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- [00:00]
Evelyn Castle
Ebola is in Nigeria. Those words had me freaking out back in 2014. And that is what today's episode is all about. My name is Evelyn Castle, and thanks for joining the EHA Founders Podcast, where myself and my co founder, Adam Thompson discuss our journey, founding our companies, the challenges we faced, and our lessons learned along the way. This conversation about the Ebola response in Nigeria is my favorite conversation Adam and I have had so far, and I'm really excited to share it with you. So I won't even bother with a long intro. Let's just get right into it. Welcome to our fifth episode. Today we're going to be talking about the Ebola response in Nigeria. And, like, yes, what we did in the Ebola response. But I think a lot about, like, kind of how we felt about it in Nigeria and what our opinion was about the response in general. Because obviously Nigeria gets coronavirus credit for having, like, a really successful Ebola response. And you know, how that that impacted Covid and all of these other things and polio and whatnot. And so I think it'll just be kind of an interesting conversation, especially now that we're sitting here a year into Covid and, you know, did the Ebola response really have that big of an impact on. On how well we were able to do Covid?
- [01:19]
Adam Thompson
Yeah.
- [01:19]
Evelyn Castle
So let's start a little bit just with, like, the beginning of Ebola. So we're sitting in Nigeria, and. Yeah, in Kan. The first time I really remember thinking about guinea and Ebola was when I remember seeing the news story that came out that said that there was, like, a big concert in Guinea. It was in Conakry, and, like, multiple people got Ebola, like, in that concert hall. And I remember thinking to myself, like, what the hell is happening? Like that an Ebola patient is at a concert, like, a big concert in Conakry. And there was like, a couple hundred suspected cases or something after that. So that's the first time I really remember even thinking about it. Do you have a specific memory?
- [02:03]
Adam Thompson
I don't think so. I mean, I just think I remember the news, you know, the various different news stories. And we were kind of watching it spread, you know, into Sierra Leone and obviously into then Liberia. And we were worried that it was kind of, you know, if things weren't really under control. It was a matter of time. I do remember. I think my feeling at the time and was I was, like, a bit calm. Cause I remember seeing things like, oh, US cdc. And those things. I remember those were the times where, like, well, we My vision of CDC was from the movies, from outbreak and these things where it's like, oh, these super teams. I'm like, I remember being quite calm about it even as it was spreading, thinking, okay, well, this is what they do. They'll get this under control. And obviously that vision of the global epidemic pandemic response has changed dramatically. So since then.
- [02:50]
Evelyn Castle
Yeah, but at the time you felt super secure.
- [02:53]
Adam Thompson
Yeah. And calm. And they got this.
- [02:55]
Evelyn Castle
Well, because it's actually funny. So I went back into my email and I just typed in search for Ebola. And I just went as far back in my email chain as I could find to find, like, the first mention of ever us mentioning Ebola. And so it's funny because I'm sure we were starting to have some of these conversations, but the first email that I found about it is in August, which actually was like, right before it came. Well, I guess right when it came to Nigeria, because it came to Nigeria in July and we still weren't even really talking about it that much until August. But in August, we really started planning for, like, what happens if the outbreak continues. It's funny because, like, the other, like, really vivid memory I have is I remember starting to panic and starting to say, like, I think that we should write an email to the Gates foundation about, like, what we're going to do if Ebola, you know, spreads and like, what will stay open and what will not stay open. I remember you being like, calm down. Like, let's take a breath. Let's wait and see what happens. But we did actually start planning, like, I have the email where we started talking about, like, the EOCS will remain on duty. And then I think we had said, like, GIS tracking wouldn't be suspended if cases are found in that state, basically. But again, it's funny because, like, looking back on it now, you know, if Ebola had really spread, I think it would have been probably all over the country pretty quickly.
- [04:13]
Adam Thompson
Yeah. Given how much people move.
- [04:15]
Evelyn Castle
Yeah. So anyways, we started kind of worrying about it much more in. In August. So I guess it must have been like the first week of August. But. So when it came to Lagos.
- [04:25]
Adam Thompson
But it's crazy thinking about it because all the stuff that we've learned. At no point did they stop flights. It's crazy. At no point do they stop flights into Nigeria, even from the affected countries. That blows my mind that they should have. Yeah, of course. Outbreak of Ebola in Liberia. I think if it was today, they'd stop flights. They'd stop allowing people From Liberia to come into Nigeria, you would just pause and be like, okay, let's see how to get this under control. You wouldn't just be like, well, let's see.
- [04:52]
Evelyn Castle
Yeah, I mean, I guess it's just like. Because I think they just made the assumption that everybody that had Ebola was so crazy sick that they wouldn't be getting on plane.
- [05:00]
Adam Thompson
There's also this weird idea that, like, somehow you could screen for them at the airport by taking people's temperature. But as we've learned with COVID no one knows how to even use those temperature things. And they don't actually even work most of the time. And so that was a stupid assumption that you could look at someone and be like, that person's sick with Ebola, can't come in. Because then what do you do? You have them wait in the airport, infect more people, and then send them home. What people assumed was possible in the airports, I think even during Ebola, Obviously, we've learned during COVID that was silly to even think that that was an option. And a lot more thought has to go into around how do you manage travel that didn't go. That thought. That didn't go into it during Ebola so much. There were certain types of ideas and plans that you would restrict travel or. But they just kept checking for yellow cards. And that always blew my mind. It's like, it's Ebola. What does my yellow fever vaccination have to do with anything? But they would just like. But before Ebola, they would never check. After Ebola was gone, they wouldn't care about your yellow cards. But during the Ebola outbreak, we have to check your yellow fever vaccination. And I was like, that doesn't stop anyway. But yeah, all these things and systems that didn't make sense. Even though we knew the dysfunction in Nigeria, we kind of assumed. I assumed that those were relatively in place.
- [06:11]
Evelyn Castle
Yeah, I mean, I guess, right. Not right away did they limit flights, but eventually they did. They ended flights from the Ebola endemic countries. Because remember, like, only Air Morocco was flying in at a certain time. Like, BA pulled out of Sierra Leone, Air France stopped flying. Yeah, at a certain point that did happen.
- [06:28]
Adam Thompson
But that was the airlines deciding they're not going to go.
- [06:31]
Evelyn Castle
That's correct, yeah. Okay. So do you remember when it came to Lagos, do you remember, like, what your initial thought was?
- [06:40]
Adam Thompson
I mean, I remember thinking that this is the kind of thing that would tear through Legos. I just remember thinking, like, the close proximity of everybody, the fact that Legos is just people on top of people on top of people. Yeah, I really thought that was like, that was the end.
- [06:54]
Evelyn Castle
Well, and I think we all kind of did. And that's why, like, we went into such hyper alert at that point, you know, and why, I guess when we were asked to go down to help, we immediately said yes, even without, you know, that much financial control and all of that. But I was trying to remember. Do you remember who called us? Was it Faisal? Do you remember the phone call where he called us?
- [07:15]
Adam Thompson
Yeah, I remember I was sitting in the ECNX office, our office in the second floor or first floor. I don't remember the details, but I remember sitting there having the phone call saying, let me get back to you. Then you and I chatting. Faisal called this. And then talking with him a bit later in the day. And then, yeah, it's starting to make plans right from there. About like, okay, let's get down there.
- [07:32]
Evelyn Castle
So we decided that we were going to do it. I stayed in Kano because obviously we had a ton of ish that we were doing in Kano. And you went down with just yourself, right? At first.
- [07:43]
Adam Thompson
Just me at first, yeah.
- [07:44]
Evelyn Castle
Yeah. And do you remember, like, what it was like being down there? Because, like, I didn't go to Lagos, I think, until months, maybe it was like a month or so later. And I remember the kind of like hysteria. Like, it's really hard not to compare now, like Ebola to Covid. Right. You know, because it was like people were so much more freaked out about. No, about Ebola. But like, there was no such thing as, like lockdowns. People were not like reducing their travel or anything like that. I remember it was just like.
- [08:11]
Adam Thompson
But they did voluntarily. I mean, yeah, there were some hand washing stations and there's a huge run on hand sanitizers and soaps and things like that. But when I first got to Lagos, people were staying away from other people. People weren't wearing masks. Some people were not like, with COVID people are wearing masks. People were wearing gloves. But not everybody. But I remember going by one of the bus lines and seeing people. Usually you just see this group of people, like 10 people all trying to get in the door at the same time. I remember going by and seeing a line of people spaced out where everyone was. And again, not mandated. No one told them to do it. There was very little coming out at the time around things like social distancing and hygiene and stuff like that. They were starting to kind of get the messaging out. Like, be careful. Do these Things. But yeah, people were so scared they just kind of did it voluntarily. Which is so funny now compared to Covid, where it just feels like such a slog to convince people to wear a mask and wash their hands. Whereas during Ebola everyone was like, stay the hell away from me. Don't touch me.
- [09:06]
Evelyn Castle
Which again, totally understandable. If Covid had you bleeding out of your eyes, you would have the exact same response to that. And then the other big thing that I remember during that time was all the local cures that were coming out that more people were dying of. But again, just the salt overdose and weird stuff, the kola nut as well. But don't you remember? I don't know if you were part of that conversation, but I remember I'm pretty sure it was taking bath in salt and it ran through Nigeria in a night. And I remember like the next people.
- [09:35]
Adam Thompson
Waking up at 4:00 in the morning to have baths and salts.
- [09:37]
Evelyn Castle
Like mothers were calling their kids saying like, you have to get up right now. I remember the cleaner being like, my mom called me at 4am and she said I had to wash the children and myself in salt and a cold water salt bath or whatever. It was like right now, just like the crazy level.
- [09:51]
Adam Thompson
And then some people were like bathing in it. Some people were like, you've got to drink three buckets of it and then dying. Yeah, I mean more people died in that one over ingestion of things than died during Ebola at the end of the day. And like there's 20 people that died were like in a day and just from like.
- [10:05]
Evelyn Castle
But it was interesting because like during that time it was all of the. It was much more of like the local cures, they weren't doing like what they're doing now with COVID with the.
- [10:13]
Adam Thompson
Medication, buying erythromycin from the distributors and yeah, the pharmaceuticals. I mean there was some stuff early on with like a lot of lemon and ginger and a lot of people were like, yeah, doing that kind of stuff. But yeah, the hydroxychloroquine that people were buying off the shelves and azithromycin and all these diabetes medications. And yeah, it's been very pharmaceutical.
- [10:32]
Evelyn Castle
Yeah.
- [10:32]
Adam Thompson
In its response where that was very much like, come here, tb, Joshua will cure you. I remember that being the one scary thing is besides how scary Ebola was in and of itself in Lagos. The idea that people were getting in buses from Liberia to drive to Nigeria to get cured by tb. Joshua in his church because of his miracle cure that he was selling and the fact that by whatever miracle that didn't bring a ton of Ebola with it still kind of blows my mind how lucky that was. And it is just by chance that it just happened to not be so heavy in those areas where people were traveling from.
- [11:07]
Evelyn Castle
Yeah. And I think that maybe in a lot of ways, it kind of does make sense now that we're talking about it though, because of how disgusting Ebola is. I mean, it really feels like the devil. Right. And so I can understand why the response to that would be much more of religious or traditional healing type thing.
- [11:23]
Adam Thompson
I remember early on, the death rate was still 90%. And it's only kind of over a period of time that that death rate kind of, I think, went down to like maybe 60, 70, but that's still. When you compare that to 1%, that's a dramatic number when you think about scale. And if it was anywhere near as infectious as Covid, I mean, you'd be talking about 60% of Lagos just being gone. And that's what worries me about the whole idea of pandemic preparedness and just how I think Ebola showed all these gaps, but also showed that there was steps that could be taken to fill them. Covid showed that one. We didn't take any of those steps on a large enough scale. And the gaps were even bigger than we thought. And the systems were way more fragile than we thought. And so even the confidence I had after Ebola being like, okay, there's stuff that can be done here. I didn't realize how quickly it could be wiped out. And the whole world would just go completely nuts with wanting to spread the disease and thinking it's the right to spread the disease as fast as possible. Yeah, it's very weird. Like, we are 100% screwed if there's a more deadly pandemic. Like, even after Covid, there's no preparation, there's no change in system. The only thing we've done is figured out is like, no one will wear a goddamn mask. If you ask them to, they will refuse. Maybe if it's an Ebola like thing, maybe that changes.
- [12:39]
Evelyn Castle
And that's the only thing I can think is basically how disgusting the disease is and what you're dying from. Again, if you're dying from coughing up mask blood like that, I think that that's gonna be.
- [12:50]
Adam Thompson
But don't you think that's a bit crazy? Because we didn't know how deadly Covid was, but everyone was like, no, screw that. I wanna see how deadly it is first. Before I take any precautions. Because if you take precautions and you're successful, they'll be like, well, what do we take all those precautions for? So we don't all die. They want to see people dying in the streets and then they'll be like, okay, fine, give me the mask again. We're screwed.
- [13:10]
Evelyn Castle
Yes, correct. I'm not disagreeing with you.
- [13:12]
Adam Thompson
I just think. Yeah. Anyway, that's, I think from the outcome of. Because we had that during Ebola as well, not Nigeria. But as time went on there was like, well, is Ebola real? Because that started creeping up in Lagos even. But things were more under control. But in Sierra Leone, that was like a common thing.
- [13:28]
Evelyn Castle
Yeah.
- [13:29]
Adam Thompson
Like when I got there and they'd been dealing with Ebola for almost a year. And when we were in Sierra Leone, they were like, but is Ebola real or is this just a government thing?
- [13:37]
Evelyn Castle
Yeah, well, we'll get to that response another day. So we get into Lagos and what were the. And this is why I actually had to tag you in this, to try to remember, because you were doing so much more of this work than. Than I was. So what were the key things that we really were down there doing? I mean, we did the eucs, obviously.
- [13:58]
Adam Thompson
I mean, it was the whole handful of things. It was figuring out one what the physical infrastructure was going to look like. More on the coordination, less around the. Well, we did some work on the treatment centers in terms of supplying them with power and things like that. So it was basically making sure things could work, setting up the physical infrastructure, obviously the communication, the data tools, and then managing a bit of the kind of incoming and outgoing finance around when things were provided and donated. And when I say finance, some of that was also in kind. So the donations from the fuel companies and the vehicles and those things. So managing a bit of that incoming and outgoing stuff. Because remember, all the health workers were on strike as well. So some of it was figuring out, okay, well, this group is offered to pay them. I think there was one foundation. So we had to kind of coordinate them getting the money and then coordinate it getting to the contact tracers or whoever was doing the follow up. So it was that whole setup, but it started primarily with the infrastructure. But then it kind of just got layered on because there was no one else to do all of these other little bits. I remember the team would meet, the coordination team would meet. You'd have all the Ministry of Health people. But then they'd be like, okay, well who's going to pay the. Oh, who's going to fuel the cars that are going to take the contact tracers around. And then that's when we started kind of emailing around with different groups. I remember Airtel donated a bunch of phones for the contact tracers. Oando donated the fuel. But all the private companies wanted to participate, but none of them wanted to work with government because they knew that it wasn't going to go anywhere. And so once they knew we were there, they just started calling me all the time, being like, we've got this. How can we get it to you?
- [15:32]
Evelyn Castle
Which I guess is one thing that the private sector probably learned better out of. That response was for Covid was the creation then of Caught Covid, which was, you know, their ability to respond to the emergency.
- [15:45]
Adam Thompson
So, yeah, unfortunately, it wasn't an improvement.
- [15:47]
Evelyn Castle
It was not an improvement, no, because still, bureaucracy happens. But yeah. So out of like all of those people, do you remember thinking or do you remember like, who were like the real heroes during that time, you know, not the people who necessarily got the credit at the end?
- [16:02]
Adam Thompson
Yeah, I mean, I think the impactful thing was the FETP fellows, like having 50 or more trained epidemiologists that could really kind of hit the field and know how to track down and trace and report back. And I think that was really probably the thing that had the most impact was being able to have them get the data quickly because we had this backlog in the lab because the Vice Chancellor had to sign off on the results, but he was always traveling. So once we put an ODK form in place that he could just click on it and say it's approved when he was wherever he was, then we could get the results the same day. And we had the dashboard. But the FET pitfellows could then do all the follow up and things like that. There's a lot of administrative movements. I mean, I actually do think Faisal did a really good job bringing the partners in and like letting them do their work. Because even during some of the polio things, you know, with the incident commander at Sano, like the partners were there, but there was a lot of like fighting back and forth and this kind of like the government's in control kind of thing, were in charge, but with Ebola, Faisal much more like, okay, who you're doing that. Unicef, you're doing that great. There wasn't this, I'm the boss, I'm in charge, you guys have to do what the government wants you to do kind of thing. It was very much like he let them kind of set the Direction and let the experts kind of make the decisions around or proffer the decisions around what they wanted, what they thought should happen. CDC had a big. I mean, John Furtive was there for most of the setup and beginning. And so having someone like that kind of senior around that everyone was willing to listen to, I think really helped. Well, one, it helped generally, and it also kind of helped back up Faisal because Faisal and John would always go meet separately and then host the meeting, and then people would kind of get in line. Even who was relatively in line, they weren't trying to run their own system, which they did in all the other countries with this group. They were really kind of like, this is our role we're in here. This is our team. And they did it, and they managed their pillar and contributed back, and that was it. They didn't try and take over the whole thing.
- [17:59]
Evelyn Castle
I mean, obviously that's why that command control structure is successful, which is why they asked us to do it in the other countries. And again, lesson not learned. As to why we didn't do that for Covid as well, who knows?
- [18:12]
Adam Thompson
Yeah, I mean, there's technically an incident manager at ncdc, but then there's also a ptf. And it's just that we were mostly constrained to Lagos, except when they also opened up the Port Harcourt one. But, yeah, kind of that idea like setting up and having the states kind of like have this leadership with COVID Yeah, it's just a mess. There was the infrastructure in place in Nigeria to do exactly what needed to be done. But instead of NCDC tapping in and saying, okay, we have these state EUCs. This is what we're going to do. This is what we've done. They kind of tried to do everything upfront. And then there was the ptf, and then it was kind of confused between who's doing what. But then as the states kind of got up to, they're like, well, this is our job. Why are you telling us what to do? You know, it's just.
- [18:52]
Evelyn Castle
Yeah, I mean, it was very different in how the whole thing was done. But it's frustrating. Looking back, the setup for Ebola, I think could have worked really well for. And I guess it's more. The setup for polio would have worked really well for Covid if there had just been maybe a more conscious decision about doing that. But the presidential task force was already set up. That was already kind of like a thing. And so it'd been hard to.
- [19:12]
Adam Thompson
But also, no one. No one sat down and said, like, well, what worked? Like this is what we learned and this is what we worked. But what happened was they sat down and like, oh, once the cases hit here one very people did pre prep work. The lab infrastructure building capacity didn't start until cases started actually hitting. They're like, oh, we should have labs that can do this. And also then they're just like, oh, well everyone else is locking down. Should we just do a lockdown? They didn't actually go through the process of like what would that lockdown look like in Nigeria?
- [19:39]
Evelyn Castle
Anyways, I think we'll have to do more conversations about COVID in general. But yeah, it's really hard to talk about Ebola without comparing it.
- [19:46]
Adam Thompson
Sorry, I was going to say the other thing. I think that really also had a big impact. There was all the private sector work on Ebola. On Ebola, yeah. Yeah. If we didn't have fuel from Oando and Total and cars and if we didn't have some of the private foundations step up and contribute to pay those salaries for the contact tracers and actually the medical staff themselves, like this would have not gone very far.
- [20:06]
Evelyn Castle
Yeah. So then I just wanted to highlight technically to just remind us about the payments of this. So again we got called down to support and I tried to go back through the emails to really fully understand, but basically like BMGF told us that they would front the cost, then MPACDA was supposed to pay us and then we would reimburse the foundation. That was the original agreement. Yeah.
- [20:30]
Adam Thompson
And there was a million dollars. It was Dangote set aside a million dollar response fund that was going to go through the Ministry of Health. And then that number just kept decreasing every conversation. Well, no, it wasn't a million dollars. It was this. And I was like, well, I've spoke with the Dangote group. I know it was them. But then the funny thing is by the time we got around to them, because I thought they were aware we were involved, by the time I got to them, they're like, oh, you guys are doing it. We would have just given the money to you instead of putting it in the government account. But it went into a government account. That money never. Well, as far as we can. That money never came out of that.
- [20:57]
Evelyn Castle
Never came to us at least.
- [20:58]
Adam Thompson
Yeah. Then we kind of settled on about $400,000 or first it was 600, then it was 400 and that was it. That's when we actually ran out of cash. We're like, well, we can't spend anymore. We had about $400,000 ish in the bank, and we spent it all. And then they were like, oh, that million, which was then 6, which was then 4, is now 0, and there is no money coming. And that's when I remember, like, wanting to die.
- [21:21]
Evelyn Castle
Yeah. And I remember wanting to kill you. But I have this memory of me calling Michael to tell him this. I think so, yeah. Because I remember specifically having a call with Faisal, and Faisal being like, they're sending it to your account. Because I remember I was driving from the house to the office at the time. Like, I remember very specifically this conversation. I just remember being like, faisal, like, there is no money. Just being, like. Like, really freaking out at this point. But I do think it was me that ended up calling Michael and saying, like, they have not paid us. Like, will Gates foundation just cover the cost of it? And he said, yes, I do think it was around that 400,000 mark for the EOC. But then who paid for all of the other support that we gave, like, on the contact tracing stuff? Did we have another.
- [22:04]
Adam Thompson
We all did that.
- [22:05]
Evelyn Castle
We just did it for free.
- [22:06]
Adam Thompson
Well, we all did it within the budgets, the $400,000 that we had.
- [22:10]
Evelyn Castle
Okay, well, I'm sure that there was a lot of work that was paid for by, you know, the polio funding and stuff like that, but. Yeah, yeah.
- [22:16]
Adam Thompson
The staff that were already on. Yeah, those things. Because it wasn't Michael. There was another call we had with Michael, and then I feel bad for forgetting her name, but she was in charge of the. Because they have an emergency response team at Gates Foundation. Yeah. And there's the woman that was in charge of it.
- [22:31]
Evelyn Castle
Yes. And you're right. And she gave us money.
- [22:33]
Adam Thompson
That's where the 400,000 came from.
- [22:34]
Evelyn Castle
Yeah.
- [22:35]
Adam Thompson
And they basically just balanced it. We were like, this is how much we spent. And they just put it back in our account.
- [22:39]
Evelyn Castle
Yeah. Did we get any other money for Ebola from anyone else in Nigeria? I don't think so. I think that was just it.
- [22:45]
Adam Thompson
I mean, again, nothing that came to us. Like, it was a lot of, like, someone allocated money and we made sure it got paid.
- [22:50]
Evelyn Castle
Yeah.
- [22:51]
Adam Thompson
So there was a lot of, like, there's some small managing of funds, but it was just like, this person's doting. We're putting it there. This person's doing it. We're putting it there. And it was a lot of things like fuel vouchers and food vouchers.
- [23:02]
Evelyn Castle
Yeah. Okay. So then it spreads to Port Harcourt. And I remember it spread because some people had run away from the Ebola treatment. Right. I mean, were you still in country when that happened? Do you remember? You must have been, right. Yeah. Why did I go to Port Harcourt? Because I wanted to, I think.
- [23:19]
Adam Thompson
Because I was preparing to go to Sierra Leone, maybe.
- [23:21]
Evelyn Castle
Or was it because you were doing a lot of the contact tracing stuff in Lagos? But I feel like that would have already kind of happened.
- [23:28]
Adam Thompson
I mean, we were doing lots of stuff. But I remember, like, we decided that we would go to Sierra Leone.
- [23:32]
Evelyn Castle
Yeah.
- [23:33]
Adam Thompson
To do like an assessment visit. Even just the initial, because we didn't have the contract. We had like a consulting contract.
- [23:38]
Evelyn Castle
Yeah.
- [23:38]
Adam Thompson
Like for a few thousand dollars. So I agreed to go. Yeah. And I think I took like a break.
- [23:42]
Evelyn Castle
I remember I did it because you were completely burnt out. And I still was okay. Because.
- [23:47]
Adam Thompson
Because I caught some, like, flu or something that.
- [23:49]
Evelyn Castle
And I just think you had worked yourself like a crazy person for like a month. I remember you and I were at each other during that time quite a lot. Like, our arguments were a bit intense, but I think it was just a lot of stress at that time.
- [24:02]
Adam Thompson
Yeah. I remember, like, because I got to that one room when I was sick and I slept in that room. I didn't leave it for three days. Like, I just, like. And then eventually I felt well, and I was like, okay, well, it's just a flu. I'm not dying. And then went back to, I think Kano for maybe a week. And in that whole time you were setting up and then I was preparing to, mm, get out.
- [24:18]
Evelyn Castle
Oh, well, I mean, so we're talking about payments. So that was interesting. An interesting thing because, remember, the state government paid us one.
- [24:24]
Adam Thompson
We were very specific, like, we're not getting anything.
- [24:27]
Evelyn Castle
We're not moving until we get the money. Yeah.
- [24:29]
Adam Thompson
Upfront payment. We need this much money, then we'll go.
- [24:31]
Evelyn Castle
Yeah. But I thought it was really funny because I remember going to Port Harcourt. I remember being in the place and developing the budget with the special assistant to the governor who was going to be paying us. And I remember so specifically saying, like, if you want anything added to this, I said, now is the time. Because this is my actual cost of what I need to do this. And if you guys then come and ask me for anything after that, I don't have any money for you. So I said, if you need to add anything, tell me what it is so I can add it into the budget now before we submit to the government. I remember the guy just being like. Like, you know, not like, offended, but like, you know, this kind of like I don't even know what you're talking about. Like, this is an emergency. We would never ask for anything. And again, I think that this was still. I was so Nai back then and me just being like, this is so great. You know, the state governor is willing to pay for this. They don't even want anything. They're just going to pay us and we'll do it. I mean, we weren't stupid enough to start working.
- [25:25]
Adam Thompson
I think we were very specific. Like, we were just like, well, get in there and get out before they ask for something.
- [25:30]
Evelyn Castle
Yeah, I guess. Yeah. But I mean I should have just put money in it from the get go, like, is really what I should have just done.
- [25:36]
Adam Thompson
I think we did it fine.
- [25:37]
Evelyn Castle
Yeah, I mean, I think we did it fine too. But I remember I got on the plane to leave and I remember Femi at the time was with us and I remember him calling as I'm on the plane and saying, you need to get off the plane. The governor wants to shake your hand. And I remember being like, no way in hell am I getting off this plane. I was like, I know exactly what you mean when you say that. And I said, I already told them, no, I'm out of here. Like, because we had already spent all the money, we'd already done all the deliverables, so there was zero reason for me to do that. But I just remember thinking like those mother. I told them if they wanted something to put it in the budget, they can't come back to me now.
- [26:13]
Adam Thompson
And to be honest, what we know now, it's very possible that if the governor was there, they would have figured out and they would have. Can you spend more money?
- [26:21]
Evelyn Castle
Yeah, because I'm sure the budget wasn't very much. I'm sure the budget was like $100,000.
- [26:25]
Adam Thompson
I remember being in the $200,000 ish range. But yeah, I mean, I'm sure on paper they spent a million dollars.
- [26:31]
Evelyn Castle
Yeah. Again, great. You guys take care of that behind the scenes. I don't need to participate in any of that. And also, like, you guys know how to do that way better than we do. So just do what you're going to do and then just leave me out of it. Which it did happen that way and they were able to sort it out. So that's good. But we didn't do anything else there. Just the eoc, I think.
- [26:49]
Adam Thompson
Yeah. And just ran it for a couple months, I think.
- [26:51]
Evelyn Castle
Yeah, it wasn't very much. So. Yeah. So then I remember. So I had to look at this up, Nigeria was declared Ebola free on October 20, 2014. Do you remember where you were? You must have been in Sierra Leone, I assume.
- [27:03]
Adam Thompson
Sierra Leone. Yeah.
- [27:03]
Evelyn Castle
Yeah. I don't remember celebrating. I don't remember taking a breath. I don't remember doing anything. Being like, congratulations to us.
- [27:10]
Adam Thompson
Yeah, no, no, I couldn't really remember. I know, because it was September that I was in Sierra Leone. I might have even, like, had already moved to, like, Liberia by then. There was a lot of, like, movement around that. Around that time.
- [27:20]
Evelyn Castle
Yeah, I know you were gone. I know I was for sure still in. In Nigeria. But even that, I don't. Being in Nigeria, I don't remember any sort of celebration or anything.
- [27:29]
Adam Thompson
No, it was just more about, like, how do we, like, clean up and get back to work.
- [27:33]
Evelyn Castle
Yeah.
- [27:33]
Adam Thompson
Because, like, we, you know, all the Nigeria work, like, we were net zero after all that. Like, we'd spent all that time, and then we had to kind of get back to polio work. And, like, we just broke even on everything that we did. So it wasn't like we made any income. We didn't make any net income. Yeah, I do remember there was a lot of talk about, like, you know, because everyone wanted to be like, oh, well, can you help us build a center so we can prepare for the next one? So there's a lot of running around afterwards. I remember Atsif was running around meeting with people that wanted to build whatever. And it was a lot of state contracts where people wanted to. They had all this money that they were able to allocate, and they wanted to spend it, but they didn't actually want to build anything. It was just a way to embezzle money. And so none of those actually came through, I think, except for the airport thing, the thing that we put at the Lagos airport.
- [28:14]
Evelyn Castle
But again, that was a private. An NGO gave us that money.
- [28:17]
Adam Thompson
But all the state contracts. Yeah. Never came.
- [28:21]
Evelyn Castle
So what is your opinion? Was Nigeria successful in stopping the outbreak or was it luck?
- [28:27]
Adam Thompson
I mean, it's hard to not have a little bit of both. I think the system worked as well as it could. Obviously, it would have fallen apart if it didn't have private money, because not a single Nigerian naira got spent from the government side of things, which is quite shocking. So it could have easily been terrible. Like, if we didn't finance it, if we didn't put $400,000 upfront to pay for all that stuff, what would have happened? There would have been no staff, no contact tracers. There would have been Nothing.
- [28:58]
Evelyn Castle
No location.
- [28:59]
Adam Thompson
I mean, yeah, no EOC even take the EOC out of it. Like the doctors were on strike. They were not willing to do contact tracing. The FETP fellows, I guess technically they were paid for by cdc. So they were sent down there, but they didn't have cars to get around, they didn't have fuel. I mean they didn't have all of these things. I guess maybe they could have sorted it out. But there was a lot of stuff that happened that if it didn't happen, it would have been really bad. And things moved so quickly that things were under control quite fast. And so there was a good thing. That doesn't mean that it wasn't luck. There was just some behavioral luck, things that happened in Lagos that really kind of freed up the space for that. The fact that so many people left as well to get out of Lagos. So there was. The congestion was gone. That obviously helped stop the spread because people went back home. And luckily they went back home before they could take it with them.
- [29:48]
Evelyn Castle
Yeah.
- [29:48]
Adam Thompson
Again, luck that those first few cases got identified so quickly and isolated so quickly.
- [29:54]
Evelyn Castle
Yeah. And I think that's probably the major thing is like the way that it came into the country. If it had come in, like you had said, on a bus, then we would have been, I think, totally screwed. But because it was a wealthy person that came in on a plane and then was brought to a private hospital. Yeah, that was fortunate, I guess.
- [30:09]
Adam Thompson
And then that private hospital, that nurse past like, you know, making the decision to like not let this person leave when he tried to leave. All of that, you know, those actions combined with some luck, combined with some like quick responses, I think is what ultimately led to that happening.
- [30:25]
Evelyn Castle
I never saw that movie, did you?
- [30:26]
Adam Thompson
I started watching it and it was really bad. It wasn't great. I mean, it might be worth a watch just for fun.
- [30:31]
Evelyn Castle
Yeah, I think it'd be fun to watch. Yeah.
- [30:33]
Adam Thompson
I do think that there were some key lessons that could have been learned and implemented. And I think then what happened is then NCDC and some of the other states were like, okay, well now we're going to learn from that and build all this infrastructure. But it's like infrastructure, like a name, only there's no processes. And the reality is it's money. At the end of the day, if you don't allocate money to deal with an emergency response, it doesn't matter if you have a building, doesn't matter if you have staff, doesn't matter if you have a fancy contact tracing app. If there's no money to get things moving, things break. And that's what I think we've seen during COVID It's like, yeah, great. Edo has an eoc. Great. Now what do they do with that eoc? They can't hire staff, they can't set up treatment centers, they can't pay people money to stay at home during lockdowns. They can't do any of that. They just have a building that has the letters EOC on it. And that's different than having an actual emergency response and the ability to respond. And I think those things in Nigeria get convoluted together because again, emergency response is always your kind of coordination pillars, your epidemiologists, your logistics, your whatever. But the biggest one's always finance. And if your finance isn't there, then there's no point.
- [31:37]
Evelyn Castle
Yeah, but I think like the kind of shocking thing is how little money it actually takes to get things moving.
- [31:42]
Adam Thompson
Yeah. When you just do it.
- [31:43]
Evelyn Castle
I mean, the fact that again, you're saying that like our $400,000 got things moving, that's a penny in the bucket of emergency response money, you know, I mean, so it's just being able to utilize money effectively. And I think that that's also like, again, the point is that, yeah, the process is to manage that money quickly. And they definitely, I don't think, have that.
- [32:05]
Adam Thompson
Well, I mean, very few people do. Right. And that's the challenge.
- [32:08]
Evelyn Castle
Which is why it's almost so frustrating that again in the last 10 years, so many organ, all of the organizations like us have failed because now you're left with small local NGOs who cannot take that type of money because they have no experience managing it. Or you have these giant NGOs that have so many processes in place that you can't buy a $10 fuel card. So there is a reason why organizations like ours should exist and it's a shame that we don't have them.
- [32:37]
Adam Thompson
Yeah, it doesn't even have to be non profit. But just in the US you have all these contractors that when something happens like FEMA signs a guarantee of payment and a bunch of food and water shows up. Because those contractors know the US government's good for the money. Once I get that email saying they're going to buy the food, I drop off the food. I don't even think about it. I do it the same day I get that email. Even if the money comes a month or two weeks or whatever later. But in Nigeria, none of those private companies, no private companies are going to be like, oh yeah, I'll take your guarantee of payment and then spend all this money. And you get these issues of where the US agencies in charge of emergency response overseas aren't like fema. They can't just issue these quick emergency fund contracts like cdc. Our emergency contract took. Yeah, to come through and that was an emergency fast tracked approval. The vaccine trial I think was a little bit more sped up from that because that came from different pool of money. But yeah, it just shows you. And then Trump at the helm and the cdc, it just shows you how much that institution is broken. The CDC is a useless organization when it comes to disease response.
- [33:42]
Evelyn Castle
It's like now. I mean, yeah, it's now.
- [33:45]
Adam Thompson
And it was then as well, because that was, I think the other eye opening thing is they were sitting there, we were spending money, CDC was in the room in Lagos being like, oh well, I'll make some phone calls to see if we can get some approvals. But they had no money. They had the risk of like Nigeria having community spread of Ebola and they still had no money and they had no window at which they knew they were even going to have money or get approvals. Like from that point, it took a year to get any actual government money out of that process. And then that was during Ebola when people were active and trying. Then during COVID they were completely dismantled and even less effective. And I think going forward. Well, it's the same thing that happened now. Like, you know, we had the whole discussion about WHO being the coordination mechanism after Ebola because they were so useless and they got even more money, said we're going to do a reform, we're going to reorganize. And they did that. And then Covid happens and then what? There's some guy on TV every night giving an update about how the numbers are in different countries. You're like, what in the hell does that have to do anything? Why are you holding a press conference? Go away. It's such a useless, expensive ordeal that doesn't actually add any value because all the countries were like, well how can who help us? And they're like, oh, they can't do your own thing. Okay, we'll do our own thing. But then who kept having daily press conferences just to update people on what the numbers were. And it's like, people can go to the website and look at the numbers. We don't need you giving a conference reading out that we should wear masks and read the numbers. It's weird that we're still here and we're still pretending these agencies can respond.
- [35:18]
Evelyn Castle
Or are the right people to respond.
- [35:20]
Adam Thompson
Yeah, we're still pretending like they can respond to an outbreak, even though we proved that they couldn't during Ebola. Now we've proven again that they can't.
- [35:26]
Evelyn Castle
During COVID Yeah, well, so I think going back to though, you know, was Nigeria successful again? I think probably the biggest outcome from Nigeria was this. The fact that, like, the model of the EOC and the command control worked. Because until Nigeria, they weren't even doing that in the other countries.
- [35:44]
Adam Thompson
They weren't even doing it when we arrived there.
- [35:45]
Evelyn Castle
That's what I mean. So it wasn't until, like, you know, Nigeria was able to say this worked and that, you know, the other countries or the groups, whatever, in those countries said, okay, we're going to do the same thing.
- [35:56]
Adam Thompson
But that's because they had two years of polio experience sitting down in the same rooms, agreeing on work plans. And even though it was a struggle, they just had that experience of going and sitting in the same room and who saying, oh, we're okay with you being in control? None of the other countries did it happen. They were still fighting over who's in charge when I got there in September.
- [36:15]
Evelyn Castle
But so I think, like, if anything, I think that was a fairly successful piece of Nigeria. Was. I mean, if Ebola had never come to Nigeria, Nigeria, I think that system may never have even reached the other countries, you know, as the right model to run the response. And then who knows where, you know, how that they would have managed that response, you know, again, in that siloed kind of manner. So if anything, I think that's kind of interesting. But then I guess the question here really is because we've had the Ebola cases come back in guinea, and I have not heard anything recently, by the way, which is concerning about that. But say it comes to Nigeria again, do you think we could do it again, you know, at the same type of level of, you know, 20 or so cases?
- [36:58]
Adam Thompson
I don't think so.
- [36:59]
Evelyn Castle
I don't think so either. Why don't you think so?
- [37:01]
Adam Thompson
I think because the government would try and do it themselves. Like, they're less likely to kind of let another group or let that kind of system work. For example, it landed in Lagos. Lagos State didn't run the coordination. They let this group do it from national. They let them have it. They would not let them do that now because, 1. I don't even think it's an ego control thing. I think it's more of just like they Want the money? Because Lego State, during the Ebola response, had their own EOC that they were feeding money into, but they weren't doing anything. And it was just a way to, I think, move money around.
- [37:33]
Evelyn Castle
Yeah. Which is fine as long as the response can still happen without that fight.
- [37:38]
Adam Thompson
But I think now you'd still have a fight over, even with NCDC there, you'd still have a fight over, is NCDC in charge? Is the Lego State in charge? Is the president in charge? And then you'd have this issue of like, okay, well, who's paying? Since you guys have your emergency system, do you contract? They'd still want us to then provide support, but they don't want to pay for it. And if they do pay for it, it's these long government contracts you can't trust. Yeah, unfortunately, I think if it happened, it would break down just like it did over Covid.
- [38:07]
Evelyn Castle
Yeah, I completely agree on that side and would add, I also think that, like, the general public's response and mistrust in government and in government and health care, I just feel like has been amplified so much since then as well, too, that I don't think that people will do what they're told to do. I don't think that they will believe if it comes back. I think that they'll say that it's government trying to control them. I just think that, like, and rightfully so.
- [38:33]
Adam Thompson
Or they'll say, don't worry about it. Go buy the hydroxychloroquine.
- [38:35]
Evelyn Castle
Yeah.
- [38:36]
Adam Thompson
Like, there was a lot of misinformation being spread during Ebola.
- [38:39]
Evelyn Castle
Yeah.
- [38:39]
Adam Thompson
It's gone up 10,000 times.
- [38:42]
Evelyn Castle
With COVID With COVID Yeah.
- [38:43]
Adam Thompson
So whatever the next outbreak is. Yeah. I think we're going to suffer the same fate because I don't think we've learned anything. And I think it also shows how important, even with things happening in Nigeria, how important, like global leadership is, the fact that we had Trump during the majority of it kind of also led a lot of people in Nigeria to be like, well, the US Isn't taking it seriously. They don't think it's a problem. Why do we care? And there's a lot of that kind of watching what other people are doing. And with the US not really caring. That led to, okay, well, why should we listen to NCDC tell us it's serious when the US doesn't think it is?
- [39:15]
Evelyn Castle
Yeah, it's a really good point. The other thing, too is, like, again, it's just so crazy to think about, like, where we were, technology Wise and communication wise in 2014 versus where we were in 2020. And, you know, the amount of people using WhatsApp and with access to information and all of that has just like, really blown up, which is fabulous. But yeah, it just means that the misinformation campaigns are huge.
- [39:38]
Adam Thompson
Yeah. And this access to the Internet somehow makes everyone feel like they can become a public health expert, including, like all the pastors.
- [39:45]
Evelyn Castle
Well, even just the things, though, about, like sharing around the misinformation is way easier for people to be taken. Taking videos of things and then saying, I mean, they could definitely be true, or twisting that story a little bit and then that goes spiral.
- [39:59]
Adam Thompson
I'm really interested to hear what different groups are doing when it comes to this discussion, because no one's talking about. At least I haven't heard a lot of discussions around, like, what is who? Like, what are they doing? What is their role when the next pandemic hits? Because their role this time was useless. Even Covax was set up with a separate administration. Like, yeah, with a rep from who, but not like, even inside who. And to me, that's like, that's kind of mind boggling. Why did we have to create another administrative unit if WHO exists? If WHO does what, theoretically, on paper, they should be doing. Why does Kovacs exist? Why isn't it just a unit within who? But it's because they don't have the. Anyway, there's a lot of things like that where you're just like, okay, what do they do and why are they there? And given that we know they're not a useful response agency, why are we still giving them money?
- [40:44]
Evelyn Castle
Yeah.
- [40:44]
Adam Thompson
And why.
- [40:45]
Evelyn Castle
Why are we preparing for the next pandemic with them as the leader of the money?
- [40:49]
Adam Thompson
Because people have sent all the emergency response money to them and it still takes them months and months and months to get that money out. And it, like, just.
- [40:56]
Evelyn Castle
And again, we're not even allowed to get any of it. Which is like the crazy thing.
- [40:59]
Adam Thompson
You can't get it from who. It makes it really hard. Yeah. And so I think that, like, they've actually responded to Ebola by making things worse.
- [41:06]
Evelyn Castle
More bureaucratic.
- [41:07]
Adam Thompson
I mean, they said the same thing with Ebola. Like, oh, main mistake they made is not declaring it soon enough. And then what did they do with COVID They just kept being like, well, it's not a pandemic yet. And everyone was like, it's a pandemic. Just call it a pandemic. And their money for their pandemic response doesn't get released because then when they called a pandemic, then someone's got to do one month, two months of paperwork to get money even distributed to start people distributed. And so they just delayed everything by an extra month for something that spreads as fast as Covid. And again, if anything's ever deadlier than that 1%, like, we're really screwed.
- [41:43]
Evelyn Castle
Yeah. So I wanted to talk about this because I was going through these emails and like, I was just shocked. Some of the emails. But. So who are our. Who are some of the key staff that were working with us at that time? Do you remember, like, who went down with you to Lagos eventually?
- [42:04]
Adam Thompson
I know Otif was there.
- [42:06]
Evelyn Castle
Yeah. Dee Dee. Yeah. Was that when Didi started with us?
- [42:10]
Adam Thompson
It was around the time, the beginning. Yeah, yeah, I know Justin was there for part of the time.
- [42:16]
Evelyn Castle
Yeah. Do you remember anyone else? I mean, I remember Femi.
- [42:18]
Adam Thompson
Yeah, Femi.
- [42:20]
Evelyn Castle
Yeah.
- [42:20]
Adam Thompson
There was the woman that was like. Actually she was in Sokoto for a while. She came down to Lagos. She was our coordinator in Sokoto. Ori.
- [42:28]
Evelyn Castle
Oh, okay. She went down. She still was with us, you know, she's been.
- [42:32]
Adam Thompson
Yeah, she was there. Mustafa from the Dykes were there.
- [42:37]
Evelyn Castle
Yeah. But that was basically it, I think, from our side.
- [42:40]
Adam Thompson
Yeah, we didn't have many.
- [42:42]
Evelyn Castle
Yeah, we didn't have that many. Okay.
- [42:43]
Adam Thompson
I feel like other software developers came. I think more software developers like Musa and.
- [42:47]
Evelyn Castle
Yeah, I think there were. There was a small team of software developers down there with you guys. I don't know where they must have been working out of.
- [42:52]
Adam Thompson
I don't think they're there for long. I think they kind of came, worked on some stuff and then did most stuff remotely. But there was like, someone doing, like, IT stuff for me. I know there was a lot of stuff with that stupid system they were.
- [43:02]
Evelyn Castle
Using, which, I mean, makes sense because.
- [43:04]
Adam Thompson
There was a. Oh, yeah, me was definitely there.
- [43:05]
Evelyn Castle
Yemi. Yeah, yeah, that makes sense because it. For the EOCs as well. So that made sense. Yeah. Because I was going back and reading through and we'll have a whole other episode where we just kind of talk about, like, our growth as leaders and, you know, kind of like management styles and stuff like that. Now we're at the end of this kind of conversation. I guess my question to you were like, what were your top, craziest moments from the Ebola response that you remember?
- [43:29]
Adam Thompson
I mean, the biggest one that stands out was just when all the ambulance drivers hadn't been paid because we thought they were being paid and they all just showed up at the OC demanding to be paid. And so.
- [43:40]
Evelyn Castle
And what happened?
- [43:41]
Adam Thompson
Well, I was just convinced I was going to. I was like, well, got an Ebola now? Great.
- [43:44]
Evelyn Castle
Well, explain the scene. What happened? So they all. How many people came and stormed the eoc?
- [43:48]
Adam Thompson
Well, I mean, it wasn't a storm. Like, they. They just walked in. They were like, we're not leaving until you pay us. Like, we're not.
- [43:54]
Evelyn Castle
What, like 20 people? 100 people?
- [43:56]
Adam Thompson
It was probably, like, a couple dozen. Yeah, but it was like. Wasn't a big space. I don't know what you're looking at me for. Like, I don't pay salaries. Like, I don't have anything. But I remember having to, like, realizing, okay, the government had promised to pay their salaries. Obviously, they didn't. So then I had to call the woman that was at that foundation that they set up that was coordinating things. And then she made a few calls, and it was like. Then the money came from some rich.
- [44:17]
Evelyn Castle
Bank person and what else?
- [44:20]
Adam Thompson
Yeah, I mean, I think, like, that was the kind of scariest thing, because I just remember thinking, like, so terrified of Ebola at that point. And I think that was close towards the end when I was, like, sick. Kept thinking back to that moment. I was like, here's people that have been, like, taking dead bodies around Legos and driving infected people back and forth. And now they're just sitting here. And I'm like, great, we all have Ebola. And then I was, like, sick, like, three days later or a week later, I guess that sounds like incubation time. I mean, what was crazy was how disgusting that Central Public Health lab was. It was biohazard zone. I mean, it was so gross, like, indescribably disgusting. And we had to turn it into a functioning center in, like, a very short period of time.
- [44:58]
Evelyn Castle
Explain it to me. Why was it disgusting?
- [45:00]
Adam Thompson
They had some labs running down at the bottom, but they didn't do, like, incineration. When they were, like, finished with the blood samples, they would dump it down the sink, and then the sink just ran out into the courtyard. So there's just like this kind of bubbling brook of, like, blood and waste from the lab. And then that was on one side of the courtyard, which we had to clean up, and then obviously close all that up and spray a ton of disinfectant and chlorine and not go anywhere near it. And then, yeah, the rooms upstairs, which were kind of functioning labs, but they had obviously been not used for a long time, just had old specimens that they hadn't thrown away that were just rotting in the corner and you didn't know if it was blood or body parts or what. I mean, it was really bad. And all that had to be taken out. Like people in hazmat suits taking it out and. And just like, burning it and then. Yeah. Having to, like, clean that up. Yeah, it was a special level of gross.
- [45:49]
Evelyn Castle
And then what about that story about the time that the guy with Ebola came into the eoc? Were you there for that?
- [45:55]
Adam Thompson
I don't think I was, actually.
- [45:56]
Evelyn Castle
But do you remember the story?
- [45:58]
Adam Thompson
I, like, I vaguely remember it. I think people made a big deal about it, but, like, yeah. Thought he had Ebola or did he actually have Ebola?
- [46:05]
Evelyn Castle
I think maybe you're right. I think maybe they thought he thought he had Ebola and he came.
- [46:08]
Adam Thompson
Oh, yeah. Because people thought that was like the treatment center. No, actually, that happened a lot. You're right. Sorry. People kept coming, thinking that's where they get when they were really sick. So, yeah, these sick people kept showing up, wanting to get treatment for Ebola. And yeah, that caused a lot of.
- [46:21]
Evelyn Castle
Rightfully so. It would freak me out. Do you have any really standout best moments during the response?
- [46:30]
Adam Thompson
Yeah, I think the best moments for me was I really kind of got to know a bit more about the actual intricacies of an emergency response. We knew roughly the polio system, but the polio system was kind of like a modified emergency response, right? Yeah. There weren't the kind of pillars and management systems that needed for a more rapid response. And so I got to learn a lot of that from John Verdefey. And I think it was Lisa who took over for him afterwards. So I thought that was good. And then it was actually just like. Yeah, I was working with all the private sector groups. I found that when I got to kind of meet with Total and, you know, they approved the vehicles and then I got to meet with Oando and they approved the fuel. And, you know, those were like, the good moments because, like, one, I wasn't dealing with whatever the government was doing and kind of got to, like, make things move and keep things going without spending any more money, because we didn't have money to spend. So it was just asking people for money or things.
- [47:24]
Evelyn Castle
Yeah. I think another kind of really interesting thing that came out of that response was it was the first time that you and I were working, like, very separately on different things. And I think that it was just like a really great experience to be able to know that, like, we both can do it. On our own. You know, I think that obviously we're better together when we can, like, strategize, but at the end of the day, both of us can run these things on our own. And that basically kind of doubled our capacity to do things. And if we weren't. If we hadn't been that successful, there's no way we could have done, you know, what we were doing in the other countries. Yeah. If we both had to be kind of helping each other along the way. And I think, like, again, looking back, it's just. It's hilarious to think, like, I was 24 at the time that this happened. And for me personally, I think that that was just a really good growth experience of, like, for my confidence as well. Of, like, you were gone and I couldn't ask your opinion about these things because you were doing your own thing. So, you know, I was running the entire company basically by myself while you were running the Ebola response in legos. And I thought that was, for me, a really good, good experience. Stressful, but good. Which, again, I think is why you and I were kind of at each other's throats for some of that.
- [48:30]
Adam Thompson
But. Well, I mean, I mean, it was stressful, but, like, I mean, the thing that we learned even later on was around, like you said, the leadership and the staff, like, we had these senior staff that we let mess with us and mess with other staff and bully us and manipulate us and cause all this extra stress that didn't need to be there. And I think didn't really learn it as an outcome of legos, but definitely learned it as an outcome of that expansion in general. Right. And that, yeah, like, people are really toxic and figuring that out early on, and as soon as you see those toxic traits, just immediately ending it, not letting it be like, okay, well, maybe they were in a bad mood, but just being like that sounds really toxic and manipulated. Goodbye. And that's obviously my attitude now of, like, just don't, like it's so destructive. So amazingly destructive.
- [49:13]
Evelyn Castle
Like, yeah, so, yeah, the fact that we were able to do all of that, and it kind of was a lot by ourselves, to be honest. You know, like, we didn't really have that much support. Yeah, it was fairly impressive. And again, at the age that we were at, you would only just turn 30 too, or 29, whatever. Yeah. So is. You could go back and something differently. Is there anything that stands out that you have, like, a regret about? Like, oh, I would definitely have done this differently if I could have.
- [49:41]
Adam Thompson
Not necessarily for Legos. I mean, I think the only things that could have been better is if it was financially better for the organization, if we could have figured out how to play a more essential role in. For example, I worked with that foundation. They set up all those donations. That foundation still exists. They made so much money raising money during Ebola. They still exist. And it was only just because we didn't have the capacity to. That we didn't do that. I mean, it was like they were a good, easy outlet and they were really, really helpful. But if we would have had the resources and capacity, we could have played a more central role in coordinating those as well. And that probably would have led to more income during the thing. So it wouldn't have been a wash, but also would have kind of built up as the kind of leader in that space. Because I think we left that space and not. Except for the central people, no one knew what we did. Like that foundation that's left behind. They're known for raising the money to fight Ebola. Right. I mean, and some of the other groups that popped up around that time, I think we didn't invest enough in the contact tracing software and really making that system work. Part of that was we didn't necessarily have the right people, but there were some easier things that we could have done. Like, we built basically what is now Sormos, but obviously someone else took credit for it and then kind of made their own version of it. And now that's a big thing. And so I think there are a couple big missed opportunities that were made up later. Because I think running the vaccine trial later on was way more exciting for me than a contact tracing app that's used in four countries.
- [51:03]
Evelyn Castle
Yeah, No, I would agree with that. I think that, like, maybe it would have been nice. Yeah. If certain things had happened differently. But I don't think any of that was our choice during that time. I think the things that, you know, were our choice was probably how we could have leveraged on. On what we were doing. I mean, I think, like, you know, and. And there was a little bit of publicity that we did get. You know, remember I went to that Paris Next Blow thing and got that award, which was really cool. And I think we probably could have tried to make a little bit more of a name for ourself afterwards.
- [51:37]
Adam Thompson
Yeah. But in the groups that had that experience and knowledge in place, kind of made a name for themselves. Right. Like, you know, even like DHIS2 used it to their advantage. Comcare basically said, well, we did all the contact tracing in Sierra Leone. And we're like, no, you didn't. Like, we did.
- [51:52]
Evelyn Castle
And I mean, it's hard, you know, because, like, there weren't that many organizations that went from. I mean, we're the only one, really, that went from Nigeria and then went to all of the other countries. If we had only been in Nigeria, then, sure, we would have had the time to have done.
- [52:05]
Adam Thompson
Or even just only in Sierra Leone or only in Liberia. Right?
- [52:07]
Evelyn Castle
Yeah, but I mean, we were stretched so thin. There was really zero percent opportunity for us to do anything.
- [52:13]
Adam Thompson
But. Yeah, but I mean, I'm just saying, like, having a team that could have, like, gone back and been like, okay, great, this is our kind of debrief. These are all the systems that weren't there. Like, let's spend time just doing. Figuring out, like, what a series of tools would look like. But again, we had that our software leads were just like. They were more about, like, building really complicated, expensive things than actually, like, a useful set of tools. And I think that's where. That's where we kind of just ran in most of that software we just threw away. Right?
- [52:37]
Evelyn Castle
Yeah. And I think that's probably what will be the main. If I could do it differently on the entire Ebola response, that's what it would be. Or actually, even just as an organization, I think the solutions piece is really. But it's hard to say because again, hindsight is 2020 and like, again, the E. Health M Health world has changed so much in 10 years. It's really outrageous how quickly everything has changed. So. Yeah. All right, well, we are at time over time, actually. So I guess this was more of a, yes, the Nigeria Ebola response, but also a slight comparison of the Ebola response in Nigeria to Covid as well. All right, thank you. Thank you so much for listening to this episode of the EHA Founders Podcast. Please like and subscribe on your podcast app or on our YouTube channel so that you can be updated as we continue to post new videos about our journey and impact investing in Africa. Thanks.