With health authorities and medical personnel battling Guinea’s first outbreak of Ebola, there have inevitably been concerns about finding the human and physical resources to combat other diseases. Unlike Ebola, measles and meningitis are well known to Guinea and require a major, coordinated response from both the state and NGOs. Despite the ‘Ebola factor’, health organizations say they have maintained their operations and are combating measles and meningitis effectively.
Ebola still advancing
According to World Health Organization (WHO), over 200 people in Guinea have died of Ebola, with 344 infected since the outbreak started, probably as early as December 2013, in the forested south-east. Despite strong response and containment efforts, the numbers continue to rise and the outbreak is spreading both within Guinea and neighbouring Liberia and Sierra Leone.
Confronting measles and meningitis
For Guinea in particular, the pressure is on to maintain resources for other medical priorities.
“Because Ebola is new to Guinea, it has certainly impacted on response times to other health crises,” acknowledges Timothy La Rose, spokesman for the UN Children’s Fund (UNICEF) in Guinea.
Due to low vaccination coverage, Guinea is hit by major outbreaks of measles every few years. Last year, 143 cases of measles were reported across several regions. During a 2009 epidemic, there were 4,755 suspected cases, most of which were concentrated in and around Conakry. Ten children died. Just 37 percent of children in Guinea are fully vaccinated, according to UNICEF.
Guinea is part of Africa’s meningitis belt and sees frequent meningitis outbreaks. There were at least 400 suspected cases in 2013 and more than 40 deaths. Since November 2013, there have been 5,425 suspected cases of measles in eight districts in Guinea, including the capital Conakry. Out of those cases, 129 have been confirmed and 12 people have died. Most of the cases have been children under the age of 10, according to the Ministry of Health’s Disease Prevention Unit.
Since January 2014, meningitis is believed to have affected 539 people, mostly in three districts of Upper Guinea: Siguiri, Mandiana and Kouroussa. Fifty-two people have died.
Working away from the headlines
The fight to contain the spread of Ebola has inevitably drawn more media attention, but health experts say that, away from the headlines, essential work is being done on other diseases.
“It’s never easy, but the response has been quite good,” said Corinne Benazech, Head of Mission for Médecins Sans Frontières (MSF) in Guinea. “Of course we don’t talk about measles or meningitis like we’ve been talking about Ebola, but on the field, the action has been done and I think that’s the most important thing.”
MSF continues to provide measles treatment free-of-charge, as well as for follow-up cases where there have been complications. UNICEF has been donating medical supplies and other materials such as needles, biohazard boxes, gloves masks and transportation.
As for meningitis, MSF has been working with local health clinics in three districts in Upper Guinea, where the meningitis outbreak has been concentrated. MSF’s activities focus on reinforcing the training and activities of health staff, as well as the supply of drugs and equipment.
Timothy La Rose of UNICEF agrees. “UNICEF has been continuing as we always do. Ebola is certainly discussed more, particularly in the media, and Ebola is certainly a major, major priority, but from UNICEF’s side, we continue to deliver the same as we would have without Ebola.”
Vaccinations remain vital
UNICEF, WHO, MSF and other aid groups launched massive vaccination campaigns targeting 1.6 million children under 10 after the government declared a measles outbreak in January.
Moustapha Diallo, West Africa region spokesman at International Federation of Red Cross and Red Crescent Societies (IFRC), concedes that “for the time being, Ebola has mobilized all our efforts and attention in Guinea as it is dangerous and deadly.”
But the IFRC too is still heavily implicated in work against measles. In February, it released around US$ 135,000 to support Guinea's Red Cross Society and mobilized more than 800 volunteers to help with UNICEF’s mass vaccination campaign, as well as educating and sensitizing families throughout the country about the symptoms, origin and modes of transmission of measles.
La Rose said the vaccination campaign, which lasted about two weeks, was deemed successful as it stopped the immediate outbreak of measles and dramatically slowed down the spread. Health workers say they are now monitoring and treating new cases as they arise.
Improving the coverage
Sakoba Keita, head of the Disease Prevention Unit, said last month that the government, alongside UNICEF and WHO, plans to start a vaccination campaign against meningitis in the northeast of the country. The campaign will target 3 million people between 1-29 years in 17 localities. UNICEF says the campaign hopes to reach 95 percent of the population at-risk.
Bringing down the mortality rate
“In the beginning, the mortality rate was quite high, but now it’s been going down,” MSF's Benazech said. “So this means that the case management has gone quite well, and with the coming vaccination campaign, we hope to decrease new cases and avoid the extension of this epidemic.”
Despite bringing the latest measles and meningitis outbreaks under control, Guinea’s health service still suffers from a weak public health infrastructure and poor levels of sanitation.
Many of the country’s hospitals and health clinics lack access to clean water, electricity and basic medical equipment. As the rainy season approaches, UNICEF and their partners say they have already begun prepositioning supplies and are gearing up for likely cholera outbreaks.
“Ebola didn’t come here in a vacuum,” La Rose said. “We had meningitis, we had measles. Cholera is probably coming. And when Ebola is over, we are still going to have these issues, so we need to think broader… We have to improve the health structure so that an outbreak like this isn’t as destructive as it currently is.”