WEST AND CENTRAL AFRICA feature story for Guinea

© UNICEF Guinea/2009/Sow

Gnamakoro Dioubaté awaits treatment for her five-year-old granddaughter, Saran, at a health centre in Faranah. Saran has a fever and severe diarrhoea. Water-borne and diarrhoeal diseases account for nearly 17 per cent of Guinean child deaths.


The health center is located on the main road that crosses the town of Faranah. A plate indicates access to the inner courtyard of the Health Center. In front of the main building, patients can wait for the prenatal and postnatal consultations on two wooden benches.

Time is rolling by slowly and people are getting restless. In the back, Gnamakoro Dioubaté, a grand-mother, holds Saran, her five-year-old grand-daughter, on her lap. The little girl is all curled up, her body feverish. This morning, Gnamakoro took her to the health center because she had been suffering from diarrhea for more than 24 hours. Grandma knows that in such cases, one should never waste time at home. She had prepared and given a solution of oral rehydration salts but nothing worked. The diarrhea has not stopped. Saran’s eyes are watery but the rest of her body seems dehydrated. "She’s always crying. She did not sleep at all last night, "says Gnamakoro, in an anguished voice.

At the doorstep of her  office, a nurse calls the patients, one by one. But she realizes quickly how urgent Saran’s physical condition is and brings  the grandmother and her grand-daughter in the consultation room. Immediately Grandma Gnamakoro’s tired face relaxes. The nurse asks the usual questions, and conducts a careful examination of the child prior to administering oral rehydration salts (ORS). She then leads Saran and her grandmother in an adjoining room where the girl will remain for at least two to three hours for observation before being allowed to return home.

Cases such as this one are common. In Guinea, the causes of child mortality are malaria (31%*), respiratory infections (20%*) and  diarrhoeal diseases (17%*). Malnutrition can be an aggravating factor in these diseases.

The response of UNICEF and its partners (WHO, UNFPA, PSI, HKI) 

In order to better involve the community in protecting the welfare of the child, the health center organizes outreach activities to make people realize that small gestures and basic rules of hygiene can sometimes save lives. Inside a hut built in the yard of the health center, Mariam Diallo and Illiassou Diallo, two members of the Management Committee of the center organize an awareness session every Monday and Friday, from 8 a.m. till 10 a.m.  Today, they brought with them a few small blue plastic bottles, labeled «Sur' Eau» on which one can see the logo of UNICEF. Using a very figurative language, they show the bottle around and explain in simple terms how people should use it. « Use a disinfectant like Sur'Eau, to make the water drinkable. Sur’Eau is a solution of chlorine that kills germs in the water and will prevent diarrhea in children and their parents,»  they say.
The two leaders add other practical tips for their female audience : "Do not leave stagnant water near  your homes, so that mosquitoes will not be able to breed. Remove all dirty objects near your settlements and bury the garbage to avoid catching diseases”. And they urge them to come regularly with their children to the health center for comprehensive care. The women are all ears.
In addition to the information and outreach sessions held in the health center, community workers organize talks within the communities and in public places. The awareness sessions are focused on learning positive behaviors to prevent childhood diseases such as diarrhea with the proper use of oral rehydration salts. These community workers were trained at a workshop organized by the health system, in partnership with UNICEF and other NGOs.

The Guinean government and several other stakeholders of the health sector are fighting childhood diseases. UNICEF and the National Program against Malaria work for the promotion and use of insecticide-treated nets, the distribution of medicines and and supplies to prevbent and treat malaria.

Thanks to the care of children and distribution of medicines offered by UNICEF, the health center is experiencing a significant decrease in childhood diseases. In 2008, the center has recorded a 14 per cent decline of diarrhea episodes.

UNICEF provides free therapeutic food, deworming, medicine against malaria, antibiotics, as well as vitamin A and insecticide-treated nets to pregnant women or recent mothers and to children who are not yet five. During the month of November 2009, UNICEF and its partners have planned a national campaign during which every child under 5 years-old was given an insecticide-treated mosquito net.  Thus, the coverage of insecticide-treated nets  will reach nearly 70 per cent at the end of 2009. By 2010, nearly 80 percent of health centers in the country will be supported by WHO, UNFPA, UNICEF and the GTZ to the rehabilitation of the primary health care system.

* Statistics source: Lancet 2003
              (Kadiatou Sow + Mab)