The study, published in the journal PLOS Neglected Tropical Diseases, uses statistical modelling to measure the impact of Red Cross safe and dignified burial (SDB) teams during the Ebola outbreak. It found that the practice of safe and dignified burials potentially averted as many as 10,450 Ebola cases, decreasing the scale of the outbreak by over a third (36.5 per cent).
Red Cross teams in Liberia, Sierra Leone and Guinea took on the complex task of burying people who had died of Ebola, a crucial yet dangerous task given how infectious dead bodies were. The work of the Red Cross SDB teams was further complicated by deeply valued traditional burial practices of washing and touching the dead, which contributed in the early stages of the outbreak to increased infection rates.
“To respond effectively, we had to change our entire approach to dealing with people who had died and their families,” said Elhadj As Sy, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC). “We stopped talking about ‘dead body management’ and instead started talking about “safe and dignified burials’. We talked to communities and did our best to understand their beliefs and priorities. Ultimately, we earned their trust, and this was critical to success.”
In all, Red Cross teams managed over 47,000 safe burials, accounting for over 50 per cent of all burials conducted during the outbreak. The teams were made up entirely of local volunteers, who spoke local languages and who understood cultural norms and community dynamics. Around 1,500 trained volunteers were involved in this work. As a result of their efforts, many of them were stigmatized and threatened.
“This study reveals the vital role of communities and community-based organizations in the Ebola response,” said Dr Julie Hall, Chief of Staff and Special Advisor on Health at the IFRC. “The success of the SDB programme can be largely attributed to the Red Cross teams who were there before, during and after the outbreak. It was they who provided the basis for a response to the crisis that was both acceptable to local communities, and sustainable.”
IFRC is repeating its call for greater investment in strengthening local and community-level health capacity, including by investing in National Red Cross and Red Crescent Societies.
“The 2017 Ebola outbreak in the Democratic Republic of the Congo reminds us of how precarious global health is,” said Mr Sy. “International partners need to better harness and invest in local capacities, building on homegrown knowledge and skills, that will help communities respond, protect themselves and put an end to future health crises.
“The price tag on this investment is far less than the alternative: outbreaks that are deadlier and more expensive.”