Prior to the current Ebola outbreak that is ravaging Liberia, Friday Kiyee worked as a mortician at the Redemption Hospital in the capital Monrovia, so he is used to dealing with the dead.
“We are not happy to see our own Liberian brothers dying,” says Kiyee, a leader of one of the Liberian Red Cross Society’s safe and dignified burial teams in Monrovia. “We go out in the street picking up their bodies. We are not happy about that, but the fact of the matter is that we just have to do it. If we don’t, the virus will keep spreading.”
His working day begins with a list of communities where he must go to collect the bodies of suspected Ebola victims. His team, one of six operating in Montserrado county, can expect to collect up to 15 bodies on any given day. The numbers are steadily rising and the nature of the disease means that the bodies are highly contagious with a virus that kills more than half of the people it infects.
“There has not been one day since we started in late July that we did not pick up a body,” says Kiyee. “It is playing on everybody’s mind.”
His team received training from the Red Cross, Médecins sans Frontières and the World Health Organization. “My life is at risk because if I make the slightest mistake I will get infected,” he says. “The best thing we can do is to dress properly and follow all the safety procedures before going to pick up a body.”
This attention to detail, ensuring that all team members are properly attired in protective clothing and that disinfectant is used appropriately and unsparingly, has meant that none of his team has become sick, despite the contagion all around them.
“We have two sprayers,” says Kiyee. “The ‘dirty’ sprayer is the man who goes in first to disinfect the area before the others come to pick up the body. And then we have a ‘clean’ sprayer who disinfects those coming out from the house or the retrieval scene.”
Not all families are happy to see the bodies of their loved ones taken away for disposal by men in protective suits. It can lead to confusion, resentment, sometimes even hostility.
“Before we take the body, we do a bit of social work activity,” he says. “We call the bereaved family and community together and introduce ourselves and the emblem of the Red Cross. We talk to them and make sure they are satisfied before we take the body from the community.”
“No one wants to be near me”
But things do not always go smoothly. A reporter for Time magazine was with one Liberian Red Cross Society team when they were confronted by a crowd of villagers, angrily asking why no one came when they called for an ambulance, but now they come for the body. One of the team members, 29-year-old Nelson Sayon, told Time that many team members have also been ostracized by their communities.
“No one wants to be near me,” Sayon was quoted as saying. “They are afraid. They refuse even to take our money if we want to buy something in the store or eat in a restaurant.”
Teams in Sierra Leone face similar challenges. “Sometimes when we get to a village, they say we are bringing the disease to them so they, too, will be affected,” says Julius Tamba Kamanda, a 21-year-old member of the Sierra Leone Red Cross Society safe and dignified burial team. “Sometimes they stone us, they ask us to get out of their town.
“Without the help of the chiefs and other humanitarian groups who come to their aid and tell them that the community will not be affected, they would not accept us,” he says.
The crews work long hours, sometimes from 08:00 until midnight, or later, depending on the need. Another challenge for some of the teams is a lack of vital equipment.
“The way we carry the bodies to the cemetery is by hand,” Kamanda says. “We strain a lot, when we are carrying it to the site. So we, as a burial team, are requesting that they provide us with a stretcher so that it will be easy for our movement.
Recently, his team had to carry a body more than 3 kilometres to reach the cemetery. “Maybe we stopped about five times before we could get to the place,” he recalls. “So that can lead to delay, to dangers: maybe when we put the body on the ground, on the stones, the bag could get torn and the disease could be exposed.”
The teams also have to confront people who are grieving and who are being asked to forgo their accustomed burial practices. In Sierra Leone, community members traditionally bury their own. Part of the practice includes hugging the body to ensure ancestral lines are continued. But it is at death that the Ebola virus is at its strongest.
“This is why now, when we enter a community to prepare a body for burial and after talking with the elders, we invite the family to come and watch our proceedings,” says Daniel James, coordinator of the safe and dignified burials team for the Sierra Leone Red Cross Society.
“It is safe for them to watch from the window. They see we are treating their loved one with respect and care; that we will stop for a prayer if they so wish. The family can still be involved and we find it helps dispel some of the rumours of what we are doing with the bodies.”
The good news, says James, is that more people are getting the word about how Ebola spreads and what they should and shouldn’t do. “More communities are beginning to notify authorities when someone passes away at home, which is great,” he says.
It is dangerous work, James says, but absolutely vital and he plans to keep going. “I keep going and working despite all the red flags,” he adds, “because it is the right thing to do.”
By Victor Lacken and Katherine Mueller
Victor Lacken is a photographer and writer; Katherine Mueller is communications manager for the IFRC’s Africa Zone.