Safe & Dignified Burials

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The family of the deceased look on and say a prayer before the body is removed for safe and dignified burial in Sierra Leone, November 7, 2014. From October 2014, families were allowed to attend burials again, and to invite an imam or minister to pray at a safe distance. Photograph by Lisa Pattison, IFRC

As the response evolved, burial protocols embraced the concept of safe and dignified burials. Groups of locally-staffed, specially-trained teams handled the emotional duty of safely removing bodies from people’s homes. These teams worked to observe family and community customs, and, at the same time, ensured that the dead were buried in a safe manner. In the best scenario, when called to a home, the burial teams would first meet with the families of the deceased. They offered condolences and consulted with the families, making sure they approved of the burial process. Then, while some team members remained with the families, others prepared for the burial. They dug graves to a safe depth of 8 feet, often together with community members, and donned their protective gear. Then they carefully moved and buried the dead bodies. Families were able to observe the burials and say prayers from a safe distance.

A proper, dignified burial with meaningful acts of closure restored a tiny sense of normalcy to a mourning process heavily impacted by medical protocols. When family members participated in a respectful burial experience, they told their friends.  People in the community then became more willing to turn over the bodies of their loved ones to burial teams.

Lee-Kwan, Seung Hee (Interview 1)

Dr. Seung Hee Lee-Kwan

Dr. Seung Hee Lee-Kwan discusses some burial practices and emotion that had to be addressed in Sierra Leone in ensuring safe and dignified burial.

What is a Safe Burial?

During any Ebola outbreak, all dead bodies are considered potentially infectious, and are tested post-mortem for the disease. The bodies of people who die from Ebola are highly infectious, so strict infection prevention and control is necessary. Burial teams tasked with picking up bodies from homes and villages are required to wear personal protective gear. In the case of an ETU death, the hospital hygiene team takes the body to the morgue until time for burial. 

However, these strict procedures don't account for cultural and religious customs. In the West African epidemic, they were later adapted to allow family members and communities more opportunities to participate in burial rituals without risking exposure to Ebola.

The following visual aid provides instructions for what to do when someone dies at home to follow prevention protocol.

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Allow for Safe Burial When Someone Dies at Home visual aid. Produced by CDC's Division of Creative Services
View full size PDF

Rao, Carol

Carol Rao

Carol Rao, CDC epidemiologist, describes her experience accompanying a burial team in Sierra Leone.

Burial Teams in Liberia and Sierra Leone

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Chief Zanzan Karwa (center), chairman of the National Council of Chiefs and Elders, leads a group of traditional leaders with the ashes of some 3,000 Ebola victims cremated at the height of the crisis, March 7, 2015. Courtesy of Global Communities

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A woman grieves for the loss of a loved one. Photograph by Dominic Chavez, courtesy of the World Bank.

The Liberian National Cemetery

In Liberia in August and September 2014, the numbers of people dying as a result of the outbreak were too many for burial teams to keep up with. As a result, highly-infectious bodies were left in the streets. In August 2014, the President of Liberia made the decision to introduce cremation—an affront to traditional burial practices and a cultural taboo. The Hindu community offered the use of its crematorium, and all bodies were cremated—even when Ebola had not been confirmed as the cause of death.  

Working with the U.S.-based NGO Global Communities, the Liberian National Cemetery at Disco Hill outside of Monrovia opened in December 2014. The site was purchased by the government of Liberia to provide safe and dignified burials and managed by Global Communities. When the cemetery management was transferred back to the Liberian government in January 2016, over 3,000 people had been buried there.

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A gravedigger at King Tom Cemetery, Freetown, November 17, 2014. Photograph by Jari Lindholm, IFRC