The Ebola outbreak in Guinea began in December 2013 and was declared over in June 2016, resulting in 3,814 cases and 2,544 deaths. The outbreak and response efforts were affected by community opposition, which was more intense in Guinea than in the other Ebola-affected countries of Liberia or Sierra Leone. This has been attributed to social and political tensions, including previous coercive health interventions and regional and ethnic conflict. Negative reactions to Ebola response teams ranged from refusing aid materials and declining to participate in response activities to violent demonstrations and verbal and physical assaults against response workers. Over time, the intensity of the opposition decreased, due in part to social mobilization and community engagement efforts.
We conducted a search for peer-reviewed literature, news articles, and response reports using the terms “hemorrhagic fever,” “Ebola,” and “Guinea” and excluded any reports that did not describe Ebola response activities in Guinea, did not mention community engagement, or did not provide some reflection on success or failure. The initial search yielded 508 reports, of which 46 met the criteria. The following report is a review of the 46 published reports of Ebola-related activities undertaken during the 2013–2016 outbreak in Guinea that met these three criteria. Some efforts were successful, some not, but all provide useful information for current efforts.
The summary below is organized into nine sections, which roughly parallel six Ebola response pillars (contact tracing, Ebola treatment centers, safe and dignified burials, vaccination, infection prevention and control, risk communication/community engagement), and three topics that cut across pillars (response structure/processes, use of health services, reintegration of survivors). In each section, statements and links to the original reports are categorized into “what worked,” “challenges and problems,” and “lessons learned.”