Nigeria in the Time of Ebola

http://www.nytimes.com/2014/09/06/opinion/adewale-maja-pearce-nigeria-in-the-time-of-ebola.html

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LAGOS, NIGERIA — People avoid shaking hands here these days. The government is urging us not to. This is a serious matter in a country where a casual “hello” is downright rude and everyday greetings involve elaborate rituals based upon age, rank and even the state of the weather and the day of the week. Until about a month ago, it was by no means unusual for two friends, male as well as female, to remain hand-in-hand long after the protocol of the greeting was complete. Now not so. The Ebola scare has introduced a new awkwardness in social relations.

I first heard about the government’s call to avoid shaking hands from a priest at Mass three Sundays ago. It was not long after the Ebola virus had landed at the Lagos airport on July 20 in the person of Patrick Sawyer, a Liberian national and naturalized American citizen who had fled the Liberian capital Monrovia in hope of better treatment in Nigeria. He died five days later, by which time others had been infected, whereupon the Lagos state government, in collaboration with federal authorities, was quick to promulgate the message: Avoid physical contact, wash your hands frequently, and leave it to professionals to handle the dead.

While the country’s myriad radio stations broadcast the warnings, the authorities also asked churches and mosques to spread the word. (Most Nigerians are profoundly religious, and even many nonbelievers attend services, compelled as often as not by neighborly tradition rather than pietistic pressure.)

Working from the airline passenger list and hospital patient information, the authorities were quickly able to develop a comprehensive list of those who came into contact with Mr. Sawyer, and sent medical workers to locate those who might have been exposed to the virus. Some 200 people were put under observation until the 21-day incubation period had passed.

The authorities wanted to avoid the panic and mayhem that occurred in Liberia, and I have to say (though I usually find very little to praise in any government in Nigeria) that the speed and efficiency with which the Lagos State authorities reacted was exemplary. It seems as if the virus has been contained in this city of 20 million people. Agence France-Presse reported this week that 320 people suspected of exposure to the virus have been certified clear and released, and that another 41 remained under surveillance.

But the situation here and elsewhere is still uncertain. Despite all the precautions, one of the nurses who had treated Mr. Sawyer managed to escape a poorly guarded isolation ward and travel to the southern city of Enugu. Her name was never released, and it is not known why a professional nurse would suddenly take flight. In any case, the Enugu state government was quick to act. All of the 20 or so people she is known to have come into close contact with during her daylong trip from Lagos were located and placed under surveillance. Though the nurse, who apparently did not know she was infected, has since been reported to have died, there have been no reports — so far — that any of the people she came in contact with have been infected.

People in Port Harcourt, the oil capital in the south, have not been so lucky. Another suspected carrier also escaped from a Lagos isolation ward. Unlike the nurse, he allegedly knew he was infected. The doctor he consulted died of Ebola on Aug. 22, according to the World Health Organization. The doctor’s wife, who was flown to Lagos for treatment with her three-month-old baby, is also said to have died, according to local media reports. The infant’s fate is unknown. The authorities say the man who infected them may be tried on manslaughter charges. W.H.O. officials said this week that there were three confirmed cases of Ebola infection in the city, and that some 200 people remain under surveillance there.

The tendency to panic in the face of a deadly virus with no known cure is of course understandable, especially given the stories that have been coming out of Monrovia and elsewhere in West Africa. Foreigners from suspect countries are regarded warily. Just recently, the Lagos police, acting on a tip from fearful neighbors, raided a hotel and arrested 39 people, 35 of them from the Democratic Republic of Congo. The others were from Senegal, or Sierra Leone, depending upon what newspapers you read.

There have also been the inevitable quack cures, as well as traditional herbal remedies from folk doctors. In one bizarre case, claims that drinking and bathing in salt water would prevent infection flooded the Internet. A surprising number of people apparently believed it. Two are reported to have died from drinking salt water, and another 20 have been hospitalized.

Yet it is remarkable how calm most people have remained. Not that they aren’t taking precautions. The other day, for instance, a bank security guard offered me some of the hand disinfectant that most people seem to carry about these days, as did the owner of a local cafe I frequent.

There is little doubt that quick action by the authorities has generated a broad sense of civic responsibility that is rare in Nigeria. Even the federal government, otherwise so mired in corruption that it is helpless in the face of our home-grown Islamist insurgency, appears to have taken an atypically responsible approach. Despite the perennial distrust that most Nigerians have toward any government statement, the fact that the virus has so far been relatively contained has given this nation of skeptics hope that our leaders can govern, once they put their minds to it.

Nevertheless, fear remains that Ebola may yet spiral out of control. Another death was reported here this week, this one at the Lagos University teaching hospital. It is said, though not confirmed, that the health workers who attended to the victim were not wearing the recommended protective equipment.

This does not inspire confidence. Though United Nations officials have praised the way Nigeria has handled the threat so far, the nation’s health minister warns that “a few” more cases are likely. In the meantime, most of us are crossing our fingers, rubbing our hands with disinfectant, and carrying on as best we can. Meanwhile, newspaper cartoonists are having a field day dreaming up alternatives to the handshake.

Adewale Maja-Pearce is a writer and critic, and the author of “Remembering Ken Saro-Wiwa, and Other Essays.”