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In reply to the discussion: Ebola outbreak: Liberia shuts most border points [View all]Divernan
(15,480 posts)3. One problelm: locals associate hospitals with dying, so don't take people there.
Another problem - people who die at home, i.e., have not been quarantined. Relatives prepare the body for funerals, and in doing so contact Ebola from touching the bodies.
I've seen both these problems discussed in articles on Ebola, and will look for some links.
On edit: Here's info from research on the cultural context of Ebola.
Funerals and Burials
National and international healthcare workers were concerned that burial practices contributed to the amplification of EHF. A brief study indicated that once a person died, his or her paternal aunt (fathers sister) was called to wash and prepare the body for burial. If the father did not have a sister, an older woman in the victims patriline was asked to prepare the body. Generally, the woman removed the clothes from the body, washed the body, and dressed the deceased in a favorite outfit. At the funeral, all family members ritually washed their hands in a common bowl, and during open casket all were welcome to come up to deceased person and give a final touch on the face or elsewhere (called a love touch). The body was then wrapped in a white cloth or sheet and buried. The person was buried next to or near their household. This practice is the normal system of burial.
However, when disease is classified as gemo, burial practices change. The body is not touched and is buried outside or at the edge of the village. The designated caregiver, someone who has survived the outbreak or an older woman, is responsible for washing and preparing the body for burial.
Various activities associated with burial practices contributed to transmission of EHF (Table 2). Washing the body was a possible means of infection for women only, while a touch was a more common means of infection among men. The fact that 63% of the survivors in this study had their first symptoms in October implies that they probably became infected before laboratory tests confirmed EHF and before the disease was designated as a type of gemo in many communities. Caregiving, especially by women, contributed substantially to many cases, which explains, in part, why 67% of all presumptive EHF cases in Uganda were in women.
WHO was also concerned that local persons were not coming to the hospital when symptoms first emerged. Healthcare workers theorized that patients were afraid of being buried at the airfield if they died. Persons were running and hiding when the ambulance arrived to take them to hospital. Later interviews indicated, however, that the airfield burial was not the problem. As described in the protocol, once an illness is identified as a killer epidemic, burial at the edge of the village is expected. Rather, sources indicated, many persons ran from the ambulance and did not seek treatment quickly because they feared they would never see their family once they were admitted to the hospital. This fear is common in many parts of central Africa but was especially pronounced in Gulu hospitals because bodies were placed in body bags and taken to the airfield to be buried without relatives being notified. Relatives were not always around at the time of death, and healthcare workers were required to dispose of the body as quickly as possible. The anger and bad feelings about not being informed were directed toward healthcare workers in the isolation unit. This fear could have been averted by allowing family members to see the body in the bag and allowing family members to escort the body to the burial
ground. http://wwwnc.cdc.gov/eid/article/9/10/02-0493_article
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One problelm: locals associate hospitals with dying, so don't take people there.
Divernan
Jul 2014
#3
I just edited my post to add info re a lot more medical personnel being treated/died
Divernan
Jul 2014
#19
In that you have to understand that the staff and facilities are not what we are used to here
Marrah_G
Jul 2014
#29
Ebola is a virus, and as such hard to adapt to mutiple creatures, as needed with a vector.
happyslug
Jul 2014
#42
Monclonal antibodies taken from survivors could provide vaccinations for strain variants.
DhhD
Jul 2014
#10