The outbreak of Ebola virus disease (EVD) in 2014 left out as unprecedented both in the context of terrestrial scope as well as number of cases and decease. The major highlights of the disease were exposed on 23 July 2014 in Lagos State of Nigeria and it had covered nearly 19 laboratory justified EVD cases in that region. The river state quantified out of 2 definite cases, 1 was dying. Measures were directed towards swift implementation, in order to foresee the wide exposure of the disease in the country. It was analysed that the outbreak has affected ten countries in numbers which includes (Liberia, Leone, Guinea, Sierra, Mali, Nigeria, Italy, Spain, United States of America and United Kingdom) which forms part of three continents (Europe, North America & Africa). Moreover, 11,300 people were killed by the consequences of disease and closely 28,000 were infected. Nigeria is the densely populated country located in West Africa. The increased level of population travel across the borders of this country is the root cause of informal spread of EVD. The factors of its high affect in West African countries are justified on the grounds that the region had never experienced an outbreak of such a kind and is unacquainted at every level (Egbule, 2015).
At the same time, the Centralised Ministry of Health declared an emergency in the Nigeria on the account of existence of Ebola virus. The ministry acted in collaboration with the Nigeria Centre for Disease Control (NCDC) for the evolvement of issue. Nigeria was declared by World Health Organization (WHO) as free country from the effects of EVD on October 20, 2014 (Awojobi & Lamptey, 2014).
In order to accomplish the research objectives, following research questions needs to be accessed:
The aim of this research study is to forecast how Nigeria effectively coordinated and contained the outbreak of Ebola virus. While achieving the aforesaid aim, the following objectives will be assessed.
This chapter includes relevant literature review related to the research question. There is no much literature that is documented on Ebola. In the literature review, researchers studied the journals and reports that had been done on Ebola in Nigeria.
Definition of Ebola- Ebola Virus Disease is the viral infectivity that is the reason of a serious disease which can be dangerous if unprocessed. According World Health Organization (WHO), the outbreak of Guinea was the first documented case which was the largest Ebola outbreak ever recorded (Bausa, 2014). There are some high risk factors with this disease i.e. Contact with dead bodies, human body’s fluids and activities with infected people. The key way to protect self is to maintain the highest standards of cleanliness and personal hygiene. Ebola was introduced in the human population by the direct contact with the organs, blood, secretions and other bodily fluids of infected animals like forest antelopes, monkeys and fruit bats (Belpois-Duchamp, Tiv, Astruc & Aho Glélé, 2014).
Treatment-
The first step in the treatment of Ebola is source isolation to prevent spread of infection. Following measures are taken while managing patients affected by Ebola Virus Disease.
The Ebola virus disease had spread to major cities with the channel of international air travel. It forms prominent part of the unparalleled epidemic which started off in Guinea within the era of December 2013. In current time, the virulent infection is the concern in all over the world but there are various health care measures are taken in the Ebola-infected areas. Ebola Virus Disease (EVD) is basically haemorrhagic fever which is challenging societies, health workers and health systems of various countries across the world (Diakite, 2014). It is very important that health workers and nurses are trying to contain the disease effectively and providing safe and secure care to those who are affected with this disease. By the time, this issue has been become a serious challenge for the health sector (Miller, 2016). According to World Health Organization (WHO), Ebola is the serious issue that needs to be addressed on the urgent basis. Due to Ebola, current death rate in West Africa is 50% and now it is affecting other countries i.e. Sierra Leone, Guinea and Nigeria. These are those countries that have unable and inadequate health systems along with widespread poverty. In order to contain the infection, the training is provided to the health workers (Duru, 2016).
WHO and International Red Cross are the part of the international workforce making efforts data collection, treatment, co-ordination and containment. It is observed that infected people are still not getting effective treatment in many countries as there are not enough beds, and aid agencies. Along with this, there is the shortage of doctors, health workers and nurses (Lupamo & Tavakolipanah, 2016). Despite of risks of infection to themselves, nurses, doctors and other health workers with the government and non-government workers are on the ground of Nigeria in order deal with EVD. Overcoming from misinformation and myths is the big part of community efforts to deal with the disease and to get early treatment of the affected people (Gsteiger, Althaus & Shuaib, 2015). For this, nurses need to have special training to stop the disease. According to International Council of Nurses, in 14 districts in the country, around 568 nurses has received training related to Ebola care, information, measures and treatment to prevent its spread including safe burial of death. Along with this, ICN also pointed out the government and organizations need to focus on addressing the impact of Ebola on people by ensuring that they are receiving adequate and appropriate training, protective equipments and support to deal with the disease. It is not easy for the health workers to deal and manage the disease. For instance, it is observed that The Nigerian nurse who cared for the victim has died. Along with this, according to Australian news team report, around 40 nurses are died in every country that is affected by Ebola (Moghadam, 2015).
Ebola Virus disease is a dangerous and highly infectious disease among the infected humans. EVD can be transferred from both infected human as well as animals by the direct contact with body fluids. Presently, there are five recognized types of Ebola virus along with four being recognized in to origin disease in persons. They basically include Zaire Ebola virus, Sudan Ebola Virus, Tai Forest Ebola Virus and Bundibugyo Ebola Virus (Breman, & Johnson, 2014). In 2014, the Federal Ministry of Health coordinated with the appropriate outside bodies authorized that Ebola Virus Disease as an urgent situation and specially made the Ebola incident management Care (IMC). The key objective of IMC was to take actions on the up-and-coming eruption by helping with national response team (Pietiläinen, 2016). Along with this, Emergency operation centres (EMC) were also formed by which all the partner organizations, response teams and volunteers operated. An incident manager was also appointed who was responsible for overseeing the response team and deliver liable feedback to Federal ministry of health in the country. The strategy teams further developed various guidelines and activities for every operational team. The infection control team was prepared in the cases of identifying EVD signs. After identifying situation of EVD by the laboratory teams, the infection control team is accountable for taking care of patients and purifying their environment and environment. Persons who are supposed of disease are kept in isolation at the specialized treatment (Umukoro, 2016).
In order to collect the data related to Ebola Virus Disease and adopted healthcare models in Nigeria, both secondary as well as primary data is used. Articles in newspapers and journal articles are studied in order to collect the relevant data of Ebola Disease. Basically, the data for the study is collected from review of literature and interview method. The success of this study depends upon the readings of assorted documents published on Ebola Virus Disease, the infrastructure of Nigeria, and Ebola outbreaks and their resolutions. Some materials from the World Health Organization, the Centres of Disease Control and Federal ministry of health of Nigeria are studied carefully so that relevant data can be identified for the study. Along with this, various online sources are also used for taking relevant information. Next, questionnaire survey will be done of the head of some hospitals in the country that were involved in dealing with EVD. The selection of participants is done by the sampling methods based on the preliminary list of important contributors. Participants are selected from the international organizations that working or having worked in the Ebola response, NGO founders who worked in the health systems during the outbreak of Ebola and organization that worked with the government in order to communicate about Ebola disease. The questionnaire form will be sending on their email.
For this study, both qualitative as well and quantitative methods are used. In the analysis, both primary and secondary sources are used for the methodology purpose. In the qualitative approach, various journal articles and available articles are studied. Basically, qualitative analysis will be done based on the review of literature presented by various researchers. Further, quantitative data will be collected by the questionnaire method. The questionnaire forms are sent to the customers on their emails (Chilisa & Preece, 2000).
The methods used in this research are both qualitative and quantitative as it includes methodology and design. The method of the study is based on questionnaire. The rational for the selection of the respondents, the distribution of forms and the collection of data are documented. This is the descriptive study that identifies the healthcare models used in Nigeria in order to deal with Ebola Virus Disease. Along with this, the study evaluates the social impact of the epidemic on the communities. By the study, disease control model to contain the Ebola Virus will be evaluated. In the quantitative method, survey is done by the questionnaire as it can provide relevant information about the healthcare practices and measures to deal with Ebola Virus in Nigeria. This method is selected as this allows the questions to be completed in the systematic manner. The survey is widely used to collect the relevant information to specific set of questions related to strategies and practices adapted to outbreak the Ebola Virus. The chosen method provides some specific benefits for this study. It is considered that asking questions with various types of people would provide an insight to the use of healthcare strategies to deal with Ebola disease.
In West Africa, the outbreak of EVD has arisen and disappeared in consort with leaving families and societies in its wake. The number of death recorded in Nigeria was believed to surpass the total of death marked in previous 25 Ebola occurring combined. The major factor behind the spread of EVD was identified as the deficiency of infectious disease surveillance capacity prevailed in West Africa. The experience of an outbreak of such infectious disease was nil. The embedded version of new context from an old disease is favoured as major reflection in spread of EVD. The speedy control of the flow of EVD in Nigeria was expedited by measures of comprehensive contact tracing, in addition the foundation of index case as well as segregation of subordinate cases. The time gap in between of arrival and its detection, thereby allowed for its infectious and deadly speedy coverage.
In the midst of several uncertainties, which formed part of initial limited days of EVD reaction in Nigeria, the regulatory authorities of Lagos Sate delivered the intense leadership along with the joint efforts of Federal Ministry. The massive support of private sector plus international community was hitched using the approach of incident management, which was synchronised by the efforts of EOC. A total of about 894 acquaintances were acknowledged and nearly 18,500 person to person visits were made in regards of assessment of EVD symptoms. Some others tracing exercise implemented involve phone histories and flight exhibits.
For the treatment of cases, secondary in nature initially there was lack of isolation facilities. Priority should be given towards the endowment of isolation facilities and skills enhancement of health care personnel. Considerably, the enactment of former will lead to the out breaking of harmful disease in African settings. Even before the outbreak of EVD in Nigeria, the professionals from the Centre for disease control and prevention (CDC) had directed efforts on the training and development of approximately 100 physicians on the subject matter of epidemiology. As a result, it acted as a robust response towards the threat befallen. The faceoff social enlistment using multimodal policies was an evident factor in response of Nigeria to the disease. There was a crystal clear mirror effect reported with electronic channels i.e. Facebook and twitter. It also ensured the effectiveness of propagating educational constituents. In the adverse circumstances, e-communication devices should be used at the extreme level as it becomes best common platform. Also, it provides wide coverage which could drive behaviour change at great pace as well. The widespread rumour was vital which states that consumption of bitter cola along with salt could antidote EVD (Pharr & Ezeanolue, 2016).
This section includes analysis of data gathered from the answers in the questionnaire. In the first part of questionnaire, personal information of the respondents is given. The information includes designation, age, gender, department, qualifications and year of experience. The information provided by the respondents will be kept confidential. Respondents are requested to not to put their name on the questionnaire form. The analysis of the collected data and information is discussed below:
Section A-
Designation- A total of 20 participants take participation in the research. The participants were student nurses, Hospital Matron, doctors, registered general nurses and environmental health technicians.
Age group- Majority of the participants were between the age ranges of 30 to 39 years. Further, some of them were followed by the age range of 20 to 20 years. The study findings showed that most of the participants were young and active in acquiring more proficiency and information in new circumstances such as Ebola.
Work place and work experience- Around 40% of the participants were working in the ward. Further, 30% of respondents worked in the school of nursing where they were assumed to have relevant information on Ebola Virus. Further, 15% of the participants worked in the outpatient department where they would come first in to the contact of Ebola Virus disease. Next 15% participants worked in the laboratory and have key responsibilities to identify the causative organism of Ebola Virus. Along with this, some of the participants are supervisors of all the health care employees and some worked in the environmental health department
Section B-
Defining Ebola Virus- From this question, it is analyzed that 11 numbers of respondents were able to provide correct definition of Ebola Virus. On the other hand, 9 participants provided an incorrect definition of Ebola Virus disease.
Knowledge of causative organism of Ebola Virus- The respondents are characterized based on the knowledge on causative organism of Ebola Virus. Around 50% of respondents answered ‘yes’. These participants knew about the causative organism of Ebola Virus. On the other hand, 50% of participants answered ‘no’. They did not have knowledge about causative organism of Ebola.
Knowledge of signs and symptoms of Ebola- The pie chart below shows the division of study participants by the information of symptoms and symbols of Ebola Virus. 95% of the respondents in the study answered ‘yes’. On the other, 5% of participants were not aware about the signs and symptoms of Ebola Virus. It is analyzed that 95% of participants had information about the signs and symptoms of Ebola Virus. There are following symptoms i.e. fever, headache, muscles pain, vomiting, rash, fatigue, and internal and external bleeding. But, 5% people did not know about the symptoms (Alli & Ibekwe, 2016).
Knowledge of mode of transmission- Based on the answers, it is observed that 70% of people have knowledge about the mode of transmission of Ebola virus. On the other hand, 30% people still are not aware about the mode of transmission. The study revealed that Ebola can be extended by the straight contact with broken skin, with the spoiled blood and body fluids. But there is the need to provide in-serving training on Ebola Disease.
Incubation period of Ebola Virus- Based on the analysis, it is observed that around 70% of people are aware about the incubation period of Ebola Disease. Further, 30% of respondents of did not know about the incubation period. The majority of participants gave two days as the incubation period. So, incubation period of Ebola Virus is 2-21 days.
Risk factors for contracting Ebola Virus- It is analyzed that 80% of the participants’ area aware about the risk factors of Ebola Virus. So, participants answered ‘yes’. On the other hand, 20% of the participants responded ‘no’. These participants did not know about the risk factor of Ebola Virus. The risk factors include going to the various countries and contact with dead bodies, and human body fluids (MacIntyr & Ajisegiri, 2018).
Training of health workers- In below pie chart, the training provided to health workers on infection control is analyzed. 80% of the participants answered ‘yes’. They were agreed that healthcare workers are trained on the infection control. 10% of the participants gave answer in ‘no’. It means they were not aware about the training of employees on infection control. Apart from that, 10% are not sure about the workers are trained or not. This shows that health workers are trained in infection control (Esangbedo & Iwegbulam, 2016).
Availability of infection control policy- Graph depicts the study on availability of infection control policy. 85% of the respondents answered ‘yes’. It means participants knew that there are infection control policies implemented in departments. 15% of participants answered ‘no’; it means they were not aware about the availability of infection control policies. The guidelines of infection control are available to them properly. This reveals the availability of infection control guidelines in health care facilities (Arrubla, 2015).
Availability of infection control guidelines- The chart displays the study on the accessibility of guiding principle for the control of infection. 95% of respondents revealed that they had knowledge about accessibility of guiding principle for the control of infection. On the other hand, 15% of respondents did not know about accessibility of guiding principle for the control of infection.
Availability of standard operating procedure- In this section, all the respondents gave answer in ‘yes’ that means the accessibility of the criterion operating processes was acknowledged by the all the respondents. No any of the respondents answered ‘no’. The standard operation procedure is shown in all the wards and departments. This demonstrated that standardized actions are taken effectively.
Area with infectious condition- The study reveals that 30% of respondents are aware about the places for the patients with infectious situations like Ebola Virus. Further, 70% of the respondents did not aware about selected regions for nursing patients. So, infection control team is needed to inform all the healthcare employees about the identified areas for the nursing patients with the infectious situations.
Availability of hand washing point- The study focuses on availability of hand washing points. All the study respondents know about the hand washing points in their departments. They use hand sanitizers and liquid soaps for the hand washing. Hand hygiene is important for the treatment of Ebola Virus as virus is transferred by the contact (Chutiyami & Salihu, 2016).
Knowledge educations like Ebola Virus- It are observed that 80% of respondents stated that the health education on Ebola Virus is conducted at all. On the other hand, 20% of respondents stated that health education was not being conducted during the outbreak. The study finds that people have proper knowledge and education about the Ebola Virus disease. The community is well informed about this disease.
Opinion to encounter Ebola Virus- In the given chart, 40% of respondents stated that drill can be helpful to the hospitals to be ready for the Ebola Virus. Further, 35% of the respondents suggested that carrying out workshops could be the best option to prepare hospitals for the Ebola virus. Next, 10% participants recommended that arrangement of hospital attentiveness team can be cooperative to be ready for disease. At last, 15% respondents were not sure on what could be done to be prepared for the Ebola Virus outbreak. In the study, people highlighted that in house training and workshops to prepare the health care workers on Ebola (Otu & Idris, 2018).
The findings of the study actually revealed that healthcare workers are prepared to handle the infected patients. The research also has shown that health education and training trainings was also carried out in the wards. Health care employees had proper knowledge on Ebola Disease. Along with this, Ebola Virus narratives, and strategy are also accessible for the employees.
Conclusion
The Ebola outbreak of 2014 in Nigeria has recorded momentous gains from the management approach extended by private and international societies. After this phase, several sanitary and water facilities were provided in school of Lagos and various other fragments of the country. The habits of timely hand washing should endure in long run as it leads to the minimisation in incidence of infectious diseases. As African subcontinent recuperated from the assault of EVD, measures should be taken for repositioning so that it can breathe in future outbreaks. The experience highlights of Nigeria EVD majorly provide insights of undue significance to monitor these vital improvements. Further, the research objectives were achieved and the study was completed in the set timeframe. It is observed that Nigeria has successfully outbreak the Ebola Virus. The study is managed to reveal there were infection control policies, guidelines and standard operating processes in the healthcare specific to Ebola Disease. Apart from this, the nursing environment was also analyzed. The research revealed that there were designed areas in the healthcare organizations for the nursing patients with the infectious conditions. Further, the research revealed that there was information provided to the people related to Ebola Virus Disease. The research was successful as no participants were forced to participate. The participants showed keen interest in the research. The reasons given in the research revealed that Nigeria is able to outbreak Ebola Virus Disease successfully. The study respondents were completely able to give answers of all the questions asked in the research related to outbreak of Ebola Virus Disease in country. There was limited time for the research so study had significant impact of this factor.
References
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