Cultural practices raise risk of Marburg spreading

Traditional funeral rites in Angola are putting the families of Marburg victims at risk of contracting the killer virus. For most Angolan families, preparing the body, and kissing and embracing the deceased loved one are integral to bidding a final farewell. But the secretions from a body increase after death, making such practices highly dangerous in the case of a Marburg-related death. "We're just telling them: 'please don't touch [suspect corpses]'; 'you cannot touch them - call in the specialised groups from the nearest health unit and let them deal with the corpse because you can get very easily contaminated if you try to touch them'," the UN Children's Fund (UNICEF) communication assistant, Celso Malavoloneke, told IRIN. The death toll from the epidemic - the world's worst to date - now stood at 235 of a total of 257 known cases. In northern Uige province - the epicentre of the Marburg crisis - medical teams had been dispatched to people's homes when alerted to a suspected case or death. Information was being disseminated via radio and television advertisements, traditional leaders and healers, churches and mobile teams of 'activists', telling people how to spot a suspected case of Marburg and to alert the health authorities immediately, and advising family members on how to care for the sick and protect themselves from the Ebola-like fever. This included wearing masks and gloves, or using strong plastic bags without holes if gloves were not available. Malavoloneke said passing on the message about how to care for the sick or bid farewell to the deceased while protecting oneself was not always easy. "We know it's hard, and that's where the cultural challenge comes: we're all parents and it would be very hard for someone to tell you not to touch your own child if he is sick," he pointed out. "You know that all these African societies are very much tied to ancestry, and also the way you treat deceased beloved ones; for the people here not to be able to pay their last tribute and respect to deceased beloved ones - that's particularly hard," he added. Overcoming deep-rooted traditions remained the biggest challenge, according to health ministry officials. Although Uige's provincial hospital now had a fully equipped and staffed isolation unit, many families were still 'hiding' the sick at home. Medical workers said there was widespread mistrust of the isolation unit, in part because the Marburg mortality rate of more than 90 percent meant the sick did not return home once they were admitted. World Health Organisation epidemiologist Francois Libama said he had hope that the epidemic could be stamped out, despite the rising death toll. "If we succeed in managing all the cases and the funerals, we'll start reducing the risk of transmission," he told IRIN. "In the case of an epidemic it's impossible to say how many days or months lie ahead, but I believe in the days to come we will have more hope," Libama added. "I believe a day will come when we will see the end of the tunnel."