Dr. Ada Igonoh says her faith and ORS (oral rehydration salts) helped her pull through after she tested positive for Ebola. The 28-year-old Nigerian doctor was on the medical team that cared for the country’s first Ebola patient, Patrick Sawyer, a Liberian-American who flew into Lagos sick and died at the clinic where she worked. Nigeria was hailed for halting what many feared could have been a catastrophic outbreak. Dr. Igonoh shares her story of fear, faith and recovery.
Tell me a little about yourself.
My name is Dr. Ada Igonoh. I’m a medical doctor. I’m also a motivational speaker and I live in Lagos.
And you are a survivor!
And I am a survivor, yes, an Ebola survivor.
Tell us about that.
Well, I was at work one day when Mr. Patrick Sawyer was wheeled into the emergency room of the hospital, where I work, First Consultants Medical Centre in Obalende.
The doctor who initially saw him took a history from him and got the information that he came from Liberia, through Togo, but that he had no contact with an Ebola patient and he had not attended a funeral in the three weeks prior to his presentation at the clinic.
So the doctor was already alert that Ebola was a possibility?
Yes. But Mr. Patrick Sawyer denied any contact with any patients like that. And he came with fever and body weakness, so he was admitted as a case of malaria and started on anti-malarial treatment.
Then the blood tests actually came out positive for malaria, which further confirmed that he had malaria, so we treated him for malaria.
But then, I was on duty the following day, when he asked to see a doctor. I was the doctor on call. I found him in bed, with the IV bag just beside him in bed.
So, you know, on impulse — an IV bag should not be in the bed. It should be hanging [or in some cases] it won’t be able to flow into the patient’s veins.
You’re talking about the intravenous fluid bag.
Yes. So, I took the intravenous fluid bag and placed it back on the stand. He said he wanted to use the bathroom, and I told him I would call a nurse to help clip the IV line, so that he could go conveniently.
He said he had been to the toilet about five times that day. That sparked my curiosity. Why is this man having diarrhea and vomiting? Is this just malaria?
My consultant, Dr. Adadevoh, was informed, and we started suspecting Ebola.
The fact that he was having to go to the bathroom so often rang alarm bells in your head?
Yes. That was actually what made me start to think this is not just malaria. We went in to further ask more questions, to ask more about the whole Ebola thing. But he still denied that he had any contact with anybody.
And we didn’t really have any reason to suspect that this man, of this caliber, would be lying. He wasn’t an illiterate. He was an educated man — a man that you would not expect to tell such a lie.
I mean, if you’re been in touch with an Ebola patient, you’d want to save your life and save the lives of other people around you. So you’d want to come out clean and ask for help, so that you can be helped in the appropriate way.
When he started to get worse, we took some blood samples for investigation, which gave us a signal for Ebola — but was not a confirmatory test result.
We had to send the remaining samples to Dakar [Senegal] where it was actually confirmed that he had the Zaire strain of the Ebola virus.
By the time it was confirmed, he was already gravely ill. And just a couple of hours after the confirmation, he was not responsive. I went to the room and saw him. He was in the bathroom, slumped over — and I just knew that this man was gone. I did the necessary, I checked him, checked his pulse. But we had already started putting [in place] the protocols that were needed — the strict nursing barrier, personal protective equipment.
So we were all armed with the necessary tools to be able to work with him. But by that time, the risk and the harm had already been done. We had already been in contact with him for at least two days before we started to institute all the necessary measures.
On the 25th of July 2014 he was gone. So it was hysteria, tension — it was such a tense moment in the hospital, because everybody was asking just how much contact did each person have with him.
Anybody who just touched the doorknob was wondering — “did I wash my hand after touching the doorknob?” It’s easy to just put your finger on your mouth, your eye, without really knowing what you’re doing.
We were all asking ourselves questions. I’d ask my colleague — “Did you see me touch him? Do you remember whether I went close to him? Did I touch his bedding? Do you remember me washing my hands?” Because we all knew the grave implications of being in contact with an Ebola patient.
And you are officially under surveillance until you begin to develop signs of the infection or not, by the grace of God. We were placed under surveillance, given thermometers.
You said that you had picked up the IV bag – did you have gloves on?
I was not wearing gloves. I picked it up from the bed, put it back on the stand, left the room and I washed my hand. So, between picking up the bag and going to wash my hand, I may have actually touched my eye or some part of my face and it must have gotten into, maybe, the mucosal membrane or something.
That’s a possibility. It may not even be that. It may be just from touching the door handle.
When did you begin to worry?
The panic began when he died. You know, if he had survived, we wouldn’t have been so much tensed up, because we would say there’s hope, he survived.
But the very first case coming to Nigeria dying on us and we’re looking at the news, watching the television, the radios, we’re hearing what everybody’s saying about Ebola and the numbers keep skyrocketing in Liberia — the numbers that are dying, the numbers that are being infected.
Then, we started to fall ill — one by one.
When did you fall ill?
I actually started to feel really sick four days after he was declared dead. It started with joint pains, aches, muscle pains, feeling like I’d walked a mile when I hadn’t really done anything.
Then a sore throat, then a loss of appetite, then a mild fever, then a high fever. From then on, I knew that the possibility of this being Ebola, even without being tested, was very high.
How did you react when you did test positive for the virus?
There is no experience in my life that I can actually compare with the experience I had when I was told I had Ebola. It was the worst news that I can hear in my life, that I’m going to be one of those people who have Ebola and that the possibility of dying is higher than the possibility of living.
Some of your colleagues lost their lives, including the most senior doctor at your hospital, Dr. Ameyo Adadevoh.
In the hospital, seven people were affected and four lost their lives. So if you can imagine losing four people from one institution and at the same time. Everybody is important in the hospital, but the top clinician, Dr. Adadevoh, was my boss, my mentor. Dr. Adadevoh taught me. We went on ward rounds. We worked together in the clinic. She was somebody who could call me at 2 a.m., and I’d pick up the phone, because she’s my boss, and we had so many things to discuss, patients to treat.
So, it’s been really a sad time for us, mourning her loss. Nobody expected that she would succumb to the illness. But God knows best.
Let’s go back to you. You’ve had a fever and a positive Ebola test and you’re swept into isolation. But you were doing your own monitoring, trying to manage your own care, swallowing gallons of oral rehydration salts’ solution – orange flavored, I’m told.
I was at home when I started to have this frequent diarrhea. And I just said “take ORS [oral rehydration salts],” just to support my system.
There is no cure, they say there is no vaccine. “What do I have left to do? OK, take the ORS. It’s not the cure. The [fever reducing] paracetamol is not the cure. The bananas I’m eating are not the cure. So, what’s the cure for a disease that has no cure?”
For a disease that is said to have a mortality rate of 60-90 percent, why am I special? Why should I survive?” I said to God, “You are the greatest physician I’ve ever known, you are the greatest healer, heal me O Lord and I will be healed.”
I have always been a Christian. I gave my life to Christ a couple of years ago and so I held onto this belief that God can heal any disease, any sickness. I began to read Psalm 91 every morning, meditating upon it day and night. And then, partaking in Holy Communion with the rest of the people on the ward with me.
When you have nothing else to hold onto, Jesus becomes the only thing that you can hold onto. And that is what I believe saved me.
So, faith, oral rehydration solution, keeping yourself hydrated, keeping yourself strong. Physically, how weak were you when you were downing these gallons of ORS?
My husband said I looked like a zombie. I had black gums, my complexion had gone really really pale [in patches] and dark [in patches]. And he said I would walk like someone who needed support. I didn’t see how bad I was. He, from the outside, saw. But I knew how weak I felt inside.
There were times when I wanted to give up. There were times when I said, “God, how much more can I take, I’m really tired.” There were times when I didn’t even have the strength to talk on the phone.
There was a time I scolded my husband for calling me. I said “Stop calling me, I don’t want to talk, I’m tired. Speaking is taking the energy away from me. I need energy.” So it was that bad.
One day, things just started to get better. The vomiting started to reduce. Then, the diarrhea started to subside. That was how my energy started coming back — gradually. Until I was declared Ebola-free, after about four days of no symptoms and a negative blood test.
Were you on an isolation ward alone? How did you deal with that?
The second day on the isolation ward was the day the person in the ward with me died. And I just looked in shock as I noticed that she was no longer breathing. She was just in bed and I knew that the end was coming. But what do you do when the end is coming for somebody in the room with you and there is nothing you can do?
I would watch her on the bed and watch her chest rise up and down and I’d say, “Okay, she’s still alive.” I’d watch again until I watched and I couldn’t see any chest movements. And I said “Oh, we’ve just lost her.”
So, it was a battle seeing people die before you. Then you’re wondering: “Who is next? Is it me? Am I not too young to die? But 10-year-olds die of Ebola, six-year-olds die — what makes me special? Why shouldn’t I die?” But I didn’t die.
You said you scolded your husband for calling too much. You say he could see you from the outside. How was he able to see you?
He would stay outside and speak to me through the window.
Even my parents came and that was the only way they could speak to me. At a point, I was so tired that I had to tell them to stop coming, because they made me stand up to go to the window to talk to them and I also had to look my best, so that they wouldn’t go home depressed and I just couldn’t keep up with that.
When the diarrhea and vomiting stopped, what did you think?
I was obviously happy that I was getting better. But something happened. I developed a fever. And I said to myself, “Oh God.” The fever had gone initially. Why had I developed a new fever?
I asked the World Health Organization doctor, “Why do I have a fever right now?” He wasn’t so sure but he said, “Well, a fever is sometimes the last thing to go, but the fact that yours went and has come back again gives me cause for concern. But let’s just watch it.”
And I said “No. I don’t know what this is, but I need this to be something good.” You know, I prayed at night about it and a thought came to me that you actually have malaria, you have been bitten by mosquitoes in this room. The fever is not Ebola, it’s malaria fever. Treat for malaria and let’s see.
As soon as I completed the malaria medication, the fever resolved. And I got stronger and stronger and stronger and stronger and better.
Until your blood said no Ebola? How did that feel?
I wanted to somersault. I wanted to hit the roof. I just wanted to do something crazy. But I had very sore joints. I had knee joint pain. My feet were aching, so I couldn’t express the relief and the joy I felt in my spirit. But I was so overwhelmed with happiness.
There are no words to express how I felt that day. There are no words.
What about post-Ebola. Some survivors say they feel stigmatized.
I have been blessed to come from a family where, regardless of whatever you go through, you are accepted.
From the moment I left the ward, I didn’t speak to anyone about my experience with Ebola until I actually wrote my story and put out my article and people were so drawn to me by the story, that they embraced me, hugged me.
But there’s always that group of people, who would say – “Even though you are Ebola-free, how am I sure that you don’t have Ebola on your skin?” You would hear doctors who would say, “I’m sorry Ada, I love you, but I will not hug you.”
So stigmatization is not limited to the uneducated. It’s also among the educated. People fear what they don’t understand, and it’s the fear that actually drives people to stigmatize. Once that fear is eliminated, people would stop stigmatizing.
But there would always be that group of naysayers and once you are able to accept that, you live your life and you’re happy.
The right approach, really, is to sensitize the people, educate them, teach them, let them know about Ebola. Let them know how preventable Ebola is. Let them know Ebola is not a death sentence, because once people know that this thing can actually be prevented, and it’s not a death sentence, they become calmer about it.
How has Ebola changed your life?
It’s affected my life physically, spiritually, socially, psychologically. Physically, there is something called the post-Ebola syndrome, where you are weak and you start to gradually get your strength back. It sometimes takes months.
It varies from person to person. Don’t expect that because person A recovered in two months that person B should recover in two months. Person B might actually take four months to recover.
I have gradually gotten my strength back. I’ve lost my hair — I believe it will grow back but, yah, I’ve lost my hair. And, occasionally, I experience joint pains here and there and that has actually got much better than it used to be when I first came out of isolation [in August].
It’s also affected my perspective on life, because you’ve had a near-death experience. You are sort of face-to-face with your creator and then you begin to ask yourself: “What have you done with the life you’ve been given? Have you fulfilled your purpose? If you haven’t, what is stopping you from fulfilling your purpose?”
It’s not about the number of years that you live. It’s about how well you live. It’s about fulfilling the assignment, completing the assignment that you were sent to earth to do, because I feel that everybody has an assignment. You were not just born so that you can have children and just live to a good old, ripe age and just die. No.
So once you’ve done what you’ve been called to do, whenever you are taken home is when you are supposed to be home, whether it’s 28 or whether it’s 92 years old. It’s not about the number of years.