--- title: Ebola: How Guinea Found the Best Way to Survive the Disease description: As the world waits for new treatments and a vaccine, doctors in Guinea have found the best way to help patients survive Ebola infection canonical: https://time.com/3559256/ebola-guinea-iv-fluids/ author: Alice Park article:opinion: false article:content_tier: free article:published_time: 2014-11-05T22:00:17.000Z article:modified_time: 2026-08-04T08:00:23.417Z article:section: Health og:title: How Guinea Found the Best Way to Survive Ebola og:description: As the world waits for new treatments and a vaccine, doctors in Guinea have found the best way to help patients survive Ebola infection og:url: https://time.com/3559256/ebola-guinea-iv-fluids/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt560ee18631231210/6987646f0b72e3f9ed6db687/ebola-guinea.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 3625 og:image:height: 2039 og:image:alt: GUINEA-HEALTH-EBOLA og:type: article twitter:card: summary_large_image twitter:title: How Guinea Found the Best Way to Survive Ebola twitter:description: As the world waits for new treatments and a vaccine, doctors in Guinea have found the best way to help patients survive Ebola infection twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt560ee18631231210/6987646f0b72e3f9ed6db687/ebola-guinea.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # How Guinea Found the Best Way to Survive Ebola > Sponsored content. 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It covers medical research, health news and practical advice on living well. #### Where can I get reliable health news by email? Health Matters is TIME's daily health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free daily newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ## Video: Nigeria is an Ebola Success Story: Here's What The Country Did Right [Watch (HLS stream): Nigeria is an Ebola Success Story: Here's What The Country Did Right](https://cdn.jwplayer.com/manifests/mSo7iFZ3.m3u8) (2:43)  _Published 2014-10-21. The World Health Organization declared Nigeria free of Ebola on Monday, a containment victory in an outbreak that has stymied other countries’ response efforts._  by [Alice Park](https://time.com/author/alice-park/)  ## Alice Park Senior Correspondent Nov 5, 2014 10:00 PM UTC  A medical staff worker of the 'Doctors without Borders' medical aid organization at a center for victims of the Ebola virus in Guekedou, Guinea on April 1, 2014. A medical staff worker of the 'Doctors without Borders' medical aid organization at a center for victims of the Ebola virus in Guekedou, Guinea on April 1, 2014. Seyllou—AFP/Getty Images  by [Alice Park](https://time.com/author/alice-park/)  ## Alice Park Senior Correspondent Nov 5, 2014 10:00 PM UTC With the number of cases topping 13,000 and deaths climbing close to 5,000, the current outbreak of Ebola in West Africa is the virus’s worst yet. But from the tragic illness and mortality emerge some important lessons from the region. The latest, published in the [_New England Journal of Medicine_](http://www.nejm.org/doi/full/10.1056/NEJMoa1411249?query=featured%5Fhome), details the cases that first appeared in Guinea’s capital city of Conakry between March and April. Unlike in other parts of the region, where the mortality rate from Ebola averages [around 60% to 70%](http://time.com/3546306/ebola-sierra-leone/), in Conakry it has remained around 43%. **MORE:** [Here’s What Scientists Know About Ebola in Sierra Leone](http://time.com/3546306/ebola-sierra-leone/) Why? As Dr. Robert Fowler, a clinician in pandemic and epidemic diseases with the World Health Organization (WHO) and physician at the University of Toronto, explains, Guinea’s first Ebola treatment center, established in the capital, took a very aggressive approach to handling patients. Working with the humanitarian aid group Medecins Sans Frontieres (MSF) or Doctors Without Borders, the WHO and the country’s Ministry of Health set up a facility where Ebola patients were immediately hooked up to IV fluids and treated for dehydration—often a complication of infection. They were also monitored regularly for changes in their blood chemicals, including the electrolytes that are a marker for whether the body’s cells are getting enough water and nutrients to function. While routine blood work is standard practice at every hospital in developed nations, such testing wasn’t at Conakry health facilities. “At the beginning of the outbreak, there was no \[Ebola\] treatment center,” says Fowler. “It evolved from an old cholera treatment facility and the evolution of care went from having no beds to having IVs, IV fluids, antibiotics and antimalarial \[drugs\]. We were only able to do hand-held point-of-care testing \[of blood samples\] but that was quite novel for treatment centers anywhere in the outbreak, even though that’s expected and routine almost everywhere else in the world.” **MORE:** [This Map Will Show You Every Ebola Outbreak in History](http://time.com/3554416/ebola-history-map/) The key to helping Ebola patients survive their infection, Fowler and his colleagues saw, was hydrating them with IV fluids, ensuring that their blood work remained stable and addressing any changes in their metabolites as quickly as possible. In the first month of Ebola cases, 37 patients tested positive for the virus, 28 were treated with IV fluids and 16 died. While the death rate remained high, it was lower than that typically seen in other parts of West Africa. “Our hypothesis has always been that we wanted to establish a culture of very aggressive supportive care for patients who were coming in dehydrated with electrolyte and metabolic abnormalities and try to correct those very early on, so the complications of very severe depletion don’t compound the effects of Ebola virus infection,” Fowler says. **MORE:** [Why Cuba Is So Good at Fighting Ebola](http://time.com/3556670/ebola-cuba/) Fowler is convinced that the key to improving Ebola survival rates is to think about it differently. Instead of thinking of Ebola as an almost-always fatal disease, see it instead as one that is survivable with the right treatments, he says. If people understood that survival is possible—and at higher rates than previously thought—then more people who might be exposed or infected would seek care sooner rather than later, when it’s too late. “I truly do think we can change the way people think about this illness if we evolve the thinking from needing to have isolation facilities…to saying we need rapidly mobilized treatment facilities that can help care for patients with aggressive supportive care as early as possible,” he says. Even with the dozens of patients he and his team saw at the treatment facility in Conakry, “we just weren’t keeping up with their fluid needs as much as we needed to,” he says. “Collectively as a team, we were thinking we were failing miserably in terms of our goal of delivering optimal care.” To succeed takes an enormous amount of resources, labor and personnel. Health workers need to routinely draw and measure patients’ blood to track any slight negative changes in their physical state. Fowler acknowledges the need for drug treatments and an effective vaccine, but for now, as thousands of patients struggle to fight off the virus, “we really, really need more health care workers so we can spend enough time with patients and deliver the kind of supportive care that will improve their outcomes,” he says. **MORE:** [Nurse Explains Why She Fought Ebola Quarantine](http://time.com/3556032/ebola-nurse-kaci-hickox-quarantine/) Fowler admits the challenges facing recruitment. For starters, working with Ebola patients requires health care personnel to suit up in personal protective equipment that leaves no skin exposed, making them uncomfortable in the equatorial heat of the region. “We are nowhere near hitting the mark that needs to be hit to improve outcomes,” he says. But as data like his starts to build, best practices and the most effective ways to treat Ebola patients are emerging. And hopefully they will start to make a difference. ## Transcript Africa's most populous country, Nigeria, is free of Ebola after it went 42 straight days with no new cases reported. As the epidemic rages out of control in neighboring Liberia, Guinea, and Sierra Leone, how did Nigeria become an Ebola success story? [ MUSIC ] Declaring an emergency right away. When Nigeria had its first confirmed case of Ebola, the government declared a national public health emergency immediately. That means that strict procedures for treating patients and screening people were quickly put into place. For example, local health workers paid $ 18, 500 face to face visits to take the temperatures of nearly 900 people who had contact with Ebola patients. Training local doctors. The World Health Organization and Doctors Without Borders trained local doctors on how to treat patients effectively. But the country posed a unique challenge as the number of people living in Lagos is around 21 million. That's almost as large as the populations of Guinea, Liberia and Sierra Leone combined. How can the disease be contained under such circumstances? The answer, high quality contact tracing by experienced epidemiologists. With the help of GPS systems and daily mapping, government officials reached 100 % of known contacts in Lagos and placed them in isolation wards. Managing Fear. Nigeria used social media and televised campaigns to reach its 174 million residents. To prevent panic, the country showcased patients who were successfully treated, and produced awareness campaigns on the disease. From national TV appearances by the president, to an online campaign starting Nigerian actors. No effort was spared to reassure the country's vast population. 0800 EBOLA HELP now. Keeping borders open. Nigeria made the decision of keeping it's frontiers open to travelers from Sierra Leone, Liberia, and Guinea. Saying that closing the borders would only hurt commercial activities in the countries whose economies were already struggling due to Ebola. At the same time effective screening procedures checked incoming visitors. The average number of travelers screened each day reached more than 16, 000. Even though the outbreak was contained Nigeria is now slowing down its training and preparation procedures in case there are new cases. 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