Monthly Archives: August 2014

HIV In The Time of Ebola (LUTH Chronicles and Doctors’ Strike)


Almost as soon as it was decided by the doctor, it was one month and time for me to go for my checkup. I do not know any other time I was more reluctant to go to the clinic than this time. I had a lot of personal issues on my mind and the news of the Ebola vurus finding its way to Nigeria added to my apprehension about going to a hospital.
Ebola. That was one word Nigeria never believed would enter its vocabulary. And in terms of misfortune and ill luck, the country could have done without this epidemic. (As at today 7 people have been quarantined with 5 of them testing positive and one dead from the virus.) I imagine the general emotional atmosphere in the country can be summarized in feelings of helplessness, overwhelming fear and neglect. Kind of like how I felt when I was pregnant and assailed with a multitude of issues. There have been kidnappings, extra-judicial killings, massive corruption, Boko Haram/ terrorism, and now there is Ebola. A virus that has no known cure, is super-contagious and makes no distinction between caregiver and patient. Suddenly we are scrutinizing our neighbours, suspicious of every cough and irritated by every unguarded flick of the arm. The fear of Ebola is the beginning of antisocial behaviour.
I wasnt the only person worried about  infection by the Ebola virus, it seemed. At some point while we were sitting and waiting to be attended to, one woman half-jokingly remarked that she wanted the clinic to speed up the consultations to reduce our chances of being exposed to the Ebola virus. As if on cue little pockets of discussion about Ebola began all around the gathering. One group which involved a misinformed healthcare worker pondered on how doctors were always the first to be infected by any virus naming SARS and swine flu as examples. Another group was in agreement that HIV was a much better virus to contract. One woman right behind me was particularly informed, talking about  preventive measures and ‘shutting down’ a lady who had started on the ‘we reject it in Jesus name’ path by emphasising the need to prevent not pray.
Ignorance and denial are a major factor in the spread of disease in Nigeria. I know this for a fact, and have spoken about this severally, with reference to HIV. Ignorance allows people to unwittingly continue unhealthy practices that perpetuate the transmission of the illness and/or prevents them from seeking a proper medical solution to it. Denial is worse because in this case people are deliberately constituting a hazard to the health of others. And it is helped by over zealous religious and cultural practices. There are those who still go to churches to seek solution to their HIV+ status even though clinics exist. There are those who have not bothered to ever check their status but engage in high-risk behaviour. Then there are the ones who know their status, seek treatment but do nothing to protect their partners and loved ones. My fear now is if we have people like this with an illness as treatable as HIV will we not have this with Ebola? The incubation period is 3 weeks at most, is that not enough time for damage to be done? For the person to move inter-state before he/she is weakened by the disease? How many of his primary contacts would they have been able to trace then?

America tried a secret serum on its two citizens infected with the Ebola virus and they are said to be in stable condition. I hear Nigeria is requesting that trial drug and honestly I do not know if I want that request to be granted. If the country’s handling of the HIV APIN and PEPFAR schemes have been anything to go by -and they have- then for a long time people will be dying of Ebola even when the serum is available. Poor people. The serum will be super-expensive if sold, or if dispensed free in a controlled situation will only be available to the super rich, highly connected and healthcare staff. And leaving such critical life-saving decisions in the hands of the present crop of staff I meet at the clinic is not a happy prospect. I will explain.

When the Ebola- centred discussion was going on one lady made to go into the consultation rooms to get her vitals done but a member of staff stopped her saying there was no light (electricity). Probably thinking the staff did not understand the lady explained that she was only going to get her weight and blood pressure checked. “There’s no light!” the staff screamed, grumbling about ‘all these people who dont listen’. (For some reason when the electricity goes out, everything stops even if it is in broad daylight where everything is visible.) Two ladies to my left were very disgusted with the rudeness of the staff and began discussing among themselves how one matron was the only courteous person in the whole building. I was surprised they still felt that badly because the general reaction all the years I had been coming there was for these people to act as if it was okay to be spoken to rudely. The doctors barely even glanced at you when you sat in front of them -I know mine didnt- except you said something to startle them. They were rude, curt and condescending and explained nothing that was not absolutely necessary. (After receiving my CD4 count results -which had risen by almost 20 points- I took the stub of paper to the doctor who said ‘youre ineligible for drugs’ and gave me my next appointment date.) But they had friends who they skipped the queue for, attended to while you stood waiting and so on. Would you trust them with a much-needed serum if Ebola came knocking?
It is these doctors’ attitude that earns them almost no sympathy from the public on this strike they have begun. Almost every Nigerian has a story about the shoddy treatment they receive in public hospitals from doctors and healthcare staff. I have shared mine here. These are people who take out their remuneration frustration on the patients; why will they then ever put their lives on the line all in the name of containing Ebola? They do not treat pregnant women with any care so why would they treat any patient well who has a 90% chance of dying?

Whatever the case, this is one time where HIV does not seem that bad afterall. I mean look at inconsistent me getting healthier without medication. In discussions with my teen and preteen neighbours about Ebola the general concensus was “HIV is better o”. I just wish we had a responsible government that understood its priorities not one that loots with impunity.