Strengthening the health sector post-Ebola in Guinea

I had the opportunity to meet with Expertise France during the Ebola outbreak in 2014 and we began working together in 2015. It was a very frightening time and France and Morocco accepted to collaborate in the battle against this disease. Expertise France helped with mobile laboratories in areas where the disease was present, and then with the LAB-NET project which strengthened the diagnostic capabilities of the national public health institute. Samples no longer needed to be sent to Dakar or Bordeaux. Then there was the creation of a regional team of warning and response to epidemics (ERARE) which Expertise France helped create and train. This involved early detection and rapid treatment of infectious diseases and strengthened their capacity for response for future epidemics.

With Ebola we realised that our health system was fragile, and that we needed to do things differently. The healthcare system recovery plan called for care centres to be set up throughout the country—there are now care centres in every jurisdiction. Most healthcare staff was not trained to deal with epidemics or epidemic management. With the support of our partners, we’ve trained doctors and healthcare staff in all regions. We were also able to strengthen logistics. Before the epidemic, there was no means of transportation for patients. With support from our partners, we increased the number of ambulances from 33 to 480, which is a major achievement in terms of transportation. In the specific case of Expertise France, I’d highlight the training in epidemiology in order to deal with emergency situations.

We mustn’t focus only on epidemics. With the PASA project, we are improving governance. To improve planning, we need to draw up procedural manuals, strengthen structural and audit capacities, and improve the institutional framework. Another aspect is to strengthen decentralisation. The grassroots communities need to take ownership of healthcare. For that, we have developed the concept of community healthcare, and the local authorities will pilot the politics involved. We also need to improve healthcare services—we have a very high maternal mortality rate—we need new infrastructures with better health centres and maternity wards. And we need to continue to integrate a new dimension into prevention and control of infection including disease control in healthcare settings.