Agencies remain in Guinea despite killings of health workersBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5807 (Published 22 September 2014) Cite this as: BMJ 2014;349:g5807
International aid agencies have vowed to carry on working in Guinea after health workers were attacked and killed last week. Government reports said that health workers were attacked with stones and machetes in the village of Wome in the south of the country. Some members of the team, which was raising awareness about Ebola virus disease, managed to escape, but eight people, including health workers and journalists accompanying the team, were killed. The bodies were dumped and found in a septic tank.
The health workers were working for the Guinean government, and a World Health Organization spokesman in Guinea said that its security may be reviewed. “We are working closely with the authorities, who have appointed a national security coordinator in that area,” he said.
A spokeswoman for the aid charity Médecins Sans Frontières, which is providing the bulk of the frontline treatment of the disease, said that it did not have staff in southern Guinea and that it had no plans to alter its operations in the country “as a result of these tragic events.”
This was not the first time that health workers have been targeted in Guinea. In April Médecins Sans Frontières was forced to temporarily close a clinic when it came under attack by local people.1
The World Health Organization reported on 18 September that there has been a total of 5335 cases of Ebola virus disease, including 2622 deaths, in the three worst affected countries, Guinea, Sierra Leone, and Liberia. Some 45% of these cases occurred in the preceding 21 days.
In Guinea the situation seems to be stabilising, with no new cases reported in the previous week. However, in Sierra Leone and Liberia the incidence of the disease is rising rapidly.
A countrywide curfew that took place in Sierra Leone last weekend was used as an opportunity for raising awareness about the disease. Earlier this month Sierra Leone’s government announced that people across the country would be confined to their homes from 19 to 21 September so that officials could go from house to house to identify new cases. However, the focus seems to have shifted to education, with around 30 000 volunteers distributing health information and free soap.
A WHO spokeswoman who is based in Sierra Leone said that the goal to reach as many households as possible seemed to have been achieved. However, she said that some pockets of mistrust remained, with some householders being suspicious of the soap. Some people were disappointed not to receive the soap after supplies ran out.
WHO and the United Nations children’s agency Unicef put together the training material and also trained 100 workers to carry out spot checks so that the agencies could ascertain the reach of the campaign.
“The goal of the campaign was to provide prevention information and to give people a chance to ask questions. At the same time, because of increased awareness, more cases were reported,” the spokeswoman said.
The head of Sierra Leone’s Emergency Operations Centre, Stephen Gaojia, told the BBC that the exercise was largely successful and that the compliance and receptiveness of Sierra Leoneans was “overwhelming.” The exact number of new cases identified has not been verified, but WHO said that finding facilities for new patients was a “challenge.”
The spokeswoman said, “WHO continues to work closely with international partners and the Ministry of Health to support the opening of new facilities as quickly as possible, but there remains a shortage of personnel to work in these centres.”
According to WHO’s latest report on Ebola, bed capacity in Liberia meets just 20% of demand, and in Sierra Leone it stands at 25%.
Cite this as: BMJ 2014;349:g5807
thebmj.com Editorial: Ebola in an unprepared Africa (BMJ 2014;349:g5597, doi:10.1136/bmj.g5597); Blog by Grazia Caleo: Ebola—a blind outbreak (http://blogs.bmj.com/bmj/2014/09/18/grazia-caleo-ebola-a-blind-outbreak)