FIU College of Medicine Professor Dr. Aileen Marty crisscrossed Southern Nigeria for 31 days this fall leading an international team under the auspices of the Nigerian government to rapidly contain and extinguish the Ebola outbreak within the country’s borders.
Marty, an infectious disease expert, was called on by the World Health Organization in August to join the Global Outbreak Alert and Response Network team on the ground in West Africa. The Ebola outbreak is the largest in history, affecting multiple countries.
In Nigeria where Marty was assigned, international health experts moved quickly to assist Nigerians in preventing the disease from spreading into the crowded, urban slums of major cities, or out into the impoverished areas beyond the cities.
“Nigeria is by far the most densely inhabited country in Africa. It is very densely populated with the overwhelming proportion of individuals living in highly impoverished areas,” she said. “If Ebola had gotten into those areas of Nigeria, the explosion of disease could have been huge and catastrophic. It was a critical international threat that needed intensive efforts. We poured our energies into this and are pleased that we definitely accomplished what we set out to do.”
Marty’s task as the World Health Organization’s lead in the international Points of Entry Team was to empower Nigeria to secure international and domestic air, land and seaports to ensure no one infected with Ebola entered or exited. This required training screeners, doctors, nurses and others to recognize and distinguish potentially infected persons while maintaining their personal safety.
It also required developing processes and securing needed equipment and resources. Marty worked with her team of WHO, U.S. Centers for Disease Control, and Nigerian experts to successfully solicit donations of equipment and other resources from Airport Managers, Air France, Shell Oil, Heineken, Chevron, Exxon Mobil, private donors and international aid agencies.
Working from dawn to almost midnight every day in challenging conditions – like spotty electricity and no hot water — Marty helped coordinate with local transportation officials to create assessment protocols to pinpoint those potentially infected with the disease and helped establish medical screening practices and triage areas.
“The biggest challenge was the work to secure the land borders, particularly those with Benin because West African tribes move back and forth between borders,” she said. “There are about 85 legal border crossing points operating over Nigeria’s 2,500-mile land border compared with over 1,400 illegal crossing points.”
One state she visited, Ogun, just northwest of Lagos has more than 83 known illegal crossing points. “So while we worked with authorities to secure the legal crossing point in Seme Border with Benin, we knew we had to enlist the help of local chiefs to help secure the illegal crossing points.”
Marty also worked at the Ebola Emergency Operation Center (EOC) contributing to multiple projects including a public awareness campaign to encourage citizens who might have been infected to come forward. Treated as soon as possible after becoming symptomatic, patients can and usually do survive Ebola, she noted.
“This was a big message: Do not hide if you have been in contact with someone who had Ebola because the sooner we treat you, the better your chances for survival individually and the less chance there is that you will harm someone you love or a member of the community,” she said.
Marty brought her many years of experience in public health crisis management to Nigeria, where she spent considerable time training fellow physicians and others on proper protocol to stay healthy and to identify, triage and isolate individuals at risk for Ebola. She spent 25 years as a Navy doctor traveling the world and treating diseases like leprosy, dengue, malaria and Ebola in Africa.
This particular strain of Ebola, she said, is not airborne. Transmission requires contamination of broken skin or rashes, eyes, or mucous membranes (mouth, nose, sexual tissues, etc.) with infected bodily fluids (blood, sweat, tears, nasal secretions, emesis, etc.) from living or dead infected persons or animals.
“It is critical to keep your hands super clean,” she said, of the daily regimen used by any team member who went to the treatment wards. “Exiting from the high containment ward required a bleach shower. It’s like bathing in a badly done swimming pool. You shower in bleach to kill the virus and then, after you are safely out of the containment area you can shower again in regular water to remove the bleach.”
After a month, Marty felt confident the EOC team had largely contained the outbreak in Nigeria and helped to create a legacy that will prevent the future importation or exportation of dangerous diseases in Nigeria.
“Even though the numbers weren’t big in Nigeria, Ebola affected every Nigerian. It closed schools. It affected air travel. It affected the oil industry. It’s a huge social and economic burden,” she said. “And had it spread, it could have been a national and international crises. So I feel very good about the work we did there. We made a difference.”