Samura Osman, a former soldier, died at home from an unspecified illness. He was 35. Osman’s corpse – a potential public health risk following the Ebola outbreak – lies swaddled and zipped in a body bag, awaiting safe burial by a team of trained volunteers equipped with masks and protective clothing.
As Sierra Leone counts down to 7 November in the hope it will be declared Ebola-free – the date marks 42 days since the last recorded case – families must continue to bear the strict public safety procedures that have helped to contain the disease.
No shaking hands, washing hands when entering or leaving buildings, and safe burials for all, whatever the cause of death.
Fiona McLysaght, from the NGO Concern, says that 70% of Ebola infections in the country resulted from touching or washing a corpse.
“The cultural practice is to wash bodies by hand and hold very elaborate, long funeral ceremonies where the body is laid out at home,” she says.
“To have a loved one whisked away in a body bag by masked strangers has been one of the hardest things for this society to bear.”
In the mortuary car park, the burial team prepares to inter Osman’s body.
They stand in line to don their protective gear.
In a well-rehearsed drill, every team member’s suit is double-checked by the person next to them. Clad in yellow, a colleague with a spray gun that dispenses chlorine solution leads them silently inside the mortuary. The body bag is unzipped and a cheek swab taken to test for Ebola.
On the cause of death form, the family stated Osman had a fever and was passing blood when he died. “That’s a possible red alert for us. But I am not worried. We had 10 similar alerts yesterday. These are common symptoms of most illnesses here,” says the mortuary assistant.
After the procedure the team disrobes, taking care not to touch parts of their gloves and suits that may have been in contact with the body. Then they suit up all over again – three pairs of gloves, suit, apron, mouth mask, visor and wellington boots – for the actual burial.
Osman’s body is placed on a stretcher before being driven by ambulance to a graveyard, where his family await. As the vehicle passes, people bow their heads at what has become a tragically familiar sight on Freetown’s streets.
During the height of the crisis, the burial teams – consisting of 12 people – were carrying out between 100 and 180 burials a day. Medical authorities reported receiving more than 250 calls in one day to report patients with Ebola symptoms.
In the scramble to contain the disease, thousands of bodies, an average of 50 a day, were buried in mass graves, most of them in Freetown’s King Tom graveyard. More than 4,500 bodies now lie there, not all Ebola victims. King Tom filled up so quickly that ground had to be hastily reclaimed from the rubbish dump next door.
“There were 270 people involved in the burial teams and cemetery decontamination,” says McLysaght. “They are from all walks of life – male, female. [From] illiterate people to people with master’s degrees. There was great camaraderie, but many have had to have psycho-social counselling to deal with anger management and depression. Seventy of them are still having ongoing support.”
Lansanna Sinngah is one of those. “My wife wouldn’t let me come home for a month when I started doing this. But I wanted to do it because these are my countrymen,” he says.
She was taken by ambulance to a holding centre where she was next to people who had the disease, so if she didn’t have it then I think she caught it. My sons ran after the ambulance when they took her. I came home and went to the centre. I was only told she had died the next day, but not where they took her.”
Tracing families is slow and difficult. Concern has been doing painstaking work to move bodies from mass graves to single plots. The NGO has also commissioned 11,000 locally-made headstones to replace hastily placed wooden crosses.
It plans to commission more in the coming weeks, for the bodies buried in King Tom cemetery.
“It gives solace, but it’s also thinking ahead about the legacy the international community leaves behind,” says McLysaght. “In five years’ time, someone can come back and identify a grave. Seventy-two mortuary and funeral home staff have been trained in cemetery management so we hope this will inform how they operate post-Ebola too.”
As yet there is no fixed timeline for phasing out the safe burials. McLysaght would prefer them to continue until 90 days after the last recorded case, the date when responsibility for disaster and public health emergency management will transfer back to Sierra Leone’s Ministry of Health and Sanitation.
“I think there will be resistance from the public to continue beyond 42 days,” she says. “People will undoubtedly be celebrating in the street. All they want is to get back to normal as quickly as possible. But I fear a lot of people think Ebola is already over when it isn’t quite yet.”
No comments:
Post a Comment