Conakry (dpa) – For three full days, a man lies dying in midst of Marche Madina, a bustling market in Guinea’s capital, Conakry. It is one of the largest in West Africa. He is writhing in pain, then unconscious. Nobody dares approach him.The fear of Ebola, which killed more than 4,900 people across the region during the worst haemorrhagic fever outbreak in history, is written on everyone’s faces.A toll-free telephone number, 115 – set up by the health department as an Ebola hotline – is ringing but leads to a recorded message: “This number is currently unavailable.” Panic starts to spread.On day three, the Red Cross finally arrives to collect the man. But it’s too late. His body is taken straight to the morgue.The teams have been busy since the number of confirmed Ebola infections in Conakry dramatically shot up this month, according to the World Health Organization (WHO). A hundred new cases were reported in the capital in the second week of October alone.Ten months into the outbreak, which started in December in a small village in Guinea’s east, the country roughly the size of the United Kingdom has only two Ebola treatment centres.
One 85-bed facility is located in the capital, the other, with about 35 beds, is situated in the town of Gueckedou, at the opposite end of the country, a two-day car drive further east. There is no help for Ebola patients in-between.
Both treatment centres are run by medical charity Medecins Sans Frontieres (Doctors Without Borders), with some support from Guinean health workers.
The country’s public hospitals don’t have the know-how to treat Ebola patients. The only other facility for the population of 12 million is a transit centre in the south-eastern town of Macenta, the country’s current Ebola hotspot.
“There should be a treatment centre in each [of Guinea’s 33] prefectures,” says MSF project coordinator Caroline Scholtes.
The WHO says 10 additional Ebola facilities are needed.
Even the better off middle class, which has the means to access private health care, is currently at a loss. The private Ambroise Pare Clinic in Conakry was shut down on October 10 after a nurse was infected with Ebola.
The entire staff is under observation for 21 days. A note reading “heightened epidemiological vigilance level” is plastered across barricaded doors.
That means the vast majority of the 1,553 Ebola cases the WHO recorded in Guinea by October 25 continue to be cared for at home – placing families and communities at high infection risk and making it extremely difficult to stop the spread of the deadly virus.
“We have a huge catastrophe on our hands,” a United Nations source in Conakry told dpa. “This is just the beginning.”
He believes the number of unreported cases is likely to be 10 times higher than the number recorded by the WHO.
The lack of treatment centres also means that most patients have to travel far, sometimes hundreds of kilometres, to reach help. Few Guineans own a car. Most rely on crowded, public transport.
Although the nation has a lower case load than neighbouring Sierra Leone and Liberia, experts believe the epidemic will be harder to contain here. Ebola cases are spread out across the country – and not concentrated in the capital, like in Liberia – and therefore harder to trace.
“In Guinea, Ebola is increasing exponentially in terms of case numbers as well as geographically. One or two cases in remote areas are enough to create a hotspot if systems are not in place,” warns Scholtes.
With every new case, contact tracing gets more difficult. One Ebola patient has an average of about 100 potential contacts.
“The outbreak is completely out of control. Ebola is likely to become endemic in Guinea. It’s depressing,” says Scholtes.
Disapproval of President Alpha Conde’s Ebola response is perennial among international aid organizations in Conakry, but no one wants to criticize the government publicly, out of fear their work might be hampered.
On paper, the president has led a strong fight against Ebola. He declared a “national health emergency,” warned against panic and believing in rumours.
Conde tried to negotiate with Guinea’s neighbours to lift travel bans that hurt the economy and pleaded for attacks on health workers and burial teams to stop. Last week, he called on retired doctors to offer their assistance in treatment centres.
“If we fight back immediately, the faster we can stop the disease from spreading,” said Conde.
But for now, Conde has translated few of his appeals and promises into practice.
For more background on Guinea and Ebola: