Key considerations: 2021 outbreak of Ebola in Guinea, the context of N’Zérékoré

This brief summarises key considerations about the social, political and economic context shaping the outbreak of Ebola in the N’Zérékoré prefecture, Guinea, as of March 2021. The outbreak was declared on 14 February 2021, two weeks after the death of the first known case, a health agent (Agent Technique de Santé) from Gouécké. Gouécké is located 40km north of N’Zérékoré via the paved Route Nationale 2. The nurse sought care at a health centre in Gouécké, a clinic and then a traditional healer in N’Zérékoré. She died in N’Zérékoré on 28 January. When they became sick, the relatives of the first known case referred themselves to N’Zérékoré regional hospital, where the disease was transmitted to healthcare workers. Although the potential for transmission in rural areas of the Gouécké subprefecture was high, to date, most cases have been reported in the urban setting of N’Zérékoré, which is the focus of this brief. At the time of writing (22 March), the total number of cases was 18 (14 confirmed, four probable), with nine deaths and six recoveries. The last new case was reported on 4 March.

This brief offers 15 key considerations regarding the Ebola outbreak, including: 

• A key lesson from previous Ebola outbreaks is that safe and dignified burial (SDB) protocols must be tailored to the local context in collaboration with the community, balancing risk of transmission with the need to maintain (modified) customary practices. 
• Given their precarious economic situation, the majority of the population is likely to prioritise daily needs over concerns about Ebola. The response should look for ways to integrate Ebola response measures into complementary livelihood interventions. 
• Response organisations should employ personnel from different ethnic groups, both for language reasons and to ensure the fair distribution of employment. When responders are being deployed, their linguistic competence and ethnicity should be aligned with that of the communities they are working in.