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COVID-19: We’re not relenting in sensitising, training people in communities – Ezenyimulu



Mrs Chioma. N. Ezenyimulu a medical doctor, is the Executive Secretary, Anambra State Primary Healthcare Development Agency (ASPHDA). In this interview with, CHARITY UZOAGBA, she explains the right way to use face masks and other programmes that the agency has embarked on in relation to the coronavirus pandemic.Excerpts:

WHAT is the function of the agency in Anambra State?

  ASPHDA is an agency that coordinates all primary healthcare activities in the state. We take care of programmes such as immunization, health education, nutrition, integrated management of childhood illnesses and a host of all other functions.

We are practicing primary health care under one roof, where the agency coordinates primary healthcare activities in the 21 local government areas of the state. Consequently, all the health workers in the 21 LGAs have been moved to the agency. So we control the activities from here.

  The use of facial masks in public gatherings has been made mandatory by the state government, what are the proper ways of using the face masks to avoid contaminating or exposing oneself to the deadly virus?

  The proper way of wearing the facial mask is to make sure the nose and the mouth are well covered and the reason for this is that coronavirus spreads through person- to- person, through droplets and when we talk of droplets, we mean secretions from the nose that come out during coughing or sneezing.

So if you are able to place a barrier in this case; the facial mask, then one will not be able to transmit the infection from person- to – person.

The facial mask serves two purposes, one is that it prevents the spread of body fluids from the face when coughing, talking or sneezing and also, it prevents one from touching the nose or the mouth because you can also spread the infection by touching a contaminated object or surface and touching your own mouth.

The mask, in addition to preventing transmission of droplets of the virus and other infectious diseases also protects the wearer from touching parts of his or her face which is another way one can get the infection.

The virus we are talking about is invisible and it requires carefulness. To put on the mask, you have to make sure that your hands are very clean first either by using alcohol based sanitiser or properly washing your hands in running water with soap.

While putting it on, make sure that you don’t touch the inside part of the mask that is rectangular in shape which covers the nose and mouth. Place the mask over the ear lobes one after the other with the aid of your hands touching only the elastic rope attached at both ends.

Make sure that the nose bridge and the mouth to the chin are properly covered and when you put it on, you don’t keep laying your hands on it or fiddling with it. Leave it on and when you want to remove it, you also pull it off from the ears. Avoid touching the surface or rubbing it on your face. Pick up one ear at a time and the second follows. That is how you should fix and remove it.

It is highly not advisable to remove it while talking or placing it below the chin or forehead. You can talk comfortably while wearing the mask especially when you are going out of the house. Equally wear it to come back to the house. Don’t put it inside your bag or pocket while in office or outside. The same thing applies to other shields used to cover the body.

When you come home, if it is the reusable type, wash it immediately and separately with clean water and soap, hang it to dry. On the other side, if it is the disposable type, discard it properly tied in nylon in a bin.

  What is the agency’s plan to ensure compliance of people putting on facial masks and other personal protective equipment in local markets, offices, and public gathering.  Any campaign?

  The agency has carried out a lot of different levels of sensitisation and trainings and is still on it in the communities.  We are able to do this using our Primary Health Centre (PHC) per ward approach. Every political ward in all our communities has a functional PHC.

Those centers each have a ward development committee (WDC) from members of that ward, so ASPHDA had a two day serious sensitisation activities.

On the first day, we sensitised the stakeholders in the wards, where there are the representatives of traditional rulers, presidents general, the women leaders, the youth leaders, the religious leaders, the market associations and etc.

 We enlightened these stakeholders in the various wards on the first day, telling them about all that they should know about coronavirus; ways of prevention, especially the social distancing, wearing of mask, proper hand washing.

We were able to convey our health safety messages geared towards containing the virus and they understood the methods of prevention. The next day, they were now able to do the community general sensitisation in the company of our health workers.

We went to the markets, teaching them the proper method of hand washing, whereby you wet your fingers first, apply some soap and wash palm to palm, palm facing the back of the other palm, interlocking the fingers, washing the thumbs and finger tips very thoroughly before rinsing the entire hands.

We taught them this correct technique of washing their hands, more so, the right way of wearing face masks and social distancing.

We engaged in these activities simultaneously in the 330 political wards in the state. As we speak, every community has been adequately sensitised on the COVID-19. Earlier on March 28, there was a training we did for the officers in charge (OIC) of the health facilities. We did for some selected OICs and the directors of primary health care in the LGAs.

It was our first stage of sensitisation which they later stepped down to the OICs of the facilities in the local governments and the WDCs, last month ending. Then, we had the two days sensitisation that I aforementioned where we did the stakeholders sensitisation in the wards and also in the markets which depended on the market day of the ward.

Majorly, we were able to engage traders in the markets on Wednesday, but those who didn’t  have market days on Wednesdays, we did theirs Thursdays, Fridays and a little on Saturdays. So we have concluded that part of senisitisation in the wards.

Moving further in ensuring that people adhere to the health safety measures because we have trained our primary health care officials on infection prevention and control of coronavirus, more so on case management which is the actual treatment of cases; but you know for the primary health care facilities, we are to refer to the Isolation (protection) centers when we have a case of suspected coronavirus.

How do we know those we are likely suspects? If somebody has a history of recent travel from a country abroad or even within- right now we have infections in Lagos, Abuja, Kano and other states.

When such a person is presented, then there is a high index of suspicion and of course, the symptoms of coughing, sneezing and fever. That is why we have to fit a mask on such a patient while applying the basic first aid and now calling for referral with the phone number that the state has provided for any suspected case.

  As we are still battling with the novel COVID-19, what happens to the routine immunization exercises? Are you planning to continue with the immunisation campaigns or stop at this time thereby making people to go back to the status quo of other diseases?

  We are not relenting. We have sent out a public announcement, as well as produced jingles informing the general public that routine immunisation is still ongoing at all our primary health centers across the state. We never stopped for one day. Routine immunisation is for children under the age of two years. We have a schedule- at birth we give BCG and also OPV to prevent polio, then at six weeks, 10 weeks, 14 weeks, we equally give OPV. That is for prevention of polio as I said and other vaccines for infections. So, we didn’t stop and we will not stop.

Furthermore, at nine months, measles immunisation and vitamin A supplementation for Meningitis are given to children. We have told the general public to disregard any rumour of coronavirus vaccine. There is no such vaccine in the state or even in Nigeria.

The vaccines we have are the normal routine immunisation we give against diseases like tuberclusis, yellow fever, polio, meningitis, measles, pneumonia, hepatitis, whooping cough), tetanus and the rest of them. We don’t have any vaccination against coronavirus.

We keep urging parents and care givers to bring their children with their immunisation cards to the health facilities to take routine immunisations and we are doing that because we don’t want when the coronavirus pandemic is over, then we would have cases of polio for instance, in children who were not immunised.

We are also continuing our sensitisation in that area like I told you, we have done the public service announcement and jingles on radios to encourage mothers to bring their children as expected.

  With the controversy over coronavirus vaccine as our people believe that it will kill them, how do you convince or make people to still believe in the previous vaccines that are administered to children to be safe?

  The coronavirus vaccine rumours are not true. We have dispelled all the rumours and there are no such vaccines against the virus. In fact, the vaccines being developed abroad are still undergoing trial.

They are testing it on one or two people. It is not available for mass vaccination. There is no such vaccine in Anambra State and the nation at large.

The only vaccines we have like I said are only the usual ones we give to children under two years and nobody should be scared.

They should come to the health facilities with the cards because once we give the vaccine, we also write it down in the child’s card. So they should come with their cards at the appropriate time to take vaccines for their children.

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