An Igbo proverb speaks to the imperative of proactivity and preparedness: “The disease that gives a man warning seldom kills him.”
Trite, yes. Cliched, no doubt yet that aphorism is infused at its core with a morsel of truth.
Chikwe Ihekweazucaptures the imperative in the following quote: “The pandemic was a painful reminder of our vulnerability to new and emerging diseases. It also highlighted the importance of investing in research and development of treatments and vaccines in preparation for future outbreaks.”
This is what comes across from a close consideration and interrogation of Chikwe and Vivianne Ihekweazu’s book, An Imperfect Storm: A Pandemic and the Coming of Age of a Nigerian Institution.
The memoir written by the couple focuses on Dr. Ihekweazu’s medical training and distinguished public health career in institutions across the world from Germany to the UK and South Africa leading up to his appointment as Head of Nigeria Center for Disease Control (NCDC), the country’s premier public health institution.
The book tracks his effort to build a world class public health institution even as he warns of the need to prepare for a health emergency.
His dire warnings and call for preparation come to pass with the coming of the pandemic and in this book, he details his and his colleagues efforts to contain the virus despite the challenges that confronted them.
And the challenges are myriad from a lack of qualified human resource to a paucity of funds; antagonistic colleagues to a disinterested supervising minister.
But it is not all a tale of gloom. Chikwe’s tale finds glimmers of light and cheer from a presidency that was committed to seeing NCDC succeed, a dedicated team of young colleagues who agreed to be mentored and a wife who was both sounding board and support base.
The book opens with a “Foreword” by Dr. John Nkengasong, Camerounian born virologist and like Chikwe, the man who made Africa Centers for Disease Control and Prevention a globally respected institution.
Next comes “Alignment” which is written by Vivianne Ihekweazu and which, if this were another book, would have been the introduction or preface. In those two and half pages, you get the sense immediately that Vivianne is the story teller in the family. Her style is gripping, evocative and poignant.
Chikwe on the other hand comes across as he should; a man of science beholden to facts and data and results. Even though the book is narrated like a novel in a cyclical fashion with constant switches across time, his style is clinical, precise and unardorned. There is a focus on the story as the thing.
Chikwe took over at the NCDC in 2016 as the first Director General (his predecessor was designated National Coordinator), two years after Nigeria had survived Ebola and four years before the world was hit by COVID-19 and in the years before the pandemic, he was like a prophet in the wilderness warning of something dire.
Ebola was a blessing in disguise for Africa. It sharpened our sense of epidemiological surveillance and helped operationalise the the protocols for Tracking, Testing and Treating.
Chikwe’s acceptance of the NCDC job is one of the abiding ironies of life; that need to prove to your home base that the knowledge acquired in foreign climes can be put to use in the interest of the common good.
But altruism can often be misjudged. In Chikwe’s case, there was push back and antagonism from colleagues who saw him as a “young man” and “outsider” who had not “humbled” himself.
Where did his determination to accept the job and make a success of the assignment come from? Maybe it was from his early days as a medical student listening to boring lectures on community health as public health was known back then. Maybe it was forged out of the smithy of tragedy following his mother’s tragic passing or maybe it was from a belief as we say on the streets that “oyibo people no get two heads!”
Whatever the reasons were, Chikwe took over at NCDC, fought for the institution to have legal legs to stand on with the enactment of the NCDC Act of 2018; digitised the operations of the center, trained staff and built capacity both human, technological and mechanical to bring an end to over-reliance on parachute researchers, donors and UN agencies and by so doing made the center a world class facility.
You can sense the pride in his words; “As I strolled through the NCDC office daily, I felt an overwhelming sense of pride and joy at the progress my colleagues had made. Many of them started as interns or entry level staff but had grown to taking on more responsibilities and managing projects on their own.”
Chikwe’s approach to leadership is one that deserves some attention. His mantra was “Forget that I’m DG” and an admirable focus on mentoring and reverse mentoring. He taught and allowed himself to be taught too.
There is also another aspect of his character that deserves consideration; what one might call his lack of ego and propensity to give everyone his or her due. Names are mentioned copiously with everyone’s contribution to the success of the NCDC acknowledged.
Chikwe also evinces an uncanny ability not just to build relationships with ease anywhere he finds himself but to cash with that same relative ease from the overflowing bank of goodwill. He has vast network of allies and collaborators across the world that seem always willing to help out.
Many Nigerians came to know Chikwe Ihekweazu during the pandemic via his appearances on the Presidential Task Force briefings. He was the “oyibo” in a sea of black faces that often included Boss Mustapha and Sadiya Umar Farouq and his presentations were facts and statistics led which were easily verified via the NCDC social media pages which were chockful of information.
The communication aspect of public health is a key part of non-pharmaceutical interventions during a health crisis because it helps contain panic and re-assure the public. Chikwe Ihekweazu has his wife Vivianne to thank for bringing her crisis communications brio to bear. During the pandemic, Mrs. Ihekweazu seconded staff from the Nigeria Health Watch, a health communication and advocacy organization which she leads, on a pro bono basis to support NCDC staff.
Mention has been made of Chikwe’s narrative style which is clinical, precise and unardorned but there are moments when he rises to the occasion as a storyteller.
One instance would be when the first COVID-19 case was announced right in the middle of a simulation exercise in preparation for that eventuality. “It was at this point, in the middle of a simulation exercise, that the call came. The inevitable had happened; the novel coronavirus had made its way across our borders.”
Another instance provides us a glimpse into how public health surveillance protocols can sometimes seem like espionage as public health experts fight to keep us safe:
One evening, I received a call about an Ethiopian Airlines flight enroute to Kano with a passenger who was coughing and had a high fever. The State Epidemiologist was notified, and colleagues went to the airport in personal protective gear to wait for the plane. The ill passenger wasn’t allowed to disembark, was stabilised on the aircraft, and flown back to the country of departure.
An Imperfect Storm: A Pandemic and the Coming of Age of a Nigerian Institution is a personal and public testament from a man who gave his all in the service of his country at great personal cost to his health and nuclear family. It is a book about public service which other public servants should read and use as a template in giving account of their stewardship.