In Guinea, the revealing effect of the coronavirus

Text by: Carol Valade Follow

If the number of deaths remains low in Guinea, the rapid increase in the number of cases worries, highlights the failings of the health system, weakens the daily economy and crystallizes distrust of the government, four years after the end of the epidemic of Ebola.

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From our correspondent in Conakry,

Forehead to forehead, the eyes flash. We grab each other, we invoke our finger pointing towards the sky. We pretend to walk away before coming back to the charge, held back by the friends. Among the fifty onlookers who came to put their grain of salt in this banal hanging, two have their faces covered. The others wear their masks on the chin, on the forehead or hanging from the ear.

Ten days after the entry into force of the compulsory wearing of the bib to fight against the spread of the coronavirus, the measure is especially respected on the axes controlled by the police.

Conakry officially records seven deaths from coronavirus. A paltry figure compared to malaria (6,000 to 9,000 dead in 2017, estimates WHO) but the number of cases is skyrocketing and Guinea is now in the trio of, the most affected countries in West Africa .

"  It's a sign that we are testing the right people,  " says Bouna Yattassaye, who heads the National Health Security Agency (ANSS) since Dr. Sakoba Keïta tested positive for Covid-19.

Underestimated epidemic

But the daily capacity of 250 tests "  does not allow all cases to be identified  ", insists in its first report the scientific council. The scale of the epidemic could be underestimated, as could the number of deaths.

The very young population (77% is under 35 years old, according to the UNDP), seems better protected against complications, but other data cause concern: several hundred cases noted "  to be looked for  " by the ANSS, patients "  lost to follow-up  ", neither hospitalized nor confined, in the wild.

"  The sudden increase in the number of cases is also explained by the refusal of certain patients to be treated,  " continues Dr. Yattassaye. Here, the virus arrived by the elite, traveling and reluctant to seek treatment in their country. "  Influential and very sought after people," he adds. Their contamination chain shows 82% positivity. "

►Also read: Guinea: "All together, we can overcome the epidemic"

Donka, the country's first hospital, which has been undergoing renovation for four years, reopens hastily to welcome the sick. Drilling is necessary to supply it with water. Its director Fathou Sikhé Camara is tested positive. Patients complain about the reception conditions and the unhealthy premises.

"  Donka reaches its maximum capacity  ", recognizes Dr. Yattassaye, ensuring that Guinea will "  double its bed capacity  " with the opening of new centers in the coming days.

Ebola, what's left?

At the end of the Ebola crisis (2,500 dead from 2013 to 2016), President Alpha Condé had declared that the epidemic would be "  an opportunity to strengthen [the] hospital capacities  ", promising the construction of hospitals in all the prefectures. "  A utopia  " launched, bitter, the opponent Cellou Dalein Diallo.

"  Ebola has above all taught us to divert international funds  ," sighs an association player, on condition of anonymity. "  Nothing remains of the millions poured into the country. Many fear that the "Corona business" succeeds the "Ebola business" while the World Bank points an "  overestimation  " of $ 40 million on the electricity bill of the economic recovery plan.

NGOs deplore the “  lack of coordination  ”, “  power struggles and personal rivalries  ” which would slow down the response. "  The management of funds is causing a war between the Ministry of Health and the ANSS,  " said a senior official of the ministry, on condition of anonymity.

More optimistic, Dr Yattassaye said "to  capitalize on the experience acquired  ", the NGOs already present (MSF, ALIMA) and especially the centers for the treatment of infectious diseases with epidemic potential (CTPI) installed in the interior of the country. 'Ebola. The latter, abandoned, are now being reactivated.

Indoor spread

The actors of the response fear that the disease will follow the opposite trajectory of the Ebola virus by spreading from the capital to the most remote regions which are also the least equipped. "  This is probably already the case,  " worries one of them, stressing that only one laboratory is currently carrying out tests in the regions.

Despite the roadblocks, the ban on leaving Conakry is not respected, the government acknowledges in a press release. A woman who tested positive in Conakry was found in the city of Kankan, more than 600 km from the capital.

As for the concept of social distancing, "  it is almost foreign to our culture where contact is essential, where all daily activities are done in common in small spaces  ", explains the sociologist Alpha Amadou Bano Barry.

"  For people, it's a disease " from above ". They have more urgent priorities such as daily food,  ”he adds. Inflation, usual during Ramadan, is multiplied by health restrictions. Since the number of passengers is limited to three per vehicle, the price of transport has doubled. The aid measures announced by the government have been slow to take effect.

Covid-19 and politics

Those involved in the response fear a “  triple crisis  ” in health, economic and political terms. The opposition directly accuses the government of having favored the spread of the virus by organizing the double legislative and referendum poll of March 22, 2020. The president of the Independent National Electoral Commission Me Salif Kébé died of coronavirus two days after the results were announced final by the Constitutional Court, followed by the secretary general of the government .

Since the installation of the new National Assembly despite the ban on rallies, the National Front for the Defense of the Constitution considers that the health truce has been broken. One of its members, Oumar Sylla, has been incarcerated at the central house in Conakry for having called for the demonstrations to be resumed, with one case and several suspected deaths. Other opponents were reportedly transported to a military camp in Upper Guinea.

Human Rights Watch points to alleged security force responsibility for looting or abuse under curfew that "  exacerbate already deep distrust of the authorities, creating an additional obstacle to the fight against Covid-19"  "

"  With a weakened social fabric, our fear is that health measures will backfire on us,  " worries Dr Yattassaye. This week during a meeting with the medical profession, President Alpha Condé, tapping his fist on the table again, demanded that the epidemic be brought under control "  before the rainy season  ". But on the horizon are already thick clouds.

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• Guinea
• Coronavirus
• Health and Medicine
• Corruption
• Ebola

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