fresh change of clothes. By his own admission, he then passed by a nearby bar and downed two beers before sneaking back into the hospital for the night. Test results released the next day showed that Muthoni had succumbed to a bad case of pneumonia and not Ebola and the country promptly sighed in relief and moved on. The utter recklessness by Kagoi and the healthcare personnel who should have watched him like a hawk was never punished.