The Coronavirus disease (COVID-19) was declared a pandemic in 2020, a declaration that not only put many world activities at a standstill but also overwhelmed global health sector preparedness. The disease outbreak which was first identified in Wuhan, China, in 2019 has led to over 7 million fatalities worldwide so far.  Covid-19  pushed most countries to seek new ways of strengthening health systems.

Despite responses from government and private quarters like the Coalition Against COVID-19 (CACOVID), in Nigeria, the health sector remained largely the same in terms of sub-optimal healthcare service delivery, with recurring factors such as the shortage of human and material resources, underfunding and poor motivation of health workers.

The first case of COVID-19 in Nigeria was recorded in 2020 as the case toll climbed globally. Cases climbed similarly in Nigeria, overstretching the healthcare system which caters for an estimated 200 million people.

Against this backdrop, Mrs. Ekahe Elijah, a public health practitioner, was posted to Abia state as a frontline supervisor to help carry out testing.

Elijah was determined to approach the COVID-19 pandemic with the same level of dedication she has exhibited in her previous workplaces. She was posted from Teaching Hospital Uyo, in Akwa-Ibom state.

She wasted no time in setting up testing facilities in the community and coordinating with local health workers to ensure that everyone who had come in contact with the virus was promptly tested, often working overtime to ensure the work gets done. This dedication she says stems from her upbringing.

She said: “I grew up in a Christian home and my parents are disciplinarians who taught us to always uphold fairness, equity and justice. These are some of the values I was brought up with, so there’s no way I will compromise on those standards now.”

She also attributes her zeal and meticulousness to issues from her previous work experience, “When I was working in my former place of work [Thinking Health Initiative and Imitation for Community Heath], there was zero or no tolerance for indiscipline and as such, I haven’t had any challenges.”

Mrs. Elijah knew the importance of maintaining integrity and transparency in all aspects of her work. She took her responsibilities seriously and made sure that all data was accurately reported each day to track progress and identify areas for improvement.

One issue that many frontline responders were facing at that time was contact tracing of those exposed to the infection. This led to Nigeria’s Presidential Task Force Committee on COVID-19 criticising those who refused to assist contact tracers. This refusal often stemmed from a fear of stigmatisation.  Mrs. Elijah says she was able to mitigate this through “approach” and “empathy”.

“To ensure accountability I make sure every trace is followed very well. There has been no challenge getting people to talk about where they have been or people they have been in contact with. I believe it’s in the manner of approach. I try to be emphatic with them and encourage them and whatever information I need they provide it with no hassle,’’ Mrs. Elijah narrates.

Despite the daunting circumstances, she diligently reported daily data, organised review meetings, and maintained open communication channels with her colleagues and relevant communities because she knew that collaboration was key to success.  She reached out to the community health workers and invited them to work closely with her team. Together, they devised a plan to reach the most vulnerable in the community and provide them with the care and support they needed.

Mrs Elijah and the community health workers went door to door, educating people on the importance of wearing face masks, washing hands, and social distancing. They set up mobile testing sites in the most remote areas, ensuring that everyone had access to testing and treatment.

Their efforts did not go unnoticed as the number of cases started to decrease, and hope began to spread throughout the community.

One thing she did to ensure maximum cooperation from her teammates was to ensure timely payments to everyone in the programme – including vendors, consultants, and local help.

Nevertheless, all was not rosy as she detected financial misconduct among her team.   When she stumbled upon evidence of financial misconduct within her department, Mrs. Elijah knew she had a difficult decision to make. She had uncovered discrepancies in the accounts that pointed towards mismanagement and corruption, and she couldn’t just turn a blind eye to it.

Determined to get to the bottom of the matter she spent countless hours poring over spreadsheets and reports, gathering further evidence to support her suspicions. She interviewed her team members and other staff members, quietly but methodically building a case against those responsible for the financial misconduct.

It wasn’t an easy task. She faced pushback from her colleague who was implicated in the wrongdoing and even received threats to deter her from pursuing the matter further. But she stood firm in her resolve, knowing that exposing the corruption was the right thing to do.

Upon further investigation, she discovered that a colleague who was in charge of the payments was diverting funds meant for experts in her team.

“A colleague of mine who was also in charge and didn’t pay the experts was collecting money. I confronted him and filed a complaint. The case was later resolved at the top and it never happened again”, she narrates.

After weeks of hard work and dedication, Mrs. Elijah presented her findings to the appropriate authorities. The culprits were swiftly brought to justice, and Mrs. Elijah’s bravery and determination were commended by her superiors

Speaking of corruption associated with the covid-19 period, Dr Fabian Orji a consultant and health practitioner said the corruption during the COVID-19 pandemic in Nigeria “is deeply troubling and poses a significant threat to the country’s ability to effectively respond to the public health crisis.”  He said the diversion of funds meant for essential healthcare services and pandemic response efforts is not only a betrayal of public trust but also puts the lives of vulnerable populations at risk.

He calls on the Nigerian government to take immediate action to investigate these allegations, hold those responsible accountable, and strengthen transparency and oversight mechanisms to prevent future corruption.

An epidemiologist, Dr. Yakubu Bello, also urged  all stakeholders must work together to ensure transparency and accountability in the management of pandemic response efforts, while adding that corruption allegations during the COVID-19 pandemic are a serious concern that must be addressed swiftly and decisively.

Joshua Emmanuel has worked closely with Mrs. Elijah for an extended period of time. Having observed her work ethic nominated her for the Accountability Lab Integrity Icon. This, he said was because “she is a woman who meets her professional standard and is always diligent towards her job.”

He added that Mrs. Elijah is  “focused” and “always pushes for the right thing to be done at all times.’’

Commenting on how she has been described as a transparent person by her colleagues she says, “I cannot really tell how good and transparent I am because a better description about me will better come from another.”

She however said she has been able to make a difference because she has nothing to hide. “I have always said with integrity, you have nothing to fear, since you have nothing to hide. With integrity you will do the right thing, so you will have no guilt.”

Her legacy as a frontline supervisor during the COVID-19 pandemic in Abia state would be remembered for years to come. It remains a testament to the power of dedication and compassion in the face of adversity.

This report is championed by Accountability Lab Nigeria and sponsored by The John D. and Catherine D. MacArthur Foundation and Luminate.