Social Tension Surrounding Burial Practices and Ebola Transmission in West Africa - Coursework Example

Ebola in West Africa Misconceptions about Ebola The first misconception about Ebola is that its transmission is airborne. This is utterly wrong. The disease is transmitted through bodily contact with fluids from the body, infected humans or animals, and contaminated objects. The disease could only transmit through the air in rare cases where the patient vomits, and the droplets suspend in the air over a short distance to reach another person. Evidence has not substantiated the claim by the WHO that the Ebola virus can mutate and spread through the air yet. Liberia, Sierra Leone, and Guinea simply have weak health systems to counter the disease. However, the increased instances of infection do not justify the transmission of the disease through the air. It is also misconceived that patients without symptoms of the disease can still spread it. According to reliable evidence, a person without symptoms cannot spread the disease. Notable symptoms include severe fever, weakness, muscle pain, diarrhea, and vomiting. In other cases, there could be unstoppable bleeding and organ failure. The disease has an incubation period of 21 days. Quarantining the patient for a similar period has been proven not to be protective enough to public health. Suggestions have been made to extend the period to 42 days or more. The other misconception is that plane crew and passengers are at high risk of infection. The US health worker diagnosed with the disease was on a domestic flight from Cleveland to Dallas a day before the diagnosis despite not showing any symptoms during the flight. The health department contacted all passengers that were on board the plane to diagnose them as well. However, it was stated that the risk of these passengers contracting the disease was minimal as the disease is not airborne. Travel bans, therefore, are inappropriate. It is also believed that no victims of Ebola ever survive. The death rate has reached 70% so far. However, a number of Ebola victims have survived in the absence of a vaccine or licensed medicine. Survivors find it hard to fit into the society because they are believed to have not recovered fully. Consequently, they suffer stigma and discrimination (Onishi 1). Evidence has proven that survivors of Ebola are immune to the particular virus strain they had. In addition, these people develop resistant antibodies in their blood, which could be useful to other patients. The Zaire strain of the virus is still considered the deadliest among the identified five strains. It is also believed that the Ebola outbreak in West Africa could last forever. The WHO has noted that the disease could attain permanent status in the region if it is not contained in these early stages. Despite the 2014 outbreak being the worst ever recorded, historical occurrences show that the disease can end if properly handled. The Senegal situation where the victim recovered after rapid care is enough proof that the disease can be contained. Nigeria could soon be declared free of Ebola according to the WHO. However, West African countries are still vulnerable to the disease because they are in close proximity. Eradication in one country could be overturned by pilferages from neighboring countries. Society and Culture The mix of logistical issues, inadequate infrastructure, conflicts with healthcare providers, and burial traditions has caused great difficulty in preventing the spread of Ebola among the people taking care of the dead and the mourners. The World Health Organization issued clear guidelines on the mode of transportation and burial of Ebola victims. Among the guidelines were the awareness of the cultural practices and religious beliefs of the family of the victim. Transporters and burial teams have to make the family members understand that they are not entitled to the exercise of some of the beliefs and practices because of the risk of infection. A number of traditional practices have been identified as posing serious threats of infection and, therefore, cannot be followed when an Ebola victim is involved. These include religious rituals that call for physical and direct contact with the victim’s body and burial preparations led by the family. In the Muslim tradition, for instance, the family members are required to wash the victim’s body themselves before burial can take place (Cooper 1). The tradition does not favor preparation of the body in the mortuary. Religious rules are quite strict on who can handle the body of a dead person and the manner of doing this. However, must of these rules are in direct conflict with recommended procedures, which health officials should follow so that the risk of infection and spread is minimized. Death is a dangerous stage of Ebola infection. The level of contagiousness increases when the person dies of Ebola. At death, the virus overtakes the body in entirety thereby manifesting the most serious consequences. The problem gets worse because Ebola makes the body of the victim release quite infectious fluids. These fluids include diarrhea, blood, and vomit. These symptoms manifest at the later stages of infection. The patient bleeds from all openings on the body and develops rashes on the skin. Customs and religious beliefs in West Africa have dictated procedures for handling dead bodies and conducting burials. These procedures have conflicted with safety precautions on Ebola. The traditional burial practices include touching, washing and kissing the body of the victim prior to burial (Cooper 1). These practices pose serious challenges because the transmission of Ebola occurs through direct contact with body fluids. Dead victims are the most dangerous in terms of infection because they discharge high quantities of body fluids. The World Health Organization (WHO) estimates that 20% of infections are caused by bodily contact with the victim. According to the communities, the prohibition of family members from performing the burial rights is an attack on the wishes of the deceased. It also puts the family in danger. The spirits of the deceased are believed to cause harm and havoc to the family if the traditional burial procedure is not followed (Faye 1). In West Africa, burial teams have preferred safety over traditions. The teams wear protective gear and douse the dead body with bleach before it is lowered into grave 6-feet deep. In addition, the dead body is wrapped with not less than two body bags. In Sierra Leone, the families of Ebola victims have always hidden the bodies away to conduct proper burial. In certain instances, the medical officers are bribed to allow the family to conduct the traditional wedding. People have been seen driving dead bodies at night on motorcycles. So worse was the situation in Liberia that the government ordered the cremation of all victims of Ebola following the lack of appropriate burial sites. The order prompted most families to avoid taking their patients to the hospital and instead conduct secret burials (Hinshaw 1). The government took note that cremation was not the culture of Liberia, but it had to be done due to the disease threat. Casket-makers were most affected because nearly all deaths in Liberia were considered Ebola deaths. Other families complained that their relatives were subjected to Ebola procedures, but they died or other illnesses. Intervention Measures and Challenges Despite the large number of studies on cultural differences that curtail the prevention efforts of Ebola, it is clear that the ground lacks enough trained personnel to help deal with daily deaths. Infected areas need teams of trained personnel to respond to Ebola infection reports or death alerts as quick as possible. Health officials work round the clock to improve response times, but it still takes too long for the available trained personnel to deal with the dead bodies (Pandey 1). This causes increased tension and heightens the risks of infection. Ebola victims in most cases are buried immediately they leave the treatment center. This practice minimizes poor handling and cushions family members from infection. In situations such as these, family members have to be detached from the bodies of their loved ones, which are then buried outside the communities. The burial places for Ebola victims are often designated to avoid the spread and transmission (Pandey 1). However, the situation gets worse when the victim dies at home and has to be retrieved by health workers for appropriate handling and burial. The WHO came up with a procedure for tackling such a situation. First, the body is disinfected thoroughly. It is then wrapped in at least two body bags. At burial, anything that was in contact with the body, including protective clothing, pillows, and bed sheets are burned or buried with the body. In most communities, people have often blamed outsiders for spreading the disease. Most frontline workers have made claims of physical attacks by community members while attending to Ebola victims. A number of villages in Guinea have been classified as inaccessible because the residents are hostile to health workers sent there (McNeil 1). International health officials are trying to devise ways of boosting local reporting of Ebola cases and deaths in the communities. Reporting has been a serious challenge in most communities. Success rates vary from one country to another. The WHO has identified and trained villagers in Sierra Leone to report Ebola cases and deaths. The community members have been taught to exercise surveillance over their neighbors and friends. Trained reporters have been given mobile phones and money to as incentives to report Ebola cases and deaths to relevant authorities. Sierra Leone has also relatively succeeded. Dead body management teams have been established in the country at high-risk areas. The team members are paid for their work, which includes burying the Ebola victims and taking them to the hospital through appropriate handling (Pandey 1). Social Tensions over Ebola Social tensions exist in Ebola stricken countries. This tension arises due to the government insistence that Ebola bodies have to be handled in a certain way. On the other hand, cultural practices require that certain procedures be followed upon the death of an Ebola patient. Several things should happen in the event of death as a matter of culture. As mentioned above, the corpse has to be washed, which means physical contact with the body and a great danger to Ebola transmission. Dead men are washed by fellow men while fellow women, mostly sisters, wash dead women (PLOS 1). Because these people move are not static in one village, the threat of Ebola transmission to other villages is quite high. Wives are required to shave the heads of their dead husbands. In addition, the wife is smeared with mud that concentrates in the husband’s washing. It is believed that such a practice protects the wife from any jealous spirits thereby preparing her for inheritance by one of her husband’s brothers (PLOS 1). This practice increases the risk of Ebola transmission. On the other hand, the death of in-married wives means that the body is transported to her family usually located in another village. Again, this practice facilitates the spread of Ebola to other villages. Regarding incomplete marriages (that is, marriages in which dowry payment has not been finalized), the deceased’s body is usually returned to the village of origin pending completion. In the event of such deaths, the husband to the deceased has to make efforts to travel to the deceased’s village to settle the outstanding dowry before he can be allowed to bury his wife. If the settlement is made, the man will bury his wife at his village (PLOS 1). This means the corpse is transported again to the man’s home. However, where the wife’s village is too far away and no means is available to transport the body, the husband can bury her wife in his home. The husband will then take immediate steps to travel to the wife’s home to settle the dowry payments. This movement is a risk to Ebola transmission especially where Ebola caused the death. Marriage is not deemed complete until the husband settles the outstanding dowry. The wife’s family may even come back for the children if the husband fails to pay the dowry (PLOS 1). Clearly, these movements pose a threat to Ebola transmission. Families in Liberia believe that funerals not conducted in the traditional way lead to poor agricultural production. Specifically, rice production is hampered due to what the families consider a curse by ancestors (PLOS 1). One can then understand why villagers in West Africa are so vigilant when it comes to protecting their funeral practices despite the measures by government to stop traditional burials due to the Ebola threat. In certain instances, villagers simply wait a little for health workers to turn up at the scene of death. Where this does not happen, the villagers resort to their traditional burial practice. In some towns in Liberia and Sierra Leone, people have been reported to dump bodies of their Ebola victims on the streets and water bodies out of fear of being quarantined by the government. The dogs are now feasting on dead bodies all over the streets (Onishi 1). It is clear that the Ebola scourge has disrupted social practices in a big way. The disruption is attributed to the confusion that exists concerning the handling of the disease and victims. There is the need for extensive education on the same to restore social order. Otherwise, the West African society could suffer from many angles. Works Cited Beck, Julie. "Ebolas Territory: A Land Without Human Touch." The Atlantic 17 Oct. 2014: n. pag. The Atlantic. Web. 24 Feb. 2015. . Cooper, Helene. "Ebola’s Cultural Casualty: Hugs in Hands-On Liberia." The New York Times October 5, 2014. Web. 24 Feb. 2015. . Faye. "Chains of transmission and control of Ebola virus disease in Conakry, Guinea, in 2014: an observational study." The Lancet. Infectious Diseases (2015): n. pag. PubMed.gov. Web. 25 Feb. 2015. Frankfurter, Raphael. "The Danger in Losing Sight of Ebola Victims Humanity." The Atlantic 22 Aug. 2014: n. pag. The Atlantic. Web. 24 Feb. 2015. . Hamilton, Lisa M. "Ebola’s Hidden Costs." The Atlantic, January 14, 2015: n. pag. The Atlantic. Web. 24 Feb. 2015. . Hinshaw, Drew. "In Liberia, Burial Practices Hinder Battle Against Ebola." The Wall Street Journal September 1, 2014: n. pag. Web. 25 Feb. 2015. . Improving Burial Practices and Cemetery Management During an Ebola Virus Disease Epidemic Sierra Leone, 2015 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6401a6.htm McNeil, Donald G. Outbreak in Sierra Leone Is Tied to Single Funeral Where 14 Women Were Infected. 2014 http://www.nytimes.com/2014/08/29/health/ebola-outbreak-in-sierra-leone-is-tied-toone-funeral.html?_r=0 Onishi, Norimitsu. "For a Liberian Family, Ebola Turns Loving Care Into Deadly Risk." The New York Times 14 Nov. 2014: A1. Web. 24 Feb. 2015. . Pandey, Abhishek, et al. "Strategies for containing Ebola in West Africa." Science Magazine October 30, 2014: n. pag. Web. 24 Feb. 2015. . PLOS. Social Pathways for Ebola Virus Disease in Rural Sierra Leone, and some Implications for Containment. PLOS, 2014. Accessed at http://blogs.plos.org/speakingofmedicine/2014/10/31/social-pathways-ebola-virus-disease-rural-sierra-leone-implications-containment/ 14 April 2015 Sierra Leone: a traditional healer and a funeral http://www.who.int/csr/disease/ebola/ebola-6-months/sierra-leone/en/ Read More