By ANNE CHAON, AFP From Business Insider

A health worker from Sierra Leone’s Red Cross Society Burial Team 7 carries the corpse of a child in Freetown on November 12, 2014

Freetown (AFP) – Sierra Leone’s Ebola burial boys wrap the highly-infectious body and present it to the family for dignified last goodbyes before it is taken gently away.

Removal of the dead is a necessarily traumatic experience for those left behind, but the process is a far cry from the way things used to be done.

In the panicked early days of the outbreak, when the only consideration was sanitation, teams of what looked to shellshocked relatives like space men would come to pick up the dead.

Armed with disinfectant hoses that looked like weapons, they would bag the body without ceremony, driving off before the relatives could ask where they were going.

In recent weeks the emphasis has shifted and “dignity” is as much the mantra as “safety” in a country where locals are deeply reluctant to give up their dead.

Traditional funeral rites involving washing bodies are particularly important in the culture of Muslim-majority Sierra Leone.

But Ebola spreads through contact with infected bodily fluids and the World Health Organization (WHO) estimates that these practises are responsible for 20 percent of new infections.

In rural areas and even in Freetown, local authorities estimate that the figure might be as high as 60 percent.

Keen to persuade families to give up their dead, but aware of their fear of cold, clinical Ebola burials, the WHO issued guidelines on “Safe and Dignified Burial” last week, backed for the first time by Muslim and Christian leaders.

– ‘Less sinister’ –

It is early morning in Freetown and the Red Cross has been called to remove a number of bodies in the Wellington neighbourhood, where cases are on the rise, operations director Thomas Abu tells AFP.

Relatives line the potholed road leading up to the first house, and men with grave expressions take the team to one of the victims, a 43-year-old-woman who has just died.

Mustapha Rogers — whose nebulous job title is “beneficiary communicator” — stops his co-workers and approaches the relatives on his own.

“I’m in charge of relations with the families,” he explains, before painstakingly setting out the process of removing the dead.

He satisfies himself that no one has touched the victim in the two weeks before death or washed her since, explaining that men fully equipped with biohazard gear will be the only people allowed anywhere near.

The body will be placed in white tarpaulin, deemed less sinister than the black plastic they used to use.

If the victim is Muslim, the team will wrap the body in white cloth, in a nod to Islamic tradition which is valued enormously by grieving relatives.

The body is wrapped and disinfected out of sight and only then presented to the family, who are invited to accompany the Red Cross to the cemetery to make a note of the burial plot.

“If he is a Christian, a pastor is called. If he’s Muslim, an imam,” Rogers tells AFP.

As he explains the protocol, the burial experts approach clutching their biohazard suits, which they put on in full view of the family.

The idea is that relatives are not suddenly confronted by the intimidating and sinister approach of the “spacemen”.

“This shows them that this is about human beings,” says Abu, the operations director.

– Seventy bodies –

Rogers takes a telephone number and notes down how many relatives are present, the beginnings of a survey of nearest and dearest that will come in handy for quarantine purposes should the victim test positive for Ebola.

Meanwhile a woman approaches, telling him she rang 117, the emergency hotline, and asking if he has come to pick up her sick relative.

A brother of the dead woman flies suddenly into a rage, shouting that he also rang 117, and the ambulance refused to take his sister because her name didn’t match the information the paramedics had.

“They have no mercy. This lady suffered terribly and nobody could help her. We just watched her suffering and now she is dead,” he wails.

The 10 Red Cross burial teams — each with 10 members — are the only workers picking up bodies in Freetown. All day, every day, they race around the capital collecting the dead.

Nearly 70 bodies will be buried by the charity in the late afternoon at King Tom Cemetery, a repurposed military graveyard.

In the absence of clear information to the contrary, all will be treated as Ebola victims.

Rage having given way to grief, the brother, now dressed in a suit, plants a shrub on the grave of his sister and takes a picture of the plot number so that, at least, he will know how to find her.

IMAGE: A health worker from Sierra Leone’s Red Cross Society Burial Team 7 carries the corpse of a child in Freetown on November 12, 2014

© AFP Francisco Leong

For more on this story go to: http://www.businessinsider.com/afp-in-ebola-hit-sleone-dignity-in-death-protects-the-living-2014-11#ixzz3J5OHUiub

Related story:

Cost of keeping Ebola out of Caribbean still unknown

By Glen Bart St Kitts & Nevis

The recently adopted 10-point plan to stop Ebola from entering the Caribbean- ‘Stop Ebola There and Here’ (SETH)- would require funding into the millions of dollars, but no clear amount is known at this point.

The Caribbean’s leaders agree however, that the region’s preparedness plan for the Ebola Virus Disease must be multi-agency and multi-national in nature.

“Responses to diseases must be a community effort. No member state of CARICOM must battle these public health challenges on its own,” CARICOM Chairman Antigua and Barbuda Prime Minister Gaston Browne said at a press conference following the November 4 Ebola preparedness meeting in Trinidad. It was attended by CARICOM heads of government, health ministers and representatives from regional health institutions.

PM Browne stressed that the response to the Ebola Virus Disease must have a collective and collaborative approach within the region.

According to Port of Spain media sources, Trinidad and Tobago’s Prime Minister Kamla Persad-Bissessar is reported to have said, “There would be some level of funding, and I believe the number of US$7 million was mentioned, but that was only for the work of CARPHA. So there will be national efforts, as well as regional efforts and efforts outside of the region of those who have expressed interest in partnering with us in terms of financial assistance.”

The meeting also recognized the substantial contribution that Cuba has made in the fight of the disease in most affected West African countries.

It is understood that Cuba has expressed an interest in assisting CARICOM in building capacity and capability to deal with Ebola, should it come into the region. Cuba’s participation in SETH is to be discussed in an upcoming CARICOM-Cuba summit.

The SETH ten-point plan

• Strengthen effective, coordinated measures at ports of entry to prevent Ebola from entering the regional community, including harmonizing travel restrictions

• Strengthen health systems including training, equipment, laboratories and containment, and enlist the participation of airlines in the Region in transporting specimens and response teams

• Create a Regional Rapid Response Team (Carib React) able to reach any member state in 24 hours to support the national response team to contain/stop an outbreak early on

• Launch an intensive public education campaign for citizens of the Region, visitors and those outside.

• Organize a comprehensive resource mobilization effort including a possible Stop Ebola There and Here (Seth) Fund, to which governments, citizens and businesses here and abroad may donate

• Finalize and implement the harmonized regional operational response plan by end-November, coordinated with national response plans;

• Participate in capacity-building efforts at the global and regional levels to gain experience for our benefit;

• Establish a Regional Coordinating Mechanism on Ebola (RCME) with CARPHA as Chair, including the CARICOM and OECS Secretariats, IMPACS, CDEMA, and inviting Cuba to participate, The RCME will report to the lead head of government on health, with the immediate responsibility to develop a comprehensive regional strategy to address Ebola preparedness in collaboration with PAHO/WHO.

• Invite PAHO/WHO, the United Nations, development partners and other contributors to a meeting within one (1) month to expand the effectiveness of our collective response;

• Review and reinforce the effectiveness of these measures as implemented at intercessional meeting of conference in February and the conference of heads in July 2015.

For more on this story go to: http://www.thestkittsnevisobserver.com/2014/11/07/ebola-cost.html