Twenty percent of new Ebola infections occur during burials of deceased Ebola patients. This high number and attempting to build trust and respect between burial teams, bereaved families and religious groups has prompted the World Health Organization (WHO) to publish today, “How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola virus disease.”

Liberia Ebola  public service poster/CDC
Liberia Ebola public service poster/CDC

Ebola infections occur during burials when family and community members perform religious rites that require directly touching or washing the body, which still contains high levels of Ebola virus; and when family members distribute personal property of the loved one, which may be infected with the virus.

Related: Ebola Q & A with infectious disease experts Smith and Racaniello

Developed by an interdisciplinary team at WHO, in partnership with the International Federation of Red Cross and Red Crescent Societies (IFRC) and faith-based organizations including World Council of Churches, Islamic Relief, Caritas Internationalis and World Vision, this updated protocol outlines step-by-step processes for safe and dignified burials. The protocol encourages inclusion of family and local clergy in the planning and preparation of the burial, as well as at the burial event itself, giving specific instructions for Muslim and Christian burials.

“We are becoming known for “dead body management”, but we do not “manage” dead bodies. We safely, respectfully and in a dignified manner, accompany our deceased fellow human beings and help to prepare them, in accordance with their cultures, for their last resting places. It is in this spirit that our volunteers carry out their difficult work” says Elhadj As Sy, Secretary General, IFRC.

“It is clear from Islamic juristic ruling that the necessity of religious washing of the body before burial of patients who die from Ebola is over-ruled,” says Rehanah Sadiq, a Muslim chaplain with University Hospitals Birmingham NHS Foundation Trust who served as consultant to WHO on the protocol. “However, it is vital to help bereaved families grieve and find closure by ensuring that sacred rites, such as performing a dry ablution, shrouding the body, and praying over the deceased are represented in Muslim funerals. Providing safe alternatives for families to maintain deeply-cherished practices helps them be part of the decision-making process, which is critical particularly during a time when they may be feeling helpless.”

“Giving the family an opportunity to view the body of the deceased, ensuring that the grave is appropriately labelled, and allowing religious leaders to offer prayers and family members the option to throw the first soil – these are important incentives for encouraging families to continue to find strength in their faith, and to keep other family members safe from becoming infected,” said Rev. Msgr. Robert J. Vitillo, Head of Delegation, Caritas Internationalis.