Interviewed
by the Chronicle News Paper.
Dr Ngwanyam, are you
happy and satisfied with the way we are facing up to the Ebola challenges in
our country?
 |
| Dr. Nick Ngwanyam |
No. We are not doing the
right thing. I know the Minister of Health is
doing his best the way he understands it but the strategy has to be different
and more refined. The emphasis has to be shifted and we need to use a new
approach to solving problems otherwise we shall lose against Ebola.
We have a formula for
doing things that work according to our own bench marks. We like to deal with
feelings and not facts. This time around, we think we can use our old methods
and go at our own pace the way we want. Ebola is like the armed robber who
writes a letter to you to inform you that he is coming. What do you do in such
cases? Do you continue to drink and pretend he will not show up? Or do you
prepare earnestly to challenge him? That is what we are up to. We want to ‘see’
Ebola before we wake up from slumber.
Ebola does not respect those
old management techniques. Ebola does not know presidents, army generals,
ministers, cardinals, judges and so on. A whole battalion of soldiers armed to
the teeth is of no moment. Ebola is afraid of education, hygiene and
the use of common sense even by a primary school child. Someone
remarked that if Ebola were to strike any where anytime in Cameroon, it will
kill us just in the same way we spray mosquitoes with insecticide. Our
money and wealth cannot help you.
The Americans have
sophisticated armament and technologies for fighting conventional war fare.
Dealing with Talibans, Boko Haram and others who use guerrilla tactics and
infiltrate into the civilian population is a different ball game all together
and fighter jets, warships, atomic bombs are useless. To fight this guerrilla
wars, they need a lot of intelligence, small rapidly deployed efficient hit
squads. They must understand how the enemy thinks, operates and attacks. Then
they have to deploy counter measures to these operation strategies. Short of
these, they are wasting time.
In Cameroon, we are used
to doing things in a particular way. We have one strategy and command chain for
all. We have just one answer and a one track mind for everything. To us every
business is political, then, the administration is heavily implicated in it.
The military and intelligence have their say and technology and
technicians have no place. The population has an observer status with little or
no contribution to make. The reverse is the truth this time around.
The power to deal with Ebola is completely in the hands of the communities and
health personnel.
These old techniques and strategies
would not and will never work for Ebola. They are the same strategies we have
used for polio and cholera which have yielded partial fruits. To think that
dealing with cholera is so simple and we have not handled it and we convince
ourselves that we shall handle Ebola is a dream and a joke in bad taste.
Hygiene is about having water everywhere, cleaning our hands after using the
toilet along with proper food handling techniques. Handling human and house
waste is a real concern. Do you know about the many schools in the nation
that do not have potable running water and functioning toilets? How many
markets have these facilities? I know some university professors who do not
even wash their hands after using the toilet. What is wrong with us? Would you
swear that all ministers wash hands? Fanfare is one thing and doing the right
thing is a different cup of tea.
I understand in the current
dispensation, the Head of State is the Chairperson of the fight against Ebola
and the Prime Minister is next in command. Thereafter, is the Minister of
Health who is assisted by Governors at the Regions. Then the SDOs take the
baton at the divisions. Sorry this is all wrong. The fight
is led by technicians and the politicians and administration should only lend a
helping hand. The army should stand back.
The minister of health
is the head of the team and assisted by Regional delegates for health and
divisional medical doctors. This is called taking responsibility, being
proactive and accountable. You cannot use a mason to roof a house.
The whole health structure
including all personnel of public and private health institutions should be
trained, educated and equipped NOW not TOMORROW. Presently, nothing is
happening in this light until a budget is provided. These are the soldiers who
face the Ebola daily. Doctors, nurses, lab technicians and cleaners would pay
the Ebola price with their own precious lives if they do the wrong thing
in the face of a challenge. Nobody has embarked on a mass training of all these
foot soldiers and that is the beginning of the mistake; that is why I am so
worried because I do not want to die out of carelessness and neglect.
Doctor, you might be
worried but 630,000,000 frs has been set aside for this fight. Is this not
enough?
The Ebola fight has nothing to do
with money for now. Money is
important but even if we have billions of dollars with the wrong attitude, we
shall create more problems with people fighting over money that facing Ebola.
The thinking should first of all be straight; then, we shall know how to use
the money to meet some logistics. When you have a lot of money and do not know
what is important, it can only get wasted. We ask for money and a budget and
think it is the way. It could become the problem when people refuse to work if
someone disappears with the gombo as we a prone to do in Cameroon. Suppose
there were no money at all. Are you telling me we will do nothing?
What the population and health
personnel need is mass education which in itself does not need money. The
nation is in a crises situation. We have state radio stations and
televisions that broadcast naked women dancing, music from morning till
dawn for holiday makers, sex scenes and people drinking beer or better still
political party jamborees. It is time we should use these, for free, to
educate. We have a lot of private TV stations, radio stations, community radios
and private news papers which will be just too glad to participate in
structured educational programs to target Ebola if we take them on board in a
participatory approach with a win-win mentality and not a boss-subordinate, top
to bottom heavy handed approach.
We have churches, village
development organizations, fondoms, ‘njangis, schools, universities and
all these at our disposal and we are not making use of them. Everyone is
waiting for a budget as though it were a political campaign where we need to
give gifts to unwilling voters. That is not the case. We are all in a sinking
boat and we either choose to live together or commit mass suicide. We are also
more concerned about what we shall benefit from the exercise. This is wrong and
unfortunate.
The President should declare one of
these coming days a PUBLIC HOLIDAY FOR EBOLA EDUCATION in the whole nation. All
offices and markets should close and everyone should be out on the streets
doing something for Ebola. All schools and universities should be involved. All
farmers and fishermen and hunters should take the lead.
For once, we should learn to
do the best we can, where we are, with what we have. If you do not know how
this works, ask the staff of the University of Buea, who have been on the field
doing the best they can in the community with little or no assistance. They
have used what they have in the interest of their communities. The mindset is
more important that money. ‘ If you no play politics, politics ko play
you’. This is an expression we can interpret under any circumstance
to mean that someone will lead us to the slaughter house whether we choose to
go or not. This happens when we fail to take our responsibilities in society.
If you fail to choose, someone will make the bad choice for you and you must
bow.
Just before we go
Doctor; can you please comment on the quarantine efforts that government is
making at the boarders?
Yes, it is logical to stop
people at the boarders and quarantine them for a minimum of fifteen days before
you release them to continue into town. The problem is to understand what it
means by quarantine and what measures must be put in place to make this exercise
palatable and fit for human consumption. The way it is going is a disaster in
the making.
This is the best case
scenario. If you have ever been to an operation room in a hospital with
surgeons and nurses all dressed up for surgical procedures, you will begin to
understand where we stand with managing Ebola. The watch word is ‘non-touch’
technique. If you have also been to a factory that produces IV
drugs, you will be speaking the same language. How do we disinfect, clean and
sterilize the used equipment? How do we dispose of the human waste, pus, blood,
urine, used needles and blades in the hospital? The whole nation needs to rise
to this level of understanding though we would be short in practice. Without
grasping this need for sterility and non contact as far as Ebola is concerned,
we are doomed.
Let me paint for you what is
happening in our borders. First there are no houses to take all the people
arriving there. Five, ten or fifteen people are squeezed into whatever space
they can afford ‘for observation’ supposedly for fifteen
days though in Cameroon, three or five days can easily pass for fifteen days if
you know what to do.
If you have 15 persons in one room
and assuming that one of them has Ebola. At the end of 15 days, the 14 others
who were originally healthy would be contaminated. Do you get the point?
Now when you release
them and keep the single sick individual as he waits for death, you seed the
families and communities with the other 14 and so you contributed in making a
bad situation worse for your lack of resources and inability to do the right
thing. So keeping people without knowing what you are doing could
instead be catastrophic.
When you lock them up; tell me, what
toilet facilities do they have? Is there running water, soap and ‘la
croix’ available? How do they feed themselves? Do they eat from the
same dishes with mixed cutlery from the woman who comes to sell food to them?
How much contact exists between them? What about some of the women in those
places who by chance could be sex workers? What happens with a rising,
clientele that sits and counts days with no work to do? Oh, I forgot to find
out the place of money in all of this. Can money somehow transmit Ebola? Check
out how much ‘33’ would be sold. Are the endless bars functioning?
I understand that at the
border town of Ako in Donga and Mantung Division, one supposedly trained nurse
has been deployed out there to detect and handle Ebola cases. What tools has
she got to come to that diagnosis? If it is only a thermometer to pick up
temperatures; please answer me; are all temperatures caused by Ebola? How would
she know the difference?
If you want to quarantine, you
must provide single rooms and toilets for every person and break contact
between them at all cost. The rooms must be thoroughly cleaned and disinfected
before others are put in them. Think of how you will feed them and also
treat other diseases like malaria and diarrhea not related to Ebola. If we lock
up people in cells as it happens in our police custody areas, I am afraid we
are doing the wrong thing as we cause more harm than good.
Any last word doctor?
Yes, I will come up in the next
issue of the Chronicle with the strategic plan for fighting Ebola.
What should each ministry be doing? What do we expect from the President, Prime
Minister and other Ministries as their contribution to the fight? We need to
come up with action plans as to what we must do at individual and collective
levels if the disease were to strike. While we do our best to keep it away, we
should also know what to do if it shows up. We must prepare to handle the sick
by having in place what we need in sufficient amounts deployed all over the
nation. You keep your bullets and guns in wait. You train before time. You do
not place an order for stuff
when the enemy is already in. You
prepare before hand.
These action lines or policies
and procedures would be built and fashioned on the line up for disaster
management. Everybody has to know it and learn it. By preparing and fighting
Ebola, this is a good chance and opportunity for Cameroonians to learn and
improve on hygiene, food and water preparation and manipulation and we also
will create more national unity and love amongst us because we all face the
same enemy and the same fate down the road. It shows us that with Ebola, there
is no Jew nor Gentile. All the hatred, discrimination, stealing and segregation
amount to nothing. Love stands the test of time. Love will win.
DR NICK NGWANYAM, MD
CEO ST LOUIS GROUP
POB 661 BAMENDA
NORTH WEST REGION
REP OF CAMEROON
When News Breaks Out, We Break In. (The 2014 Bloggies Finalist)
