Anthropologists in the Frontline Against Ebola

Weekly French Translation

To fight against the Ebola virus epidemic in Guinea , it was declared Friday, March 21, the World Health Organization (WHO) and Médecins Sans Frontières (MSF) have sent epidemiologists, doctors, nurses and even statisticians, accustomed to health disasters, to the field. But they also sent, unexpectedly, anthropologists. This last cohort has been entrusted with the delicate task of negotiating with the families of the dead who were infected with the virus for the adaptation of funeral rites.

Pour lutter contre l'épidémie du virus Ebola en Guinée, déclarée vendredi 21 mars, l'Organisation mondiale de la santé (OMS) et Médecins sans frontières (MSF) ont dépêché sur le terrain des épidémiologistes, des médecins, des infirmiers ou encore des logisticiens, habitués des catastrophes sanitaires. Mais aussi, et c'est plus inattendu, des anthropologues. Ces derniers se sont vu confier la délicate mission de négocier avec les familles des défunts, contaminés par le virus, l'adaptation des rites funéraires.

This article has been translated from French. Click here to read the original version on Le Monde.

"One characteristic of the hemorrhagic fevers is that when families and relatives wash the body, they come into close proximity to the virus, which remains active even after death," says Marie-Christine Férir, responsible for international emergencies for MSF in Brussels. The pathogen exponentially multiplies during the twelve hours after death, and fluids and secretions flowing from the body are highly contagious.

Funeral ceremonies are, therefore, times of high risk: concentration of families, contact with infected bodies, dangerous sanitary and hygienic conditions ... "In Congo, for example, in some contexts, the garment of the deceased is soaked, washed in the water, and those who came to greet the dead drink some of that water, " says Peter Maes, head of hygiene and water at MSF. These are very sensitive situations, and anthropologists help logistical specialists to negotiate with the locals.

Sanitizing the Home with Chlorine

"When the ceremonies take place before are able to intervene, they then become the epicenter of new epidemics," says Maes. "I've experienced funerals that were very difficult to control with families which were very close; it was important to supervise at a distance with respect." The priority, in a context of widespread fear, is to win the trust of the families.  "If we fail to engage in dialogue, if we appear to be too rigid, there is a risk of families concealing cases, deaths, in order to preserve the traditional rite, taking the risk to prevent the spirit from leaving the body, " says Marie-Christine Férir .

To properly minimize the risk of an epidemic, the MSF and WHO teams enclose the bodies in "body bags," or sealed bags. An opening is provided at the face so that the family can see and photograph the deceased. Moreover, the home must be disinfected with chlorine. Other teams are specially in charge of monitoring everyone who had come into contact with the patient.

Tact and Diplomacy

Each culture has its own traditions regarding death. Sometimes death is regarded as a manifestation of bad luck. "The task of working with local health teams often facilitates contact," says M. Maes. "But the advantage, coming from the outside, is that you can appear as naive, excluded from local traditions."

Everything must be done with tact and diplomacy. "We realized that arriving at a home fully outfitted in coveralls and helmets and masks, it was scary and prevented contact," says Peter Maes. "Now we arrive in civilian clothing and one person wears the 'scary' outfit, entering the house and offering one member of the family the same outfit." MSF teams have already intervened during seven or eight outbreaks of Ebola.

Article translated by Allie Stauss, Staff Intern for the Africa Program at the Wilson Center.

Photo courtesy of Kerry Lanert via Flickr Commons.