Ebola: Nigeria’s 1,479 illegal borders may spread virus

L-R:A Médecins Sans Frontières medic treats a suspected Ebola patient in Kailahun, Sierra Leone. Health workers carrying the body of an Ebola virus victim in Kenema, Sierra Leone... on Thursday. Photos: Dailymail.co.uk

There are fresh fears that porous Nigerian land borders may thwart the Federal Government’s efforts to check the spread of the deadly Ebola virus in the country.

Saturday PUNCH’s investigations revealed that the porosity of Nigerian land borders exposed the country to the risk of the deadly disease.

At the last count, there are about 1,479 illegal routes into Nigeria through which smugglers, undocumented immigrants and terrorists have been infiltrating the country.

Checks also show that port health officials, who are usually deployed by the ministry of health in border points, are not available at many of the unauthorised routes where individuals infected with Ebola virus could access the country without let or hindrance.

Findings revealed that the 114 regular border posts manned by immigration and health officers, were inadequate to protect the country from Ebola virus which could be imported into the country through infected migrants and even documented visitors.

Although visitors to Nigeria are expected to possess the International Health Certificate (Yellow card), investigations show that most foreigners using the international land borders do not have the document.

Investigations by Saturday PUNCH indicated that the Nigerian Immigration Service, with 23,000 workers, and other security agencies do not have the manpower, material resources and capacity to secure even the normal legal and massive borders and prevent infiltration of the country by immigrants infected with Ebola disease.

Thus, infected persons, who do not show symptoms of the virus can easily enter through the land borders as the deadly Ebola disease may not be obvious to the health officials and immigration personnel at land borders.

Nigeria, being a hub of economic activities in the West African sub-region, is an attractive destination for illegal migrants from Chad, Mali, Niger, Cameroun, Togo, Benin Republic and other countries.

Though the Federal Government had issued a health advisory to port health officers and the immigration service personnel, Saturday PUNCH’s investigation showed that they were not given enough equipment that could assist them in the task of identifying and isolating infected persons coming into the country.

Ebola is an acute viral illness and often characterised by fever, intense weakness, muscle pain, headache and sore throat.

These are followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.

Experts, including the Medical Director, Clinical Research Physician, United States, Dr. Hezekiah Adesanya, said that Nigeria was at the risk of the disease through land borders.

Adesanya said the Federal Government should set up Ebola quarantine centres at land borders like it did in airports.

He stated that the possibility of the disease spreading through land borders is worse than air and sea ports because more people preferred roads as a mode of transportation.

“Due to the long travel from Liberia to Nigeria in cramped and close proximity, potentially infected people have more time to interact and opportunities to “touch” and therefore spread to co-travellers,” he stated.

Advising Nigerians going through land borders, he said, “Be careful and observe the same care; no touching of anyone. If anybody manifests any of the symptoms, inform the driver, evacuate the bus and get the person to the nearest health facility which is to be isolated immediately.”

According to him, the Federal Ministry of Health should liaise with ECOWAS and the WHO to set up health posts along the ECOWAS highway.

On his part, the Vice -President of the Commonwealth Medical Association and former President of the Nigerian Medical Association, Dr. Osahon Enabulele, said, “Indubitably, there is a possible risk of Ebola Viral Disease spreading to Nigeria on account of the highly active migration activities at all of Nigeria’s land borders, including the active and unrestricted movements of immigrants from afflicted African countries such as Guinea, Sierra-Leone, Liberia and Ghana.”

He called for the re-orientation of the Nigerian border patrol and health staff as well as the strengthening of the disease surveillance mechanisms at the land borders.

Enabulele stated, “The spread can further be buoyed through contact by uninfected persons with persons infected with the Ebola Virus following contact with infected bodily fluids, blood and blood products or the consumption of infected animal meat products by unsuspecting persons migrating through Nigeria’s land borders.”

Also a reproductive Endocrinologist, Prof Oladapo Ashiru, said that the virus could spread through contact with infected blood or infected body fluid, eating infected meat, bush meat or monkey.

He stated, “Some patients may experience rashes, red eyes, hiccups, cough, sore throat, chest pain, breathing difficulty or difficulty in swallowing things, internal and external bleeding. The symptoms may appear between 2 to 21 days after exposure to Ebola virus, though 8-10 days is most common, the average is 5 – 8 days before becoming ill.

“Some who become sick with Ebola virus are able to recover while others do not and the reasons behind this are not yet fully understood.

“However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death,” he added.

He also advised Nigerians to ensure frequent use of sanitisers, exercise care in contact with bodily fluids, use of soap and sanitiser on getting to the house before shaking hands, and that meat sellers should quarantine their meats for some time before slaughtering.

Ashiru said that sanitisers should be in cars, ladies’ hand bags and around the office places, adding that care should be taken when dealing with fresh fruits.

“Avoid ‘suya’ for now unless you are very sure of the source of the meat; meat and other food items must be frozen and properly stored,” he said.

According to the United States Department of State, you cannot contract Ebola virus by handling money, buying local bread or swimming in a pool.

Another expert, Dr. Rotimi Adesanya, said “Health workers need to make sure they are fully and universally protected by wearing double gloves and safety goggles to prevent any transmission.”

The medical expert said, “People need to get tissue paper, so that when they use it to cough, they throw it away. Handkerchief is not advisable because when they use it, they put it back in their pockets and still use it moments later, thereby transferring it to others through handshakes.

“Hand washing at every point in time is also very important, be it after driving, coming from public places, coming from toilet because hand washing has been found to reduce any form of germ drastically.”

The Federal Government, in a bid to check the spread of the virus, had on Sunday agreed to set up isolation disease centres at international airports in Nigeria.

The Coordinating General Manager, Aviation Parastatals, Mr. Yakubu Dati, had said the Federal Government had commenced screening of international passengers suspected to have the virus.

The National Primary HealthCare Development Agency, told Saturday PUNCH that it had put its workers on the alert to check the disease.

But the Executive Director of the NPHCDA, Dr. Ado Muhammad, in an email to one of our correspondents, said that the possibility of Ebola virus patients crossing land border was very unusual.

The Director, Disease Control and Immunisation, Dr. Emmanuel Abanida, who sent the email on behalf of the executive director, stated, “The EVD runs a very rapid course. That means there’s no luxury of time for infected patients to really roam about borders. That’s the truth.

“Contagiousness is almost at the height of clinical illness and presentation by the infected individuals. Most sick individuals, therefore, may be too weak to crawl the border areas. The possibilities are however that crossing the land borders by patients are possible; this is thought to be very unusual.

“This assumption, however, excludes localised practice of bush meat hunting and consumption, which are controllable through intensified public/community enlightenment in the border areas.”

Explaining efforts of the agency, he said, “Guidelines have been issued to frontline(PHC) workers across the country (especially health workers at the border areas) on the steps to take in early warning signs, surveillance and case management of case(s)/suspected case(s) of EVD.”

The Immigration Service Public Relations Officer, Emeka Obua, assured that the service was collaborating with the Ministry of Health to secure the borders and prevent infiltration by EBV carriers.

Obua stated that NIS personnel at the borders and airports had been issued hand gloves and masks to protect them from contact with infected persons, adding that they are working with health officials who knew the symptoms to look out for in infected persons.

He noted that the men had been directed to quarantine anyone that showed the symptoms of the disease and to limit their exposure to such infected persons.

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