Liberia’s Burial Workers Struggle to Forget Horrors of Ebola

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Liberia - the hardest-hit country with some 4,800 deaths - was declared Ebola-free for a third time last week. REUTERS/James Giahyue

By Kieran Guilbert

MONTSERRADO, Liberia, Jan 21 – Clinging to the corpses of her parents, the cries of the four-year-old girl echoed around the house as Ezekiel Kalapelee and his colleagues entered the building in the middle of the night.

The former burial worker recalls how the hysterical, hungry child, who had been abandoned by her community due to fears over Ebola, hung onto the bodies tightly before Kalapelee and his team carried them out of the house.

The burial team gave the girl something to eat and informed the local authorities. Yet a lack of free beds in the nearby Ebola treatment unit left the workers no choice but to leave her behind, alone again, as they took the bodies away for burial.

“I found out later that she died that day – in the house,” 23-year-old Kalapelee said softly, his voice faltering.

“I felt sad, and disturbed, and still do when I think of how Ebola took families away, leaving so many people on their own,” he said, sat outside his house in Liberia’s Montserrado County.

Kalapelee was part of the Red Cross’s 140-strong burial team in Montserrado and one of thousands of workers deployed across Liberia in June 2014 as the nation’s Ebola death toll escalated.

They endured stigma, abuse and attacks from traumatised and terrified communities as they worked to curb the epidemic by safely burying the highly infectious bodies of the Ebola dead.

The world’s worst Ebola outbreak has killed 11,300 people in Guinea, Liberia and Sierra Leone in west Africa since December 2013. Liberia – the hardest-hit country with some 4,800 deaths – was declared Ebola-free for a third time last week

With the epidemic now under control, former burial workers are trying to rebuild their lives, many using the money they earned to pursue education or training, or set up a business.

But six in 10 are suffering from trauma, many battling depression, post-traumatic stress disorder (PTSD) and psychosis, with the Red Cross providing psychosocial support through group sessions and one-on-one counselling over the phone or in person.

Many have turned to alcohol to cope with the stigma, sleepless nights and harrowing visions and flashbacks, said Jestina Hoff, Red Cross psychosocial counsellor and supervisor.

“One has nightmares of walking through corpses, another sees a child crying as he sucks his dead mother’s breast,” she said.

BACKLASH

Many former burial workers joined the fight against Ebola despite fear, pleading and even rejection from their families.

“My family were terrified, asking: ‘Why are you risking your life, and our lives too?’ 28-year-old Benedict Kpukuyou said.

But for several, such as nurse Martha Kroma, alarmed at how Ebola ravaged Liberia’s health system, already fragile after 14 years of civil war, such fears compelled them to step forward.

“Hospitals were closing, people were afraid, and staff were fleeing. I thought: ‘Who will be on the frontlines to fight this – to fight for our country?'” said the former case investigator.

Kroma’s role was to establish the details of suspected Ebola deaths by speaking to communities, and trying to gain their trust before taking the bodies of the Ebola dead to bury safely.

Yet this proved difficult in a country where burying and honouring the dead is sacred. Mourners often touch the corpse at funerals in an intimate, spiritual farewell to their loved ones.

When scores of people caught Ebola via the infectious fluids of the deceased at traditional burials, at the height of the epidemic in August 2014, the Liberian government started mass cremations – sparking a backlash towards burial workers.

“Workers were attacked, stones were thrown at vehicles and burial teams were twice held hostage for hours,” said Roselyn Nugba-Ballah, former coordinator of the Red Cross burial teams.

“In one case, a family dug a body out of its grave, took it back to their house and chased the team away with machetes.”

Amid public outcry and a dwindling number of Ebola deaths, cremations came to an end in December 2014 after the government secured a 25-acre burial site for victims of the deadly virus.

This eased tensions between grieving communities and exhausted, overworked burial workers, but some stigma remained, Kalapelee said glumly, staring at the floor as he spoke.

“We often got called ‘Ebola carriers’… people wouldn’t even sell you food or water, they would refuse your money.”

PAIN AND PRIDE

Some former workers were deserted or outcast by partners and relatives over fears of catching Ebola, with the Red Cross now helping to reconcile and reunite them with their families.

Kalapelee recalls how he managed to hide his job as a burial worker from his uncle with whom he lived – until his team was summoned to collect a dead body from near his relative’s house.

“He told me to leave as he feared for his children – it was tough not having a home to go to after working for days on end.”

The young Liberian has since made peace with his uncle, and has used the money he earned as a burial worker to build a house for his parents, learn to drive, and go back to school.

The $1,000 monthly salary and grant given to former burial workers by the Red Cross has enabled Kroma to open a pharmacy and Kpukuyou to have his own hairdressers and hardware shop.

Despite the difficulties they have faced, Kalapelee, Kpukuyou and Kroma brim with pride as they reflect on the roles they played in Liberia’s battle against Ebola.

“We were like soldiers, keeping our eyes on the unit and watching each other’s backs – and we still do,” Kroma said.

Kpukuyou added: “I’m happy that the war I fought is over – and that I helped my country to erase Ebola.”

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