Guinea's untold story
Community Surveillance Post-Ebola
Imagine a country where there is an outbreak of cholera once a year, where over 50 from every 1,000 people get malaria and where health facilities are so poorly equipped that pregnant women have to bring their own delivery kits with them to the maternity ward.
Then Ebola comes, shattering the already overwhelmed health services and destroying entire villages in a matter of weeks.
The outbreak that devastated West Africa last year and killed more than 11,000 people produced 3,351 confirmed cases in Guinea alone — 2,083 of which were fatal. The epidemic was officially declared over in late 2015, but two new cases were reported in the south of the country earlier this year and small flare-ups are to be expected for years to come.
Despite this, the Ebola-ravaged country has to a large extent fallen off the news agenda.
Yet Ebola has had many long-lasting effects on the country and each person living in the remote areas of Guinea has their own story to tell – that is 11.8 million stories that to this day remain untold.
In N’Zérékoré, Coyah, Dubreka, and Kindia entire villages were decimated by the virus. In Guekedou, Macenta, and Kissidougou numerous survivors lost their livelihoods and are now unable to support themselves due to financial and health-related reasons.
Without support, these communities remain vulnerable to future outbreaks.
Through a consortium partnership with Plan International, Première Urgence Internationale and ALIMA, International Medical Corps has trained almost 5,000 community health workers and staff from 99 health facilities in community surveillance of five deadly epidemic diseases.
Community health workers learn to identify symptoms of meningitis, cholera, measles and yellow fever, as well as those that are related to Ebola. They then alert health facility staff who immediately follow up on each suspected case in the community.
Project partners are also equipping community health workers and health facilities with the necessary materials to improve information flow and data management. For instance, supported health centres will transition from a paper-based to an electronic system - the ultimate purpose being to create information that is quickly and easily understood and acted upon at community level. One of the reasons why Guinea experienced such a devastating epidemic was a weak data management system that prevented alerts from being forwarded from communities to health centres.
All these activities help keep Ebola at bay and lay the groundwork for fighting other epidemic diseases while raising the population’s awareness of healthy habits that can help prevent future outbreaks.
“When Ebola first appeared we didn’t know what was happening,” said Dr Bah Salimatou, the General Manager of Hafia Community Centre in Conakry.
“Now community health workers inform us immediately of any health-related events. They also refer all suspected cases of illness to our health centre, they write reports and tell us what is happening on the ground.”
Dr Salimatou adds that the solar panels, computers and mobile phones donated by International Medical Corps enable health workers to update health records much more efficiently than before. This helps lower the probability of Ebola – or other similar outbreaks – having such a devastating impact on the community in the future.
“International Medical Corps has brought about many changes,” said Dr Salimatou. “Community surveillance has been very successful.
“We have put the outbreak behind us – but if it returns, we will be ready.”
In addition, as Ebola still lurks in overcrowded neighbourhoods and villages throughout the country – if not physically, at least in the collective consciousness of the Guinean people – International Medical Corps proactively engages people to circulate messages that encourage healthy behaviours in the community, such as handwashing and other hygiene practices.
Mohammed Lamin Saneh, a community health worker supported by International Medical Corps, says: “Everyone knows us in the community and heeds our advice.
Over the next five months the community surveillance project led by International Medical Corps will be rolled out across nine prefectures, reaching 3.2 million people whose stories will be rewritten to keep Guinea Ebola-free.