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As Guinea grapples with a fresh Ebola outbreak, community resistance to measures needed to rein in the deadly virus remains dangerously high, a top Red Cross official has warned.
Guinea confirmed the disease was back in mid-February following first deaths the previous month.
The west African country and international actors have reacted swiftly to stop the spread, isolating and treating cases, tracking contacts and launching a vaccination campaign.
But Emanuele Capobianco, the health chief at the International Federation of Red Cross and Red Crescent Societies (IFRC) said reluctance within communities to go along with measures was an obstacle.
“What we are seeing on the ground is quite a lot of community resistance and also some religious resistance,” he told AFP in an interview Friday.
This is not surprising, he said, pointing out that “Ebola is a disease that scares people. It is a dramatic disease that kills a lot.”
Ebola, which is transmitted through close contact with bodily fluids, causes severe fever and, in the worst cases, unstoppable bleeding.
Death rates are high, at around 50 percent on average of those infected, and up to 90 percent for some epidemics, World Health Organization data shows.
‘Lot of trauma’
Guinea recorded new Ebola cases on February 13 near the town of Gouecke, in the southeastern Nzerekore region, and declared an epidemic shortly after.
To date, 18 cases have been reported, 14 of which have been confirmed to be Ebola, including four people who have died, WHO said Friday.
These mark the first Ebola cases to surface in West Africa since a devastating 2013-2016 epidemic that left more than 11,300 dead in Guinea, Liberia and Sierra Leone.
“There is a lot of anxiety naturally for the comeback of this disease,” Capobianco said.
“We do have a lot of trauma,” he said, adding that in some cases this “actually manifests in some resistance.”
During the last epidemic, communities across West Africa, but particularly in Guinea, revolted when outsiders in hazmat suits initially arrived to help halt the spread.
In 2014, eight members of an outreach team in the southeastern town of Womey—just 50 kilometres from the current epicentre in Nzerekore—were killed by protesters.
The resistance sparked a shift in the response, with more efforts made to engage communities and seek assistance from traditional and religious leaders in explaining the disease and the necessity of the measures taken.
‘Safe and dignified’ burials
And IFRC, which is deeply involved in many aspects of the response, helped develop an approach to burying people possibly carrying Ebola safely while still respecting traditions as far as possible.
People infected with Ebola are at their most contagious right after death, making traditional funeral practices that often include washing, touching and kissing dead bodies dangerous.
The current outbreak in Guinea, for instance, began when several people were infected at the funeral of a 51-year-old nurse, who is the first known case.
But Capobianco said IFRC were running into resistance when seeking to conduct so-called safe and dignified burials of anyone who dies in communities where Ebola is spreading.
Such burials “have a massive impact in terms of reducing transmission”, he said, adding though that “we have not always been able to perform (them) because the community simply refused to have the burials performed by the Red Cross teams.”
While this was worrying, Capobianco stressed that the resistance was “a problem that can be solved.”
“It can be solved by listening to the communities, by reflecting on their fears, by explaining what this disease is, and by showing that actually people are not condemned to death by having Ebola,” he said.
Those battling Ebola in Guinea today had tools not available during the last epidemic, including vaccines and therapeutics driving down the fatality rate, he said.
More than 1,600 people, including contacts of cases, their contacts, and health workers have been vaccinated so far, according to the WHO.
Capobianco said the first IFRC health workers received their jabs on Friday.
“This time we have tools that are very powerful that we can deploy,” he said.
“As long as we can win the communities over and ensure they are part of the response, we should be able to bring this under control.”