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Public mistrust could undermine Ebola response in Guinea

By Maxine Betteridge-Moes, MA Media in Development

The World Health Organization began administering Ebola vaccines in Guinea just nine days after the latest outbreak was declared in Gouécké in the far southern region on 14 February. The swift rollout of the vaccination campaign came after international calls to action to halt the spread of the deadly disease that ravaged parts of West Africa between 2013 and 2016 and killed approximately 11,300 people.

‘Time is of the essence,’ Mohammed Mukhier, Regional Director for Africa at the International Federation of Red Cross and Red Crescent Societies’ (IFRC) said in a statement. ‘The resurgence of the virus in Guinea comes at the worst possible time when the country is already facing the Covid-19 pandemic … While we are extremely concerned, we are also reassured by the lessons we learned from previous outbreaks and by recent medical advances.’  

The development of two Ebola vaccines since the last epidemic will be a key intervention in bringing the resurgence under control. On 23 February, the Guinean government received a shipment of 11,000 vaccine doses from a global stockpile in Geneva, Switzerland. A vaccination campaign began in the N’Zérékoré prefecture, where the first confirmed cases and deaths have been reported. But according to reports from local and international media, widespread misinformation about the disease has resulted in some peoples’ denial of its resurgence, while mistrust of authorities has meant others have resisted taking part in innoculation campaigns. 

‘The key issue here is to rebuild the trust between communities and health authorities,’ Al Jazeera correspondent Nicolas Haque said in a podcast. ‘The last outbreak … left a deep trauma for the people of Guinea, Sierra Leone and Liberia.’

Ebola spreads through infected bodily fluids and unsafe burials are a known danger in transmission. Those from the most affected areas remember their loved ones being taken away to medical centres and treated in isolation, never to be seen again. Many were not allowed to bury the deceased with local traditions. But medical anthropologists and researchers have pointed out the importance of understanding and respecting local communities’ concerns in disease response. 

In a research paper on social resistance to Ebola response in Guinea in 2016, University of Cambridge anthropologist James Fairhead observed that ‘Western common sense’ of disease outbreak and control silenced local framing, and the intervention of Ebola treatment centres undermined local social practice.

‘With the arrival of Ebola … political authority was bolstered by the humanitarian biopower associated with [it] and … came to be perceived as ‘the enemy.’’

‘With the arrival of Ebola … political authority was bolstered by the humanitarian biopower associated with [it] and … came to be perceived as ‘the enemy,’’’ Fairhead wrote. He cited advice to circumvent social isolation that included ‘enabling families to cook for patients, supplying mobile phones to communicate with those in isolation, treating suspicions seriously, and enabling highly respectful burials.’

 In order to address community mistrust directly, Health Minister Remy Lamah, who is a native of Gouécké, travelled to his hometown to convince people of the benefits of taking the vaccine. Local government officials and prominent religious leaders have also been publicly vaccinated. In an interview with Guineenews, the WHO’s representative to Guinea, Georges Ki-Zerbo, said they were working with various NGOs on the ground to support community awareness and response.

‘The idea is to explain what is going on based on the facts and to effectively avoid panic and rumors that can interfere with the quality of the response,’ he said. ‘This supposes that we listen to the communities … in order to have their support for all the interventions.’

Lessons learned from the previous epidemic, which killed approximately 2,500 Guineans, will be put to the test in the coming weeks. But Lamah told AFP news agency that the country is largely prepared. 

‘I think that in six weeks, we can be done with this disease,’ he said. 

Photo caption: The Ebola vaccine is an important intervention in controlling the outbreak, but many Guineans are untrusting of health authorities. (Credit: World Health Organization) 

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