The Day Ebola Disembarked in Nairobi
There is a fear pervading Nairobi culture, causing spikes in sales of everything from bottled water to generators. It’s a threat that is coming from the outside, it’s almost alien. Streets are empty, shops abandoned, the airport checkpoints overrun. Matatu touts are on an open-ended strike, vehicles left stranded around the city centre. People walk around with paranoid expressions, nobody talks about it. The word is almost a curse unto itself.
This is, of course, all fiction. An exercise in imagining what would happen to Nairobi, if the Ebola virus did decide to pay us a not so friendly visit. But the story is not necessarily so far from the truth. To ask ourselves whether the Kenyan government is prepared for an outbreak of the most terrifying disease the world has witnessed this century so far, is justified. After all, even the United States seemed taken by surprise when the disease first surfaced.
The whispers are there, especially among those who could escape if the virus were to pop up in the overcrowded streets of Nairobi. Many have taken to muttering darkly that Ebola would be the end of Nairobi life, that there is no possible solution to the problem. One thing is certain: there are different camps that would have a role to play in putting out the fire.These are the government, the medical community and of course, the international disaster relief agencies. Each has questions to be asked; all three will be rendered virtually useless without the others.
Government Emergency Services
When it comes to assessing to what extent the Government is ready to combat an Ebola pandemic, it is hard to find anyone willing to talk on the record and even harder to find any concrete facts and figures. Ideally, the government should make available lists of the amount of ambulances, emergency personnel and first aid responders that are hovering in the wings, waiting to hit the ground running at the first signs of the disease. In practice, however, we have little indication of what the level of preparedness actually is.
One government worker that accepted to talk to us, did so not only on condition of anonymity but also under the understanding that we would not mention which department she is from.
“I truly don’t have a clue if they could hack it,” Zoey (not her real name) mutters darkly. “They’ve made quite a show about these isolation wards, but if it got beyond it, things could really go sideways.” She says she is often bothered by what happens in her work and that her biggest fear is the short-sighted nature of the government programs. “It’s hard to say if they could plan and prevent it beyond the first few days,” she says, adding that her other fear is that the money might dissipate before it reaches the ground.
To be fair, the government has set up safeguards in case Ebola does come into Nairobi. JKIA is undertaking thorough screenings; the hospitals have their wards and public service announcements have found their way into the media, trying to reach as many citizens as possible. Ebola is a disease that thrives on misinformation and lack of awareness and to this end, Kenyans appear much better informed than their West African counterparts.
Emergency services also come in the form of military and police units that can help contain and quarantine infected areas. Yet, if recent events on Kenyan borders and by the Coast are anything to go by, the country’s military personnel seems to be spread pretty thin. What would come first, one can’t help wonder, fighting the nation’s chronic insecurity or combating a disease that takes few prisoners?
Medical Community
Dr. Patrick Muli sits perfectly straight at a fluorescent-lit desk. He is dressed almost too well for his surroundings, suit coat and purple tie clashing sharply with the charts of the inner ear on the walls. Formerly working at Kiambu District Hospital and now a clinical practitioner in Nairobi, he is well equipped to address inner workings of Kenya’s health care system.
Within the medical system, there has been a great deal of independent preparation. Staff being trained frequently, endless meetings and the running of drills in the event of a possible Ebola outbreak hitting Nairobi. “We are very prepared, the hospitals have special units, isolation wards and they are more than capable. If it happens it will be handled.”
Dr. Muli outlines what would happen step-by-step, if a patient were found to be positive. “We would immediately go into what we call contact tracing, finding everyone they met up with. The people would be quarantined and isolated.”
Working in conjunction with Nairobi’s NGOs, Dr. Muli insists that the process would keep going if an outbreak continued to spread. “You would see the establishment of checkpoints, such as you already can see at the airport: screening people, checking for possible cases and moving forward.” Despite his seemingly stoic outlook about the threat of an outbreak, Dr. Muli has hesitations about exactly how smoothly the process can go, especially given the nature of the Ebola virus itself. “Ebola is not like HIV, which is chronic and something that can be lived with for fifty years. It’s acute and once a person gets to that point, it’s very difficult to help them. It can be passed even with a handshake, which is the biggest cause for concern,” Dr. Muli confides.
Despite the best preparations, nothing replaces simply having the human resources, the boots on the ground to best fight an outbreak.
Disaster Relief Agencies
He sits in a chair, on a balcony of a small apartment overlooking a newly paved road during a torrential downpour. He lights a cigarette with the smouldering end of the previous one. He is a volunteer for Red Cross - USIU-Africa; for the purpose of the interview, his name will be Keith. He lights another smoke as he begins to talk about the NGO response. “People will band together, do you remember Westgate? 200 Million Kenyan Shillings raised in days, the money will come for Ebola.” This sounds quite nice, but it may be more complicated. One needs to look no further than the slums of Nairobi to see it.
“They’ve set up isolation wards at the hospitals, especially at Kenyatta,” says Keith, as he outlines a battle plan that has been drawn up in recent months by some the biggest disaster relief agencies in Nairobi. “If it struck tomorrow, we would hit the ground running: Aga Khan, Kenyatta, Nairobi Hospital, there would be a Red Cross response to all of them.” However, at the idea of a continued infection, Keith isn’t absolutely sure about what would truly happen, “I just don’t know how it would be handled if it continued, it’s hard to say, especially if it hits Kibera or the like”.
The situation, however, may not be as bleak as it has been in other nations. “At least we have infrastructure and roads and the rural areas have clinics” Keith says, with gloomy optimism. “At least people won’t flood to the capital as the only way to get treatment”.
Larger health-focused organizations such as the World Health Organization, the Kenya Red Cross and Medicines Sans Frontiers (Doctors Without Borders), have been issuing protocols and awareness about this type of scenario occurring. Their knowledge and experience in the affected areas of Western Africa would undoubtedly be crucial to stopping Ebola.
Pulling Together
One thing is certain about Ebola: the only way to fight it is persistence. It is a street-to-street, house-to-house struggle and the effort has to be maintained and resources supplied, so that it may be eradicated. The different bodies, institutions, departments and international agencies would have to come together within a matter of hours to effectively combat it.
In the past, miscommunication, distrust and flat out bad relationships have hit the outcomes of Nairobi’s worst crises hard. At no point during the September 2013 Westgate attack did the police, military and first responders appear to coordinate their efforts to respond to the terrorists. A fact that was painfully obviously every time the Cabinet Secretary for the Interior Ole Lenku made public statements over course of those traumatising three days.
Ebola would be the necessary catalyst to get all agencies on the same bandwagon: helping instead of hurting, giving instead eating, acting instead of posturing. While the consensus seems to be that Nairobi is much better prepared for an outbreak than many of the smaller West African nations currently waging war in haz-mat suits, there is still a lot to be desired. It sounds cliché to state that the only way to beat what could prove to be a very substantial health risk to an under-prepared Nairobi is to work as a team, but it is the bottom line.
For Nairobi’s sake lets hope they play nice.
By Alex Roberts
