July 2018,  Red Cross volunteers talk with the community in the Democratic Republic of Congo

At the scene of a tragedy in the Democratic Republic of Congo, a team of Red Cross volunteers faced a very sensitive dilemma. A resident of a remote village in the north of the country had died from Ebola. The family had been patiently and respectfully talked out of doing the traditional burial practices that have proved so deadly during previous outbreaks. They agreed to allow a safe and dignified burial by the Red Cross team.
But there was a problem.

Balancing beliefs and safety

The soul of their loved one could not pass through the body bag and join the ancestors, the family said. The bag must be unzipped to show the person’s face. Anything else would be disrespectful. The ancestors would punish the living; more death and misfortune would follow.The volunteers hesitated. They knew body fluids inside the bag were pulsing with the Ebola virus, and the smallest leak could kill anyone who came into contact. The bag had to stay closed at all costs. What could they do? The safe and dignified burial went ahead because the volunteers were from the same communities and culture as the grieving family.

Mbandaka June, 2018
IFRC ERU team training health care workers on the treatment of Ebola patients.

This happened just over a month ago, when I was working in Itipo, a remote village, to provide community engagement support during the country’s ninth Ebola outbreak.

While we are now responding to the new Ebola outbreak in North-Kivu province, this is what we have learned:

Preventing Ebola is emotionally painful

Ebola creates fear. Not only is preventing its spread at odds with many religious and cultural practises, it goes against our human instincts. Imagine not being able to hug or touch your child if they were sick with fever and vomiting blood. Imagine people from outside your community coming to your house dressed in what look like space suits and take the body of your loved one away to bury them safely? What would it feel like to be followed for 21 days by health workers you’ve never met before?
It also creates fear because illness in this part of Africa – especially diseases like Ebola – is often believed to be caused by witchcraft or curses.

Being part of the community is crucial

Community volunteers are as powerful as medical treatment. They enable people to put aside deep-rooted and potentially dangerous beliefs and take action to prevent the disease. Local organizations, people and communities are the only people who have the knowledge, relationships and access to change the course of an outbreak or disaster.

 Start where they are, not where you are

Beliefs related to death are an essential part of life in the Democratic Republic of Congo. Failing to follow tradition is believed to show disrespect for ancestors, which can lead to punishments like illness and death. Trained volunteers can quickly to respond to a disease threat, finding safe and sensitive ways to respect local traditions while changing high-risk practises like burial rituals.
This is why an important part of our community work is to support volunteers as they understand their own beliefs and fears in the context of an outbreak.

 Listen constantly

Ebola can give rise to a range of powerful suspicions, like the disease being caused by witchcraft or a curse. In Itipo, which was affected by the previous outbreak, Ebola was linked to the arrival of foreigners by helicopter – something the communities had never seen before. We know local practices and beliefs shift all the time. Our volunteers have to listen and then respond, refining and updating messaging and advice.

By Ombretta Baggio, senior community engagement and accountability adviser, IFRC