After Ebola: New Questions Raised About Burial Rites in Outbreak Nations

Admittedly, Ebola is still a very real issue, with a grand total of 18 confirmed cases of the often fatal disease indentified in West Africa, as of this week. However, compared to the whopping 450 to 1,000 weekly cases reported in the peak of last year's epidemic, it's safe to say that the worst is over. But now, experts are looking back and wondering what could have been done better. The burial of victims, according to a new report, is one issue that should have been better addressed.

"Existing laws, both domestically and internationally, are inconsistent and underdeveloped in ways that not only jeopardize public health, but also disregard the wishes of the deceased and their survivors, and often conflict with religious beliefs regarding care of the body," Aileen M. Marty, a 25-year Navy veteran, now with the Herbert Wertheim College of Medicine, said in a statement.

Over the course of last year, Marty made several trips to West Africa, offering her expertise in a bid to help prevent an invasion of encroaching Ebola virus disease (EVD) into regions neighboring Sierra Leone, Liberia, and Guinea - considered ground zero for the epidemic.

"I think it's really important to make sure that we do things that make a difference," Marty explained. "That we can feel at the end of the day, or even at the end of our lives, that we've made a real difference."

However, for all the good she and her colleagues did in disease-threatened countries, they were also struck by the pressing need for effective laws governing the handling of human remains. After all, Ebola is stronger than death itself, often outliving a host to threaten friends, family, and medical workers in contact with a corpse. (Scroll to read on...)

When Marty returned to the United States, she immediately teamed up with law experts Eloisa C. Rodriguez-Dod (of FIU) and Elena Marty-Nelson (of NSU) to closely analyze how various countries were trying to keep their people safe while simultaneously struggling to preserve burial rights and religious tradition.

The result is a paper titled "The Intersection of Law, Religion, and Infectious Disease on the Handling and Disposition of Human Remains," which was presented last week at the Annual Conference on Law, Religion, and Health in America at Harvard University.

"Although some organizations, including WHO, have written guidelines for culturally sensitive handling and disposition of human remains," Marty-Nelson added, "those guidelines may not be effective without a legal framework to ensure their implementation."

But what's to be done?

How exactly a government should go about implementing those laws, however, is a delicate act. (Scroll to read on...)

"Christianity, Judaism and Islam all have traditions that disfavor cremation, or outright prohibit it," Rodriguez-Dod explained.

As a result, people grew suspicious of and even feared officials who suddenly asked them to disregard those tenants.

When Liberian President Ellen Johnson Sirleaf decreed last August that the bodies of Ebola victims were to be cremated, for instance, many residents panicked, hiding their sick relatives from aid groups and often holding secret burials that simply propagated the spread of EVD.

"At least 20 percent of new Ebola infections occur during burials of deceased Ebola patients," Pierre Formenty, one of WHO's top Ebola experts, had estimated back in November.

With this in mind, he had echoed this latest report's sentiment.

"By building trust and respect between burial teams, bereaved families and religious groups, we are building trust and safety in the response itself," he said, "Introducing components such as inviting the family to be involved in digging the grave and offering options for dry ablution and shrouding will make a significant difference in curbing Ebola transmission."

Trust in the law, however, as Marty's team presses, may be most important of all.

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