Via The Guardian: Thankless, dangerous – the task of the Ebola burial boys in Sierra Leone. Excerpt:
The night after Alfred Jusson buried his first Ebola victim he had a nightmare: the corpse sat on the edge of his bed, blood dripping from her nostrils. When he got up to run away, she chased him.
Three months ago, Jusson had never heard of Ebola, one of the world's most lethal viruses. Now he volunteers to collect corpses, a job that puts him at the frontline of battle as the disease is spread by contact with bodily fluids.
"Sometimes when I think of it at home when I'm alone, I become scared. It's not easy to just [handle] a dead body like that," the 22-year-old said one evening after carrying out four burials in Kailahun, the remote, forested district at the heart of Sierra Leone's Ebola outbreak.
Malaria, cholera and tuberculosis – endemic diseases that fell tens of thousands annually in Sierra Leone – used to be the illnesses that filled Jusson's days as he worked in his parents' tiny, dusty pharmacy and dreamed of one day becoming a doctor. In his spare time, he worked on the family's farm, saving and studying every day, until he was able to sit pre-university exams in December.
Then in March, weeks away from Jusson getting his results, Ebola erupted in neighbouring Guinea. It arrived in Liberia in April, then Sierra Leone the next month. Unlike previous outbreaks, the disease has mushroomed in the capitals of all three countries, killing more than 1,900 people. Nigeria and Senegal have recorded cases. "
The outbreaks are racing ahead of the control efforts in these countries," said World Health Organisation (WHO) chief Margaret Chan. The WHO says more than 20,000 could eventually be infected in an outbreak that in the best case scenario will continue for six more months.
Everything from surgical gloves to ambulances is in short supply, but Ebola's real lethality may lie in the fear and isolation it spawns. One morning, residents in Kailahun woke up to find their only bank closed. Those with cars fled. Life did slowly pick up again, but a state of emergency in July shut down schools. Soldiers poured in to quarantine entire communities and, in these lush farming hills, trade slowed to a trickle.
In desperation, 20 young men signed up for the burial teams, each paid $100 (£61) a month for the task. "Hunger is killing more people than Ebola," said Abraham Kamara, 21, a fellow digger. They work to rigorous standards enforced by the Red Cross, but pay a heavy price.
"When I'm passing, people I know say, 'don't come near me'!" Jusson said. He looked skyward for a moment before continuing: "I try to explain to them. If we don't volunteer to do this, there'll be nobody to bury the dead bodies because all of us will be infected."
The burial team's battle for acceptance is a reflection of a wider struggle. Amid fear, confusion and conflicting public health messages surrounding west Africa's first recorded encounter with Ebola, Kailahun and its surrounding chiefdoms must make decisions that will be vindicated by time or become tragic missteps.
"What would people do if they had 10 people in their neighbourhood dying every day?" said Barry Hewlett, a medical anthropologist who has worked in three outbreaks in central Africa. "Would they trust the government; which news station would they trust; would they try to flee their neighbourhood?"
Some communities have encircled themselves with denial and trenches, violently blocking outsiders from coming in; others have overturned long-ingrained traditions to accommodate bewildering advice on identifying and isolating infected people that can result in victims facing a lonely death in a clinic far from home.
"Ebola kills!" was the initial motto of a belated nationwide campaign, a stark tone which may have dissuaded some sick people from coming forward to face that truth. The scramble for containment meant counselling was sidelined, an oversight that has boomeranged with vicious consequences.