Update from Guinea-Bissau: Education and collaboration key to Ebola preparedness

May 25, 2015

Dr. Placido Cardoso, INASA Director & Christy Craig, IANPHI

At the peak of the Ebola outbreak, IANPHI partnered with high-risk countries to identify their needs and offer support for their emergency preparedness efforts. One such country, Guinea-Bissau, borders the Conakry District of Guinea, one of the districts most ravaged by Ebola. INASA, an IANPHI member NPHI in Guinea-Bissau, was given lead responsibility for epidemiologic and laboratory investigation of suspect cases. However, resources at INASA are limited, and there were desperate needs for information dissemination on management of suspect cases, handling of specimens, and laboratory testing. Personal protective equipment (PPE), hand sanitizer, and other supplies were in short supply. Furthermore, there was limited capacity at national borders to assess potential cases, including among travelers from countries with Ebola.

Following a request for proposals, INASA identified limitations, and IANPHI was able to support the institute to address these needs over the subsequent months. One of the first priority activities of INASA was building capacity of the health workforce and providing further training to existing health workers. With support from the United States Centers for Disease Control and Prevention (CDC) and IANPHI, INASA trained an additional 40 technicians to join the existing health workforce in Ebola response preparations.

Being located near a highly infected area of Guinea, supervision of points of entry into Guinea-Bissau was an additional priority for INASA. Through support from IANPHI, INASA was able to expand its border surveillance capacities, including visiting the sites and training staff on appropriate techniques for registration and Ebola screening of people entering the borders of Guinea Bissau, as well as preparing Ebola testing mechanisms at these crossing sites. Staff members working at entry points were also subsidized for their additional work performed during this crucial time. Throughout the months that followed, INASA carried out supervisory visits and sent support teams to health regions focusing on strengthening epidemiological surveillance in the community at border entry points.

Recognizing the importance of international collaboration in the outbreak response and prevention, INASA was able to conduct a visit to the INSP in the Republic of Guinea in order to establish institutional relations of cooperation regarding the exchange of epidemiological information, and discussion of the possibilities of carrying out regular cross-border meetings. The president of INASA traveled to the Republic of Guinea with a technical team, allowing INASA to exchange information in the search for lost contacts seen in both countries, and to better understand the situation in terms of common borders between the two countries. In addition to developing the human resources and collaborations needed to prevent and respond to a threat such as Ebola, INASA also understood the need for effective and efficient health communications during this time. The institute distributed surveillance report forms to all the health regions in Guinea-Bissau, and provided 200 Integrated Disease Surveillance and Response manuals to public and private health care facilities and religious institutions that provided care. Training on the proper use of these materials was also provided to health care workers.

A final priority of Guinea-Bissau’s INASA was the decentralization of epidemiological surveillance activities. INASA searched for contacts at the regional level, and with IANPHI funds and US CDC field epidemiology training, prepared regional teams to respond when necessary at the regional level, without having to wait for support from the national level. Through this effort, 45 technicians were trained in private establishments of Bissau on the manual for Integrated Disease Surveillance and Response in order to enable their participation in the notification of cases of potential epidemic diseases including Ebola, measles, meningitis, Chikungunya and cholera.

Through support from IANPHI and others, INASA continues to take measures to prevent cases of Ebola and other infectious diseases and is grateful for support to expand and improve its operations.

Additional IANPHI Project Work in Guinea-Bissau:

Transform the national public health system by creating a new NPHI
Build financial management capacity at INASA 
Gather data to inform malaria control policies 
Intensive course on monitoring malaria control