Patrick Oliver Sawyer : “He was so adamant and difficult that he took the tubes from his body and took off his pants and urinated on the health workers, forcing them to flee”

Former Finance Ministry Consultant who died from Ebola had an ‘Indiscipline’ Encounter with Nurses after being told he had Ebola; He denied making contact with any suspected case and ran amok when Medical Authorities at the First Consultants Hospital in Lagos tried to contain him; A last-ditch Evacuation effort was blocked by ECOWAS and the Nigerian government, FrontPageAfrica has learned

Lagos, Nigeria – Barely 24 hours before his death, Patrick Sawyer had a rather strange – and in the words of medical and diplomatic sources here, “Indiscipline” encounter with nurses and health workers at First Consultants Hospital in Obalende, one of the most crowded parts of Lagos, a population of some 21 million inhabitants, FrontPageAfrica has learned.

Looking to get to the bottom of Sawyer’s strange ailment on the Asky Airline flight, which Sawyer transferred on in Togo, hospital officials say, he was tested for both malaria and HIV AIDS. However, when both tests came back negative, he was then asked whether he had made contact with any person with the Ebola Virus, to which Sawyer denied. Sawyer’s sister, Princess had died of the deadly virus on Monday, July 7, 2014 at the Catholic Hospital in Monrovia. On Friday, July 25, 2014, 18 days later, Sawyer died in Lagos.

The Center for Disease Control (CDC) recommends that the average incubation period for suspected cases or someone who has made contact with an Ebola patient is eight to ten days from exposure to onset of symptoms.  The range is from two to 21 days.  “That’s why we recommend that contacts of an infected person go on a fever watch for 21 days,” says Stephan Monroe, deputy director of CDC’s National Center for Emerging Zoonotic and Infectious Diseases, at a briefing Monday.

‘Against Medical Advice’

Since the first report surfaced in March, there have been more than 1,201 cases reported and unfortunately 672 deaths in Guinea, Liberia and Sierra Leone, the CDC says.  “This is the largest Ebola outbreak in history and the first in West Africa.  It’s a rapidly changing situation and we expect there will be more cases in these countries in the coming weeks and months. The response to this outbreak will be more of a marathon than a sprint.”

Back in Lagos, authorities at the First Consultants Hospital in Obalende decided that despite Sawyer’s denial, they would test him for Ebola, due to the fact that he had just arrived from Liberia, where there has been an outbreak of the disease with more than 100 deaths.

The hospital issued a statement this week stating that Sawyer was quarantined immediately after he was discovered to have been infected with the deadly virus. In addition, a barrier nursing was implemented around Sawyer and the Lagos State Ministry of Health was immediately notified. Hospital authorities also requested the Federal Ministry of Health for additional laboratory test based on its suspicion of Ebola.

FrontPageAfrica has now learned that upon being told he had Ebola, Mr. Sawyer went into a rage, denying and objecting to the opinion of the medical experts. “He was so adamant and difficult that he took the tubes from his body and took off his pants and urinated on the health workers, forcing them to flee.

The hospital would later report that it resisted immense pressure to let out Sawyer from its hospital against the insistence from some higher-ups and conference organizers that he had a key role to play at the ECOWAS convention in Calabar, the Cross River State capital. In fact, FrontPageAfrica has been informed that officials in Monrovia were in negotiations with ECOWAS to have Sawyer flown back to Liberia.

A text message in possession of FrontPageAfrica from the ECOWAS Ambassador in Liberia, responding to a senior GoL official reads: Your Excellency, the disease control department of the Federal Ministry of Health just contacted me through the hospital now, insisting that Mr. Sawyer be evacuated for now. Pls advise urgently.”

LUTH Lab positive on Ebola

First Consultants said that it then went further to reach senior officials in the Office of the Secretary of Health of the USA who assisted it with contacts at the Centre for Disease Control and W.H.O Regional Laboratory Centre in Senegal. According to the hospital, the initial results from LUTH laboratory showed a signal of possible Ebola virus, but required confirmation.

The First Consultants statement noted that it was able to obtain confirmation of Ebola virus disease, (Zaire strain) after working with the state, federal and international agencies. Sawyer was pronounced dead at 6:50 AM Nigeria time, on July 25 and all agencies were properly notified.

Once the case was officially confirmed, the hospital was temporarily shut down and in-house patients immediately evacuated. Sawyer’s body was subsequently cremated under W.H.O guidelines and witnessed by all appropriate agencies, according to the hospital statement. “In keeping with W.H.O guidelines, the hospital is shut down briefly as full decontamination exercise is currently in progress. The re-opening of the hospital will also be in accordance with its guidelines”, the hospital said.

In the aftermath of Sawyer’s death, both federal and state authorities in Lagos have instituted measures to curb the spread of the disease and quarantining all those who came in contact with Sawyer.

In total, Sawyer reportedly came in direct contact with 59 persons, 44 of whom were at the hospital he was taken to when he fell ill, according to the Lagos State government. The Lagos state government clarified in a statement Monday that Ms. Obi-Nnadozie, Nigeria’s Ambassador to Liberia was not among the 15 people at the airport who had had direct contact with Mr. Sawyer before his death as was initially believed.

Ashes Returned to Liberia

However, it has been reported that Sawyer came in contact with three ECOWAS officials – a driver, a liaison officer and a protocol officer. Also in the list are two nursing staff and five airport handlers.

Dr. Jide Idris, the Lagos State Health Commissioner, told a news conference this week that 20 per cent of those that came in contact with the deceased had been physically screened. “The private hospital (First Consultants Medical Centre) was demobilized and primary source of infection eliminated. The patient has been cremated and the ash will be transferred to the Liberian government whenever the need arises. Decontamination process in all affected areas has commenced,” Dr. Idris said.

In the aftermath of Sawyer’s death, diplomatic, ECOWAS and medical authorities here are baffled over Sawyer’s deception, especially armed with new information that his sister, Princess had died of the deadly virus and his denial. Finance Ministry sources in Monrovia are in quiet murmur over what they feel was a letdown by Sawyer for not being forthcoming with his peers he worked with.

The ministry has since been temporarily shut down and those who came in contact with Sawyer are on a 21-day forced incubation monitoring process. “All senior officials coming in direct or indirect contact with Mr. Sawyer has been placed on the prescribed 21 days of observatory surveillance,” the ministry said in a statement this week.

FrontPageAfrica has now learnt that Sawyer exhibited similar indiscipline behavior during his sister’s stay at the Catholic Hospital in Monrovia where she was taken because he noticed she was bleeding profusely and was later found to be a victim of Ebola.

‘Indiscipline’ Sawyer, EJS Says

Sawyer was seen with blood on his clothing after his sister’s death and had earlier demanded that she be placed in a private room. President Ellen Johnson-Sirleaf cited indiscipline and disrespect as a key reason why Sawyer contracted the Ebola virus. She said his failure to heed medical advice put the lives of other residents across the nation’s border at risk.

A disease which now claimed more than a hundred Liberians has now forced the Sirleaf-lead government to shut down the borders, schools and a host of other measures to ensure that the disease does not get out of hand, including a US$5 million initial contribution to begin the immediate implementation of this plan. “Our immediate strategy is to contain the spread, care for the afflicted with the goal of “No New Cases”,” Sirleaf told the nation in an address Wednesday. FrontPageAfrica has learned that the Ministry of Health is requesting US$20 million to combat the disease.

In addition, the President has mandated that all non-essential staff, to be determined by the Minister or Head of Agency, are to be placed on a 30-day compulsory leave and Friday, August 1, is declared a non-working day and is to be used for the disinfection and chlorination of all public facilities.

“All borders that are to remain opened are to be directly supervised and controlled by the Bureau of Immigration and Naturalization whose duties it shall be, working with the assigned health authorities, to ensure strict adherence to announce preventive measures including preliminary testing for fever. Without exceptions, all schools are ordered closed pending further directive from the Ministry of Education. All markets at border areas including Foya, Bo Waterside, and Ganta are hereby ordered closed until further notice.

But despite the measures put in place by Liberia, the effect of Sawyer’s ‘indiscipline has already taken a toll. ASKY, the Pan-African airline ASKY on which Sawyer flew, has suspended all flights to and from Monrovia and Sierra Leone as has other regional carriers, Arik Air and Gambia Bird dealing a huge blow to commercial aviation.

Linger Questions Over Behavior

Back in Monrovia, Samaritan Purse, the U.S. missionary group helping to treat Ebola patients is scaling down, announcing Wednesday, plans to evacuate nonessential personnel given the five-month-old outbreak is worsening as the fate of two Americans infected with the Ebola hang in the balance on hope and prayers.

For Sawyer, questions are lingering over his behavior, both at the Catholic Hospital in Monrovia and the First Consultants in Lagos and what led him to behave the way he did. More importantly diplomatic observers here are puzzled over his demise: The timing and behavior. A few persons who spoke to Sawyer, including FrontPageAfrica reported that he sounded fine hours before his death. It is unclear what pushed him to the wall and why?

As for the other eight members of the delegation that flew to Lagos, along with Sawyer, diplomatic sources in Lagos confirmed toFrontPageAfrica Wednesday that they were all checked and told to report to the Ministry of Health in Monrovia upon their arrival. It is unclear how close they were to Sawyer or whether authorities in Monrovia have begun monitoring them as the clock ticks on the recommended 21-day incubation period.

 

FPA