The Ebola Incidence Management Chair, Mr. Tolbert Nyenswah, assigned me to provide technical assistance to Nimba County in the fight against Ebola in that part of Liberia. Since July 2014, I have been working with the Nimba County Health Team (NCHT) and the County authorities to control Ebola in Nimba.
The following is a narrative of how my encounter with the late Oliver Koah, Driver for the NCHT, who died of confirmed Ebola on September 9th 2014, caused me to undergo a self-imposed quarantine for 21 days.
Sometime on Monday September 1, 2014 I called Mr. Ramsay Leesala, County Health Services Administrator for NCHT, to kindly allow one of the drivers take me to Monrovia the next day since my Driver was in Monrovia repairing my vehicle. My instruction to Mr. Leesala was very clear and emphatic: “I did not want any driver assigned with any Ebola-related activity,” to which he agreed.
On Tuesday morning, Mr. Leesala called to inform me that the driver, Oliver Koah, was on his way from Sanniquellie to drive me to Monrovia. Koah came to my residence in Ganta and after a few questions I handed him the keys. He inspected the vehicle (a used vehicle given to the NCHT by MOHSW) and made certain inquiries about the vehicle. Because I didn’t have the answers, I called my driver and handed Koah my phone to talk with my driver. We later left Ganta, headed for Monrovia.
At the Nimba-Bong checkpoint, Koah was held longer than usual because his temperature was high. After being detained for sometime, they allowed him to return to the vehicle and we proceeded.
At the Bong County Iron gate, Koah was again detained. This claimed my attention and I went to inquire from the nurses what was happening. I was told that his temperature was high, and that we should wait for a while so that he could be closely monitored. He was given cold water to drink and his temperature was repeatedly monitored.
Later, the nurse, Hawah, decided to interrogate Koah and observe him closely. She asked him lots of questions regarding previous involvement with Ebola cases or transporting Ebola patients and he responded in the negative to all her questions. He even said his skin was not hot and that he was not feeling sick. Hawa noticed that his eyes were red and when she asked, he said he rode a bike from Sanniquellie to Ganta in a hurry to get to me, and because the road was very dusty, a lot of sand got into his eyes.
I later asked the nurse whether she thought it was necessary for me to get another driver. She didn’t think so, but advised me on what to do (no close contact etc) and we continued on to Monrovia. The AC was on in the vehicle and Koah even removed his jacket to convince me he was “ok.”
On our way to Monrovia, I called Mr. Leesala and explained all of the nurse’s observations to him.I informed him that I was going to give Koah some money to go to SOS Hospital in Monrovia to get treatment for whatever was the cause of his high fever and that he (Leesala) should give me feedback on Koah’s status when he returned to Nimba. That was the last time I communicated with both Koah and Mr. Leesala.
The following Friday, September 12, while going through the Nimba County daily Ebola Situation Report, I saw a record of two (2) reported deaths of health workers. Knowing that Nimba had not reported any death of health workers, I wanted to know who they were and which facilities they were from. I then called the M&E Officer, Mr. Gonlehyen Dahn, to explain these two reported deaths of health workers. He told me they were ambulance drivers and that one of them was Koah, the driver that had brought me to Monrovia on September 2nd. He told me to inquire from the G. W. Harley Hospital Medical Director for details.
I then called Dr. Loraine Cooper, Medical Director for G. W. Harley Hospital, desperately hoping she would tell me that Koah got the Ebola after driving me and not before. She confirmed that she had noticed he was not looking too well and on Thursday, September 4th she had confronted him about his health. Koah was brought to JFK on Saturday September 6th, was confirmed to be Ebola positive and he died on Tuesday September 9th.
I was very shocked and visibly afraid. I stopped the conversation and began replaying the scenes on Tuesday September 2nd when he drove me to Monrovia… from handing him my phone to helping me buy plantain on the highway and so forth.
After praying for God’s mercy on me and my family, I informed my husband, children, pastor and others of my contact with Koah who had now died of Ebola.I further informed them that I had decided to quarantine myself at home for the remaining days (up to September 23rd, 2014) to complete the mandatory 21 days quarantine period.
What is surprising to me is that, after this young man had been confirmed to be Ebola positive and subsequently died, not a single person from the NCHT called, texted or e-mailed me to alert me that I had been exposed to an Ebola patient so that I could quarantine and observe myself. Such information was the least the Nimba County Health Team could have done for me, so that, in case I was infected, at least my husband and children could be spared this dangerous disease.
Unbelievably, instead of letting me know so I could take precautions to stop the spread of the disease, their interest was in spreading the “good news” in Nimba about how “my driver had died from Ebola and I was under quarantine.” I want to believe this, because, the next day, Saturday, September 13, I received calls from church members and relatives in Ganta and elsewhere in Nimba that there was news all over that my driver had died from Ebola and that I was quarantined.
By the special grace of God, I completed my 21 days on Tuesday, September 23rd.
With such behavior as exhibited by these health officials towards me, a senior staff in government, I am of the opinion that as a people, we are in a very long fight with Ebola. I believe that unless for divine intervention, there is a very high potential for a massive spread of Ebola in our country.
Whatever motives are behind the behavior of those health officials, I give God the glory for saving my family and me. All glory belongs to Him! I honestly believe God permitted this incident to teach me some vital lessons about human beings that I work and interact with.
Yah Martor Zolia is Deputy Minister for Planning, Research and Development at Liberia’s Ministry of Health and Social Welfare.