EBOLA: My Survival Story - Dr. Ada Igonoh Recounts Ordeal ~ nomofos

Our nation continues the battle to get rid of Ebola virus brought into the country by the late American-Liberian Patrick Sawyer.

We now bring to you the amazing survival story of Dr. Ada Igonoh of the First Consultants Hospital.
She was one of the doctors who got infected by the virus by the primary case. The medical worker, however, miraculously escaped death and has told her amazing story to Bellanaija.
She shares her experience, her fears, faith and dedication.
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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 in the last couple of weeks, and Mr Sawyer denied any such contact.

He also denied attending any funeral ceremony recently. 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 antimalarial drugs and analgesics. That night, the full blood count result came back as normal and not indicative of infection.
However, on the following day 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 5.00pm 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 (I.V.) 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 Adadevohabout the patient's condition and she asked that he be placed on some medications,"Ebola survivor narrated.
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. She then instructed me to write very boldly on his chart that on no account should Patrick Sawyer be allowed out of the hospital premises without the permission of Dr. Ohiaeri, our Chief Medical Consultant. All nurses and doctors were duly informed."
During early morning ward round with Dr. Adadevoh the medics concluded that this was not malaria and that the patient needed to be screened for Ebola Virus Disease (EVD).
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 was unable to contact him 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. Patrick 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 we could muster. Dr. Adadevoh went online, downloaded information on Ebola and printed copies which were distributed to the nurses, doctors and ward maids. Blood and urine samples were sent to LUTH that morning. Protective gear, gloves, shoe covers and facemasks were provided for the staff. A wooden barricade was placed at the entrance of the door to keep visitors and unauthorized personnel away from the patient.

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, Dr Ada Igonoh was again on call. At about 10.00pm the importer of Ebola, Mr Sawyer, requested to see her.
"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. He also said he had to travel back to Liberia on a 5.00am flight the following morning and that he didn't want to miss his flight. I told him that I would inform Dr. Adadevoh.

"As I was leaving the room, I met Dr. Adadevoh dressed in her protective gear along with a nurse and another doctor. They went into his room to have a discussion with him and as I heard later to reset his I.V. line which he had deliberately removed after my visit to his room,"Ebola survivor recalled.
At 6.30am, Friday, 25th July, Dr. Igonoh was alerted by a nurse that Patrick Sawyer was completely unresponsive. The doctor had to put the protective gear on and entered the dangerous room. She found the US-Liberian slumped in the bathroom. It was over for him: no respiratory movement, his pulse was absent. The doctors had lost him and the first death from Ebola on the Nigerian territory happened.
Dr. Ada Igonoh was the first who certified Patrick Sawyer's death. She notified Dr. Adadevoh immediately and she had instructed that no one was be allowed to go into Ebola victim's room for any reason at all.
Later that day, officials from the World Health Organisation (WHO) came and took Sawyer's body away. The test in Dakar later came out positive for Zaire strain of the Ebola virus. The first EVD case in Nigeria was officially confirmed.
"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 Patrick Sawyer. Every patient on admission was discharged that day and decontamination began in the hospital. We were now managing a crisis situation,"the doctor continued.
The following day, Saturday 26th July, all staff of First Consultants attended a meeting with Prof. Nasidi of the National Centre for Disease Control, Prof Omilabu of LUTH Virology Reference Lab, and some WHO officials. They congratulated the health workers on the actions they had taken. The officials also enlightened the medics further about the EVD.
They said the health workers were going to be grouped into high risk and low risk categories based on their individual level of exposure to Patrick Sawyer, the "index" case. Each person received a temperature chart and a thermometer to record temperatures in the morning and night for the following 21 days.
"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. We were reassured that we would all be given adequate care. The anxiety in the air was palpable.
"The frenetic pace of life in Lagos, coupled with the demanding nature of my job as a doctor, means that I occasionally need a change of environment. As such, one week before Patrick Sawyer died, I had gone to my parents' home for a retreat. 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," the doctor recalled.
Meanwhile, the issue of Ebola became trending everywhere: on TV, radio and in the media, both online and paper.
Dr. Igonoh soon started experiencing joint and muscle aches and a sore throat. She did not panic immediately, thought anxiety and stress made her feel like that. So, first of all, the doctor took malaria tablets and some antibiotics for the sore throat. Measurements of temperature showed normal results. But some anxiety remained:
"Every day I would attempt to recall the period Patrick Sawyer was on admission – just how much direct and indirect contact did I have with him? I reassured myself that my contact with him was quite minimal. I completed the anti-malarials but the aches and pains persisted. I had loss of appetite and felt very tired."
Trouble started on August 1, Friday. The temperature of the doctor increased to 38.7c.
"I could not believe what I saw on the thermometer. I ran to my mother's room and told her. I did not go to work that day. I cautiously started using a separate set of utensils and cups from the ones my family members were using,"she recalled.
The fever worsened on Saturday. Thermometer was at 39c, none of the drugs, including paracetamol, helped. Dr. Igonoh could not eat due to 48-hour-long fever and worsened pains in her throat. She made a call a special helpline. They sent an ambulance to her place with some of WHO specialists. The doctors took her blood sample, but did not take her to the quarantine centre. She started stooling and vomiting later that day. Dr. Igonoh tried to distance herself from the family, washed her spoons and plates and by herself only. At the same time the parents of Ebola suspect believed her daughter was not infected.
On August 3, 2014, Sunday, the WHO doctors called Dr. Igonoh. They told me that the collected sample was not confirmatory, and that another one was required. The ambulance arrived at her place in the afternoon. The doctor felt worried and became even more confused when she got 'invited' to go to Yaba.
"I was confused. Couldn't the second sample be taken in the ambulance like the previous one? He said a better-qualified person at the Yaba centrewould take the sample. I asked if they would bring me back. He said "yes." Even with the symptoms I did not believe I had Ebola. After all, my contact with Sawyer was minimal. I only touched his I.V. fluid bag just that once without gloves. 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."
She promised her parents to be back by evening. Ada wore her usual pair of jeans, a white top, put her iPad and phones in the bag as well.
Acting as a real gentleman, a medical specialist opened the ambulance door for her. What was really strange in his action is that he moved away from the lady rather swiftly.
"They were friendly with me the day before, but that day, not so. No pleasantries, no smiles. I looked up and saw my mother watching through her bedroom window,"the doctor continued.
Upon arrival to Yaba centre she 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,"Ebola survivor recounted.
READ ALSO: Another Ebola Victim Dies In Port Harcourt
Finally, the ambulance door was opened. A Caucasian gentleman approached her, but not too close, saying:"I have to inform you that your blood tested positive for Ebola. I am sorry."
She had no reaction, just shock. The man asked the infected doctor to open the mouth and he had a look at her tongue. He then confirmed it was a "typical Ebola tongue".
Dr. Igonoh took out her mirror and looked closer.
"I was shocked at what I saw. My whole tongue had a white coating, looked furry and had a long, deep ridge right in the middle. I then started to look at my whole body, searching for Ebola rashes and other signs as we had been recently instructed."
Then she made a call to her mother, asking to lock her room, desist from touching anything and not to let anyone inside. The mother was stunned and reacted with silence. Ada cut the line.
The infected doctor was taken to the female ward. This is how she described that awful place:
"It looked like an abandoned building. I suspected it had not been in use for quite a while. As I walked in, I immediately recognized one of the ward maids from our hospital. She always had a smile for me but not this time. She was ill and she looked it. She had been stooling a lot too. 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."
The Caucasian man who had met Dr. Igonoh at the ambulance on her arrival was Dr. David. The specialist entered wearing his full protective 'hazmat' suit and goggles.
"It was fascinating seeing one live. I had only seen them online. He brought bottles of water and ORS, the oral fluid therapy which he dropped by my bedside," Ebola patient recalled.
The medic said that 90% of the treatment depended on the patient. He ordered the lady to drink at least 4.5 litres of ORS daily to replace fluids lost in stooling and vomiting. Dr. David also told that taking Imodium tablets to stop the stooling was not advisable, because the virus would replicate the more inside the victim. The specialist concluded that it was better to let it out. The doctor said good night to his new female patient and left.
Dr. Igonoh was swarmed by calls from parents and relatives on Sunday evening. Her husband called crying, as he could not believe this news.
"As I lay on my bed in that isolation ward, strangely, I did not fear for my life. I was confident that I would leave that ward some day. There was an inner sense of calm. I did not for a second think I would be consumed by the disease. 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. On occasion I would run to the toilet with a bottle of ORS, so that as I was stooling, I was drinking,"Ebola survivor revealed.
On the following day, Monday, August 4, the first red rashes on her skin, particularly on her arms, appeared. The symptoms were added by sores all over woman's mouth and her head was pounding so badly. She could not eat due to throat problems, but managed to drink the ORS. The infected doctor took paracetamol in an attempt to ease the pain.
"The ward maid across from me wasn't doing so well. She had stopped speaking. I couldn't even brush my teeth; the sores in my mouth were so bad. This was a battle for my life but I was determined I would not die,"Ada said.
The courageous Ebola patient started her day with reading and meditating on Psalm 91. She noted that the sanitary condition in the ward left much to be desired. The sheets were not changed for days. The floor was stained with greenish vomitus and excrement. The main specialist, Dr. David, would come in once or twice a day and help clean up the ward after chatting with the ailing people. He was the only doctor who attended to the patients. There was no one else at that time.
The patients had to collect the food themselves, as the matrons left meals outside the door. On the other hand, it was easy to explain: everyone was being careful.
Dr. Igonoh made another discovery on how the doctors themselves might have contracted the EVD. Mosquitoes were their roommates until mosquito nets were brought in.
Dr. David brought another female patient into the isolator. It was Justina Ejelonu, a nursewho had started working at First Consultants on the 21st of July, a day after Patrick Saywer was admitted. Dr. Igonoh recognised her immediately.