Why are we there?
- Armed conflict
- Endemic/epidemic disease
- Social violence/heath care exclusion
February 12, 2015
Since the Ebola outbreak began in March in Guinea, it has claimed 9,152 lives (as of February 12th). The outbreak has spread beyond Guinea and has affected a total of four countries: Guinea, Liberia, Nigeria, and Sierra Leone.
Following the decrease of new Ebola cases during the first four weeks of 2015, numbers in Conakry rose again, from nine confirmed cases on January 30 to 18 confirmed cases as of February 10. Moreover, with many of the country’s prefectures considered as “active,” the epidemic is still geographically spread out. New chains of transmission have been reported in areas previously considered as Ebola-free. MSF deployed rapid response teams that are able to quickly identify, investigate, and follow new cases and contacts, as well as quickly setting up isolation units within existing health structures. The number of unreported community death and unsafe burials remains concerning, especially in Conakry. Outreach activities, active surveillance, social mobilization, and training are ongoing in all projects.
Guinea: Latest MSF Updates
- An Unprecedented Year: MSF's Response to the Largest-Ever Ebola Outbreak
- MSF's Month in Focus: March 2015
- The Ebola Outbreak One Year Later
- Financial Accountability: Ebola Response in 2014
- Ebola in West Africa: Selected MSF-Authored Medical Articles
This is an excerpt from MSF's 2014 International Activity Report:
On March 22, what was to become the largest recorded outbreak of Ebola was officially declared in Guinea.
It is believed that the outbreak originated in the Guinée Forestière region in December 2013. Previous outbreaks of Ebola had mostly erupted in remote villages in central and eastern Africa, where they could be more easily contained. This time, however, Ebola broke out at the junction of Guinea, Liberia, and Sierra Leone, where people regularly move across the porous borders. The deficiencies of the public health system in Guinea and the fact that early symptoms of Ebola are similar to malaria—a salient health threat in the country—led to misdiagnosis of infections early in the epidemic and allowed for the spread of the disease.
Doctors Without Borders/Médecins Sans Frontières (MSF) was collaborating with the Guinean health ministry on a malaria-focused project in the hospital in Guéckédou and 20 community locations in Guinée Forestière when Ebola was suspected. On March 18, a reinforcement team with viral hemorrhagic fever specialists arrived in Guéckédou and started an exploratory intervention, supporting the health ministry in collecting samples for analysis. Once the Ebola epidemic was declared, the malaria program was put on hold as staff were reassigned to help the MSF emergency team build the first Ebola management center (EMC) in Guéckédou. The malaria program closed in August.
The EMC in Guéckédou opened on March 23 and served as the main center for Ebola cases in the region, caring for patients, carrying out health promotion and outreach activities, and training medical and sanitation staff. A psychosocial team also worked at the EMC to support patients, and spent time with families and communities, helping address their fears and cope with the loss of family and community members. By the end of the year, 1,076 Ebola cases had been confirmed, and 430 patients had recovered and been discharged from the facility.
Ebola in Guinea: An Unprecedented Epidemic
To reinforce the activities of the EMC, MSF opened a transit center in Macenta, Nzérékoré region, facilitating detection, triage, and referral of patients coming from the southeast of Guinea. Psychological support was also provided. Between March and November, 520 patients were transferred to Guéckédou EMC. At the end of the year, the transit center was converted into an EMC and handed over to the French Red Cross.
On March 25, MSF opened an EMC within Donka Hospital in Conakry, Guinea’s capital city. The team conducted health promotion, educational, and outreach activities, including identification of possible patients with Ebola, provided psychosocial support and trained medical and sanitation staff. By the end of the year, 1,463 patients had been admitted; 594 of these were confirmed to have Ebola and 290 recovered.
Telimele district, 168 miles north of Conakry, was relatively far from the country’s Ebola epicenter in the southeastern forest region, but Ebola cases were reported in May. MSF teams were quick to respond, transforming one of the local health center’s wings into an isolation area and building an EMC nearby which opened within days. By the end of July, Telimele was declared Ebola free.
Researching Ebola Treatment
In the absence of specific human treatments for Ebola, MSF partnered with the French National Institute of Health and Medical Research (INSERM) to trial an experimental treatment in the midst of an outbreak. The drug tested in Guéckédou for efficacy against Ebola was favipiravir, an antiviral used in Japan to combat resistant flu in adults. Soon other sites, not managed by MSF, were also included in the favipiravir trial. More trials for treatments, vaccines, and diagnostic tools were planned to start in the region early in 2015.
In order to bring the Ebola outbreak under control, critical components of the response—such as surveillance, contact tracing, community mobilization, and infection control protocols—needed to be strengthened, and MSF continually asked for more support in 2014. Many Guineans remain reticent to accept messages about Ebola, as the general level of knowledge about it is low. Health workers, patients, contacts, and survivors are often stigmatized and this prevents people from seeking medical help—such as those suffering from malaria, which has not receded as a health issue during the Ebola crisis.
Measles Vaccinations in Conakry
In February 2014, MSF vaccinated more than 370,000 children aged between six months and 10 years against measles in the Conakry neighborhoods of Matam, Ratoma, and Matoto. At the end of the intervention the vaccination coverage was just over 87 percent. Staff treated 2,948 cases of measles, 241 of which were severe.
At the end of 2014, MSF had 545 staff in Guinea. MSF has worked in the country since 1984.
David,* 25 years old, from Matam
I’ve been very sick for more than eight months. I went to a lot of health centers and hospitals here in Conakry. I tried everything, even traditional medical treatments. No one ever suggested an HIV test. Coming here, I was tested, and then told the news.
Nobody knows in my family except my uncle, who accompanies and supports me. These last months have been physically and emotionally exhausting.
*The patient’s name has been changed.