Graded IR Class

Public health professionals are beginning to look harder at Sierra Leone’s culture, which is dominated by secret men’s and women’s societies that have certain rituals, especially around burials. Many people here — just like in other cultures — believe that the afterlife is more important than this one. A proper burial, in which the body is touched and carefully washed, is the best way to ensure a soul reaches its destination.

Seventy percent of new cases here, Western officials said, are directly linked to traditional burials.

Another issue are strikes. This week, burial workers in eastern Sierra Leone dragged corpses from a morgue and dumped them outside to protest delays in being paid. In Freetown last week, some surveillance workers — the emergency medical workers to suspected cases — refused to work, demanding back pay, which added to the problems of dispatching ambulances.

“Why are the British here? To end Ebola, or party?” read a headline in a local newspaper. It added, “While their American counterparts are working hard to end Ebola in Liberia, our so-called colonial masters are busy living the life of Riley.”

Like others, the official kept citing the “Brits’ primacy” in Sierra Leone — a reference to how, several months ago, Western powers divided Ebola responsibilities in West Africa along historical lines, with the United States helping Liberia, a nation founded by freed American slaves in 1822; France helping a former colony, Guinea; and Britain helping its own former colony, Sierra Leone.

Many aid officials in Sierra Leone said they crave a more effective command structure. The government runs a national emergency center, but aid officials said that with scores of foreign experts, government delegations and private charities flocking here, coordination was still messy, with many gaps and overlaps. It is extremely difficult, they said, to get even the most basic information, including how many treatment centers exist.

There are also growing questions about corruption, with the government announcing recently that it had found 6,000 “ghost medical workers” on its payroll, even as real Ebola burial teams and front-line health officers say they have not been paid in weeks.