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The Painful Lurch Toward The End Of Ebola In Guinea

Health workers training in Conakry, Guinea
Health workers training in Conakry, Guinea
Joan Tilouine

FORÉCARIAH — Assény Touré’s tightly drawn features bear testament to his harrowing ordeal. In December, after he was diagnosed with Ebola, this taciturn 30-year-old was chased out of the village where he was born, Béta, an hour-drive away from Forécariah, in western Guinea. The virus killed 19 members of his family. He survived. And yet he's still a pariah.

“Ebola killed my family," says Touré, who has taken up shelter in a Red Cross tent where four patients are being quarantined. "I won’t let other Guineans die of that disease."

Now cured, Touré is trying to raise awareness in this town where Ebola leaves people either angry or indifferent. The epidemic, which moved from the forest in the northeast to the coast, is still ravaging the region even as it is finally being contained in the rest of the country. Nearly 3,600 cases have been confirmed in Guinea since December 2013. More than 2,300 people have died.

With Liberia and Sierra Leone farther along in the recovery from Ebola, the Guinean authorities are still hoping to announce the end of the epidemic before the end of May. Only nine cases were reported last week, the lowest number since the epidemic started. But they fear that Forécariah, the last active center, might contaminate the capital Conakry and the towns in between.

“We’re a kind of shield to prevent Ebola from spreading to the capital,” says Emmanuel Pajot, operations coordinator at the Red Cross Ebola Treatment Center, set up at the end of an alley in ochre earth. “The goal is to do as much as possible before the rainy season because some remote areas are already difficult to reach.”

Nearly 80% of the cases reported since January are located in this prefecture. Complicating matters is how wary people tend to be of health personnel. Many suspect health workers of transmitting the virus. The Ebola epidemic has also taken on political dimensions in this region, which is where Prime Minister Mohamed Saïd Fofana comes from. A presidential election is planned for Oct. 11.

“The government abandoned us and takes advantage of Ebola and NGOs to attract investments and to campaign for the election,” sighs one inhabitant. “They’re not welcome here anymore.”

"The snake's head"

As a result, some patients would rather turn to traditional healers, even if it means traveling to Conakry or 150 kilometers north to Boffa and thus taking the risk of spreading the virus. That’s how Binta Diallo, 26, was infected in June 2014. An aunt suffering from diabetes came from Kenema, in Sierra Leone, by way of Forécariah to be taken care of in Conakry. The old woman was especially weak. “We thought it was her diabetes but it was Ebola. Eleven of us were infected and six died,” Binta says.

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U.S. Air Force supporting WHO actions in Guinea — Photo: DVIDSHUB

Mandy Kader Kondé, who heads the commission for research for the fight against Ebola, says the biggest challenge right now is sick people traveling. “We’re facing the same difficulties on the coast as we did six months ago in the Guinean forest," she says. "In Forécariah, we’re in the home stretch, but it’s the most difficult part.”

“Forécariah is the snake’s head,” says doctor Sakoba Keita, the national coordinator for the fight against Ebola. “If we can control Forécariah, we can control Conakry.” So in addition to the Red Cross, Doctors Without Borders and the World Health Organization (WHO), teams of health workers are sent from the capital and are striving to raise awareness among the inhabitants, to try and clear up suspicions and potentially detect new cases.

Scrambling for patients

Pharmaceutical multinationals are also keeping a close eye on the situation in Forécariah as they compete to carry out their vaccine tests. “Guinea has become a laboratory,” a doctor says.

Since March 7, the WHO has been testing the VSV-ZEBOV vaccine developed by the Public Health Agency of Canada and the U.S. company Merck. The British foundation Wellcome Trust has allocated close to $3 million to the WHO. By the end of April, almost 1,000 tests had been carried out, one of the people in charge of the campaign said. The figure is a long way from the 9,500 required before the third phase of the trials can be validated.

“We think we can obtain preliminary results this month, but without a fresh outbreak, we risk not being able to see these trials to the end due to the lack of patients,” notes Jean-Marie Dangou, the WHO’s representative in Guinea.

Another actor is now present in Guinea: British multinational GlaxoSmithKline (GSK), which had chosen Liberia and Sierra Leone to carry out its own vaccine trials. But since Ebola is about to be eradicated in these English-speaking countries, the number of patients is running low. So they’re turning their gaze to tiny Guinea which, until recently, “they looked down on,” a civil servant says.

“GSK is calling upon us but I don’t know where to send them,” doctor Sakoba Keita says. “The latest patients have been taken care of by Merck, and they don’t want to give ground to their competitors. This is now a race for patients.”

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