With great concern about the state of affairs of the health sector in our nation, the leadership of National Association of Nigeria Nurses and Midwives expresses heartfelt displeasure and lamentation on the recent re-emergence of LASSA FEVER in one of our Federal Teaching Hospitals at Abakaliki, Ebonyi State in the South Eastern region of Nigeria. The outbreak which was confirmed by the Nigeria Centre for Disease Control on Monday, 15th of January 2018 has already claimed THREE LIVES among the cluster of health care professionals. Let me use this medium to commiserate with the families of the deceased and the professional groups the gallant health care professionals belonged.
The reappearance of this deadly and dreaded haemorrhagic fever poses a great challenge to and put to question the effectiveness of Nigeria disease surveillance, medical research, preventive health care services, diseases control and human resources development for health as well as the adequacy of attention of health care professionals to personal preventive precautions and the appropriateness of our health care financing.
As a professional association we are compelled to state that in Nigeria as a country, our state of resolve to promote wellness, preparedness to prevent communicable diseases, strategies for early detection and assurance of accessibility to prompt, efficient, affordable, timely, and equitable distribution of human resources for health, health facilities and services call for critical reappraisal as the current state of things cannot deliver our expected minimum requirements for sustainable national health care services.
To compound our situation is the current focus of the Federal government as being championed by the Federal Ministry of Health towards privatization and commercialization of the health industry. This attempt at placing and pricing profit over people is spelling doom and will make the susceptible majority of Nigerian citizenry to be more vulnerable to ill health while the privileged minority will be eating fat on the fortune of the unsuspecting masses of Nigeria. In addition, presently our hospitals are not well equipped with Personal Protective Equipment (PPE) and the culture of noninclusive policy formulation, the culture of corruption and destroyed goodwill and team spirit have made things worse in our health sector.
Moreover, it is pertinent here to mention that Nigeria is in the bad habit of neglecting well trained health care professionals to waste away while we still clamour for insufficient experts. In Nigeria today, Public Health Nurses distributed all over the states and Local governments of Nigeria are being underutilized, not recognized and not being assigned duties relevant to the expert training they acquired; this is an issue of suffering of adversity amidst surplus. Public Health nursing empowers the public health nurses to be the appropriate personnel with skill, resources and expert services in public health care services being used in other African countries, USA, Canada, UK, other part of Europe, Asia and other continents of the world with great successful outcome.
At this juncture, our professional association want to counsel every Nigerian to take the expert health advice of the Nigeria Centre for Diseases Control, Epidemiological sciences and knowledge of preventive Nursing on the useful tips on prevention of Lassa fever. Lassa fever as a viral hemorrhagic disease, is capable of being spread through direct and indirect contact with items contaminated by exudate from an infected source either with rodents’ urine or faeces, or the saliva of the rodents that touches food items. The Lassa viral agent is transmittable though zoonotic chain, between human and animals through urine, faeces, or other secretions of a person infected with the haemorrhagic fever.
Prevention of this diseases is better and far more efficient as well as cost effective than its treatment. Since healthcare professionals are highly vulnerable, nurses in particular are more susceptible. Nurses and other health care professionals should religiously and sacredly adhere to universal disease prevention, standard precautions, regulations, techniques and devices. This is not a time to panic or taking any unscientific measures but rather be vigilant and cautious, utilizing the knowledge and expertise of personal preventive techniques. We are not unaware that there is no vaccine for Lassa fever, but the succour here is that the disease as much as dreaded can be prevented.
Nurses and other health care professionals should take proper hand washing technique very serious and discountenance attitude of contempt to aseptic technique, environmental hygiene, personal hygiene and food hygiene. It is important to also avoid unhygienic interactions between man and other creatures living and nonliving in our environment.
Nurses and all other health care professionals should insist on the adequacy and proper distribution of PPE in the discharge of their professional duties so as to prevent paying the supreme sacrifice while serving the nation and caring for the needs of our clients. It is hereby advised that all patients presenting with signs and symptoms of fever should be directed to do RDT – Rapid Diagnostic Test for malaria parasite to identify or rule out evidence of malaria in all clients at outpatient departments, in emergency care, ante natal clinics and intra partum especially those presenting with malaria and other high grade fever in pregnancy. It is our view that the occupational health and safety courses in nursing should be strengthened. And many more should be trained and deployed appropriately.
In summary sacrificing self does not portray sense of responsibility and committed to duty and a life loss in human resources for health is colossal as well as a set back to the mission of attainment of our nation health target and agenda.
As a professional Association we are committed to the maintenance of health of the public. It is necessary to educate the masses not to panic and only need to take to experts’ advice in order to remain healthy. Our environment determines our healthiness, therefore our environment, our food and our body should be hygienically sound and free from reservoir of infection or disease causing germs. As a person and society we are the architect of our pleasures, comfort and wellness and otherwise.
The hand washing exercise is to be religiously observed. Live in well ventilated, hygienic houses free of rodents, insects and water logged areas and eat only hygienic food. Mothers should ensure the hand hygiene of their children, use well covered container that is rodents proof to store food stuffs. Waste and refuse disposal has to be in accordance with internationally accepted techniques, methods and technology to ward off incursion of rats into our abode and residences. The sources of our water supply should be given adequate attention to be sure we take only pure, portable and hygienic water.
All churches and mosques, community development associations, peer groups, trade groups, artisans and technicians associations should engage in health education on health care promotion and illness prevention.
In events of any death, the families should not resist process of contact tracing, quarantine and all other care required to prevent the spread of infection.
The government at the federal, state and local government levels should be genuinely committed to public health care services and personnel, to adequately finance health care services, desist from privatization of public health care services in the name of the Nigerian version of Private Public Partnership that is enmeshed in misery and corruptible practices but rather strengthening public health care services and safeguarding the nation’s health. The provision of PPE should not only be given lip services and must follow adequate procedure of equipment procurement guidelines. Health care policies must be all inclusive and not be limited to any group of professionals.
In addition, the government should sit with professional associations to discuss introduction of health care insurance for health care professionals, this will ensure the professionals’ sense of assurance and confidence that in events of accidental and untimely death from work place hazard their families will not suffer.
The present victims and those that died during Ebola as well as earlier casualties of Lassa fever should be immortalized and their salaries paid to their families up to the time they will be due for retirement, as compensation and consolation for their families.
In case of any new incidence of the outbreak of Lassa fever, the Federal and State governments should be prepared to take up the cost of treatment. Burial of any victims should remain the responsibility of federal government to curb the danger of the spread.
It is desired also, that the FMOH should present the names of these martyrs for posthumous national merit awards. They are heroes and heroines who paid the supreme sacrifice in the course of discharging their responsibilities.
Health care financing demands the involvement of all stake holders and therefore the federal government should provide leadership for all that holds stake in health and inculcate the private sector in contributing to health care financing as a mark of corporate responsibility distinct from doing business with our fragile public health.
The government should publicize the National guidelines for Infection Prevention and Control not only at the public hospitals but to include private health care institutions. The guidelines on Lassa fever and other haemorrhagic fever case management should be publicized, financed, and disseminated to Federal, States, local governments health facilities, Missionary and Faith based health organizations, and also interpreted into Nigerian major languages to attract patronage, acceptability by traditional birth attendants to aid early detection, and referral of suspected cases of Lassa and other haemorrhagic fevers. The battle is for all of us as a nation, the mass media organizations, education institutions, law enforcement agents, Civil Society Organizations and traditional institutions to join hand and put the menace of the re-emergence of this calamity of Lassa fever under check.
Just like Florence Nightingale did it in her era by reducing the mortality rate at army barrack drastically to give hope to the hopeless, nurses are prepared to be in the vanguard of health promotion, control of epidemics, early detection and appropriate as well as prompt care to the victims. The contribution of Florence Nightingale remained unbeatable in the history of epidemiology using her theory on environment and use of adequate hygiene to proffer needed solution to the dangerous trends in the morbidity and mortality rate.
Nurses are always there when the sick and vulnerable need attention and care.
Nurse Adeniji A. Abdrafiu