As the old truck-turned ambulance backs into the makeshift tent, a team of health workers swarms to receive it. In clockwork-like motion, they transfer the adult-sized body bag onto an improvised bamboo table, the tarp of the bag matching their all-white full-body protective suits. After hurriedly disinfecting the bag and anything it could have touched, a brief sigh of relief. Then, back to the truck. This time, for an infant-sized body bag.
For the staff of the Margibi County safe burial site outside of Monrovia, Liberia, the grim operations mark just another day at the front lines of the war against Ebola. And while the country is making major strides in its fight to end the epidemic – with only five confirmed cases as of January 24 – the idea that the work isn’t over until there are zero cases rings most true here.
Liberia, Guinea, and Sierra Leone are making progress versus the Ebola outbreak that has afflicted the region since December 2013, but the UN warns that it is too early to begin to letup against the epidemic, which has claimed over 8,600 lives.
“Cases are clearly declining in all three countries, but we must maintain the momentum and guard against complacency,” said World Health Organization Director-General Dr. Margaret Chan at a January 25 Special Session of the Executive Board on Ebola. “An upsurge in new cases can follow a single unsafe burial.”
According to WHO, the majority of Ebola infections in West Africa are caused by unsafe burials.
As cases drop in Liberia, it’s the job of teams like the one in Margibi County to ensure the country has the proper infrastructure to appropriately deal with the bodies of Ebola victims, and in turn prevent future cases. Run by the NGO Global Communities, the cemetery is working to ensure that when people do die from the disease, their bodies are cared for in a way that’s not only safe, but also respectful so that families of victims feel comfortable bringing their loved ones to the site.
“Both with Christians and Muslims, the traditional practice is to wash the bodies,” said Matt Ward, the Ebola Response Coordinator overseeing the site. “If you come into contact with a sick person, you’re at risk. But if you come into contact with a person who died of Ebola, you cannot be at greater risk.”
“It’s the most bizarre dichotomy I’ve ever experienced: it’s one of the worst days of their lives, and they come up and thank me,” says Ward of the families of Ebola victims. “They’re not having traditional burials, but they’re still having dignified burials, and they can still go and see where their loved one is. And that’s huge.”
As the day’s scheduled burials took place, a family of one of the deceased watched from a shaded hut, built by Global Communities so that loved ones could watch the ritual from a safe distance. The staff at the cemetery, moments ago digging, painting, and planning loudly, had stopped their work, and now silently watched as the body was lowered 6-feet under and covered with topsoil. Once given the signal from the burial team – which was still in full protective gear – the family approached, and wept over the plot as if alone in the cemetery. Not traditional, but dignified. And that was huge.