Gouecke, Guinea – Guinean authorities are in a race against the clock to limit the spread of an Ebola outbreak after several deadly disease infections were detected in the southern region of the country last week.
The West African country declared an Ebola epidemic on February 14, two weeks after patients attended the funeral of a nurse in the town of Gouecke and subsequently presented with symptoms of the disease, including fever, diarrhea and vomiting.
Among the confirmed and suspicious cases – the nurse, five members of her family and a traditional healer she had consulted – five have died and two are being treated in isolation.
Despite the ban on gatherings of more than five people, including weddings and weekly markets, the people of Gouecke seemed skeptical about government directives and the resurgence of a disease that killed some 2,500 Guineans during a previous epidemic that devastated in West Africa between 2014 and 2016..
“We’re not afraid or worried,” said Paul Lamah, who was one of the residents who defied the ban and went out to the weekly Gouecke market on Saturday.
“We know that God is with us. If the authorities want to lie to get their partners money [aid organisations], they shouldn’t say. But for us, there is no Ebola. “
Echoing his sentiments, Fatoumata Diabate, a N’Zerekore red oil seller, said the containment measures announced by the government posed a threat to people already struggling to survive.
“Our husbands finished their studies but have not found a job. We are responsible for our families, that’s why we came to sell our products, to find something to eat “, said Diabate in the market.
“We need to stop getting tired of this Ebola outbreak story. Also, we don’t believe in this disease. It’s just rumors because we’ve never seen any patients or people who have died from this disease.”
Community engagement is “vital”
In this context, the Guinean authorities, in collaboration with international experts, are trying to establish the full scale of the outbreak.
Efforts include tracking people who potentially came in contact with Ebola patients to monitor their health and stop the transmission chain. Security forces have also set up checkpoints to catch temperatures and isolate those who appear ill.
Neighboring countries are also on high alert to prevent a repeat of the previous outbreak that killed more than 11,300 people in Guinea, Sierra Leone and Liberia.
Sierra Leone authorities deployed workers at entry points across the border with Guinea to help border patrols and health workers, while Liberia increased its threat level and “increased surveillance and preventive activities.”
A resurgence of Ebola could paralyze the already tense health systems of countries in the region at a time when they are also battling the coronavirus pandemic.
Health experts stress that conveying good, clear health education information is key at the beginning of a response to Ebola, but in Gouecke some residents argued that the seemingly confusing message has played a role in the reluctance of people to heed the directives of the authorities.
“Why do they want to stop the market when the kids are still in school, three or four sitting in the same bench all week,” said Foromo, a resident of Gouecke.
A prefecture official who spoke on condition of anonymity told Al Jazeera that authorities were weighing in on sending security forces to enforce the ban, but in the end decided not to do so.
The source said an important factor in the decision was the fear of escalating tensions and potential clashes between security forces and traders, something that had happened in 2014.
This was corroborated by a gendarmerie commander who said security forces did not receive any orders to enforce the ban.
“Commitment to the community is particularly vital,” said Anja Wolz, Ebola emergency coordinator who oversees the response of Médecins Sans Frontières, also known as Médecins Sans Frontières (MSF). “We need to invest time and energy in speaking and listening to the communities in the affected areas. The response needs to be tailored to what they say and adapted to the risks of Ebola. It must be a two-way conversation. “
Listening to and interacting with locals is also key to the success of vaccination to help fight the hemorrhagic fever epidemic, according to experts, who cite the current existence of vaccines against Ebola as one of the main differences from the last outbreak.
The expected arrival in the country of some 11,000 doses of the vaccine developed by Merck has been delayed due to bad weather on Sunday, and vaccinations will now start on Tuesday instead of Monday.
But even then, authorities fear the local population may not be able to enroll in the inoculation program.
“People do not want to believe [in Ebola] and associate the disease with something else. No one intends to take the vaccines, “a prefecture official told local media.
“Citizens don’t want to hear anything from us and that worries us about vaccination.”
Health Minister Remy Lamah, a native of Gouecke, arrived in his hometown on Saturday to convince people of the merits of getting the vaccine, the source said.
“Everything comes back to community commitment,” said MSF Wolz. “We have seen it many times in the past. If a community feels involved, listened to, and empowered, the Ebola response is likely to go well, with or without vaccines. But if a community feels aligned, unheard of, and gets nervous or distrustful, the Ebola response is likely to face multiple difficulties, with or without vaccines.
Facely Konate reported on Gouecke and Ramy Allahoum of Doha