IMG_2345Ebola has no sympathy. In life, it causes untold suffering; in death, it robs you of your dignity.

Where normally the deceased in West Africa could expect a traditional burial, Ebola has denied them that privilege.

Those who have succumbed to Ebola, remain infectious. Instead of a funeral attended by friends and family, theirs is now a discreet burial carried out by men in white overalls wearing masks. They’re buried in body bags, not one, but two.

It’s a morbid task, one that is being carried out by teams of Red Cross workers.

The virulent disease, which has only recently started making headlines in the UK, has claimed nearly 900 lives across Sierra Leone, Guinea and Liberia since March, according to the World Health Organisation. Four cases have also recently been confirmed in Nigeria.

Red Cross staff and volunteers are working tirelessly to fight Ebola by raising awareness and educating people about how to prevent infections.

“Having people accept and understand information about Ebola is key to stopping this outbreak,” said Raul Paredes, deputy head of Ebola operations for the International Federation of Red Cross and Red Crescent Societies (IFRC) in Sierra Leone.

“We cannot do it on our own, which is why it is critical to engage with community leaders, be they traditional healers or religious leaders.”

Preventing infections

Education is one part of the fight. Finding those who have come into contact with the disease, is another. Disposing of the bodies is the final task.

It’s called ‘dead body management’, a somewhat insensitive and euphemistic description of what is an incredibly important and sensitive undertaking.

IMG_2280One of the ways in which Ebola has been spread is through burial rituals. Families often wash the bodies of loved ones to prepare them for burial.

It is a dangerous practice as the disease is transmitted through contact with bodily fluids of an infected person. Vomiting, diarrhoea and bleeding are all symptoms of Ebola.

In Kailahun district, in eastern Sierra Leone, a team of Red Cross workers has the job of burying the bodies.

One after the other, sometimes eight or nine a day, they bury the bodies. A few weeks ago the workers, men aged in their early twenties, would have been studying, or working on a construction site. Life has changed quickly.

To date, there have been more than 50 official burials, and with dozens of patients at the isolation centre, and more arriving every day, it is likely there will be more.

p-SLE0426“These are the deaths we have been informed about,” said team leader Daniel James.

“More communities are beginning to notify authorities when someone passes away at home, which is great.

“Calling us and not touching the body will help us control this outbreak. However, there are still many other communities who do not believe Ebola is real, and who continue with the local custom of preparing bodies for burial themselves.”

Fear of infection

The dead body management team oversees two types of burials. Bodies they receive from the isolation centre are completely disinfected in advance.

“The family is contacted to determine where they would like their loved one buried, back in their community or in one of the newly dug gravesites here in Kailahun town, created just for Ebola victims,” said James.

“We are finding that most don’t want their relatives returned, they are still so scared that the bodies are contagious.”

IMG_2411The second type of burial is more complicated and risky as it involves the Red Cross workers going into a community and preparing the body for burial.

It may test positive for Ebola, it may not, but the Red Cross team takes no chances. For their own protection, they wear all of their protective gear – three sets of gloves, masks, goggles, overalls and boots.

“We have the personal protective equipment, the rope, we have the two sprayers. We have six in number (on the team),” explained Julius Tamba Kamanda, a 21-year-old member of the team.

“Whenever we have touched the diseased we have been sprayed by the sprayer so that we will be protected from the disease so that we don’t bring it to our families.”

They disinfect repeatedly throughout the burial process, always placing the body in two body bags, to ensure there is absolutely no opportunity for the virus to survive.

Any contaminated personal items such as clothing, blankets and pillows are either burned or buried along with the body.

It is a desperately morbid undertaking and highly distressing for loved ones. But, as the world is slowly learning, there’s nothing pleasant about Ebola.

This is an edited post by Katherine Mueller, communications manager in Africa for the IFRC.

All images ©IFRC/Katherine Mueller