Managing a Pandemic in Nigeria: Lessons from the 1918 Influenza


Photo credit: Forbes, World Economic Fourm, and Africa Centre



The 1918 influenza pandemic also known as the “Spanish flu” spread worldwide between 1918-1919 (ending in 1920), infecting about 500 million people with at least 50 million deaths recorded. Nigeria was not left out, with about 4-6 million infected persons and over 500,000 people dying from it within the 2 years lifespan of the influenza.


With Nigeria currently battling to restrain the Coronavirus (COVID-19) pandemic, it is important to explore the country’s past experience with managing a pandemic and draw lessons.


Like with the spread of Coronavirus to Nigeria, the 1918 influenza pandemic flu was introduced into Nigeria (Lagos) on 14 September 1918, through international travel – this time through ship travel. Attempts to quarantine and isolate patients of the influenza as a measure to reduce its spread throughout the country ended in failure, with over-crowded urban areas in colonial Nigeria recording the highest number of cases and death rates.


Research by Don C. Ohadike (in 2002) and Jimoh Mufutau Oluwasegun (in 2015), highlight just how rapid the spread of the flu was throughout Nigeria, with the colonial transport technology being the lethal mechanism of the spread. As shown in table 1, by 1919, out of 8.6 million Nigerians, 199,325 deaths were recorded – a 2.3% death rate.


Parallels and Lessons from the Influenza Pandemic in Managing the Coronavirus pandemic:


1. Providing accurate information to citizens on the nature of the disease, and everything else related to it, is essential: During the 1918 influenza, Nigerians resorted to all sorts of vain remedies, with the colonial government’s failure to provide definitive prevention information about the influenza. For instance, camphor stocks quickly finished in stores in Port-Harcourt, while the price of Whiskey and Brandy rose in Lagos due to Nigerians considering them as remedies for the influenza. Similar to current times, some Nigerians are overdosing on chloroquine and making a number of claims on the discovery of effective remedies in their attempts to treat Coronavirus. This highlights the same mistake that was made in 1918 as regards definitive information, is currently being made by the present Nigerian government.

2. Limited diagnostic testing encourages the spread of the virus: The spread of the influenza in Nigeria was mostly by those with mild symptoms that weren’t easily detectable. These patients mingled with healthy populations in public spaces like markets, schools, mosques and churches. This ultimately resulted in over 50%-80% of Nigeria’s 8.6 million population being infected with the influenza at the time. Presently, asymptomatic individuals (people who do not display symptoms) do not get tested, potentially spreading the coronavirus to others while they go about their daily lives with no restrictions.

3. Inadequate health facilities prevent effective contract tracing and necessary isolation to control spread: Contact tracing of suspected infectious cases was difficult, if not impossible to execute, with colonial medical facilities throughout the country overstretched. For example, the government of the colony of Lagos had to convert a prison in Ikoyi into an observation hospital due to a lack of appropriate medical facilities. Today, Nigeria’s fight against Coronavirus is also suffering serious setbacks with inadequate bed spaces available (just 3,500 bed spaces) and the inadequacy of appropriate medical facilities.


Conclusion


Given Nigeria’s poor management experience with the 1918 Influenza pandemic still replaying itself today, the country must prioritize overhauling its public health care system as a matter of urgency. The core of this must be in terms of infrastructure upgrade – especially in providing emergency medical facilities, equipment, and response plan.

Photo credit: Science Direct (Don C. Ohadike)


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Still craving? Find out more: Journal of Asian and African Studies (Jimoh Oluwasegun) and Science Direct (Don C. Ohadike)


Article Credit: Basil Abia (guest writer)


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