Sierra Leone. Ebola. Invisible Heroes

Young burial workers risk their life to conduct safe and dignified burials for Ebola victims across Sierra Leone.

Some people are waiting patiently for their turn in a small room behind the hospital without air conditioning or a fan. The temperature here can reach 40 degrees. Some of them are sleeping with their head on the table, some others are reading, and those who are having conversation, avoid mentioning Ebola.
More than 4,000 people have died from Ebola and nearly 13,000 have been infected with the virus in Sierra Leone since the epidemic broke out last year in April. “These numbers do not include those people who have died or have been infected in rural areas, since data are not available”. Amadu explains to us. He is a young health care assistant working at the Department of Infectious Diseases at the Central Hospital in Freetown, the capital of Sierra Leone. We met a burial team made up of four young men and a young woman, all of them volunteers. They collect and bury the corpses of people who died from Ebola. Their main task, however, consists of isolating the highly infectious bodies and burying them with dignity, while preventing transmission of the virus to other community members. Foday, one of the team, says: “We are called to remove bodies from homes, or to carry the bodies of Ebola victims who died in hospital to a cemetery for burial. We are aware that we are among those most at risk of catching Ebola, but we do this for our people”.

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It’s 8 o’clock in the morning, the telephone rings, the burial team is asked to collect a body. The ritual begins. The burial team put on their plastic overalls, gloves, goggles, face shields, boots, and spray their bodies with chlorine. They take ropes, shovels and bags of water with them as well to cool off, as burials are generally done around midday. Burial teams work in silence, every single gesture is studied. Everyone knows what he is supposed to do. Preparation is fundamental. Nothing can be left to improvisation. The meticulousness of gestures is astonishing. Just a few glances, there is no need of words. Two ambulances are required for this service, one carries the burial team members and another one the body of the Ebola victim. “Wheels, handles, stretchers and all ambulance car interior equipment are disinfected with chlorine”, says Kossi, the ambulance driver.

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On their way to the deceased’s house, the ambulances, which are used for Ebola victims and burial teams, are recognised by people. “Their faces express contempt for our work,” says Musa, “sometimes, even members of our own families do not want to have anything to do with us anymore. We are stigmatized and vilified because we have direct contact with the lethal virus”. After an hours drive the two ambulances reach the house of the Ebola victim. There are many people there. “Team members know that they must be careful”, says Anthony, the team leader. “We can often see frustration on the faces of mourners at not being able to do more for their deceased loved ones. We must respect their tears, their pain, so therefore we must proceed slowly”.

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The burial team enters the house, the highly infectious body is in a small room. It is difficult to move inside there. They start by spraying chlorine throughout the room, the body is disinfected and placed in a plastic bag with the deceased person’s name on, and it is carried into an ambulance. As the team moves the body, they spray disinfectant as they go. Margaret says: “We are Muslim and do not approve the current burial procedures imposed by authorities. When Muslims die, family members don’t turn to a funeral home or crematorium to take care of the body. In Islam, death is handled much differently. Relatives personally wash the corpses of loved ones. Often, several family members participate in this posthumous bathing ritual. But we understand that in the face of this tragedy, we have no other choice”.
The two ambulances drive to the cemetery slowly in order to show respect for the body which is transported and, at the same time, to guarantee additional protection and caution. There are many people waiting at the cemetery which was built in just a few weeks. Once the engine of the ambulances is switched off, one can hear only the sound of birds chirping, and the sound of the warm wind blowing and rustling through trees. Passersby do not speak, motor bikes slow down. Soldiers patrolling the street salute respectfully. Traditions must be honoured. The body inside a plastic bag placed on a stretcher is pulled out of the ambulance. There is no hurry, there are no words.

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Handles, stretchers, all ambulance car interior equipment, the ground and the burial team members themselves are disinfected with chlorine by Joyce, the female of the team. An Imam (or a Pastor) is present to pray for the deceased, but also for the family, for the community, for all Ebola victims. The team members then lower the body into the grave by using some straps. They spray disinfectant chlorine lime and start to shovel until the grave is completely filled with earth. Relatives and friends watch the ritual from a safe distance.
Finally, the burial team places a tree branch over the grave.
After a few days, a black gravestone is due to be placed over the tomb with an engraved inscription of white writing on it, which includes the name, age, home town and the identification number of the deceased. The team leaves the place calmly, not to make it seem that they are anxious to leave the cemetery.

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They get into the ambulance and when they arrive at the hospital they begin to disinfect their boots, gloves and glasses. They take off their heavy plastic overalls and spray their bodies with chlorine once again.
“It’s a tough job”, says Anthony. “We are aware that our health and our life are at risk. I have been doing this for eight months now. I’ve buried hundreds of bodies. In the evening, before going to sleep, I pray. I think of the things I saw, the people I met and their faces … it is not easy but we have to move on”. (J.R.)


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