Facilitators and Barriers to Community Acceptance of Safe, Dignified Medical Burials in the Context of an Ebola Epidemic, Sierra Leone, 2014

Figures & data

Fig. 1. Seven chiefdoms included in focus group discussions in Bo District, Sierra Leone, October 2014. The map was produced by B. Maholland, Geospatial Analyst with the CDC/OPHPR/DEO/Situation Awareness Branch (GADM Database of Global Administrative Areas, Version 2.0).

Table 1. Themes and suggested solutions from the focus group discussions (FGDs) to identify barriers to and facilitators of community acceptance for safe, dignified medical burials, Bo District, Sierra Leone, 2014

Theme	FGD findings	Suggested solutions
Community’s understanding of Ebola	Substantial familiarity with the key Ebola messages.Disappointment and sadness concerning inability to perform traditional burial practices.	“Ebola time is special—similar to wartime,” a recognition that guidelines to promote safe, dignified medical burial had to be followed.
Barriers regarding safe, dignified medical burials	Witnessing or hearing about burial teams disrespectfully “taking away” the body.Family members that were not permitted to observe safe burials.Little awareness of what happens to bodies at the cemetery.Stigma around Ebola and fear of quarantine.	Discredit inaccurate rumors by explaining what happens at the cemetery to the community members.
Facilitators regarding safe, dignified medical burials	Restoring trust and confidence in safe, dignified medical burial.Community safe burial: community members could dig the grave while waiting for the burial team to arrive.	A religious leader (pastor or imam) to pray for the dead person.Notifying family members if a patient died in an Ebola Treatment Unit so that they could be present at the cemetery.Many were willing to learn how to conduct safe, dignified medical burials themselves.

Sierra Leone Ministry of Health and Sanitation. (2014, October 1). Ebola virus disease – situation report (Sit-Rep). Retrieved from http://health.gov.sl/wp-content/uploads/2014/10/Ebola-Situation-Report_Vol-127.pdf

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