Dr. Ada Igonoh of First Consultants Medical Centre is one of the doctors who attended to Patrick Sawyer, the Liberian who imported the Ebola virus into Nigeria. She was infected by the virus but she survived, Here is her story of survival:
On the night of Sunday July 20, 2014, Patrick Sawyer was wheeled into the Emergency Room at First Consultants Medical Centre, Obalende, Lagos, with complaints of fever and body weakness. The male doctor on call admitted him as a case of malaria and took a full history.
Knowing that Mr. Sawyer had recently arrived from Liberia, the doctor asked if he had been in contact with an Ebola patient recently and Mr. Sawyer denied any such contact.
Blood samples were taken for full blood count, malaria parasites, liver function test and other baseline investigations. He was admitted into a private room and started on anti-malarial drugs and analgesics. That night, the full blood count result came back as normal and not indicative of the infection.
The following day, however, his condition worsened. He barely ate any of his meals. His liver function test result showed his liver enzymes were markedly elevated. We then took samples for HIV and hepatitis screening.
At about 5.00 pm, he requested to see a doctor. I was the doctor on call that night so I went in to see him. He was lying in bed with his intravenous fluid bag removed from its metal stand and placed beside him. He complained that he had stooled about five times that evening and that he wanted to use the bathroom again. I picked up the I.V. bag from his bed and hung it back on the stand. I told him I would inform a nurse to come and disconnect the I.V. so he could conveniently go to the bathroom.
I walked out of his room and went straight to the nurses’ station where I told the nurse on duty to disconnect his I.V. I then informed my consultant, Dr. Ameyo Adadevoh about the patient’s condition and she asked that he be placed on some medications.
The following day, the results for HIV and hepatitis screening came out negative. As we were preparing for the early morning ward rounds, I was approached by an ECOWAS official who informed me that Patrick Sawyer had to catch an 11 o’clock flight to Calabar for a retreat that morning.
He wanted to know if it would be possible. I told him it wasn’t, as he was acutely ill. Dr. Adadevoh also told him the patient could certainly not leave the hospital in his condition.
During our early morning ward round with Dr. Adadevoh, we concluded that this was not malaria and that the patient needed to be screened for Ebola. She immediately started calling laboratories to find out where the test could be carried out.
She was eventually referred to Professor Omilabu of the LUTH Virology Reference Lab in Idi-Araba whom she called immediately. Prof. Omilabu told her to send blood and urine samples to LUTH straight away.
She tried to reach the Lagos state commissioner for health but he was unable at the time. She also put calls across to officials of the Federal Ministry of Health and National Centre for Disease Control.
Dr. Adadevoh at this time was in a pensive mood. Sawyer was now a suspected case of Ebola, perhaps the first in the country. He was quarantined, and strict barrier nursing was applied with all the precautionary measures.
Despite the medications prescribed earlier, the vomiting and diarrhea persisted. The fever escalated from 38c to 40c.
On the morning of Wednesday 23rd July, the tests carried out in LUTH showed a signal for Ebola. Samples were then sent to Dakar, Senegal for a confirmatory test. Dr. Adadevoh went for several meetings with the Lagos State Ministry of Health. Thereafter, officials from Lagos State came to inspect the hospital and the protective measures we had put in place.
The following day, Thursday 24th July, I was again on call. At about 10.00 pm Mr. Sawyer requested to see me. I went into the newly created dressing room, donned my protective gear and went in to see him. He had not been cooperating with the nurses and had refused any additional treatment. He sounded confused and said he received a call from Liberia asking for a detailed medical report to be sent to them.
At 6.30 am, Friday 25th July, I got a call from the nurse that Sawyer was completely unresponsive. Again, I put on the protective gear and headed to his room. I found him slumped in the bathroom. I examined him and observed that there was no respiratory movement.
I felt his pulse; it was absent. We had lost him. It was I who certified Sawyer dead. I informed Dr. Adadevoh immediately and she instructed that no one was to be allowed to go into his room for any reason at all. Later that day, officials from the WHO came and took his body away. The test in Dakar later came out positive for Zaire strain of the Ebola virus.
It was a sobering day. We all began to go over all that happened in the last few days, wondering just how much physical contact we had individually made with Sawyer. They said we were going to be grouped into high risk and low risk categories based on our individual levels of exposure to Sawyer.
We were all officially under surveillance. We were asked to report to them at the first sign of a fever for further blood tests to be done. The anxiety in the air was palpable.
One week before Sawyer died, I had gone for a retreat in my parents’ house. I was still staying with them when I received my temperature chart and thermometer on Tuesday 29th of July.
I could not contain my anxiety. I soon started experiencing joint and muscle aches and a sore throat, which I quickly attributed to stress and anxiety.
On Friday August 1, my temperature read a high 38.7c. I could not believe what I saw on the thermometer. On Saturday August 2, the fever worsened.
The sore throat was getting worse. That was when I called the helpline and an ambulance was sent with WHO doctors who came and took a sample of my blood. Later that day, I started stooling and vomiting.
The following day, Sunday August 3, I got a call from one of the doctors who told me that the sample which they had taken was not confirmatory, and that they needed another sample. They came with the ambulance that afternoon and told me that I had to go with them to Yaba. I was confused. I asked if they would bring me back. He said “yes.” Even with the symptoms I did not believe I had Ebola. The only time I actually touched him was when I checked his pulse and confirmed him dead, and I wore double gloves and felt adequately protected.
We soon got to Yaba. I really had no clue where I was. I knew it was a hospital. I was left alone in the back of the ambulance for over four hours. My mind was in a whirl. I didn’t know what to think. I was offered food to eat but I could barely eat the rice.
The ambulance door opened and a Caucasian gentleman approached me but kept a little distance. He said to me, “I have to inform you that your blood tested positive for Ebola. I am sorry.”
I had no reaction. I think I must have been in shock. I was taken to the female ward. I was shocked at the environment. It looked like an abandoned building. I suspected it had not been in use for quite a while. As I walked in, I immediately recognised one of the ward maids from our hospital. She always had a smile for me but not this time.
I soon settled into my corner and looked around the room. It smelled of faeces and vomit. It also had a characteristic Ebola smell to which I became accustomed. Dinner was served – rice and stew. The pepper stung my mouth and tongue. I dropped the spoon. No dinner that night.
That evening, the symptoms fully kicked in. I was stooling almost every two hours. The toilets did not flush so I had to fetch water in a bucket from the bathroom each time I used the toilet. I then placed another bucket beneath my bed for the vomiting.
The next day Monday August 4, I began to notice red rashes on my skin particularly on my arms. I had developed sores all over my mouth. My head was pounding badly. The sore throat was so severe I could not eat. I could only drink the ORS.
Every morning, I began the day with reading and meditating on Psalm 91. The sanitary condition in the ward left much to be desired. The matrons would leave our food outside the door; we had to go get the food ourselves.
Later that evening, Dr. David brought another lady into the ward. I recognised her immediately as Justina Ejelonu, a nurse who had started working at First Consultants on July 21, a day after Patrick Saywer was admitted.
She was on duty on the day Patrick reported that he was stooling. While she was attending to him that night, he had yanked off his drip, letting his blood flow almost like a tap onto her hands. Justina was pregnant and was brought into our ward bleeding from a suspected miscarriage.
I drank the ORS fluid like my life depended on it. Shortly after Justina came into the ward, the ward maid, Mrs. Ukoh passed on. We stared at her lifeless body in shock.
To contain the frequent diarrhea, I had started wearing adult diapers, as running to the toilet was no longer convenient for me.
Two more females joined us in the ward; a nurse from our hospital and a patient from another hospital. The mood in the ward was solemn.
On my 10th day in the ward, the doctors having noted that I had stopped vomiting and stooling and was no longer running a fever, decided it was time to take my blood sample to test if the virus had cleared from my system. I prayed that I didn’t want any more samples collected from me.
On the evening of the day Justina passed on, we were moved to the new isolation centre. We felt like we were leaving hell and going to heaven.
The following night, Dr. Adadevoh was moved to our isolation ward from her private room where she had previously been receiving treatment. We all hoped and prayed that she would come out of it, but sadly it was not to be.
Two days later, on Saturday the 16th of August, the WHO doctors came with some papers. I was informed that the result of my blood test was negative for Ebola virus. If I could somersault, I would have but my joints were still slightly painful. I was so full of thanks and praise to God, my husband couldn’t stop shouting when I called him.
I went for a chlorine bath, which was necessary to disinfect my skin from my head to my toes. It felt like I was being baptized into a new life as Dr. Carolina, a WHO doctor from Argentina poured the bucket of chlorinated water all over me.