Did this doctor save Nigeria from Ebola? By Colin Freeman

Nigeria could have been Ebola's main disaster zone – thanks to a few smart medics, it has a clean bill of health

Dr Stella Adadevoh - did she save Nigeria from Ebola?

Today there's been some rare good news on the Ebola front. Three months after suffering its first cases of the virus, Nigeria has been declared Ebola-free again by the World Health Organisation.

It may not sound like tremendous news, given that the death toll is still rocketing elsewhere in West Africa. But given how bad it could have been, it's something to be extremely thankful for. I could just as easily be writing now that Ebola had claimed its 10,000 victim in Nigeria, and was on its way to kill hundreds of thousands more.

No, I am not about to embark on a paean in praise of the Nigerian state health system. That would be both dull to read, and an insult to the millions of Nigerian who have to suffer it every day. For the main credit goes to a single doctor working in a private health clinic, Stella Adadevoh, who effectively saved the country from disaster by spotting that its first Ebola patient was lying about his condition, and then stopped him leaving her clinic. Dr Adadevoh is now dead, having acquired Ebola herself in the process. But more on her later. First, let me explain why Nigeria was quite such a "perfect storm" for Ebola in the first place.

The first reason is simple demographics. Nigeria is the giant of West Africa, with nearly 170 million people. That's about eight times as much as the combined populations of Liberia, Sierra Leone, and Guinea, the countries at the main centre of the outbreak. Not only that, much of Nigeria's population is hoarded into vast, cramped, mega-cities like Lagos, many in slum neighbourhoods that are vast potential reservoirs for infection. Much of the north of the country is out of government control because of the Boko Haram insurgency. And in those regions that do submit to government writ, public services typically have a reputation for being lousy even by African standards – if they exist at all.

So when Ebola first hit Nigeria back in July, there was every reason to assume the worst, particularly given the appalling circumstances of its first case, Patrick Sawyer.
Mr Sawyer, a civil servant from Liberia, had flown into Lagos airport despite knowing he had been exposed to the virus. He vomited while on the plane and then collapsed in the airport terminal.
But the fact that a highly infectious person had passed through West Africa's busiest transport hub was not the only cause for worry. Nigeria's doctors were also on strike at the time, meaning that its health care system was in even less of a shape to respond to such an emergency than normal.

As it turned out, though, the strike was a Godsend. Instead of being taken to one of Lagos's vast public hospitals, where he might have languished for hours, infecting numerous fellow patients and staff, Mr Sawyer was instead taken to a private hospital.
There he was seen by the sharp-eyed Dr Adadevoh, who realised that his symptoms suggested he was not suffering merely from malaria, as had been previously suspected. She alerted the Nigerian health ministry, and then prevented Sawyer leaving the hospital to attend a business conference in another Nigerian city. When he got angry, she and her colleagues also had to physically restrain him – which may be when she caught Ebola herself.

Either way, though, her quick actions in identifying Mr Sawyer as a serious threat are now credited with helping to nip Nigeria's potential Ebola crisis in the bud. Others did their bit too. A small team of independent doctors and IT experts, joined forces to set up two health education websites and a dedicated Ebola call-centre and advice line, realising that by the time central government got its act together, it could be too late. And the governor of Lagos, Babatunde Fashola, who has made rare progress in improving the city, helped ensure there was a coordinated response to quarantine the dozens of other people that Mr Sawyer had already infected.

"A lot of people were very worried about Ebola coming to Nigeria," says Dr Ike Anya, a London-based Nigerian public health expert and honorary lecturer at Imperial College. "But people did pull together. The volunteer effort went well, the central command facility went well, and Dr Adadevoh also played a key role."

Thus did the country that could have been "Ebola on steroids" avoid a serious outbreak. There is, of course, every chance that new infections could occur – courtesy, perhaps, of yet another Patrick Sawyer who comes in without disclosing his exposure history. But it shows that individuals as well as governments can indeed play an important role in averting doomsday scenarios.

In Nigeria, there is already talk of Dr Adadevoh getting a posthumous national award, or having a hospital named in her honour. But perhaps the recognition should be wider than that. When the Ebola outbreak is finally curbed – assuming it is – there will doubtless be no shortage of UN and WHO bigwigs lined up for international gongs. Maybe Ms Adadevoh should be first in the queue.