Obinna Odogwu, Abakaliki
It was like the world was coming to end in Ebonyi State sometime in May 2014, when 22 health workers, which included doctors and nurses, working for the Federal Teaching Hospital, Abakaliki (FETHA), were put in ambulances and driven out off the state in a long convoy.
They had contacted the deadly Lassa Fever virus and had to be swiftly taken to Irua Specialist Hospital in Edo State for immediate quarantine and treatment. Failure to have done that may have resulted to their death.
During the period, many patients and their caregivers, upon learning that the large number of health workers had contacted the deadly virus and had all fallen seriously sick, deserted the hospital.
Since 2005, when the virus was first discovered in the state, about 40 health workers had died of the deadly virus. Many patients have also been killed by it. With that in mind, residents of the state, especially the ones in Abakaliki, the state capital, were scared.
However, miraculously, all the 22 health works who were ferried out of the state survived. To them, their survival was simply the handiwork of God. They testified that if not God, they would have all died.
At a recent event held at the second phase of the hospital, FETHA II, where a Lassa Fever observation bay donated by a team of doctors from Belgium known as Medecins Sans Frontieres (MSF) was commissioned, some of the survivors told their story.
One of them, Dr Ngozi Ugwu narrated her story:
“In May 2014, I was rounding off my ward round in FETHA II, main ward there, and then the HoD Paediatrics called me, saying that they have a baby that was bleeding there.
“I quickly rounded off my ward round and went to FETHA 1 with some of my resident doctors for us to see the child. We went there and saw the child bleeding into muscles; the whole muscle compartments, joints, bleeding from the mouth.
“So, I started asking questions as to what happened. And I then realized that the mother presented to the Ophthalmology and Gynaecology Department with bleeding and O and G Department conducted diagnosis of abruptio placentae and they started managing; took the woman to theatre.
“They did surgery and carried the baby straight from the theatre to the newborn. And then, the paediatrician decided to observe because they were like there is possibility of sepsis because of the history of the abruptio placentae. So, they took the child to the newborn to observe.
“So, when we came, they said that the mother had passed on because of bleeding. We said okay, let’s concentrate on the child first; later we will know what happened; that whatever happened to the mother may be related to what is happening to the child.
“So, we finished our review that day. When we came back two days later, they said that the child had passed on. But we continued to investigate the case. We didn’t even think of Lassa Fever because of the way the child was presented.
“There was no fever. You know in Lassa Fever, fever is somehow constant, but in this case, there was no fever. And then the type of bleeding is not the type of bleeding we usually have in PHF. The child was bleeding into muscles and joints, which was the kind of bleeding that we usually have in haemophilia.
“So, my first diagnosis was haemophilia. He was a male child and you know haemophilia is also common in males. He was just taken from theatre to the newborn. So, he was not a child that was brought from outside for me to suspect that there was exposure somewhere.
“So, the child died. About a week later, I started having bitterness of the mouth, malaria, and weakness. I thought it was malaria. So, I went and bought anti-malaria drug and took.
“Instead of getting better, I kept getting worse. If it was malaria, once I take anti-malaria drug, within four or five days later, I will get better. But this time around, instead of getting better, I kept getting worse.
“Every day I kept developing new symptoms. I kept going down. Tomorrow I will have nymph node, tomorrow sore throat will develop, next tomorrow diarrhoea and vomiting, the next day another one will come up.
“You know the way they usually show it on the television; all those symptoms you usually see there. When I took anti-malaria drug it wasn’t better; I took ACT but I wasn’t getting better.
“At a stage we said okay, probably there is an awkward infection somewhere; let’s start antibiotics. I started antibiotics like today in the evening; the following morning I started bleeding.
“I was having watery diarrhoea. I was not able to eat. So, when I started bleeding, they said that I would die of hypoglycaemia. Let them just put glucose in the water so I can drink because I was not able to eat anything.
“I was having sore throat. So, even the glucose in water was difficult for me to take. It was so bad. I kept going down. My colleagues would call to ask how I was doing, but I would respond that I was going oh! That I don’t know what was happening to me.
“During that period, I was not able to go to work. I didn’t know that my residents that also went to review that child with me were also sick. And they were also not coming to work. And then, the paediatricians that also managed the child were also sick, including the nurses that were working in the newborn.
“What exposed everything before everybody started walking up and down was that the person that was supposed to be on call in the paediatrics was sick. He was also one of the persons that managed the child.
“He now called their chief resident to make arrangement for somebody to take his call because he was sick. But the chief resident was also sick because she was the person that took me to the child.
“She said that she managed to call another person begging him to take this person’s call that he was sick and would not be able to take his call. Unfortunately, that person he called was also sick.
“She called the next person that one was also sick; she called yet another person and that one was also sick. She called another person and that one was also sick. It was at this point that she started thinking on why everybody was sick at the same time; that malaria does not present in that way.
“She reviewed the past activities and it dawned on her that all these people had contacts with the suspected case. That was when she now raised the alarm; called her HOD to inform the chief of the situation; that the general sickness also affected the haematology team.
“The CMD then, Dr Ezeonu, mobilized all the ambulances that same day. It was a rapid response. It was 22 doctors and nurses that were involved. It was the highest number so far and yet it was zero morbidity.
“So, the following morning, they mobilized all the drivers that have the courage to be in the same vehicle with us. He called the CMD of Irua Specialist Hospital; that they should get ready that 22 doctors and nurses were coming.
“So, the following morning, all the ambulances lined up and they started arranging us in them. People were crying as if the world was coming to an end here. After the arrangement, we all moved in convoy. Some person joined us with their private vehicles.
“By the time we got to Irua, they were ready. The CMD and his team were running around to ensure that we were properly attended to. They admitted all of us and took our sample.
“When they analyzed our samples, they said that my own was negative. But, because of the signs and symptoms: very high stubborn fever that refused to respond to anything, diarrhoea, vomiting, sore throat, abdominal pains, everything from A to Z.
“Seeing this, they said that I have reached the terminal stage because I had started bleeding. They ignored the result and started treatment.
“About three days after they started treatment, I started getting some strength; my appetite started improving; the bleeding started reducing, the pains and the sore throat reduced and I was able to take glucose water.
“So, our improvement continued, about 22 of us. We kept getting better until we all recovered and were discharged. We all walked out from the Lassa ward, which was built at an isolated place.
“As we were going, I kept praying. Some of us were even scared to enter inside the ward when we got to that point. Some refused and started going back because it was like they were entering the mouth of death. But I had to summon courage.
“As I was stepping into the ward, I was praying and telling God that we were all going to walk out, including those that were carried inside; that they were going to walk out by themselves. And even the patients that were there when we came, that they were going to follow us and walk out and God answered our prayers.
“Even one boy from Warri who is about 23 years old that was bleeding from everywhere: mouth, nose, and everywhere; passing urine and blood. In fact, everybody had lost hope on him. We kept praying. When we were leaving, he also left with us. Everybody was surprised on how he recovered.”
Another survivor, Dr Ike Chinonye, who secured a job with the hospital a month after her youth service, said that she was about four months pregnant when she was posted to the gynaecology department where she contacted the deadly disease.
She said that she had used her bare hands to handle the newborn baby when she discovered that blood was much and may exterminate him.
She said that the hand gloves in that unit had been exhausted, but she needed to save the baby; hence resorting to using bare hands.
She said that three days later, she noticed that she felt feverish, had body aches, bitter taste in her mouth and got unusually tired. She said that she was admitted in a private hospital and later moved to the University of Nigeria Teaching Hospital (UNTH) in Enugu State from where she was moved to Irua Specialist Hospital in Edo State.
“At a point, I became paralyzed”, she recalled.
According to her, by the time she got to Irua Specialist Hospital, she had started bleeding.
She said that she bore the pain with her pregnancy and eventually gave birth while still battling with Lassa Fever.
“The baby came out crying. I continued to bleed. For long time I had to wait for placenta one hour after delivery. The placenta could not come out. The dilemma was taking me to the theatre.
“The obstetricians could not come close because of the Lassa Fever. It was God that used senior registrar then, Dr Bon Onwe, to do a manoeuvre once after the delivery.
“Initially, they did not allow him to manage me because he was not working there. But later, they allowed him to handle me. He just did a manoeuvre and the placenta came out after one hour.
“I continued to bleed and at a time I was passing away.
“My baby was not admitted into the newborn, but was abandoned on a wet wrapper just near me. The dilemma was where to keep the baby because of the Lassa Fever because the baby could infect other babies.
“After all these, by the time they delivered the placenta, about four hours later, they took the baby to the newborn. By the special grace of God, the baby survived for 28 days and eventually died”, she narrated.