By Olowogboyega Oyebade
Do you know that we have to appreciate the Governor of the State of Osun, Mr AdegboyegaOyetola for creating quality time on Wednesday 17thJuly, 2019 to tour the corridor in the State of Osun where artesanal mining activities go on unabated by a rainbow of characters, local and foreign, united in service dedicated to undermining the law? Do you know that Mr Governor was accompanied on the tour by party chieftains, including the affable State Chairman of the party, Prince Gboyega Famodun? Do you know that every body on the tour was miffed at the level of devastation wrecked on the rich agricultural land? Do you know that we have to cooperate with Mr Governor to regulate the mining activities in the area? The statement of Thomas Hobbes cuts in: “ In a state of nature where man is under no control, he is brutish, selfish, nasty and dangerous. Hence, his life is short.” .
Hurray! As part of the steps to accelerate economic development of Nigeria, on 7th July, 2019, President Buhari signed the Agreement establishing the African Continental Free Trade Area (“AfCFTA) aiming to create a single market for goods and services in Africa. Do you know that this was the long dream of Kwame Nkrumah and some other notable leaders of Africa? Do you know that there is aesthetic disequilibrium in Africa as we have dotted wealth in some places standing side by side with perilous drought, famine, poverty and conflict across Africa, blazing to the world from Libya to Kenya, and from Nigeria to Zimbabwe? Do you know that the 2019 African Economic Outlook projects that the continent’s economic growth will grow further by 4 per cent? Do you know that conflict has pushed South Sudan into the world’s worst food crisis as half of the country’s population or about 7.1 million people are suffering from extreme hunger? Do you know that Mali, Niger, Chad, Somalia, and Sudan and South Sudan are ravaged by conflict and drought? Do you know that the UN reported that 60 million children across Africa go to bed hungry and that there are more than 250 million people in Africa that are undernourished, making them vulnerable to disease and unable to reach their full potential?
Do you know that since March 2018, 54 out of 55 member States became signatories to the Agreement, with Nigeria being the 53rd Country to sign? Do you know that with the signing of the AfCFTAAgreement, Nigeria together with the other signatory States are committed to a progressive elimination of import duties and other non-tariff barriers on imports within the continent? Do you know that the agreement is still not binding? Are you aware that Section 12 of 1999 Constitution of Nigeria provides that an international treaty or agreement would not automatically apply to Nigeria unless it is ratified by an Act of the National Assembly? Do you know that this has not been done? Do you know that the members of the National Assembly need to look at all environmental factors before ratifying the agreement as we are surrounded by many failed States? As we fling our doors open to trade, not minding our porous borders, do you know that we may equally open our borders to more international diseases and terror gangs?
Alas! The World Health Organisation has declared Democratic Republic of Congo a global health emergency after a case of the virus was confirmed in the Congo city of Goma, which borders neighboringcountry of Rwanda? The Director-General of WHO Dr. Tedros Ghebreyesus on Wednesday 17th July, 2019 cuts in:
“It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system. Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders — coming from not just WHO but also government, partners and communities — to shoulder more of the burden.”
Are you aware that the West African Virus Epidemiology (WAVE), the body in charge of addressing diseases of root crops in West Africa has raised alarm over two emerging cassava diseases in Nigeria? Do you know that not less than 95 per cent of our population relies on root crops for staple food? Do you know that the disease is a red alert to health emergency? Justin Pita, Executive Director of WAVE, at the meeting of stakeholders from the West African sub-region in Abuja, added that these viruses had negatively affected cassava production in sub-Saharan Africa, Justin Pita cuts in:
“We have to create tangible awareness on its existence and its possible impact on the nation’s cassava production if eventually it happens. ..Effective fight against viruses requires a strong understanding of how the disease in question spreads, which allows us to plan ahead for its control. They can explode suddenly into large-scale threats if they are not well monitored and controlled.”
Do you know that we have to take the warning of the World Health Organisation on Ebola serious? Do you know that the Health Organisation of the League of Nations gave birth to World Health Organisation as an agency of the United Nations as sixty one countries signed its constitution on 22 July 1946? Are you aware that its constitution came into force on the first World Health Day on 7 April 1948? Do you know that as of 2019, the World Health Organisation had 194 member States, except for the Cook Islands and Niue? Do you know that since its establishment, it has played a leading role in the eradication of smallpox with its current priorities include communicable diseases such as HIV/AIDS, Ebola, malaria and tuberculosis? Do you know that it works on non-communicable diseases such as sexual and reproductive health, development and aging; nutrition, food security and healthy eating; occupational health; substance abuse; health reporting and and networking?
Do you know that WHO addresses government health policy to enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches? Are you aware that it oversees the implementation of the International Health Regulations, including the International Statistical Classification of Diseases (ICD), the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Health Interventions (ICHI)? Do you know that the WHO along with the World Bank constitute the core team responsible for administering the International Health Partnership (IHP+), a group of partner governments, development agencies, civil society and others committed to improving health of citizens in developing countries?
Do you know that, apart from other remarkable interventions, WHO in partnership with Rotary International, the US Center for Disease Control and Prevention (CDC), and UNICEF reduced the incidence of Polio by 99 per cent in the world? Do you know that its mandate includes preventing or reducing risk factors for “health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets and physical inactivity and unsafe sex”? Do you know that it is working on global initiatives in surgery, including emergency and essential surgical care, trauma care, and safe surgery to “reduce avoidable loss of life and the burden of disease and disability”? Do you know that we had miraculous escape last time and our Adadadevoh is dead? Can you still remember that on 8 August 2014, WHO declared that the spread of Ebola was a public health emergency; an outbreak which was believed to have started in Guinea had spread to other nearby countries such as Liberia and Sierra Leone and Nigeria? Do you remember Dr Adadevor and how she painfully paid the supreme sacrifice? Who was Dr AmeyoAdedadevoh? Come along, please.
Do you know that Ameyo Adadevoh was a Nigerian physician born to the family of Babatunde Adadevoh, a physician and former Vice chancellor of the University of Lagos on 27tjh October 1956? Do you know that Ameyo Adadevoh married Afolabi Cardoso and gave birth to her only son, Bankole Cardoso? Do you know that she worked at First Consultants Medical Center in Lagos where she served as the Lead Consultant Physician and Endocrinologist? Do you know that Dr. Adadevoh was the first to alert the Nigerian Ministry of Health when H1N1 spread to Nigeria in 2012? Do you know that she was credited for curbing a wider spread of the Ebola virus in Nigeria by placing Patrick Sawyer, in quarantine despite pressures from the Liberian government? Are you aware that she was threatened by Liberian officials who wanted the patient to be discharged to attend a conference? Are you aware that she resisted the pressure and said, “for the greater public good” she would not release him? Are you aware that Dr. Adadevoh correctly diagnosed Nigeria’s first case of Ebola? Do you know that she kept Patrick Sawyer in the hospital by creating an isolation area, despite the lack of protective equipment, by installing wooden barricade outside the patient’s door? Do you know that at this time, all Doctors in public hospitals were on strike and if the patient had gone to any of the public hospitals, that could have caused severe public health crises? Do you know that she provided staff with relevant information about the virus, procured protective gear and quickly contacted relevant officials? Do you know that as a result of her report, the Nigerian government declared a national public health emergency and the Ministry of Health set up an Ebola Emergency Operations Centre?
Alas! Are you aware that on 4 August 2014, it was confirmed that she had tested positive for Ebola virus disease and was being treated? Do you know that from that moment, kind-hearted Adadevoh was isolated in a quarantine and her loving family were made only to see her image groaning in pains for public good in line with the 1999 Constitution of Nigeria and Quarantine Act? Are you aware of these provisions of the law? Come along, please.
Do you know that the Constitution empowers the President to unilaterally or at the request of a State Governor declare a state of emergency in certain instances, including when….
(c) there is actual breakdown of public order and public safety in the Federation or any part thereof to such extent as to require extraordinary measures to restore peace and security;
(d) there is a clear and present danger of an actual breakdown of public order and public safety in the Federation or any part thereof requiring extraordinary measures to avert such danger;
(e) there is an occurrence or imminent danger, or the occurrence of any disaster or natural calamity, affecting the community or a section of the community in the Federation; [or]
(f) there is any other public danger which clearly constitutes a threat to the existence of the Federation . . . .
Do you know that the Constitution recommends that the declaration of a state of emergency must be published in the country’s Official Gazette, and the President is required to immediately notify the Speaker of the House Representatives and the President of the Senate. Once in place, a state of emergency can be terminated
if the President revokes it;
if it is not subsequently endorsed by the federal legislature within two days of its declaration when the legislature is in session or within ten days otherwise;
after six months of its declaration, but the legislature may extend it for another six-month term; or
if the legislature, having initially endorsed or extended the declaration, at any time revokes it by a vote of a simple majority in both houses.
Do you know that the consequences of declaring a state of emergency for health reasons may manifest as the legislature may adopt laws that curtail certain fundamental rights guaranteed under the Constitution. It may also allow the executive to take certain actions that restrict such constitutional rights. The Constitution appears to permit the executive to temporarily suspend the constitutional protection against forced or compulsory labour “in the event of any emergency or calamity threatening the life or well-being of the community.”. . Do you know that such a law may impose limitations on the right to privacy; the right to freedom of thought, conscience, and religion; the right to freedom of expression and the press; the right to peaceful assembly and association; and the right to freedom of movement? Do you know that under emergency situations, the Constitution allows the adoption of a law for the compulsory acquisition of movable or immovable property “that is in a dangerous state or is injurious to the health of human beings.”? Do you know that the Constitution permits the adoption of a law imposing restrictions on a person’s personal liberty if the person is “suffering from infectious or contagious disease (such as Ameyo Adadevoh). . . for the purpose of [the person’s] care or treatment or the protection of the community.”?
Do you know that the Quarantine Act is the primary law governing the prevention and suppression of dangerous infectious diseases? Do you know that the Act states that it is intended to regulate “the imposition of quarantine and to make other provisions for preventing the introduction into and spread in Nigeria, and the transmission from Nigeria, of dangerous infectious diseases.” Do you know that these diseases include “cholera, plague, yellow fever, smallpox, typhus and Ebola.”? Do you know that under the Act, the President can declare any disease a contagious disease? Under the Act, are you aware that the President may make regulations for all or any of the following purposes –
(a) prescribing the steps to be taken within Nigeria upon any place, whether within or without Nigeria, being declared to be an infected local area;
(b) prescribing the introduction of any dangerous infectious disease into Nigeria or any part thereof from any place without Nigeria, whether such place is an infected local area or not;
(c) preventing the spread of any dangerous infectious disease from any place within Nigeria, whether an infected local area or not, to any other place within Nigeria;
(d) preventing the transmission of any dangerous infectious disease from Nigeria or from any place within Nigeria, whether an infected local area or not, to any place without Nigeria;
(e) prescribing the powers and duties of such officers as may be charged with carrying out such regulations;
(f) fixing the fees and charges to be paid for any matter or thing to be done under such regulations, and prescribing the persons by whom such fees and charges shall be paid, and the persons by whom the expenses of carrying out any such regulations shall be borne, and the persons from whom any such expenses incurred by the Government may be recovered;
(g) generally for carrying out the purposes and provisions of this Act.
Do you know that State governors are accorded the same powers as the President to categorize diseases as dangerous? Do you know that the Quarantine (Ships) Regulations authorize a port health officer to take a number of measures for the purpose of prevention and suppression of infectious diseases? Do you know that under Schedule Five of the Regulations,
(a) any infected or suspected ships;
(b) any ship on which there is a case of typhus or relapsing fever;
(c) any ship which has during its voyage been in a local area infected with cholera, plague or yellow fever;
(d) any suspect for smallpox on a ship other than an infected ship;
(e) any person on any ship which has come from an area infected with typhus or relapsing fever;
(f) any ship or any person on board, when the port health officer is satisfied that, notwithstanding the application of sanitary measures to that ship or person at a previous port, an incident has occurred since such previous application which makes it necessary again to apply additional measures, or when the medical officer has definite evidence that the previous measures applied were not substantially effective, the entire ship may be detained.
Do you know that under the current public health regulatory regime, transparency requirements are minimal? Do you know that the President is only mandated to declare a state of emergency and the Minister to issue a public notice via the Official Gazette? .Do you know that the only obligation as a WHO member State, is the requirement to notify the WHO of any event that constitutes a public health emergency within twenty-four hours of the assessment of such event? Do you know that the Federal Ministry of Health created a web page dedicated to informing the public about Ebola, including what the virus is, how it spreads, and signs and symptoms of infection? Do you know that Nigeria is bound by the requirements under the International Health Regulations (IHR) (2005), an international legal instrument aimed at preventing the spread of disease “to develop, strengthen and maintain . . . the capacity to detect, assess, notify ad report” outbreaks of infectious diseases?
Do you know that Adadevoh died in the afternoon of 19 August 2014? Are you aware that her body was decontaminated and cremated by the government in response to the containment of the spread of the Ebola Virus Disease? Do you know that her loving family only obtained her ashes and held a private interment ceremony on 12 September 2014, in Lagos? Are you aware that the Dr. AmeyoAdadevoh Health Trust (DRASA), a non-profit health organization was created in her honor? Do you know that the film “93 Days” is dedicated to Ameyo? Do you know that on 27th October, 2018, she was honoured with a Google Doodle posthumously on her 62nd birthday? Do you know that before WHO declared Nigeria to be Ebola-free on October 20, 2014 there were 20 Ebola cases total? Do you know that 11 of the victims were healthcare workers and of those healthcare workers, 6 survived and 5 died, including Dr. Adadevoh? Do you know that the 2018 ECOWAS Prize of Excellence post-humously awarded to a former Secretary-General of the UN, Kofi Annan and Dr Ameyo Adadevoh for their contributions to region’s well-being and presented to their families at the 55 Summit of the ECOWAS Authority of Heads of State and Government in Abuja recently? Do you know that we need more Ameyo Adadevoh in all aspects of our lives in Nigeria? We must develop the AmeyoAdadevoh spirit, the spirit of service to humanity. Are you aware that there are regulations for Public Health Emergencies of International Concern (PHEIC)? Do you want to know about these regulations? Come along, please.
The International Health Regulations define emergency (2005) as “an extraordinary event which is determined, as to constitute a public health risk to other States through the international spread of disease; and to potentially require a coordinated international response”. Do you know that the responsibility of determining whether an event is within this category lies with the WHO Director-General and requires the convening of a committee of experts – the IHR Emergency Committee? Do you know that this committee advises the Director General on the recommended measures to be promulgated on an emergency basis, known as temporary recommendations? Do you know that these temporary recommendations include health measures to be implemented by the State Party experiencing the PHEIC, or by other States Parties, to prevent or reduce the international spread of disease and avoid unnecessary interference with international traffic?
Hurray! Do you know that the Nigerian government has ordered ports officials to heighten surveillance because of the fear of Ebola outbreak? Do you know that WHO has not recommended any restriction on travel or trade, but rather the organization released recommendations for affected countries, which include to continue strengthening community awareness and screening among other actions? Do you know that the West African outbreak had more than 11,000 casualties? Do you know that the World Health Organization reported a total of 2,512 Ebola cases and 1,676 deaths involved in the outbreak in Democratic Republic of Congo as of Monday 15th July, 2019? Do you know that the emergency committee recommended that all at-risk countries must put in place the necessary approvals for using investigational medicines and vaccines as part of their preparedness for Ebola outbreak? The potent question is: do we still have AmeyoAdadevoh? Or is her spirit still living in her colleagues again? Do you know that apart from the threat of outbreak of Ebola, our country has been put on red alert on some other emergencies? Do you know that we need to give ourselves the necessary orientations on Health Emergency Preparedness and Response? Come along, please.
Do you know that the Directorate of Emergency Preparedness and Response is responsible for the mitigation of disasters and emergencies and management of its impact? Do you know that the Directorate supports outbreak response activities including the deployment of Rapid Response Teams and builds capacity, advocates and sensitises on emergency preparedness and response? Do you know that the Directorate supported the rebuilding of the surveillance system and supported the response to disease outbreaks in the North-East of Nigeria? Are you aware that emergency incidents and their associated challenges have been identified as one of the major causes of deaths on a daily basis in Nigeria? Do you know that majority of Nigeria’s highways are without plans for emergency rescue operations either by state or non-state actors? Do you know that when good ‘Samaritans’ make such an emergency evacuation successful, the Emergency Units of our hospitals may pose as an obstacle to save lives?
Do you know that the current practice is that persons with gunshot wounds are required to provide police reports before the health care providers can attend to the victims? Do you know that this does not support life enough? Do you know that the ability to be treated by qualified medical personnel within a short period of time may be the difference between life and death? Do you know that asking for police report before treating a gun-shot contravenes Section 20 (1) and (2) of the National Health Act? This section provides:
“(1) A health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason.(2) A person who contravenes this section commits an offence and is liable on conviction to a fine of N100, 000.00 or to imprisonment for a period not exceeding six months or to both.”
Do you know that in providing for the Basic Health Care Provision Fund, the National Health Act dedicated 5 per cent of the fund to emergency medical treatment to be administered by a committee appointed by the National Council on Health? Do you know that each hospital should have the Emergency Department which must provide critical care requiring prompt diagnoses and interventions to prevent avoidable deaths and disabilities? Do you know that the design of our roads and highways should take note of the need for emergency care, ambulance services and facilities to ensure that lives are saved when road accidents occur? Do you know that Nigeria’s ability to effectively deal with public health crises should be tested in each State of the Federation as any other outbreak of any disease may not take the Lagos or Port Harcourt routes? How far have we gone on vaccine productions? Do you know that we need the assistance of all Nigerian scientists in the diaspora to come home to assist with knowledge in security issues relating to diseases, poverty, education and technology?
Do you know that Ameyo Adadevoh is our own version of Mother Theresa of India? Do you know that her name should be studied in our History lessons in all schools to build the much-needed spirit of Adadevoh in all of us? Do you know that we have to thank Governor Oyetola and the Federal Government for re-introducing History back into our curriculum? Is it not apt now to insert the name of Ameyo Adadevoh into this subject? The statement of Alan Paton in the book, Cry, the Beloved Country, cuts in:
“The men that are doing the work cannot be kept down perpetually forever. “