There is no other Stella for Ebola, by Azu Ishiekwene

The most expensive thing in Nigeria is not petrol, not food or medicines, not even cement. It is memory loss – an epidemic that has obviously been escalated by screen addiction from its initial default mode of poor record-keeping and absence of institutional diligence. Nigeria has met Ebola again. Not with the terror of 2014 – which has all but been forgotten – when a Liberian-American named Patrick Sawyer walked into Lagos carrying a virus and a stubborn disregard for other people’s lives. This time, it’s with a quieter, more bureaucratic alarm – an imported case in Abuja, not from the West but from the east coast of Africa. A 42-year-old woman reportedly arrived from Uganda, developed symptoms four days later, sought care at a private hospital, and tested positive for the Bundibugyo (Ugandan) strain on October 20.

Ebola, this time

The good news is that the patient has been evacuated, is in isolation, and is receiving care. The bad news is that Nigerians have a special talent for treating preparedness like aso-ebi: impressive on D-day and impossible to find at the next occasion. Twelve years ago, Ebola taught Nigeria a lesson written in the blood of health workers. It also gave us Dr. Ameyo Stella Adadevoh, the physician whose refusal to let a highly infectious patient leave helped stop an epidemic before it became a national catastrophe. She paid with her life. Nigeria does not need another such invoice. The current case reads like a travel itinerary. According to the Nigeria Centre for Disease Control (NCDC), the patient returned to Abuja from Uganda through Addis Ababa on October 3. She developed symptoms on October 7, was admitted to a private health facility on October 11, and the NCDC was notified on October 19. Laboratory confirmation came on October 20.

Follow the timeline

That timeline deserves attention. There were 17 days between the index case’s arrival in Abuja and confirmation, and 12 days between symptom onset and notification. In infectious-disease terms, that is not a gap. It is a corridor. Ebola is not malaria. It does not announce itself with a neon sign. Early symptoms such as fever, fatigue, muscle pain, headache, and sore throat can masquerade as ordinary ailments that Nigerians treat with paracetamol, prayer, pepper soup, and the national motto: “It is well.” By October 25, the NCDC said 53 contacts had been identified and were being monitored. On October 26, the patient and her husband were medically evacuated to Switzerland, where she is receiving specialised care.

Once upon a Sawyer

On July 20, 2014, Sawyer, a Liberian government official, flew from Monrovia to Lagos via Lomé. He was infected with the Zaire strain of Ebola, the deadliest of the species. He collapsed at the airport and was taken to First Consultants Medical Centre in Obalende, where Dr. Adadevoh and some of her colleagues took the bullet that could have turned Lagos into an Ebola graveyard. Sawyer, by several accounts, wanted to leave the hospital. He reportedly resisted isolation. In a country where “the customer is always right” has been elevated to a theology, Adadevoh did something – she disagreed with the customer. She and her team kept him in the hospital, alerted the authorities, and began the difficult work of containment. Sawyer died on July 24, 2014. Adadevoh tested positive for the virus on August 4 while caring for him, and died on August 19, 2014, aged 57.

The toll

Nigeria eventually recorded 20 Ebola cases and eight deaths in that outbreak. It was declared Ebola-free on October 20, 2014, barely three months after Sawyer’s arrival. The world called it a success. Nigerians called it a miracle. Both descriptions were true, but neither should obscure the cost: eight people died, including heroic health workers, because one man’s illness met one doctor’s courage. There is a temptation to reduce Adadevoh’s story to inspiration. Nigerians love inspiration; it is cheaper than infrastructure. But inspiration is not a substitute for systems. Adadevoh’s heroism was effective because it was eventually supported by contact tracing, laboratory capacity, isolation, communication, and coordination. The Ebola Emergency Operations Centre, established during that response, became a model praised internationally. It showed that Nigeria could organise when it chose to. Nigeria showed that capacity again with COVID-19 when even first-world countries were confounded.

Forgetfulness meets tragedy

That is where forgetfulness meets tragedy. Nigeria does not lack competence. It lacks consistency. We can mobilise brilliantly for a crisis, then dismantle the machinery once the cameras leave. We build emergency operations centres with the urgency of a man whose house is on fire, only to let them gather dust until the next fire. The 2026 case is a test of institutional memory. Do we still have the laboratories, the trained personnel, the isolation capacity, the surveillance network, the community trust and the political will that carried us through 2014 and COVID-19? The fact that the NCDC was notified on October 19, eight days after admission, suggests the system eventually worked. Every day of delay expands the contact list, deepens anxiety and increases the burden on already stretched health workers.

**What’s different? **

In 2014, Nigerians received text messages recommending bathing with salt water at dawn. Grown men and women, including some who could operate complex businesses and quote economic statistics, obediently scrubbed themselves with salt. It did not kill Ebola. It did, however, reportedly cause injuries and deaths from excessive salt consumption. The lesson was simple: panic is also a public-health hazard. Fear makes people hide symptoms, avoid hospitals, blame outsiders and embrace dangerous remedies. If Dr. Adadevoh could speak today, she would probably not ask for statues. She would ask practical questions: Where are the isolation beds, gloves, gowns, face shields? Are oxygen supplies available, not “available on request,” which in Nigerian English means unavailable? Are health workers trained and insured? Is there a functioning referral system from private clinics to public isolation centres? Are contact tracers properly equipped? Is there a single, credible source of information rather than twelve competing WhatsApp broadcasts?

Emergency love

Nigeria’s political class loves emergencies. An emergency provides photo-ops, special committees, presidential directives and the dizzying grammar of “stakeholders.” One more thing: emergencies are also pipelines for big money and cash-outs. Prevention, by contrast, is boring. It involves maintenance, training, data, procurement and accountability. Perhaps it is instructive that Ebola has visited Nigeria in campaign season, when politicians remember that power resides with voters and move from town to city to village telling deadly lies like the Ebola virus. It will be easier to trace political lies in this season, when politicians are at their mobile best, than to trace a virus.

In memory of Adadevoh

But the truest memorial to Adadevoh is not a plaque. It is a health system in which no doctor has to choose between personal safety and public duty. It is a country where a suspected case is reported within hours, not days. It is an isolation centre that works before the emergency, not one hastily converted from a conference hall after the first alarm. Adadevoh stepped on a virus on our behalf. Twelve years later, Ebola has returned with a different strain, a different city and a different patient. The virus has changed its address. The question is whether Nigeria has changed its habits.

•Ishiekwene is the Editor-in-Chief of LEADERSHIP and author of the book Writing for Media and Monetising It.

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