Angola targets risky funeral rites in Marburg fight

Persuading Angolans to alter traditional rituals to prepare the dead for burial is one of the biggest challenges to the country’s bid to stamp out the world’s worst outbreak of the killer Marburg virus.

In a country with a tradition of embracing and kissing the dead in a final farewell, it is hard to convince people that handling corpses can spread a disease that has already killed more than 200 people since last October.

“You know that all these African societies are very much tied to ancestry, and also the way you treat deceased beloved ones,” said Celso Malavoloneke, a spokesman for UNICEF in the country.

“For the people here not to be able to pay their last tribute and respect to deceased beloved ones, that’s particularly hard. And the whole issue of the social, cultural and anthropological impact of the disease is becoming more and more important,” he added. The rare hemorrhagic fever, spread by bodily fluids like blood, saliva, tears and sweat, has already killed 215 of the 235 known to have been infected. There is no cure.

Most Angolan families regard kissing and embracing the body of a dead relative as an important funeral rite.

“We say goodbye on their last day,” explained one recently bereaved Luanda resident. “But now I know about this Marburg sickness, there’s no way I’ll be doing that anymore.”

Experts say protection is essential when dealing with corpses. Bodily fluid secretions increase after death, meaning the corpses of Marburg victims are highly contagious.

Simply touching an infected corpse can lead to infection.

A series of radio and TV adverts being broadcast on national media both in Portuguese and eight of the most widely spoken local languages aims to educate people to help halt the epidemic.

SPACE SUIT FUNERALS

But officials say overcoming deep-rooted community traditions remains the most difficult aspect of the campaign.

“We have some cultural barriers that are slowing the pace of results and this is a key problem we are facing now,” said Deputy Health Minister Jose Van Dunem.

“We are asking support from churches, traditional healers, traditional leaders, all important people in the community in order to mobilize the population to overcome the cultural barriers,” he added.

Doctor and epidemiologist Francois Libama spent three weeks in Uige, the epicenter of the outbreak, working with World Health Organization surveillance teams tracing Marburg infections and supervising funerals of its victims.

Every day, he had to wear bio-protective overalls. The arrival in the family home of health workers looking like space men could be traumatic for bereaved relatives, he said.

“It all depends on the way that the family is approached, how you explain that you’re going to be dressed in this outfit. You can even ask a family member to help you put the suit on to help the fear disappear,” Libama said.

Family members may still participate in funerals and medical procedures for Marburg victims, but they must be protected, he said.

“Instead of the family going to bury and contaminate themselves with the cadaver, we, the medical teams, carry out the funerals, of course in the presence of the family.”

Provided by ArmMed Media
Revision date: July 6, 2011
Last revised: by Janet A. Staessen, MD, PhD