Bodies pile up in Sierra Leone: Connect the dots!
Ebola deaths totally overwhelmed the hospital at Kono in Sierra Leone last week. The rate of deaths exceeded the capacity of burial services and bodies piled up unburied. BBC World Service reported that over 11 days in Kono after assistance arrived, "two teams buried 87 bodies, including a nurse, an ambulance driver, and a janitor drafted into removing bodies as they piled up". See http://www.bbc.com/news/world-africa-30429360
The response team also found 25 people who had died in the past five days piled up in a cordoned section of the local hospital. Bodies of Ebola victims are highly infectious.
Ebola spreads very effectively at traditional funerals in Africa. Safe and dignified burial is a cornerstone of Ebola control. In the Ebola response roadmap WHO has one KPIs related to safe burial: Percent of safe burial teams trained and in place. For the 10 December situation report, Sierra Leone had 84% of the safe burial teams needed (94/114). Unfortunately, this KPI is an indirect measure of safe burials.
Having safe burial teams trained does not mean that all dead Ebola victims can be buried safely. Being a member of a burial teams is a very hazardous and unrewarding job. The risk of death is always present and people doing this job are often shunned by their community. They can also be harassed for not allowing traditional rituals to occur. Being a member of a burial team is a daunting task. Workers are paid hazard pay of about USD6 per day. Would you risk your life daily and be ostracised by your friends and family for an additional six dollars a day? These people are heroes and should be recognised as such.
Two weeks ago members of an Ebola burial team in Sierra Leone who went on strike were sacked. They had not been paid their hazard pay for seven weeks. There had been a widespread strike in October for the same reason. It appears that someone had intercepted (stole?) their money. A spokesman for the government's National Ebola Response Centre (NERC) said "Somebody somewhere has to investigate where these monies have been going, who have been paid these monies... Action will definitely be taken against those who delayed their pay," but the most immediate response by the NERC was to sack the workers. For this story see http://www.bbc.com/news/world-africa-30191938
What a damaging message to send to national heroes! “We don’t care about you or the job you do. But we will look after our colleagues who are either thieves or incompetent.”
All segments of the response to control Ebola need support by the government and the public. Sacking safe burial team members sends a very negative message which results in bodies of Ebola victims piling up unburied.
See an Al Jazeera video on Ebola burial teams in Liberia http://youtu.be/dHTFZLxGEZI. This illustrates some of the challenges that burial team personnel face daily.
KPIs for the Ebola Response Roadmap were first presented in the 5 November 2014 situation report.
World Health Organization. Ebola response roadmap. WHO; Geneva. 28 August 2014.
World Health Organization. Ebola response roadmap - Situation report 5 November 2014. WHO; Geneva.
World Health Organization. Ebola response roadmap - Situation report 10 December 2014. WHO; Geneva.
Posted by Rick Speare