Nigeria: Ebola virus disease - Emergency Plan of Action Final Report

Situation Report
Originally published


A. Situation analysis

Description of the disaster

Since the first case was reported in Lagos, Nigeria on 20 July 2014, the Nigeria Red Cross was actively involved in the Ebola response in various ways. Mr. Patrick Sawyer arrived at the international airport in Lagos presenting with signs and symptoms of Ebola and was taken to a private hospital where he was attended to before he died 4 days later. In the process a number of people who attended to him contracted the Ebola Virus Disease (EVD). The Ebola cases spread to Port Harcourt where a primary contact of the first case went for treatment. A total number of 21 cases and 8 deaths were confirmed and 891 contacts were recorded and followed up throughout the country. A total of 12 people were discharged. Nigeria was declared Ebola free on 14 November 2014.

Summary of response

Overview of Host National Society The Nigeria Red Cross in collaboration with IFRC country office trained a total of 354 volunteers in Lagos, Port Harcourt, Oyo, Kaduna, Edo and Enugu to respond to the Ebola operation. The primary focus of the response was in Lagos and Port Harcourt whereas in other towns preparedness activities were undertaken. A total of 22 trainers from the states were trained on Ebola prevention and Psychosocial Support (PSS). Some volunteers conducted contact tracing, infection control and hygiene promotion, social mobilization/ health promotion while other volunteers were involved in screening in and out bound passengers at the international and domestic airport in Lagos. It is important to note that 10 volunteers are still working at the International airport in Lagos

Overview of Red Cross Red Crescent Movement in country IFRC supported the National Society to combat Ebola following the five pillar approach spelled out in the Ebola regional framework. These include: (1) Beneficiary Communication and Social Mobilization; (2) Contact Tracing and Surveillance; (3) Psychosocial Support; (4) Case Management; as well as (5) Dead Body Management, Burials and Disinfection. However in Nigeria only the first three pillars were applicable Overview of non-RCRC actors in country The Federal Government, State Government of Lagos and partners were proactive in the response. An isolation ward was identified and equipped swiftly including identification and allocation of appropriate staff and materials. A coordination centre – incident command centre (ICC), was established and leadership command established to coordinate the response. The Incident Command Centre to which NRCS and IFRC belonged made decisions on how to handle day-to-day issues through established committees. At the beginning there were coordination challenges, however, this was addressed when the Federal President through the Federal Ministry of Health (FMoH) appointed an Incident Command Manager (IM). The ICC was managed through committees with expertise in contact tracing, infection control, case management, health promotion and social mobilization, training and logistics/HR. Partners and Government structures were grouped in these committees where action plans were developed and implemented.

NRCS in collaboration with the Federal Government and state governments carried out assessments in Lagos and Port Harcourt. However, the additional towns of Edo, Enugu, Oyo and Kaduna were identified through an assessment as risk towns because of having international airports.

NRCS with support from IFRC was part of the initial assessments conducted by the Federal Government. IFRC and NRCS sent two health staff to be part of the coordination team at the incident command centre in Lagos and Port Harcourt where daily assessments and reviews of the response was being done. Routine group planning meetings for contact tracing, infection control, case management, social mobilization, training and coordination were held and Red Cross participated and contributed to the road maps. In Port Harcourt, the Branch staff regularly attended the meetings at the command centre where reports of the various working groups were reviewed on a daily basis. The Red Cross was a main source of information at community level due to its spread through the network of volunteers and the Government relied on it for up-to-date data.

The Nigeria Red Cross worked in collaboration with other partners at the Incident Command Centres (ICC) in Lagos and Port Harcourt which included the Federal Ministry of Health (FMOH), State Ministry of Health (SMOH), WHO, CDC and UNICEF.

In-country fundraising efforts took place. Discussions with Shell, Exxon Mobil, Japanese Embassy and ECHO were held however the efforts did not yield much results because the outbreak was immediately contained.

Risk Analysis
During the implementation of the appeal there were lots of myths about Ebola. In addition there were lots of fears among volunteers and family members about getting involved in the Ebola activities. Some volunteers who were involved in the response were discriminated against. A limited number of volunteers reported being dismissed from their employment and there were no mechanisms to seek redress.

Since the disease was contained quickly, there were no plans put in place to continue with preparedness activities in other states. There is a gap in preparing states to contain any Ebola outbreak if it occurred.

No. of people we have reached
As a result of the assistance, a total of 900,000 people were reached. The 5 million target was not reached because the outbreak was contained early in Nigeria. The majority of people benefited from life-saving messages on prevention of Ebola. The people that were reached adopted preventive behaviours.