Preventing diseases from crossing borders in West Africa post-Ebola

Published: 21 March 2016 7:00 CET

By Mirabelle Enaka Kima, IFRC

When the Ebola outbreak was confirmed in Guinea two years ago, one of the reasons the virus spread so quickly was due to the high amount of people traffic across the borders of Guinea, Liberia, and Sierra Leone. To mitigate the introduction of new Ebola cases or other diseases by cross border travellers, the Red Cross has introduced a community event-based surveillance system. It is successful, in large part, due to the engagement of community members. 

Settled near the Kolantin River, a Red Cross health screening post is now part of the picturesque landscape at the popular Binticabaya border crossing between Guinea and Sierra Leone. Outfitted with a hand washing kit, a thermometer, and a register, volunteers at the screening post are ready to monitor people crossing the river between the two countries.

"I cross twice a week to visit my wife who lives in a nearby village in Sierra Leone," says one soldier as he stops to wash his hands before going for his temperature check.

Morlaye Bangoura and Fode Camara Ali live in the Tassin District community on the Guinean side of the border. They were recently recruited as Red Cross  volunteers to conduct health screenings at the Binticabaya post. Installed behind their desks, they are busy registering new arrivals.

"We register all those who pass by,” says Fode Camara Ali. “Hand washing and temperature control are compulsory for everyone. When a person’s temperature is above normal, they are asked to sit and rest for few minutes, before I take his temperature again. If there is no change, I contact the district health team for further investigation and follow-up.

"So far, we have not recorded any suspected case of Ebola. Still, we maintain maximum vigilance and strictly observe the control rules while applying self-protection measures to avoid any risk of exposure to the virus."

Mixed community reaction

Fatoumata Drame welcomes the protective measures. She crosses to Kempo an average of three times a week to sell products from her farm and to buy  products which she does not find in Guinea.

Carrying her son, she stops to wash their hands. "The screening post helps us to preserve our health. It would be silly to avoid it. By not respecting the measures put in place, we are exposed and could be contaminated by someone coming from Kempo. This would make everyone panic,” says Fatoumata.

Though most community members follow the enforced procedures without  hesitation, there has been some resistance due to the presence of chlorine in the water. "We have noted some reluctance by women to wash their hands because of the smell of chlorine. When that happens, we multiply our  awareness efforts around the importance of observing these rules for the sake of everyone’s health in the community," explains Fode Camara Ali.

The Red Cross Society of Guinea has installed nine health screening posts in the sub-prefectures of Moussaya, Farmoya, and Sikhourou and has deployed 20 volunteers to conduct daily screenings of travellers.   

A further 140 volunteers have been trained and mobilized to conduct door-to-door awareness raising and focus group discussions on hygiene education and promotion. They are also involved in infection control through community event-based monitoring.

Acceptance by communities of these initiatives is primarily the result of the adoption of a community-based approach. Deployed volunteers are members of the communities they serve which helps ensure ownership, sustainability, and acceptance. In addition, religious and traditional leaders play a key role in community dialogue to prevent any resurgence of the Ebola epidemic or other  diseases.

"The active commitment of traditional authorities has also helped us achieve acceptance of these surveillance tools which will help ensure early warnings for various diseases,” explains Dr Madeleine Thea, surveillance officer for the International Federation of Red Cross and Red Crescent Societies (IFRC) in the Forécariah region.

The community event-based surveillance system began in January 2016 to comply with the 90 day period of heightened surveillance and is conducted in collaboration with other partners involved in the Ebola response operation. Activities are focused in the areas of Forécariah, Boke, and Guekédou bordering Sierra Leone, Guinea Bissau, and Liberia respectively.

In Guinea, the International Federation of Red Cross and Red Crescent Societies’ (IFRC) recovery plan of 23 million Swiss francs focuses on providing support to people affected by the outbreak, and includes activities related to strengthening resilience to future disease outbreaks, improving access to health care and psychosocial support, improving food security and livelihoods; and National Society development. The recovery plan is currently 14 per cent funded.

Traditional healers played a critical role in helping communities understand and accept prevention and protection measures during the Ebola emergency response. Tomorrow we will look at the role traditional healers can play in post-Ebola recovery efforts.