Ebola in Liberia: from secret burials to safe burials

Secret burials were not in my vocabulary before I arrived in Liberia. When I think of burials I think of services with a lot of people. Powerful speeches about the one who just passed away and music that makes your heart burst because you finally realize that you won’t see this person again. There’s nothing secretive about it.

The number of secret burials in Liberia shot up in August after the decree issued by the Government that all dead bodies had to be cremated due to lack of space and to stop transmission of the Ebola virus.

Burying the dead in consecrated soil is deeply rooted in the Liberian culture. Waiting for a car one day I asked one of the guards about this and he explained that cremation is not accepted because the belief is that life does not end with death, but continues in another realm. The burial ritual is also about showing the deceased respect.

But performing those rituals in the context of Ebola is playing Russian roulette. The time of death is the time where the virus has overtaken the whole body. The large number of people involved in the consecutive burial rituals – which include washing and dressing the body – greatly increase the risk of transmission.

A member of the burial team gets the tented morgue ready. (c)UNICEF/Liberia/2015/Ryeng
A member of the burial team gets the tented morgue ready. (c)UNICEF/Liberia/2015/Ryeng

The only way to end the hiding of bodies and the secret burials was to start burying the dead again. But what is a safe and dignified burial in the context of Ebola?

First, the issue of space had to be addressed. And so a piece of land was donated to the Government of Liberia by the community of Disco Hill to make sure that burials could begin again. An incongruous name for a burial site but from what I’ve been told there apparently was a disco on that hill at some point.

But having a place to bury the dead only solves half the problem. The second part is to make sure that people don’t touch people who are sick or who have died, and instead make an important call. When someone is sick with Ebola symptoms you’re supposed to call an ambulance which will take the person to a health facility in a safe way, where they will be cared for by medical personnel in protective gear.

Same goes for when someone has died. You should call the burial team. They will pick up and transport the body in a safe way and they will disinfect the area where the deceased stayed. This to prevent others from being infected.

UNICEF has developed messages on the importance of safe burials and where they can take place. A discussion card is used by UNICEF-supported social mobilizers who go door-to-door to talk about Ebola prevention. Two radio dramas on safe burials, developed by UNICEF, are also being aired on radio stations to create awareness.

The efforts are working and more people are now calling the burial team when someone dies. But behavior change takes time and secret burials are still taking place, making safe burials a top priority for UNICEF in the mission to eradicate Ebola from Liberia.

The gloves of the burial team members are taped to the overhaul suits to make sure that there are no gaps where the skin can be exposed. (c)UNICEF/Liberia/2015/Ryeng
The gloves of the burial team members are taped to the overhaul suits to make sure that there are no gaps where the skin can be exposed. (c)UNICEF/Liberia/2015/Ryeng

So what does a safe burial look like?
I watch from a short distance away as a white truck with the sign of the Liberian Red Cross Society drives up to the side of a tented morgue where three beds covered with tarpaulin and lowering ropes wait for the next body to be placed on them for burial.

A team of six in white head-to-toe protection kits, three layers of gloves, thick rubber boots, and goggles, jumps off the back of the truck and gently carries a special bag containing the body of a 30-year-old man into the tented morgue. Hands covered with three layers of gloves gently straighten out all the bag folds. The first part of the last journey is done.

The burial team carries the body to its final resting place. (c)UNICEF/Liberia/2015/Ryeng
The burial team carries the body to its final resting place. (c)UNICEF/Liberia/2015/Ryeng

The man’s family is escorted from a waiting area under a pergola to a freshly dug grave – the final resting place of their relative. An elderly man sobs quietly, while a woman he holds by the shoulder flails her arms and wails loudly. The other family members stand around the grave as the specially-trained burial team carries the body bag by its handles and carefully brings it to the grave. One person follows spraying the ground they’ve walked on with chlorine.

The team then gently lowers the body into the ground and steps back to allow the family some time alone at the grave. Another team then fills the grave.

A safe burial is over.

Helene Sandbu Ryeng is a Communication Specialist with UNICEF Liberia.

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Comments:

  1. What a difficult job everyone i doing over there. My respect is for all those who do so.
    With respect for the death and for the cultural traditions the have to convince family’s to morn their deaths in a different, safe way.
    It must be heartbreaking for everyone.

  2. […] And she insists she and her family will continue to follow the advice given by social mobilizers during outreach campaigns in her community, where Ebola killed 16 people. Teams were deployed across the country to tell people how to protect themselves and others, by washing hands, reporting sick people to the health centre, and by allowing specialized teams to conduct safe burials. […]