Ebola diary: burials go on as Christmas is 'cancelled' in Sierra Leone

After a week in west Africa, Sarah Boseley concludes that not enough is yet known about the virus, except that it must be eradicated

Mourners pray before the body of a suspected Ebola victim is taken away for burial. Photograph: Sarah Boseley

Day seven

A large group of men, women and children, all in their best clothes, is gathered in the yard of a house in Wellington, an Ebola-hit western area of Freetown. The dresses and headscarves are bright but the faces are sombre.

Alie Kamara, the owner of the house, died this morning and lies inside. He will be buried within a few hours. The manner of his burial is difficult for this community, just as it would be for friends and relatives in any town anywhere in the world.

Family and friends of a man who died of suspected Ebola gather outside his house. Photograph: Sarah Boseley

They watch in silence as several vehicles belonging to the International Federation of Red Cross and Red Crescent Societies (IFRC) draw up. Mustapha Rogers, the “ben com” - the beneficiaries communication officer who will explain events to those who loved or respected Kamara – steps forward and asks for the chief. She is Yabom Wara Kamara-Wokolo, and she answers Rogers’ questions about the manner of the death and the number of family members who live in the house.

Rogers used to be a salesman for British American Tobacco, another company that has shut down here as a result of the epidemic. “They don’t have any distributors to do the job,” said Rogers. 

He doesn’t exactly have what you would call a subtly persuasive manner. After his conversation with the chief, he walks into the middle of the road, where all the villagers can see him, and bellows his public health messages at them. But it’s effective.

Mustapha Rogers tells neighbours of Kamara how to protect themselves from Ebola. Photograph: Sarah Boseley

“Don’t touch each other! Avoid contact! Stop football – from your sweat you transmit the virus!” By the end of the day, he is hoarse.

All this time, men have been dressing in their PPE (personal protective equipment) within sight of the mourners. The first to walk past them and into the house is Dauda Mansary who will take a swab from Kamara’s mouth and dispatch it on a waiting motorbike to a lab which can confirm or rule out Ebola. “Yes, it is horrible,” he says. “But it is my profession. I’m a lab technician.” He may do up to six or seven of these a day.

Then four men, one carrying an orange stretcher and the others carrying chlorine spray and two body bags (because each corpse is double-wrapped), walk down the slope and past the crowd of relatives. Nothing quite prepares you for the incongruity of it.

The wailing and crying begins as the men are inside, spraying Kamara and the entirety of his home with chlorine. Finally the stretcher party emerges to a wave of grief. The bags are zipped up over Kamara’s face so nothing can be seen.

This is hard for families that have traditionally washed and dressed the bodies of their loved ones to give them a fitting send-off. The ICRC does all it can to lend the process some dignity. The stretcher is laid on the ground and the Imam steps forward, the menfolk lined up behind him, to say a brief prayer. Then the white bundle is loaded into the back of a pick-up truck and the team drives to another village to pick up a second body. 

They may collect more before heading for the cemetery where holes have been dug in preparation. The families are told when and where to get there and can watch as the corpse is lowered into the ground.

One of the burial team is sprayed with chlorine solution before removing his protective suit. Photograph: Sarah Boseley

The man they have nicknamed Dead Ed says the system is working. Ed Davis of the Department for International Development was an education adviser in Sierra Leonebefore Ebola hit. “There were few of us about who knew the country well,” he said. “It fell to me.”

When the command centre for the Ebola response opened its 117 phoneline to take calls from families who had sick or dead relatives on 19 October, there were about 35 burials a day, he said. “The average for the week after was well into the 50s. Now the average is around 80.”

Almost everybody they hear about is quickly interred. “For November, the average we buried was 95% within 24 hours,” he said, while adding, “community buy-in is still a challenge.”

The worry is around those about whom they do not receive phone calls. There are plenty of families who still believe the duty to their dead outweighs the risk, and they bury the corpse themselves. Others call 117 only once they have washed and dressed their relative.

People are urged to call the burial teams for any death. Most are not caused by Ebola; very likely Kamara’s is not. He was 63, an old man in Sierra Leonean terms. He had been unwell for a month and was taken to the hospital, where he was tested for Ebola and certified negative. But in this epidemic, there is no room for taking risks.

It is my last day in west Africa. The hotel has a massive Christmas tree and Santa in the lobby, which does not seem so cheerful after the president’s announcement that Christmas is effectively cancelled. There are to be no public festivities, no gatherings, and the people who work in Freetown have been urged to stay there and not join their extended families in rural areas.

I contact the treatment centre at Lunsar to find out from the International Medical Corps how 14-year-old Abu, the boy who loved to ride a bicycle, was doing. Great news – he has been discharged. The centre had a party for him, which the local paramount chief attended, and the staff gave him a green army bike. He was a bit overwhelmed.

But the news is not so good about Isatu, the 15-year-old girl who staff suspected had a romantic interest in Abu. She is now very sick, they say. When she first arrived, she was thought to be the more robust. You can’t tell with Ebola. We still don’t know enough about it, except to know that it has to be eradicated – somehow.

Source: http://www.theguardian.com/world/2014/dec/14/-sp-ebola-diary-burials-go-on-christmas-is-cancelled-in-sierra-leone