Gouecke, Guinea – Imam El hadj Moussa Soumahoro wears a serious face. He has just ended a morning sermon that concluded with Ebola preventive messages and the importance of vaccination against the virus that recently re-emerged in Guinea for the first time since the 2014–2016 outbreak. Soumahoro has joined the fight against the disease.

“Four of my brothers and cousins died of Ebola in 2015, so I know what I’m committing myself to,” says Soumahoro, as the congregation disperses while greeting each other from a distance. A handwashing station has been set up at the entrance to the mosque as has been done in all places of worship.

Since the first confirmed cases on 14 February, the imam of Gouecke – a rural community in south-eastern Guinea where the virus re-appeared – has taken to encouraging the community to cooperate with the health authorities to curb the outbreak in which 23 cases and 12 deaths have been reported so far.

Ebola claimed more than 11 000 lives in Guinea, Liberia and Sierra Leone in the previous outbreak. However, some still doubt that the disease exists. "Trust underpins everything," Soumahoro says. “The disease is real … It is a fight that should not be taken lightly. That is why … I felt it necessary to commit to the [Ebola] response by raising awareness.”

Since the latest outbreak was declared, he has concluded each prayer with preventive messages and the importance of contacting the authorities in case of death. Funerals and burials are important cultural practices.

Overcoming barriers

Among many Guinean communities, burials are based on the social status, beliefs, gender and age of the deceased. Religion also plays a central role. The fear of not being able to carry out burials according to tradition has led some people not to report certain deaths to the authorities. “The organization of [burial] ceremonies must strictly adhere to a number of age-old traditions that have remained unchanged in the community,” Sonah Mady Camara, a social anthropologist and a consultant with the World Health Organization (WHO), explains.

“The involvement of religious leaders in Gouecke in the response has been beneficial and has helped in overcoming a lot of reluctance within the community,” says Ibrahima Kone, the subprefect of Gouecke.

Imam Soumahoro was among the first people to receive the Ebola vaccine, helping to convince many in his community to accept to be vaccinated. So far around 4000 people have received the vaccine, including 2400 frontline workers.

While vaccination has been successful, screening for cases has been more challenging. Since the re-emergence of Ebola, personnel at the Gouecke health centre only carry out two or three consultations a day, compared with about 30 previously. “Ebola is scary, and fear makes people hide as soon as they observe the first signs of the disease,” says Jean-Baptiste Goumou, the Gouecke parish priest who is also encouraging community collaboration.

“There were rumours that this disease was a big lie invented by the health authorities with the complicity of the government to make money at the expense of the Gouecke community,” says Kangbe Camara, a resident of Gouecke. “It was also said that the vaccine had been brought to kill people. Thanks to the imam I got the courage to go and get vaccinated.”

Monitoring Ebola

Imam Soumahoro and the Gouecke parish priest are also members of the WHO Ebola monitoring committee tasked with addressing community reluctance in Gouecke. The committee has persuaded the population to participate in disease surveillance, screening and safe and dignified burials.

“The imam and the priest play a fundamental role in strengthening social bonds within the community. They are the confidants of everyone. This confers them a special status among the faithful and the community hence the importance of including them in the committee,” says social anthropologist Camara, who helped to set up the committee.

“When our teams work on the ground, they always start by visiting them [religious leaders]. As members of the monitoring committee tasked with overcoming reluctance, they are expected to significantly contribute in terms of observance of health measures and greater involvement of the communities in [Ebola] surveillance.”