Yuma Adolphe and his team have one of the most difficult jobs in the fight against Ebola in Congo’s Ituri province, the epicenter of the country’s deadliest outbreak of the disease. They are responsible for ensuring that those who die from Ebola receive safe and dignified burials, a task that requires them to dig graves, prepare bodies and handle coffins almost every day.
But as authorities struggle to contain the outbreak, which has killed nearly 3,200 people among more than 6,600 confirmed cases, the burial teams say they are reaching their limits. Their workload is growing, while hostility and fear in affected communities make an already dangerous job even harder.
“It is difficult, but we try to push ourselves beyond our limits,” Adolphe told The Associated Press (AP).
Since the outbreak began in mid-May, authorities have deployed small burial teams like Adolphe’s to Ebola hotspots, where they work on the front lines of efforts to contain the rapidly spreading disease. The workers are paid $20 a day for handling some of the most dangerous and emotionally difficult tasks in the response.
Despite the exhaustion and risks, members of the burial teams say they remain committed to protecting their communities, knowing that safe burials are essential to preventing further transmission of the virus.
For Adolphe and his colleagues, the work is grueling, but they see it as a necessary sacrifice to help keep their communities safe.
“We have to look at our own mental well-being, and physically the fatigue mounts, but we keep going to ensure the community is protected.”
But their work is in the crosshairs of locals’ frustration with the outbreak, which has not only taken their loved ones but also prevented them from observing traditional burial rites.
Health workers exclusively handle the bodies because Ebola spreads through direct contact with the blood or bodily fluids of infected people.
Experts say the bodies of victims still contain considerable amounts of active virus and can spread infections further.
Since May, health workers and burial teams such as Adolphe’s have been attacked by bereaved families across the front line of the outbreak.
“Usually, the body is handed over to the family, who can handle it however they wish, in accordance with our African customs,” Adolphe said. “But in this situation, it’s difficult to let the family handle the body as they please. They are deprived of certain rituals, and that’s what leads to misunderstandings.”
Jeanne Alasha, adviser to the military governor of Ituri on health and humanitarian affairs, said that “as for those who continue to assault the teams, they are committing offenses punishable by law.”
Ituri province, where the outbreak is concentrated, is also at the center of the rebel conflict in eastern Congo. The province is under a military government appointed by national civilian authorities in Kinshasa.
Shortly before noon last Friday, Justine Abineno, a chorister, was buried in Ituri. Abineno had died of Ebola. She had complained only of slight headaches before going to a hospital, where she was diagnosed with Ebola, her mother said.
A catechist presided over the ceremony, which was attended by dozens of people, as a team of burial specialists in scrubs and boots stood by.
Abineno’s mother, Sofia Wanito, said doctors only allowed her to see the body through the window of the hospital ward, and she was not allowed to touch the coffin.
“In the past, we didn’t die like this. I could not even cover her with the sheets myself and pay a final tribute,” Wanito said.
The Ebola outbreak is spreading across six provinces in eastern Congo under some of the most difficult conditions imaginable, fueled by rebel violence, displacement and intense population movements. A weak health care and surveillance system also challenges responders, as do insufficient contact tracing and laboratory testing.
Efforts to contain the outbreak have also been complicated by the lack of an approved vaccine or treatment for the rare Bundibugyo virus causing it. Authorities have started vaccinating frontline health workers with the Ervebo vaccine, which the World Health Organization (WHO) says could offer some protection against Ebola, but there is no conclusive evidence that it would work against the current virus.
Health authorities say the true scale of the crisis is likely three times as high as official statistics suggest as the disease continues to outpace efforts to contain it. WHO has said the outbreak is projected to surpass the deadliest in history, West Africa’s 2014-16 outbreak, which killed more than 11,000 people.
Frontline health workers in eastern Congo have gone on multiple strikes to demand pay for their work, complicating efforts to stop the outbreak.
Benjamin Muhindo, another burial team member, said his family worries that he might bring the virus home. For him, though, a bigger priority is ensuring the proper burial of victims, he said.
“Burials during this Ebola epidemic are very complicated, as we are working under pressure and constantly racing against the clock,” Muhindo said.
Trauma experts say the high number of cases and deaths are only one side of the outbreak’s impact at the personal and communal levels.
“The trauma of this outbreak doesn’t stop with the case count,” said Rose Tchwenko, Mercy Corps country director in Congo. The chain of transmission will only be broken by “an integrated holistic response,” which includes a social response to bereaved families and frontline workers, she added.
After the burial on Friday, Adolphe said he was very tired but more worried about the community than anything else.
“We have no choice,” he said. “We are here to safeguard our community.”