From the Editor’s Keyboard

Freetown: Ebola Medical Burial Scenario

11 October 2014 at 15:07 | 1246 views

By Alhassan Fouard Kanu, Guest Writer, Freetown, Sierra Leone.

The Ebola outbreak which started over five months ago can be described as a cruel scourge. The pain of Ebola is inherent in the relatives’ inability to get closer to their loved ones when they are departing this world. Coupled with this is the uncertainty surrounding the way and manner in which the deceased relatives are handled and buried by unknown persons to the family.

Burials have contributed the greatest to community-wide exposure to the virus, accounting for 60% of all infections. Despite continued education and appeals to dissuade relatives from attending to bodies without information on their Ebola status, there is a seeming resistance as the practice is still being observed. This is not unconnected with the rumours of disrespectful handling of our loved ones by the burial team; and coupled with the denial and/fear of a household being quarantined and stigmatized secondary to an Ebola test result on the dead. The attempt by some people to perform such practices has contributed immensely to the spread of the virus in the country.

Here is a fictitious scenario: Let’s say one of my relatives died in a village near Freetown. Let’s call her Mammy Ex, who is my aunt. She died two days ago from a chronic illness (stroke). The family cannot bury her without notifying the MOHS (through 117). We recognized the undue delay in the process of ascertaining her Ebola status. It requires that she is swabbed and a specimen sent to the laboratory. There have been instances where bodies nearly decomposed in homes during the waiting time for the laboratory result which usually takes more than 48 hours.

Mammy Ex was a devout Muslim who had always wished to be buried in the Islamic way (meaning she was to be buried on the same day she died.). As a family, we respected our late aunt’s wish. We made a decision at once that we will ignore the process of confirming her Ebola status through prolonged laboratory investigations. We notified the burial team and handed over the body for burial. The process was duly followed where the surveillance unit took a comprehensive history of the late woman including her contacts and a swab was also collected for analysis to confirm her Ebola status.

It was a painful brooding moment for us as we wallowed in the fear that our beloved aunt will be buried in a very disrespectful manner where men in overall suits will tend to her; where her body will be thrown at the back of a pick-up van. We were worried over rumours that our aunt will be sharing a grave with another unfortunate Ebola infected body or bodies. It was devastating!

Bu contrary to our fears, when the burial team arrived at our house they showed empathy and professionalism in carrying out their job. They counseled and educated the entire family on the burial process which they referred to as safe and dignified medical burial. We saw their faces and they dressed up in their gears right in front of us. They had women amongst them who tended to our beloved aunt. We gave them white cloth and spray to wrap her before being bagged.

The family was given the opportunity to choose their preferred cemetery and to invite the community Imam to pray on Mammy Ex’s body. The entire family, led by the Imam participated in the prayers right in our compound. We were told that if Mammy Ex were a Christian, she would have been buried using a coffin and her church congregation would have accompanied her to the grave site The body was later loaded peacefully on a vehicle and driven slowly to a cemetery of the family’s choice. The family was encouraged to accompany the body to the cemetery and witnessed the full burial proceedings at a 10 meter distance.

Our decision was helpful and prevented us from contracting Ebola had there been an underlying infection. Also, we averted a situation where our beloved aunt would have decomposed in the home; a state that could have robbed us of the opportunity of giving her a befitting burial. The Ministry of Health later provided us with a certificate showing that our late aunt was negative of Ebola. This certificate helped out considerably in ensuring that our family was not stigmatized. We appreciate the burial team and the MOHS for their professionalism and show of respect to the bereaved family.

To my readers, it is high time, as a country, that we take the painful but bold decision to eradicate Ebola in our midst through Ebolarizing every death, i.e. allowing our loved ones to be buried as in the fictitious story described above. There will be a new face of the burial team as in the scenario above in the context of giving a blanket safe and dignified medical burial for all deaths in the country.

The benefit of this is immense both to the immediate family/community and the government. The safe and dignified medical burial from which Mammy Ex benefited from, will help the affected families by saving them from the pain and embarrassment of their loved ones decomposing in the homes. This has the potential of infecting the entire family and the community.

Giving a blanket burial for all deaths (Ebola and non-Ebola related) will prevent a scuffle between the security apparatus and communities, especially in Freetown. These clashes are a threat to state security.

It is but important that the citizenry come to realize that the unprecedented Ebola outbreak needs extraordinary containment measures and among them is our sacrifice to let go the cultural and religious practice of tending to our dead love ones during the period of the outbreak.

The government should consider revolutionizing the burial teams and provide them with the required support to execute safe and dignified medical burials in Sierra Leone. Such a measure is critical to reducing community-wide exposure to the virus as well as preventing civil unrest resulting from decomposing bodies in homes and communities.

Photo: Ebola burial team in action.