Lassa Virus Hemorrhagic Fever in Benin in 2014 in an Ebola Context: An Epidemic Revealing the Weakness of the Health System

The history of the management of the Lassa haemorrhagic fever epidemic (FHVL), which occurred in Benin in 2014, is in the context of an Ebola outbreak in West Africa. The present research aims to understand the social conditions of the outbreak and evolution of the FHVL epidemic, on the one hand, and the technical, political and institutional processes of its management by the State and the international alert network. and health response, on the other hand. The field survey was conducted at several sites: at the Ministry of Health in Cotonou, in the health services (including the Saint-Jean de Dieu Hospital in Tanguiéta in the north of the country), and in the families of the geographical area of ​​the epidemic. The qualitative survey associated direct observations in social and hospital environments, semi-structured interviews and the review of scientific articles, gray literature and the press. The article suggests that at the institutional and medical level, the state has been weak in the emergency response, especially in communication and diagnosis. On the side of populations and health workers, the symptoms seen, heard or learned were interpreted according to local etiological models of the disease, imbued with magico-religious logic. Faith-based private health care, despite its strengths and reputation, is still ill-equipped to respond quickly to an emergency epidemic like this one. Decentralized structures in the health care system have not appropriated their roles. The state lacks a surveillance system and emergency epidemic management capabilities.