* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Health experts, governments and non-governmental organisations responding to the current West Africa Ebola outbreak all concede that much remains unknown about the disease. This lack of knowledge - it would be fair to argue - has contributed to a great extent in making efforts to contain the current epidemic incredibly challenging.
Gradually, however, experts are discovering new methods of intervention with encouraging points of concurrence. One vital lesson has also been learnt on how so much depends on cultural factors. In recent weeks, ground-breaking academic findings by the Yale School of Public Health have backed up what we know from our work on the ground: that ensuring safe and dignified burials is extremely important if we want this epidemic to be contained.
Using mathematical modelling looking at this epidemic and previous ones, researchers found that isolation and treatment of cases alone cannot fully bring the levels of transmission down. Transmission precautions for health workers, isolation of infectious patients, and contact tracing were all very important elements to bringing the epidemic under control. However, it is only when the model also ensures safe burial practices that the transmission rates fall to under one additional infection per every Ebola case – the only way that an epidemic actually burns itself out.
Despite data collection and analysis being extremely challenging in this context the World Health Organisation (WHO) estimates that, during the month of August, close to 60 per cent of the known transmissions across West Africa happened during burials. The creation and development of many burial teams in the three countries, coupled with widespread information campaigns about health and hygiene, have now seen this number halved, according to the organisation.
Safe and Dignified Burials are the key
The Red Cross Movement’s 10,000 strong, and growing troop of volunteers across the three most affected countries (Guinea, Sierra Leone and Liberia) have been moving from door to door across villages and towns, spreading messages of good health practice, prevention and care, since the outbreak was first announced in March.
Special teams have also been trained and involved in the intricate process of safe and dignified burials. Thorough training is conducted on safe use of the personal protective equipment, treating and handling contaminated items properly, as well as safely and respectfully managing the dead. These tasks leave no margin for error.
Red Cross teams are tasked with identifying and collecting the deceased, carrying out required burial rites, and transferring the dead - after chlorination and wrapping - to designated burial sites. The work demands difficult lifting and work in very hot protective equipment in weather than tends to rise past 35 degrees celsius.
The volunteers conducting these activities come from the communities that are affected, and as a result, many have themselves been affected by the Ebola outbreak. The volunteers have a personal connection with many of the victims of Ebola, knowing individual cases by face and name, rather than as a number.
Therefore, they are the most appropriate people to hold intense discussions with families, religious and community leaders.
To work in the communities and to inspire changes of behaviour on a grand scale, it takes many voices and great efforts. Red Cross Safe and Dignified Burial teams are trained to listen well and negotiate a way forward. These individuals are the true heroes of this epidemic response.
The Red Cross work, thanks to the Movement’s long-standing presence in West African communities, has seen the Safe and Dignified Burial teams carry out 100 per cent of all Ebola-related burials in Guinea. In Liberia's capital city Monrovia, the delay in safe and dignified management of dead bodies between death and burial has been reduced from three days to less than 24 hours, meaning the time for which dead bodies are exposed has reduced. The Liberia Red Cross has to date conducted more than 2,400 burials. In Sierra Leone, the Red Cross has burial teams in 19 districts of the country and is aiming to increase these teams to 20 more districts to cover the entire country, before the end of the year.
While results of the responses in the fight against the epidemic show that the change in the pace of the spread of Ebola may be reflected in burial practices, all teams on the frontline need increased support to further stem the tide of infections. With improved community engagement and social mobilisation, funding, and equipment, the outbreak can be brought to a close.
To support the Red Cross appeal please visit : www.redcross.org.uk/ebolavirus
