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Anyone who has died from highly infectious haemorrhagic fever should be buried under carefully controlled conditions, designed to minimize the risk of infection by body fluids.
But that means the ceremonies are held in hygienic conditions, with relatives and friends held at bay – for many, a traumatic break with traditions that require the body of a loved one to be seen or touched.
"We are surprised that she is buried like this," said Denise Kahambu while watching the specially prepared butembo burial of her 50-year-old cousin, Marie-Rose.
"They said she was dead from Ebola," she said skeptically.
First reported last August, the epidemic claimed the lives of nearly 1,200 people, 200 of them in May alone.
The epidemic is the second deadliest ever recorded after an epidemic that killed more than 11,300 people in West Africa in 2014-2016.
The burial in Butembo followed strict precautions. A van delivered the coffin to the burial site, where a pit had been prepared, while the family was standing at a distance.
Gloved Red Cross employees managed the funeral, which was held silently and without religious ceremony.
A family member or relative was allowed to place a cross on the grave after having also put on protective gloves.
Half a dozen police officers escorted the convoy and remained on guard all the way through.
On Friday, two burial teams at the treatment centers were attacked by rock throwing mobs in Butembo and Bunia, a little further north of Ituri province, according to the Ministry of Health. A burial worker was injured.
Culture shock
"It is customary for the body of the deceased to return home for the first time, and once people have mourned, they have the opportunity to touch it for the last time," said Seros Muyisa Kamathe, a guide and interpreter in Beni and Butembo.
"Before going to the cemetery, open the casket so that people can take a last look at the deceased."
And normally, it is family and neighbors who would be responsible for digging the grave – and deciding where, if any.
Ebola experts claim that denial and resistance were familiar obstacles to the 2014-2016 epidemic in West African states such as Guinea, Liberia, and Nigeria. Sierra Leone.
The World Health Organization (WHO) has established a 12-step protocol for treating burials to minimize the handling of remains, but it also emphasizes the importance of respect and bereavement.
"The burial process is very sensitive for the family and the community and can be the source of problems or even an open conflict," he admits.
No burial should be started until the family agreement has been reached, and workers must engage with the community "so that prayers dispel tensions and offer respectful time," the text says.
Armed escorts
The burial process is part of the notoriously tedious and time-consuming task of fighting the Ebola virus.
And in this troubled region, the challenge is further complicated with deadly and lethal attacks by local militias against Ebola treatment centers.
Suspicion, internal political struggles in the capital Kinshasa and the violence of the militias are a breeding ground for the virus.
Local residents sometimes cover the graves during the night as a sign of opposition, the ministry said.
In Butembo, health workers need an armed escort to search for Ebola cases in some neighborhoods, an AFP photographer said on Saturday night.
WHO Director-General Tedros Adhanom Ghebreyesus said Monday at the opening of the organization's annual meeting that the outbreak was "one of the most complex health emergencies we have ever faced".
"If we do not come together to end this epidemic, we run the risk that it will become more widespread, larger and more aggressive," he said.
"We are not fighting just a virus," said Tedros. "We are fighting against insecurity, fighting violence, fighting against misinformation … and fighting the politicization of an epidemic."
On the benefits side, health officials want to highlight some important gains. More than 118,000 people have been vaccinated against the virus and no cases have been recorded in neighboring Rwanda and Uganda.
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