Peter Dada
Ondo State is one of the 26 states confirmed to have the highest cases of monkeypox. Though the identity of the victims were not revealed, it was gathered that the disease was reported in seven local government areas of the state and government and other stakeholders rose swiftly to avert its spread to other local governments. It came at a time the state battled Lassa fever disease.
The monkeypox disease is a viral disease transmitted to human beings from animals with the National Centre for Disease Control confirming that cases had increased to 277. Between January 1 and August 28, 2022, suspected cases stood at 704. The report also showed that six deaths were recorded so far in six states of the country.
The World Health Organisation noted that Nigeria has the highest monkeypox death toll and confirmed cases in Africa. The organisation’s Regional Director for Africa, Dr. Matshidiso Moeti, stated this during a virtual press briefing tagged, ‘Road to defeating Meningitis by 2030.’
Moeti said most of the monkeypox cases were in Nigeria, the Democratic Republic of Congo, and Ghana.
Like other health workers across the country, medical professionals in Ondo State have been working assiduously to combat monkeypox and other diseases in the state. However, their work has not been easy because they also face diverse challenges.
During interviews with some of the workers, they identified increased workload as one of the major challenges facing them due to the insufficiency of doctors and other health workers in government hospitals. Some of them also lamented the issue of inadequate welfare packages for doctors risking their lives to save others.
The Federal Medical Centre, Owo chapter of the Association of Resident Doctors embarked on a two-week warning strike, to press home their demands for more workers in the hospital. Similarly, the state chapter of the Nigerian Medical Association earlier raised the alarm over the matter.
One of the medical consultants at the FMC, Owo, Dr. Abejegah Chukwuyem, said the doctors were facing many issues in the treatment and handling of the monkeypox cases.
The medical practitioner, who is also a public health consultant and community medicine physician, in charge of case management of infectious diseases at the federal government-owned hospital, stated that brain drain was a major challenge that needed to be addressed to save the health sector.
He said, “Monkeypox is one of the emerging infectious diseases coming up again. It has become a source of concern. For us in Ondo State, we are having a series of challenges because we are fighting many infectious disease outbreaks. It is the same set of people (doctors) that are fighting the diseases. For example, Ondo State is one of the states with the highest cases of Lassa fever. Ondo State is the ninth or tenth highest state with COVID-19 cases then in Nigeria. Then, monkeypox came and Ondo State is also one of the highest state with cases in Nigeria. These disease entities are being treated by the same set of infectious physicians, doctors, or public health physicians that have decided to give their best to the cases. It is a huge challenge for us. We have been seeing cases both suspected and confirmed. In most of the suspected cases, victims’ parents or the individuals do not want us to do tests or be labelled monkeypox patients.’’
He noted that monkeypox was a disease occurring with other diseases, citing a case he handled in which the patient was battling leprosy. He added, “We have seen cases in children and adults. Also, a woman from Akure North came with the symptoms in her eyes. What happened was that the skin rashes actually started in her eyes, showing symptoms in her eyes before we later found out the rashes were in other parts of her body. We confirmed that it was monkeypox. But she is doing well now.“
Chukwuyem also noted that the state was recorded as one of the states with the highest cases of infectious diseases such as monkey pox and Lassa fever. He added that the proactive efforts of those in the surveillance department had helped detect cases quickly and take patients’ blood samples to confirm the statuses of such patients.
“Being among states with high cases shows that our surveillance is active. There are many states where the disease will occur and they will not report it probably because of a lack of personnel. What we have done in FMC is to build what we call infectious disease units to accommodate different infectious diseases. Thanks to the hospital’s managing director and the management, NCDC, and the Federal Government. We have buildings for isolation. The one for Lassa fever is separate, the one for COVID is separate and we can also isolate monkeypox patients,” he explained.
Another doctor at the University of Medical Science Teaching Hospital, Akure, who spoke on condition of anonymity, told Sunday PUNCH that brain drain in the state hospital was affecting the work at the facility’s infectious disease section. The doctor said that a few doctors and health workers were doing many jobs. He also cited the issue of delay in getting the result of samples collected, saying the samples which would be sent to Abuja often spent days before the results were received from Akure.
The doctor said, “One of the problems we have is the challenge of brain drain. We have many doctors that have left the state, maybe to another state or outside the country for better offers. The situation makes the work in the infectious disease unit to be more and the government is not really doing much about the matter.
“Another challenge is the issue of sample collection. There is a need to decentralise the sample testing centre because everything is done in Abuja. When we collect the samples of patients with monkeypox, for instance, we have to take them to Abuja where the testing centre is. It will take many days before we will get the results. In the process, some patients will become impatient and curious and start disturbing us and at times, they become violent. However, monkeypox is a disease that is real and here with us. We are fighting it and by God’s grace, we are winning.”
A nurse at the UNIMEDTH, who gave her name only as Akin because she was not authorised to speak with journalists, described the infectious disease department as a special unit in the hospital requiring a special package from the government. She, however, stated that the reverse was the case in Ondo State as doctors, nurses, and other health workers in the unit were not getting enough from the government.
The nurse said, “We are not getting the best package from the government in terms of welfare and the work is enormous. That is why many medical practitioners are leaving almost daily. Another problem we have is the patients themselves. When they have an infection, some of them, instead of coming to the hospital so that their samples will be taken but they won’t. They would rather engage in self-medication. We have not been relenting in combating the disease to curtail its spread.’’
However, despite the challenges, the Ondo State Epidemiologist, Dr. Stephen Fagbemi, said that the state was not doing badly in the health sector, stressing that the government was proactive regarding catering to the people’s health.
Fagbemi said, “We are one of the states that take the issue of health seriously. It is not good for a state not to bother or for health workers in a state not to be aware of what is happening. Monkeypox is sporadic all over the country but we do our best because we are serious about the epidemic. In fact, we have the structure. Every day we insist that if anybody sees anything they should let us know. We collect samples and send them to Abuja for confirmation. People have been working for years at the hospitals and they know their worth in a system that is open and transparent. There is no week we don’t send samples and many of our samples always return negative. Those cases you see, I think about 13 reported in Ondo State are the ones that we have. We sent about 60 samples because we are serious. In Ondo State, we take health seriously because we are still battling Lassa fever. Everybody in the sector, even in the private sector, is trained to know that if they see something, they have to call us. We take their samples and manage them effectively.
“We have treatment sites in FMC, Owo. We also treat them at the special disease hospital, Akure and another thing to add about monkeypox is that not all cases are serious. There are some cases we have that don’t really require hospital admission. Maybe by the time they present themselves, their case is almost resolved. We do a follow-up and we ensure that they are well isolated in the house. We handle our cases well. We have also done well in the area of sensitisation because the cases I told you about are showing up, it is as a result of the sensitisation we are doing. We have done radio jingles and we have also embarked on community engagement. That is why people are coming to the hospital rather than hiding underground and they are confident that when they come, we treat them and the treatment is free and there is no stigmatisation. So when it comes to the issue of health and money pox issues, Ondo State is one of the states that are doing well. Though we are not there yet, we are conducting training for health workers across the state. We do training, not only on monkeypox but also use the opportunity to build our capacity on similar diseases.’’
In the same vein, the state Commissioner for Health, Dr. Awolowo Ajaka, said that the state was working towards addressing the problem of brain drain by improving the welfare of the health workers in the state.
He stated, “The state government is doing everything possible to ensure that the welfare of health workers is given priority. We don’t just want to employ health workers. We want to have data to know how many doctors we have and the optimal level of staffing. We want to redistribute our personnel, not just saying we don’t have enough personnel in certain local government areas while we have many in another local government area.”
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