We negotiate to make the family accept the unacceptable.
In the hills of northeastern Democratic Republic of Congo, an ancient way of honoring the dead has collided with the imperatives of survival. The Bundibugyo strain of Ebola, having claimed nearly two hundred lives in recent months, moves most readily through the very rituals of washing, gathering, and farewell that communities have long used to carry their loved ones into the ancestral world. Health workers and anthropologists now walk alongside grieving families in Bunia and Nyamurongo, seeking a path that neither abandons the living to disease nor strips the dead of dignity — a negotiation as old as human suffering itself.
- A single man has buried his father, his mother, three sisters, and a brother-in-law within weeks, and still has relatives fighting for their lives in treatment centers.
- The Bundibugyo strain spreads through bodily fluids, turning generations-old funeral rites — the washing of bodies, the multi-day ceremonies, the communal singing — into pathways of contagion.
- Health workers and anthropologists are racing to build trust with communities that still harbor disbelief about the outbreak, negotiating ritual concessions one grieving family at a time.
- Transparent body bags and coffins with clear panels have emerged as fragile compromises, allowing families to see their dead while sealed barriers prevent transmission.
- Burials that once lasted days now end in under ten minutes, and the silence left behind carries its own grief — the outbreak continues to spread, with more cases expected.
The cemetery at Nyamurongo fills faster than it should. Joel Lonza Makumbu has made the walk there six times in recent weeks — to bury his father, his mother, three sisters, and a brother-in-law. Shoveling soil into a grave, he speaks with the weight of someone who has watched Ebola move through his family like a current. "I want to say for all people that Ebola is true," he says — a plea against the disbelief still circulating in his community even as the outbreak in northeastern Democratic Republic of Congo has claimed nearly two hundred lives.
The virus is Bundibugyo, a rare Ebola strain that kills roughly one in four people it infects. It spreads through bodily fluids, which means the rituals communities have practiced for generations — washing the body, gathering for days of ceremony, singing the dead into the ancestral world — have become vectors of transmission. The crowds are gone from Nyamurongo. The singing has stopped. The multi-day ceremonies have vanished.
This collision between survival and tradition has forced health workers and anthropologists into delicate negotiations with people in the depths of grief. Julienne Anoko, an anthropologist with the World Health Organization, explains that in Ituri culture, the dead are understood to be traveling into the world of ancestors — women dressed in wedding gowns, the living celebrating a journey rather than mourning an ending. Ebola demands the opposite: immediate sealing in a leak-proof bag, no contact, no ceremony.
To hold both realities at once, health workers have introduced coffins with transparent panels and body bags with clear film at the top, so families can still see the face of their dead. Maria Munoz-Bertrand of the International Federation of the Red Cross describes the work as constant negotiation — accommodating specific prayers or rituals wherever infection control allows. When a 34-year-old mother of four was collected from a treatment center in Bunia, her father watched from a distance. "She was ill for just one week," he said quietly. "She has left us her four children — I don't know how we will cope."
At the cemetery, the burial lasted less than ten minutes. Volunteers decontaminated and left. The speed and silence were their own kind of violence — days of ritual compressed into minutes of procedure.
Anoko has navigated multiple outbreaks across Congo and West Africa. She listens, grieves alongside families, and uses her knowledge of their culture to bridge what science demands and what tradition requires. The hardest cases involve pregnant women, whose burial rites conflict directly with infection control. She reminds families that their ancestors had foresight — a way of honoring both the science and the culture at once.
Back at Nyamurongo, Makumbu finishes covering his mother's grave. Two sisters remain in one treatment center; a cousin and another sister in another. He does not know if he will return a seventh time, or an eighth. But he knows what he needs the world to hear: "Ebola is real."
The cemetery at Nyamurongo in Bunia fills faster than it should. Joel Lonza Makumbu has now made the walk there six times in recent weeks—yesterday to bury his father, today to say goodbye to his mother. He has also lost three sisters and a brother-in-law. As he shovels soil into the grave, he speaks with the weight of someone who has watched the disease move through his family like a current. "I want to say for all people that Ebola is true," he says. It is a message born of desperation, a plea against the disbelief that still circulates in his community even as the outbreak in northeastern Democratic Republic of Congo has claimed nearly two hundred lives in recent months.
The virus responsible is Bundibugyo, a rare strain of Ebola that kills roughly one in four people it infects. It spreads through contact with bodily fluids—blood, urine, vomit, semen, breast milk—which means that the rituals communities have practiced for generations have become vectors of transmission. At Nyamurongo, fifteen families are attending burials on any given day, but the cemetery looks nothing like it once did. The crowds are gone. The singing has stopped. The multi-day ceremonies have vanished. The washing of bodies by family members, a practice woven into the fabric of how people honor their dead, is now forbidden.
This collision between survival and tradition has forced health workers and anthropologists into delicate negotiations with people in the depths of grief. Julienne Anoko, an anthropologist working with the World Health Organization, explains that in Ituri culture, the dead are prepared with care and ceremony because they are understood to be traveling from this world into the world of ancestors. Women are dressed in wedding gowns with makeup. The living sing and celebrate because death is not an ending but a journey. But Ebola demands something different: the body must go immediately into a leak-proof bag, sealed and buried. The two visions are irreconcilable—unless you find a way to hold both.
In Ituri, health workers have begun using coffins with transparent panels so families can see inside. Body bags now have clear film at the top so the face of the deceased remains visible. These are small concessions, but they matter. Maria Munoz-Bertrand, a public health coordinator for the International Federation of the Red Cross, describes the work as a constant negotiation. "We need to be very close to the communities and engage with them very closely," she says. The goal is to protect families and volunteers while honoring what families need in their darkest moments. When a family asks for something special—a particular prayer, a specific ritual—health workers try to accommodate it, as long as it does not breach infection control.
The reality of this work becomes visible when you watch it happen. A team of IFRC volunteers in full protective equipment arrives at an Ebola treatment center in Bunia to collect a body. Family members wait by the roadside, ready to accompany their dead to the cemetery. Inside a tent that serves as a temporary morgue, health workers in PPE place a body bag inside a coffin and seal it. The path behind them is disinfected. Then the IFRC team enters from the opposite side, retrieves the coffin, and carries it to a truck. The body is that of a 34-year-old mother of four. Her father, Simone Nyal, watches from a distance with his son-in-law. "This is a big blow for us," he says quietly. "She was ill for just one week before she succumbed. She has left us her four children—I don't know how we will cope."
At the cemetery, the mother and sister of the deceased stand by the open grave. The burial takes less than ten minutes. The volunteers decontaminate themselves and leave. Three gravediggers cover the grave with soil. The speed and the silence are their own kind of violence—a compression of what should be days of ritual into minutes of procedure.
Anoko has worked through multiple Ebola outbreaks across the Democratic Republic of Congo and West Africa. She describes her role as one of negotiation, of helping communities accept what seems unacceptable. Sometimes it takes three days of conversation. She listens. She grieves with families. She uses her knowledge of their culture to bridge the gap between what science demands and what tradition requires. The most difficult cases have involved pregnant women. In Ituri belief, a pregnant woman must be buried without the fetus so she can "travel light" into the afterlife. But removing the fetus means contact with bodily fluids—the very mechanism of transmission. Anoko reminds families that their ancestors had foresight, that the ancestors have already planned for such things. It is a way of honoring both the science and the culture at once.
Back at Nyamurongo, as Makumbu finishes covering his mother's grave, he speaks of the relatives still in treatment centers—two sisters in one facility, a cousin and another sister in another. He does not know what comes next. He does not know if he will return to this cemetery a seventh time, or an eighth. But he knows what he needs to say: "I want everybody to know that Ebola is real." It is a statement that carries the weight of lived loss, a testimony against denial, and a warning to those who still do not believe.
Notable Quotes
I want to say for all people that Ebola is true.— Joel Lonza Makumbu, who has lost multiple family members to the outbreak
This is a big blow for us. She was ill for just one week before she succumbed. She has left us her four children—I don't know how we will cope.— Simone Nyal, father of a 34-year-old woman who died of Ebola
The Hearth Conversation Another angle on the story
Why does it matter so much to families that they can see the face of the person they're burying?
Because in their understanding, the dead are not gone—they're traveling. They need to look their best for that journey, to be recognized, to be honored as they move into the world of ancestors. Covering the face completely feels like abandonment.
But the virus is in the bodily fluids. How do you ask someone to let go of that need?
You don't ask them to let go. You find a way to hold both things. A transparent panel. Clear film at the top of the bag. It's not the same as the old rituals, but it's not nothing.
Anoko seems to have built real trust with these families. How does an anthropologist do that in the middle of a crisis?
By listening first, before explaining. By grieving with them, not at them. By knowing their culture deeply enough to speak its language—to remind them that their own ancestors have wisdom for this moment.
The case of pregnant women sounds almost impossible to navigate.
It is. The community believes the fetus needs to be removed so the mother can travel light. But that means contact with fluids that carry the virus. Anoko had to reframe it—not as breaking tradition, but as trusting that ancestors already foresaw this and planned for it.
Do these negotiations actually work?
Sometimes. But it takes time, patience, and genuine respect for what the family is losing. And even when it works, the burial is still over in ten minutes. The compression of grief is its own kind of loss.
What does Makumbu's repeated return to the cemetery tell us?
That this is not over. That the outbreak is still moving through families, still claiming people. His testimony—"Ebola is real"—is partly a warning to those who still deny it, and partly a cry that his loss is real, that it matters, that it should not be forgotten in the speed of safe procedure.