Attributed from the Guardian Newspaper England 

The doctor prevented the spread of Ebola in Nigeria – and paid with her life. Now we should honour her, and the other health workers whose dedication is inspirational

A candlelight vigil for Stella Ameyo Adadevoh and other Ebola victims in Abuja, Nigeria. Photograph: Afolabi Sotunde/Reuters

Last month, the Nigerian government released the 2014 National Honours award list: more than 300 people, many of them serving government officials, seemingly recognised simply because of the public office they hold, not for anything particularly honourable or heroic. An outcry followed, largely due to the absence of one name: Dr Stella Ameyo Adadevoh. A government spokesman was forced to explain that the awards are never given posthumously.

The public’s indignation was understandable: Adadevoh was the Nigerian doctor who oversaw the treatment of Patrick Sawyer, the Liberian national who brought the Ebola virus to Nigeria. She died of the virus on 19 August, one of eight fatalities out of 20 cases (each linked to Sawyer) in the country. Without her dedication, it is quite possible that the World Health Organisation would not have declared Nigeria – the most populous country in Africa – Ebola-free on Monday. The significance of her actions, and those of her hospital colleagues, cannot be overstated.

According to an account by Ada Igonoh, a young doctor who treated Sawyer – and upon whom it fell to certify him dead – Adadevoh vehemently turned down a request by Sawyer’s employers to have him discharged so he could catch a flight to Calabar, a coastal city 750km from Lagos, where he had been due to attend a conference (we are left to imagine what would have followed had Sawyer been allowed to leave Lagos for Calabar).

Igonoh says that from the moment Adadevoh suspected Sawyer might have Ebola – the Liberian had denied contact with an Ebola patient, even though his sister had died of the virus barely two weeks before his arrival in Nigeria – she quarantined him, made contact with the authorities, and ensured the provision of protective materials and Ebola educational material to hospital staff.

Adadevoh was born in Lagos in October 1956. Her father was Babatunde Adadevoh, a professor of chemical pathology and, between 1978 and 1980, the vice-chancellor of the University of Lagos. Her great-grandfather was the Nigerian nationalist Herbert Macaulay (himself the grandson of Samuel Ajayi Crowther, the first African Anglican bishop). She lived most of her life in Lagos, spending the last 21 years working at the First Consultant hospital in Obalende on Lagos Island, where a statue of Macaulay still stands today.

In a fine tribute, Nigerian journalist Simon Kolawole explained and convincingly that Adadevoh was only doing her job as a medical professional. He wrote: “There were various options in front of her when she discovered Sawyer had Ebola: one, quietly say ‘e no concern me’ and discharge him quickly to avoid contaminating the hospital; two, refer him to [Lagos University Teaching hospital], not minding the bigger consequences for the rest of Nigeria; three, act responsibly in line with the ethics of the medical profession and ‘detain’ him because of the peculiarity of the disease.”

That this needed to be pointed out at all is perhaps testimony to how unused Nigeria has become to the idea of people doing their jobs as they should. It is precisely the reason Adadevoh needs to be honoured: as a reminder that heroism can be attained as much in everyday work clothes as it can in superhero capes.

In September, the Lagos state parliament asked Governor Babatunde Fashola to rename the Infectious Diseases hospital in Lagos – where Adadevoh died – in her memory. There is still time to further recognise Adadevoh’s heroism. No doubt the biggest tribute Nigeria could ever give her would be to create a culture in which devotion and dedication to one’s vocation is habitual.

Up to until July, 2014, Nigeria had never before reported any case of Ebola virus infection within its borders. This was soon set to change when one Liberian national, Patrick Sawyer flew to Lagos, and he was already infected with the virus. Why he was not under quarantine back in Liberia, let alone how he was allowed to board an airplane and fly to Nigeria raises a lot of questions. It is reported that Sawyer’s sister had succumbed to the Ebola virus barely two weeks before his flight into Nigeria. Sawyer had also denied ever coming into contact with any Ebola patient, upon his arrival in Lagos.

It was apparent that the health officials inspecting travelers entering Nigeria through the Lagos airport would let Sawyer go.

But one heroine Dr. Stella Ameyo Adadevoh was not convinced that Sawyer was in the right health conditions to be allowed into the country. So she pushed for his detainment and quarantine.

It is said that Mr. Sawyer was required by his employer to attend a conference in Calabar, a Nigerian coastal city located some 750km away from Lagos.

At this time, Nigeria had little preparedness as far as handling cases of Ebola patients was involved. Dr. Adadevoh herself is said to have described Lagos’ rudimentary Ebola treatment center as being “uninhabitable”. However, she was still able to push successfully for the isolation and quarantine of Mr. Sawyer.

“Immediately he was very aggressive. He was more intent on leaving the hospital than anything else. He was screaming. He pulled his intravenous (tubes) and spilled the blood everywhere,” said Dr. Benjamin Ohiaeri, the Director of First Consultant Hospital.

During the initial days when Dr. Adadevoh was caring for Mr. Sawyer while waiting for the test results for his blood, she came under intense pressure demanding she let him leave. She faced threats of catastrophic consequences should she further detain Mr. Sawyer.

Dr. Ohiaeri said, “The Liberian ambassador started calling Dr. Adadevoh, putting pressure on her and the institution. He felt we were kidnapping the gentleman and said it was a denial of his fundamental rights, and we could face further actions.”

Despite all the threats being issued, the hospital management trusted Dr. Adadevoh’s judgment and did not give into the threats and pressure. It later turned out that Dr. Adadevoh was right all along and that Mr. Sawyer was indeed infected and a health risk to the general public. He succumbed to the virus and died from Ebola while at the hospital. But sadly, twelve health officials at the hospital including Dr. Adadevoh who were attending to him had contracted the Ebola virus from him.

It was confirmed on August 4th that Dr. Adadevoh tested positive for the Ebola virus. Nigeria then revamped its Ebola virus preparedness and opened a better-equipped health facility in Lagos. Dr. Adadevoh and all her colleagues who had contracted the virus from Sawyer were now placed under quarantine.

Dr Adadevoh’s only son, Bankole Cardoso said, “On the first day I was able to come close and at least stand by the window and have a conversation with her, the second day the same thing. I took her things to make her comfortable – towels and slippers and then suddenly the next day I couldn’t even go near the window.”

At this point, the health officials had imposed stricter rules on quarantined Ebola patients.

“As every day went on she was there – it appeared she may pull through and on my birthday on a Sunday it was the most optimistic day. Then on the Monday we went in and the whole story had changed, they called us into a room and just explained that this is exactly what is going to happen and it’s not even a matter of days anymore. It might be hours,” said Cardoso.

Dr. Adadevoh died on August 19; one of the eight fatalities out of the 20 cases all linked to Mr. Sawyer. Were it not for the heroic action of Dr. Adadevoh, Nigeria – the most populous African country would not have been declared Ebola free by the World Health Organization so soon after the first reported case of Ebola virus infection.

Had Dr. Adadevoh not taken it upon herself to quarantine Mr. Sawyer despite the standard safety precautions in Nigeria at the time not showing any reasons for the isolation of the passenger. Had she given into the threats and pressure mounted on her to release Mr. Sawyer. Had she not risked her own life by attending to a suspected Ebola patient for the sake of the general public. Nigeria would have been another case of horrifying statistics of the Ebola Outbreak 2014.

For the selfless and heroic actions demonstrated by the late Dr. Adadevoh, she has been recognized by The LSDP Top 100 Global Thinkers of 2014. This recognition is just not for the brave and selfless act demonstrated by the late Dr. Adadevoh but for setting an example that people should do their jobs as required of them. She is the embodiment that heroism can be achieved through our daily chores and in our normal work clothes, just as much as it can be achieved in superhero capes.

The first human trial of an experimental vaccine against Ebola suggests that it is safe and may help the immune system to combat the virus.

Twenty volunteers were immunised in the United States. Scientists at the US National Institutes of Health (NIH) described the results as "promising".

The research is published in the New England Journal of Medicine (NEJM).

None of those immunised suffered major side-effects and all produced antibodies.

Dr Anthony Fauci of the NIH told the BBC: "On safety and on the ability to produce an appropriate immune response we can call this trial an unqualified success, even though it was an early Phase One trial."

The volunteers were divided into two groups, receiving either a low or high dose. The antibody response was stronger among those receiving the higher dose.

The investigators found that seven of the high dose and two of the lose dose volunteers produced T-cell immune responses, which may be important in protection against Ebola viruses.

The vaccine uses a chimpanzee cold virus which has been genetically engineered to carry a non-infectious Ebola protein on its surface.

A health worker in Conakry, Guinea, wearing protective clothing to treat victims

There are four trials underway of this experimental vaccine.

The US vaccine is bivalent - aimed at giving protection against the Sudan and Zaire strains of Ebola. It is the latter which is responsible for the current outbreak.

Trials of a monovalent vaccine - against the Zaire strain - are also underway in Oxford, Mali and Switzerland.

If these also yield positive results then the monovalent vaccine will be offered to thousands of health workers in west Africa.

Dr Fauci said: "It will be this large Phase Two / Three trial in west Africa which will show whether the vaccine works and is really safe."

He added: "If the outbreak is still is still going on six months from now and the vaccine at that point is shown to be effective, it could have a very positive impact on the current epidemic."

But he said the long-term aim was to produce a vaccine which would protect against future outbreaks.

If the vaccine does work, it is unclear how long the protection would last.

Indemnity agreement

These kinds of questions are usually settled during the early stages of human trials.

But such is the pressing humanitarian need for something which protects against Ebola, the whole trial process is being accelerated at unprecedented speed.

In an editorial in the NEJM Dr Daniel Bausch said that while the trial left many questions unanswered, an Ebola vaccine was "one step closer".

The experimental vaccine is being manufactured by the British drugs giant GlaxoSmithKline (GSK).

The company says it can produce one million doses a month by the end of 2015.

This will require a significant financial outlay. It is asking for an indemnity agreement in case problems such as unforeseen side effects were to emerge in the future.

GSK's chief executive Sir Andrew Witty told the BBC: "We are not waiting for that to be settled [but] it is obvious there are some risks that companies should not be expected to carry on their own."

By Fergus Walsh

http://www.bbc.co.uk/news/world-africa-29682325

It was all grief and sorrow when President John Dramani Mahama on Friday joined the Adadevoh family at Christ the King Parish of the Catholic in Accra, for the requiem mass of Dr Ameyo Stella Adadevoh.

The church service was also attended by some professional medical practitioners, ministers of state, traditional rulers and other sympathisers.

Dr Adadevoh, who was born on Saturday, August 27, 1956 in Lagos, Nigeria to Professor Babatunde Kwaku Adadevoh of the Adadevoh family of Anyako Royal Hose, Ghana died on Tuesday August 19, 2014 from a disease she contracted during the line of duty in Nigeria.

She was a member of the Nigerian Medical Association , Medical Women Association of Nigeria, British Nigerian Association and National Postgraduate Medical College.

The late Dr Adadevoh also served as a Non-Executive Director of Learn Africa and a writer for the first ever "Ask the Doc" column in Today's Woman Magazine.

In a homily, Reverend Father Andrew Campbell, Parish Priest of the Christ The King Catholic Church said Dr Ameyo Adadevoh's death would serve as a shining example and star to all doctors in Ghana, the African continent and the entire world.

"She was an extremely dedicated, compassionate, and God-fearing individual and was a diligent Doctor, mother, daughter ,sister, aunt and friend who committed her life to serving humanity," he said.

He said everybody would render account onto God after death on one's deeds on earth and entreated Christians to remain resolute and faithful to the Lord in order to provide a better story.

"God will not ask you the kind of house you lived in or the kind of car you drove, but whether you were faithful to His words and teachings on earth and that is why you all need to be faithful in the Lord in order to become responsibly accountable to God on your death."

Tributes were read by family members, professional bodies, friends and sympathisers.

She left behind, Mr Afolabi Cardoso, husband, Bankole, son, mother and two sisters.

By Dapo Akinrefon

THE lawmaker representing Lagos Central Senatorial District, Senator Oluremi Tinubu, yesterday in Lagos, called on the Federal Government to immortalise the late Dr Stella Ameyo Adadevoh who she said "gave sterling example of due diligence and professionalism in a grave situation and thereby saved the lives of thousands of Nigerians from the Ebola virus."

Adadevoh, a physician and endocrinologist with First Consultants Hospital in Lagos State died after contact with Liberian Ebola victim, Patrick Sawyer.

Tinubu said this during the 12th Town Hall meeting with constituents of Lagos Central Senatorial District and presentation of N16.250m cash empowerment to 650 widows in Lagos.

Senator Tinubu, who advocated for Adadevoh's immortalisation, commended her for commitment and sacrifice to curb the disease.

She, however, urged Nigerians and Lagosians in particular to assist in the prevention of the disease noting that Adadevoh paid a high price by her act of professionalism and patriotism.

She said: "In recent weeks, the scourge of Ebola Virus Disease has become a major concern across the world and there is need for all citizens to adhere to warnings as prevention is always better than cure.

In Nigeria and other West African countries, we must salute the genuine commitment and supreme sacrifice made by many health workers to curb the disease. Particular mention must be made of late Dr Stella Ameyo Adadevoh who knew what to look for in compliance with global health standards and stood firmly to save Nigeria from what could have been utter devastation from the disease."

Speaking further, the lawmaker said:"I wholeheartedly endorse calls for the government of Nigeria to immortalise Dr Stella Ameyo Adadevoh who gave such sterling example of diligence and professionalism in a grave situation and thereby saved the lives of thousands of Nigerians."

What a price to pay for one's nationa. Looking at her act of sacrifice and patriotism, I believe that there is hope for Nigeria."

"There is no doubt that our nation requires more holistic policies to really make things works in all sectors towards like better for our people and the coming generations. With a people-centred leadership and appropriate policies, our country has the potential to do much better for her citizens", she added.

While presenting, N25,000 each to 650 widows aged 50years and below under the new initiative, the Widows' economic Empowerment Scheme (WEES), Tinubu said "it has been a norm at each edition of our town hall meeting to reach out to our constituents, this is in a bid to facilitate empowerment in line with our party's mandate."

Also speaking at the event, the lawmaker representing Surulere Federal constituency at the House of Reps , Mr Femi Gbajabiamila, lauded the Senator for her efforts at assissting the poor in the zone.

Gbajabiammilah said, "I want to appreciate your benevolence and urge all leaders in Nigeria to emulate your gesture".

ONITSHA – The Owelle of Onitsha and son of Dr. Nnamdi Azikiwe, Nigeria’s first President, Chief Chukwuma Bamidele Azikiwe has urged the government to immortalise late Dr. Stella Ameyo Adadevoh. 

Azikiwe, also advised Nigerians to imbibe the positive aspects  of the character and life of the late doctor which according to him deserves the highest national honour for putting her life on the line in service to our fatherland. 

In a tribute made available to newsmen in Onitsha, Azikiwe described Dr. Adadevoh as a compassionate, selfless but disciplined person said he was not surprised she restrained the Liberian-American,  Patrick Sawyer from leaving the hospital after he was suspected of having the deadly Ebola Virus Disease.

” Ameyo was both my relation and friend. She was a very kind, caring, and selfless person. She also had discipline and steely determination.I am not suprised that her selfless compassion and steely discipline will make her restrain Patrick Sawyer from leaving the hospital to probably spread the Ebola virus to epidemic proportions.This she did at  risk to her life.

“Inspite of her upper class background, Ameyo was very down to earth and  full of compassionate empathy for the disadvantaged and poor. Even when she was a medical student at  LUTH she used to tell me and my friends about the plight of some of her brilliant but very poor schoolmates.She was one of my favourites among the younger generation of our cousins.”

Family inconsolable

“I have reached the mother, Deborah, who is somewhat managing under this tragic circumstances.I spoke to Mrs Kate Aniadi, nee MacIntosh, Deborah’s sister  and Ameyo’s aunt who had not stopped wailing and screaming up to the time I put off my phone. I am in regular contact with Dr Andrew MacIntosh, Deborah’s brother and Ameyo’s uncle.”

Family relationship

 “Her mother, Mrs Deborah Adadevoh, is my cousin. Deborah’s grandmother, Okwuegbunam (nee  Azikiwe) is the immediate senior sister, same father same mother, of Obed Azikiwe, Zik’s father”.
Ameyo’s father,  late Professor Kwakwu Adedavoh, was the grandson of Herbert Macauley. Kwakwu’s mother was Herbert Macauley’s daughter. That made Ameyo Herbert Macauley’s great grand daughter. Professor Adedavoh was a medical doctor who taught at  University College Hospital, Ibadan, Lagos University and was Director-General Nigerin Institute for Medical Research Yaba.

How will you like Dr Adedavoh remembered?

First imbibing and disseminating positive aspects  of her character and life. Second she should be given the highest national honours possible for risking her life to save many. She paid the ultimate terrible price.Third, a permanent memorial should be established in her honour.

In the interest of our patients, staff, the general public the nation at large we state the following:
 
 A 40-years old gentlemen came into the hospital with symptoms suggestive of Malaria (Fever, headache, extreme weakness) on Sunday night (20th July 2014). He was fully conscious and gave us his clinical history and told us he is a Senior Diplomat from Liberia. Laboratory investigations confirmed malaria whilst other test for HIV, Hepatitis B&C were negative. He was admitted and treatment commenced.
 
However, due to the fact that he was not responding to treatment but rather was developing haemorrhagic symptoms we further questioned him. He denied having been in contact with any persons with EVD (Ebola Virus Disease) at home, in any hospital or at any  burial. 
 
In spite of this denial we immediately decided to do the following:
 
1. To conduct further tests for possible Infectious Haemorrhagic Disease, especially EBOLA VIRUS DISEASE, based on the fact that he was a Liberian citizen and the recent ourbreak of EBOLA VIRUS DISEASE in that country
 
2. We immediatrly isolated/quarantined the patient, commenced barrier nursing and simultaneously contacted the Lagos State Ministry of Health and the Federal Ministry of Health to enquire where furthe laboratory tests could be performed as we had a high index of suspicion of possible EBOLA VIRUS DISEASE 
 
3. WE REFUSED FOR HIM TO BE LET OUT OF THE HOSPITAL IN SPITE OF INTENSE PRESSURE, AS WE WERE TOLD THAT HE WAS A SENIOR ECOWAS OFFICIAL AND HAD AN IMPORTANT ROLE TO PLAY AT THE ECOWAS CONVENTION IN CALABAR, CROSS RIVER STATE.
 
4. The initial test results from LUTH laboratory indicated a signal of possible EBOLA VIRUS DISEASE, but required confirmation.
 
5. We then took the further step of reaching out to Senior Officials in the office of the Secretary of Health of the United States of America who promptly assisted us with contacts at thecentres for Disease Control (CDC) and World Health Organisation Regional Laboratory Centre in Senegal.
 
6. Working jointly with the State, Federal Agencies and Internaional Agencies, we were able to obtain confirmation of EBOLA VIRUS DISEASE (ZAIRE STRAIN), (W.H.O. Regional Center Lab-Senegal/Redeemes lab/LUTH Laboratory)
 
7. The gentleman subsequently died on Friday at a 6.50 (25th July, 2014)
 
8. All agencies were promptly notified and in consultation with W.H.O, Regional EBOLA VIRUS DISEASE Centre in Conakry, Guinea and Best Practices, the following was commenced: 
a. Orderly temporay shut down of the hospital with immediate evacuation of in house patients
b. The appropriate professional removal of the body and its incineration wunder W.H.O. guidelines witnessed by all appropriate agencies.
9. Having concluded the above, it is now appropriate to give this Press release in the interest of our partient, staff, the general public and the nation at large.
 
10. In keeping with W.H.O, guidelines, hospitals is shut down briefly as full decontamination exercise is currently in progress W.H.O. Guidelines
 
In conclusion working with the STATE, FEDERAL AND INTERNATIONAL AGENCUES, we were able to identify and confirm the diagnosis of the EBOLA VIRUS DISEASE. We hope that by our action of preventing this gentleman from being extracted from our hospital and traveling to Calabar we have been able to prevent the spread of EBOLA VIRUS DISEASE in Nigeria. 
 
The Board and Management of the Hospital wish to thank all our staff members for their diligence and professionalism.
 
Thank You.
 
Signed
Dr.B.N.OHIAERI
DR.A.S.ADADEVEOH
First Consultants Medical Centre Limited
16/24 Ikoyi Road,
Obalende,
Lagos

 

President John Dramani Mahama of Ghana has paid glowing tribute to the late Nigerian doctor, Dr. Ameyo Stella Shade Adadevoh for the role she played in averting an unprecedented epidemic in Nigeria.

Adadevoh was the lead medical practitioner at the First Consultant Hospital, Obalende, Lagos, who treated the index Ebola case in Nigeria, the late Patrick Sawyer from Liberia. She died from Ebola recently after contracting the disease from the Liberian.

President Mahama during the opening of the Extraordinary Meeting of the ECOWAS Assembly of Health Ministers on Ebola Virus Disease (EVD) yesterday in Accra acknowledged the ultimate price health professionals had to pay to treat affected persons; particularly he eulogized Dr. Adadevoh for her dedication to humanity.

"One of the dedicated heroines, who gave her life in saving many others, is Dr. Ameyo Stella Shade Adadevoh of Nigeria," who he said had Ghanaian roots as he added, "In a rather amazing but sad twist, that shows that outbreaks of this kind do not respect boundaries, Dr. Adadevoh may have been of Nigerian nationality but from a family that originally was Ghanaian in fact she has Ghanaian relatives."

Mahama stressed that it was the firmness of the late doctor that averted a probable epidemic in Nigeria stressing, "Dr. Adadevoh and her colleagues acted fast to place Mr. Sawyer in isolation and resisted pressure to have him released from the hospital- a situation that would have resulted in many others getting infected or even dying.

"Her wise and sacrificial action potentially saved many lives. But sadly, just like Sawyer, she too succumbed just a few days ago. She died trying to do what she loved most-saving lives. May she rest in peace," he said.

Drawing lessons from Adadevoh's case, he called on all West Africans to strive for integration saying that the story of Ebola deaths involving Nigeria, Liberia and Ghana attested to the extent to which 'our fates, interests, and aspirations are intrinsically intertwined.'

BBC Africa Interviews Aunty Ameyo's sister Dr. Ama and Brother Dr. Kojo Adadevoh in Philadelphia USA.








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