Via Nigeria Health Watch, an excellent post by epidemiologist Chikwe Ihekweazu: Five inconvenient Truths that the Ebola Outbreak has revealed. Excerpt:
The use of Personal Protective Equipment (PPE) is a rarity in Nigerian hospitals, public and private.
The best information that we have at the moment is that 8 of the 11 infected people in Nigeria are health care professionals. We pray for those still battling for their lives. The truth though is that other than the often dirty white coats that we wear around our hospitals, there is little else that protects health care workers and our patients against infectious diseases. Masks, boots, goggles … the closest many of us have come to seeing them used in health care settings is in Grey’s Anatomy.
In most public hospitals in Nigeria, patients are often requested to buy gloves for their own examination. Right now, as we scramble to respond to the outbreak, there are several procurement contracts being signed for PPE from all over the world. We hope that, as we get this Ebola outbreak under control (which we will), these tools will not end up in shelves and drawers.
We need a complete paradigm shift on our attitude to PPE.
We prefer sanitizers because very few public hospitals have running water.
It is no surprise that the president chose sanitizers over water and soap to demonstrate basic hygienic precautions to take regarding Ebola. Barely any public hospital in Nigeria has running water, talk less of soap.
The preference for sanitizers is therefore not surprising. They quickly sold out in most Nigerian cities after the president’s photo-op. Alcohol-based hand sanitizers can be used in addition to hand washing, but should not substitute for washing with soap and water.
While alcohol-based hand sanitizers (particularly those with 60 percent alcohol or more) can reduce the number of some germs, a study from the Centers for Disease Control and Prevention reveals that hand sanitizers don’t reduce the spread of viruses.
Secondly, they do not work when used on dirty hands, and finally, at N1000 per half litter bottle, they are out of reach for 95% of Nigerians.
The overwhelming evidence shows that hand sanitizers may have some benefits; but soap and water is much better. The proper hand washing technique is described here. Or even better – listen to a podcast in Pidgin English: REASON AM! PODCAST 11.
We are an extremely vulnerable people.
Once there is a crisis, we clutch at straws, filling up places of worship waiting for miracles. No matter how often colleagues have tried to explain that Ebola is not airborne, the “arguments” come back right at you.
When we received calls and messages regarding salt and water, we initially thought that it must be a joke, until we realized how seriously people took this. Newspapers reported on at least two deaths.
More stories emerged of the value of “holy water”, and the famous Nigerian pastor TB Joshua is reported to have sent 4,000 bottles of his own patented holy anointed water to Sierra Leone. Another popular remedy is Professor Iwu’s “bitter kola”.
But nothing could have prepared us more than a pronouncement by the Honorable Minister of Health that Nigeria was expecting the arrival of a substance called “Nano Silver”. It took the intervention of the US FDA to bring to the attention of Nigerians that this substance was a pesticide. This was really unnecessary as a cursory search of the internet would have revealed as much.
Thankfully the Honorable Minister has withdrawn his endorsement and passed the responsibility on decisions on drugs to a Professor Maurice Iwu led committee! The truth is that science does not work that way. But as long as our universities remain the way they are, we will continue reaching out for miracles.
Nigeria Health Watch is now on the Ebola Resources list.