Thursday, August 7, 2014

Ebola: the least of my worries

Abuja is in the centre but where I will be working is in Jigawa State in the north
The flying time to Nigeria from Sydney  was just on 24 hours with a three hour stopover at Hong Kong and another three hour stop over in Addis Ababa. The contrast between the two international Airports could hardly be greater, as HK was massive, clean and brilliantly organized and there was a huge range of  Duty Free shops – which didn’t interest me – and food places – which did. I enjoyed Tandoori cooked Lamb Chops with Naan bread and yoghurt, a couple of Coke Zeros and the free wifi.

The Bolle International Airport  building in  Addis looks quite impressive from the outside, a sloping three story glass frontage facing the tarmac but inside the vast halls there was almost nothing to do. There were far too few seats for the numbers of people milling round in transit, there were two tiny toilets with long queues, the Loudspeaker system was unintelligible, forget WiFi -  Internet wasn’t even available at the Internet Kiosk where the woman said it had been down since yesterday,  the Duty Free shops stocked only cigarettes and a limited range of spirits and their staff were slumped in their chairs half asleep. I managed to get some money changed into Birr, and bought a weak Cappucino and had one of the three greasy old chocolate croissants that were on offer.

The last leg to Abuja was only four hours and I had two empty seats beside me. There was a lot of cloud and I only had  glimpses of the land below until we were approaching the airport. The landscape was green and crisscrossed by a network of dirt paths and tracks between the scattered huts and family compounds, and then rough roads appeared, and closer to the city freeways which were only half finished, partly sealed, overpasses unconnected to crossroads. Clearing customs and finding the waiting driver with his MSF teeshirt didn’t take long and soon I was at the MSF accommodation, being shown my room, and after a little food, catching up on sleep. It was around 3pm local time but about 1am Wednesday back in Australia. 

In the morning we left the Compound and were driven to the MSF headquarters for rounds of introductions and debriefings. Ordinarily the extremist attacks by Boko Haram would have been our main concern, as there have been many but this week Ebola was the main topic of discussion and everyone is very worried about it. There is growing fear that a tsunami of cases is about to spread outwards from Lagos, because even though there have only been two cases, in the past Ebola has only occurred in small easily isolated rural communities - but now it has managed to infiltrate one of the most massive chaotic and crowded cities in the world where identifying and isolating  new cases will probably prove to be impossible, such is the poor state of the Public health system in this country, its lack of preparedness and the highly mobile population. Theres a feeling we are on the edge of a cliff and are going to go over in the next few weeks...

Later in the day I discovered I was standing on the edge of a cliff of my own, when a vague blurriness of my vision that I had noticed on the plane the day before seemed not to be getting better, as I had expected it would after a decent sleep. In fact when I crudely tested my vision there seemed to be a serious problem with my right eye - and when I finally managed to do some reading on the internet as all patients do these days I concluded I might be suffering a retinal detachment, an eye emergency that requires urgent surgery to prevent progression to complete blindness in the affected eye. 

Its a disconcerting feeling to realise you might need expertise thats unavailable , that I might go blind in one eye and probably no be able to operate, and also unpleasant is the feeling that I might be going to have to let  MSF down - or more importantly the women I was coming to support - if indeed I did have a retinal detachment.

I felt badly and didn't want to make a fuss but realised I had to do something straight away, because arrangements had already been made for me to head north to the project in a small country town 7 hours drive away, leaving first thing in the morning. I spoke to the Head of Mission, who was a GP from Burkina Fasso and asked her to look into my eye but she was reluctant - she said we had to find a specialist eye doctor to look at it, and so began ringing around. By now it was 6pm, and it took a couple of hours for her to find a Private Clinic way over on the other side of the city, called the Eye Foundation Hospital.  We went there and it appeared to be closed...but in the end, after paying 20,000 Nira - a vast sum for this place - the clinic was opened and the eye doctor came and examined me.

He said there was no sign of retinal detachment, much to my relief but raised some other worrying possibilities that will have to be investigated further. He thinks I have suffered an acute vascular event causing ischemic optic neuritis, but he is not certain yet so in the morning I will be going back for more tests.  Terrorists and ebola haven't been on my mind much at all today, but once this eye thing is sorted they may be. The newspapers and TV is full of shocking pictures of blown up cars and the wreckage from various terror attacks in many places around he country, but so far none in Jigawa state where I hope to eventually arrive and get to work.

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