Yuma Adolphe and his team are responsible for the safe and dignified burial of some of the people who die from Ebola in the Democratic Republic of the Congo’s (DRC) Ituri province, the epicentre of history’s deadliest Ebola outbreak. Nearly every day they dig the graves, prepare the bodies and handle the coffins.But as the authorities grapple with the outbreak, which has killed nearly 3,200 people among more than 6,600 confirmed cases, the burial team say they are at their limits, struggling with an increasing workload and hostile communities.“It is difficult, but we try to push ourselves beyond our limits,” Adolphe said.Since the outbreak began in mid-May, authorities have deployed small burial teams such as Adolphe’s in the hotspots to handle the burials. Paid $20 (R320) a day, they are a part of a group of frontline workers who are working to contain the rapidly moving disease.Despite the toll, the burial team members say the priority is to keep their community safe.“We have to look at our own mental wellbeing, and physically the fatigue mounts, but we keep going to ensure the community is protected.”‘In the past, we did not die like this’But their work is in the crosshairs of the locals’ frustration with the outbreak, which not only has taken their loved ones but also prohibits them from traditional burial rites.Health workers exclusively handle the bodies, as Ebola spreads as a result of direct contact with the blood or bodily fluids of infected people. Experts say bodies of victims still contain considerable amounts of active virus and can spread infections further.Since May, health workers and burial teams such as Adolphe’s have been attacked by bereaved families across the frontline of the outbreak.“Usually, the body is handed over to the family, who can handle it however they wish, in accordance with our African customs,” Adolphe said. “But in this situation, it’s difficult to let the family handle the body as they please. They are deprived of certain rituals, and that’s what leads to misunderstandings.”Jeanne Alasha, adviser to the military governor of Ituri on health and humanitarian affairs, said that “as for those who continue to assault the teams, they are committing offences punishable by law”.Ituri province, where the outbreak is concentrated, is also at the centre of the rebel conflict in eastern DRC. The province is under a military government appointed by federal civilian authorities in Kinshasa.Shortly before noon last Friday, Justine Abineno, a chorister, was buried in Ituri. Abineno died of Ebola. She had only complained of slight headaches before heading to a hospital and was diagnosed with Ebola, her mother said.A catechist presided over the ceremony attended by dozens of people, as a team of specialist burial team members in scrubs and boots stood by.Abineno’s mother, Sofia Wanito, said the doctors only allowed her to see the body through the window of the hospital ward, and she wasn’t allowed to touch the coffin.“In the past, we didn’t die like this. I could not even cover her with the sheets myself and pay a final tribute,” Wanito said.Containment efforts falterThe Ebola outbreak is spreading in six provinces in eastern DRC in some of the most difficult conditions imaginable, fuelled by rebel violence, displacement and intense population movements. A weak health care and surveillance system also challenges responders, as well as insufficient contact tracing and laboratory testing.Efforts to contain the outbreak have also been complicated by the lack of an approved vaccine or treatment for the rare Bundibugyo virus causing it. Authorities have started vaccinating frontline health workers with the Evrebo vaccine, which the World Health Organisation (WHO) says could offer some protection against Ebola, but there’s no conclusive evidence that it would work against the current virus.Health authorities say the true scale of the crisis is likely to be three times more than official statistics as the disease continues to outpace efforts to contain it. The WHO has said it’s projected to surpass the deadliest in history, West Africa’s 2014-2016 outbreak, which killed more than 11,000 people.Frontline health workers in eastern DRC have gone on multiple strikes to demand pay for their work, complicating efforts to stop the outbreak.‘We are putting everything on the line’Benjamin Muhindo, another burial team member, said his family worries that he might bring the virus home. For him, though, a bigger priority is ensuring the proper burial of victims, he said.“Burials during this Ebola epidemic are very complicated, as we are working under pressure and constantly racing against the clock,” Muhindo said.Trauma experts say the high number of cases and the deaths are only one side of its impact at personal and communal levels.“The trauma of this outbreak doesn’t stop with the case count,” said Rose Tchwenko, Mercy Corps country director in the DRC. The chain of transmission will only be broken by “an integrated holistic response”, which includes a social response to bereaved families and frontline workers, she added.After the burial on Friday, Adolphe said he was very tired but more worried about the community than anything else.“We have no choice,” he said. “We are here to safeguard our community.”AP