Ebola: How a People's Science Helped End an Epidemic - Paul Richards (2016)

APPENDICES: EVIDENCE AND TESTIMONY FROM EBOLA-AFFECTED COMMUNITY MEMBERS (CHAPTER 5)

1 Community techniques of burial

1a Male elders: Fogbo

1.The dead body is transferred from the bed to the mat in the room after a kola [gift] of Le 1000.00 is given to the husband or wife as a consent to allow those washing the body to set eyes on the nakedness of their partner.

2.4–6 people [move the body].

3.The dead person is taken from the mat to the backyard for washing. The head is positioned towards the rising of the sun and foot towards the setting of the sun. This is because we believe the spirit of the dead travels to eternity in the direction of the sun. If positioned wrongly, the spirit remains on earth, inflicting pain on family members.

4.In washing, a container or bucket is turned upside down where the feet of the dead person were.

5.The soil from that position [occupied by the bucket] is collected and mixed with some herb (leaves). This mixture is rubbed all over the body of the wife or husband before burial. He or she sleeps with it until the next day [and is then] washed ceremonially. This is done to separate the living from the dead so that the dead will have no power to inflict pain or ill-luck on the remaining members of the family.

6.The dead [person] is taken to church or mosque by 4–5 of his children or close family members. Sorrowful songs are rendered during this part.

7.After prayers, the body is carried to the burial site by 4 to 6 members of the village, while others will be singing songs at the graveside.

8.Dead [person] is placed in the grave and prayer is offered; the pastor or imam throws the first soil on the body in the grave and the second soil is thrown by a family member.

9.In this case it is expected of the last child, that one of the best cloths of the dead [person] is taken to the graveside by a family member (sister or brother) during burial. Part of the soil from the grave is placed on the cloth and placed on the head of the last child. The child then takes this cloth and runs with it to the river or waterside crying. Both the cloth and child are washed in the water. The soil is then thrown into the river indicating the end of a life, as the soil is carried away by the river. The child takes the cloth home and dries it. The cloth belongs to the child and she or he can use it for any purpose they desire.

1b Female elders: Fogbo

1.She was taken by four women, because she’s a woman.

2.She was a Christian.

3.Two people removed her cloth from her.

4.Two people washed her; while one was pouring the water, the other was scrubbing her.

5.Yes, she was dressed there by the woman who washed her.

6.Four women took her to the parlour.

7.She has four children, three boys and a girl.

8.Four young men took her to the church for her final prayers.

9.The grave was dug by male youths, I do not know the number because I was not there.

10.She was not buried with [a] casket.

11.Four people (young men) [carried the body to the grave].

12.Two people [prayed], including the pastor.

13.Yes, she was covered with a lapa [Krio: wrapper].

14.It was given to the last child; [the wrapper] is drawn from the grave mud, and is placed on the head of the last born of the family, and they will run with to the waterside or stream.

15.The last child after drawing the cloth [wogu lai] from the corpse will go to the stream without turning back and the cloth will be placed in the stream. One person [will] accompany him/her and the soaked cloth will be taken to the house and dried under the sun.

1c Youth: Fogbo

1.Family members will gather, decisions are taken, and report is made to chief. Chief approves burial. The body is washed by Muslims or Christians. The body is dressed and the people cry. The body-washing is done by a Christian or Muslim, and sometimes family members. People dig the grave and Muslims conduct burial on Muslims while Christians do the same [for Christians].

2.They pray on the corpse and take the body to the grave site. The grave is overlaid with sticks and grass placed on top of the sticks. Soil is added and the people will offer the final prayer.

2 Treatment of the body in Foindu, a Temne village

How the body is moved from the bed to a mat

The [corpse] is transferred from the bed to a mat in the corner of the room by 4–6 individuals, either family members or elders in the community. While corpse is on the mat, the wife/husband stays by the body to guide [guard?] it.

Washing a corpse requires drainage, at least for Muslims and Christian

The imam or pastor is called to an enclosure in the compound by 4–5 men, for washing; the water used to wash the dead is placed in a hole in an area where people will not step in it so as to avoid the sickness of the corpse spreading in the community.

The body requires to be dressed, and the grave dug

[The] body is dress[ed] with white cloth for Muslims, and for Christians a nice dress of the wife or her husband, [according to] the choice of the children. [The] grave site is prepared by 4–5 young men in community, in the village cemetery.

Appropriate prayers are said for the dead

Family members carry the body to the mosque or church for prayers. If the dead was not praying, the body is prepared in similar manner, except that no pastor/imam will pray on that body; he/she is buried without prayers.

Entombment follows

For Christians and Muslims, when the body is taken to the cemetery, by 4–6 able-bodied men, [the] corpse is placed in the hole by [these] men under the direction of the imam/pastors; prayers are offered at the graveside. Earth is placed on the body by the wife/husband/eldest child/closest family member. With Muslims, sticks and leaves are placed over the dead [body in the grave] before earth/dirt is placed on the body by a very close family member. Water is placed in a bucket outside the house where everyone from the cemetery washes their hands and feet.

Special procedures apply for senior members of the sodalities

In such a case, immediate family member must perform all societal rites before the body can be handed down to them because the dead [body] is [the] legal property of the society. They [the family] also pay redemption fees ([the rate] varies, based on the position in society) before body is taken to the mosque or church.

3 Sodality burial

When a societal head dies, only members of that particular society will be notified, ceremonies are done and the burial … is completed before pronouncing the death. Only those who belong to the society go to the grave site. An invisible [masked?] devil will carry the corpse to the grave. After all the burial practices, the invisible devils will start appearing, [but] only members will stay outside, non-members lock themselves in [their] rooms. (Town chief, Gbo chiefdom)

The death of the chief is not pronounced immediately. The corpse is taken to the mortuary. The consent of the paramount chief of that chiefdom and other chiefs is sought. Later the death pronouncement is made to the family and town. (Section chief)

Firstly, nobody will announce the death without permission. The chiefs will meet at a secret location and arrange all that needs to be done (ceremonies). The body will be buried at a special place and a masked devil does the burial in some chiefdoms. (Town crier, Baiima, Gbo chiefdom)

If a man, ceremonies are observed before the family members will be asked to collect the corpse for burial. In some instances the corpse will be buried in a sacred bush. The same is done for women. (Farmer, Gbo chiefdom)

The corpse is never buried in the day, but during the night due to customs and traditions. (Farmer, Mokebe, Gbo chiefdom)

When a societal head dies, no one is to cry until it is declared by the societal head. [People] will be told that the person is in a state of unconsciousness. All the societal heads will converge in the village. A thin thread is passed around the house to prevent non-members entering [to see] the body. When all have converged, the chief will report that the societal head is in a state of coma. And they will start to dance and sing. A fine is levied on the family. When they pay, the society people will declare that their head is dead. The society people will perform their ceremony and hand over the body to the chief, who in turn will give [it to] the family. The religious [people] are called to pray on the corpse, thereafter the body is returned to the societal head and it will be buried in a secret location. The fine levied on the family is [for the amount] he or she has been eating. Now that [the societal head] is dead s/he should refund all to the society members before permission is granted for the burial. (Women elders, Sanola Gaura)

4a Disquiet at burial team actions in a Mende village (Baiima)

I am not happy at all because our relatives are not included in the burial process.

I am not happy because the dead are not washed and not buried properly as required by us. Even the chemical they use on dead bodies is not required.

I am not happy because [the dead] are not properly buried (not well covered).

The Ebola burial team is supposed to include people in our community as well. The bodies of the dead are supposed to be wash[ed] and prayers are offered.

Let our people be trained as contact tracers, [and] burial team [members], and [let them] offer or be allowed to work in the Ebola team, so we can handle the disease properly.

Train communities to be burying their dead, and to give all materials to the community for safe burial practices.

4b Disquiet at burial team actions in a Temne village (Foindu)

No, we are not pleased with the manner in which the burial team treats our dead relative.

Dead are buried without clothes (clean decent cloth). Family members in most cases do not witness the death of their loved ones [because they die in a distant care centre].

No form of religious prayer was offered. Burial teams are all men, burying both men and women.

Dead bodies are dumped into the grave without care and respect.

Cultural issues are neglected.

The grave is not sufficiently covered.

[We want] that government trains burial team at chiefdom level, so that they will honour and respect the dead.

We are willing to be trained, and equipped to do the work with care. Tribal and regional differences should be taken into account.

5a Experiences with Ebola quarantine

The village was quarantined for 21 days and World Food Programme provided food during the quarantine. (Bawuya, Kori, female elders)

Houses and homes were isolated with sick people before they were transported to holding centres. The sick were cared for by brothers and sisters around them; Ebola persons were sent to Moyamba treatment centre. (Moyamba Junction, youths)

House is closed and flagged with red tape. None is allowed to enter the house until the body is buried and the house sanitized for 3 days. (Moyamba Junction, youths)

Yes, we are no longer working, and people are not doing things to keep life moving. No business, and we last received supply on the 3rd and 21st [October]. We have not received for the past 3 months. (Moyamba Junction, male elders)

During the 21 days [quarantine] we had supply from WFP [World Food Programme]; since then no other help. We are very poor. Red Cross also registered us but has not given supply since. (Moyamba Junction, male elders)

The entire village was quarantined for 21 days. The town was full with soldiers and police. The village was quarantined two times. WFP provided rice, oil, beans and salt, during our first quarantine without security. (Fogbo, Kori, women elders)

5b Historical experiences with quarantine for other sicknesses

[Smallpox] Affected people were taken to a separate place for medication (Mogbisi, Gbo, male elders’ group)

[Smallpox] We were not allowed to mingle with our companions until we became better. (Mokebe, Gbo, female elders’ group)

[Measles?] Isolation to a bush in the daytime to prevent spread and return to home at night. (Moyamba Junction, Fakuniya)

[Measles] Isolation in daytime – in an old farmhouse. Now controlled by vaccination. (Fogbo, Kori, youth group)

5c Goat Plague [PPR]: a model for Ebola?

[symptoms are] watery stool from goats, bloating stomach and tears run from their eyes, water runs from their mouth. Four goats [were] infected. Infected goats are taken to different locations ([to be in] isolation [= quarantine]). (Mogbisi, Gbo, male elders’ group)

[symptoms are] mucus excretion, diarrhoea, hair loss. In 2013 over 50 goats died; all died and that stopped the spread. (Fogbo, Kori, youth group)

[Action needed] To bury the affected [animal]. Remove all affected ones from the nonaffected. (Mokebe, Gbo, female elders’ group)

[Impact, action needed] Over 40 [animals were infected]. The affected ones should be removed from the non-affected. (Fengehun, Kakua, male elders’ group)

[Impact, action needed] Nearly all died. Prevent other animals from coming in contact with infected animal. (Fengehun, Kakua, youth group)

6 Village questions about Ebola

Bo-Gaura

[Is there] any plan of assisting us with some medicine for the treatment of common sicknesses like malaria?

How can [we] go [to hospital] with the sick when there is no motorbike or road?

It has been said [in] bye-laws that we should not touch dead bodies; what can we do if somebody [has] died, considering the distance?

Why did the authorities delay in intervening to stop the spread of this deadly disease?

Treat all sicknesses including malaria [not just Ebola].

Jagbema-Gaura

Why is it that [the] government has mounted checkpoints with security personnel as a means to cure Ebola?

Where is all the money sent by the West, and donors, going?

Our people are still dying.

Government should create a facility for village people to get basic training on health issues and [be] given some incentives.

Why are infected corpses buried in other towns rather than in their home towns.

Government should establish a health centre close to us in the village.

Njala-Gaura

Since the symptoms of Ebola are fever, headache, joint pain, etc., do we take for granted that anybody with those symptoms has Ebola?

We always hear from people [about] huge amounts to Sierra Leone to stop this Ebola, but yet people are dying, why?

Senehun Buima-Gaura

People say there is no treatment for Ebola, [so] why do they ask people to go for treatment?

They say there is no medicine for Ebola, [so] how are they treating people with the sickness if there is no medicine?