De døde er den største ebola-smittekilde

Laurits Holdt

Af Tyler Jump, International Rescue Committee

I Sierra Leone stammer syv-otte ud af hver 10 nye tilfælde af ebola fra kontakt med én, der er død af sygdommen. For at undgå smitten skal pårørende give afkald på de traditionelle begravelsesritualer.

Et begravelseshold bærer fuld beskyttelsesdragt – coveralls, handsker og ansigtsmaske. (Foto: Peter Biro, International Rescue Committee)

Between 70 and 80 percent of new Ebola cases in Sierra Leone are a result of contact with the body of someone who died from the disease, according to the Center for Disease Control.

Ebola cases in the Western District, which includes Freetown, Sierra Leone’s capital, jumped dramatically during October: up 37 percent (from 651 to 897) in a span of 10 days.

Alle begravelses behandles som ebolatilfælde

The spike has prompted officials to declare the district an “Ebola High-Transmission Area” and to require that all burials be handled as Ebola cases. 

Testing and confirming an Ebola death can take up to a week—too long when the rate of infection continues to accelerate rapidly.

Sierra Leone now requires all corpses to be removed in less than 24 hours by burial teams following specific safety practices.

“The corpse of a person who has died because of Ebola is full of the virus,” says Dr. Jota Echevarria, senior health coordinator with the International Rescue Committee’s emergency response team. “The possibility to get infected is much higher.” 

In the Western District, the IRC is leading a group of 10 international aid agencies tasked with the safe burial of the dead. Great care has been taken to involve families in the burial process despite necessary precautions.

En følsom sag

“It is quite a sensitive issue,” says Echevarria. “Dealing with the dead from a cultural point of view is very important.”

Traditional funerals in Sierra Leone often include direct contact with the deceased, a dangerous practice in the case of Ebola victims.

Close family members prefer to clean and dress the dead themselves. They also touch and kiss the body in a gesture of farewell.

The new protocols are intended to ensure that families are able to attend burials and observe their religious practices while securing public safety.

Outside a cemetery in Freetown, a member of one family returning from a burial understood the need for the new safety measures.

“Our job is to go back to our communities and explain what is really happening,” she said, “because people don’t believe this is happening. If we explain, then they will be more ready to hand over the bodies.” 

How to safely bury Ebola victims

1. Contain the body.

A team of four people (the number can vary) arrives at the home of the deceased in full protective gear. The team expresses their condolences for the family’s loss and counsels the family as to necessity of the special steps intended to protect them and the community. The team locates the body and places it in a body bag, allowing the family one last opportunity to see their loved one’s face before the bag is closed. 

2. Secure the body.

A coffin or second bag is disinfected with a chlorine solution and the body is placed inside. Once closed, the coffin or bag is again treated with the chlorine solution.

3. Transfer the body.

The secured body is placed in the back of a vehicle for transportation to a predetermined burial site. The family is notified when and where the burial will take place. Graves are prepared overnight and must be 100 feet from any water source. Before and after transportation, vehicles are sprayed with chlorine. 

4. Respectfully bury the body.

The burial site is treated with chlorine before designated family members and a religious leader arrive for the burial ceremony in full protective gear. The body is lowered into the ground with any personal effects the family may have provided, covered, and more chlorine is used to disinfect the area and attendants.