LEILA FADEL, HOST:
At least three treatment centers in the Democratic Republic of Congo have been attacked by the local community. This has happened in past Ebola outbreaks. Often, the people who storm the clinics want the body of their loved one back, even though it's highly contagious. As NPR's Gabrielle Emanuel reports, aid groups are figuring out how to respond.
GABRIELLE EMANUEL, BYLINE: When Dr. Babou Rukengeza saw footage of the burning and charred hospital, he was distraught.
BABOU RUKENGEZA: I was really shocked.
EMANUEL: Shocked, but not entirely surprised. This is Rukengeza's fifth Ebola outbreak. He's the Ebola response lead for Save the Children in his native DRC. He says the attacks have crystallized a problem he wants to solve.
RUKENGEZA: We didn't get the right message to the population. Let us maybe start from the scratch, and we have to build trust.
EMANUEL: A lot of the disconnect, he says, can happen around burials.
RUKENGEZA: It's really, really important culturally, you know, to take the body and to honor this relative. This is the culture in all Africa, even here in DRC.
EMANUEL: The challenge is that the body of the deceased Ebola patient is still very contagious, spreading the virus through bodily fluids. The World Health Organization estimates that in the West Africa outbreak a decade ago, funeral practices contributed to 80% of cases in Sierra Leone and up to 60% of cases in Guinea. Rukengeza says with hundreds of tribes in the DRC, there are a lot of customs, but traditionally, funerals are multi-day affairs.
RUKENGEZA: Which sometimes could take one, two or three days, where people are living close to the dead body.
EMANUEL: During this time, he says, relatives wash the body and often sleep beside the corpse.
RUKENGEZA: This is really the power transfer, and also to get the spirit from the person.
EMANUEL: But, he says, these burial rituals must change. Local authorities in the DRC have limited the size of funerals, and Rukengeza says posters and social media campaigns to explain the virus are circulating widely. Plus, his organization is doing grassroots work.
RUKENGEZA: We are working with the community leaders - religious leader, the chief of the villages, the mayor and even the governor.
EMANUEL: The goal is to explain what makes a safe burial. Micaela Serafini of Doctors Without Borders says aid groups have also learned from past outbreaks. One major problem her team identified?
MICAELA SERAFINI: We were putting the body inside a black bag, and we were zipping it. There was no image, so the family couldn't even recognize the body.
EMANUEL: This was counterproductive. So, she says, they changed the design. The new bags...
SERAFINI: Have a transparent area in which the face of that loved one can be seen.
EMANUEL: And the moment a patient comes in, she says, the relatives are given a heads-up.
SERAFINI: There's a briefing to the family on what could happen during that stage, including how we're going to treat that body the moment that life is not there anymore.
EMANUEL: She says there isn't an easy or quick fix, but hiring local staff and embedding in the community over the long term is key. Rukengeza of Save the Children says he has seen some families change, and containing the outbreak, he says, depends on it.
Gabrielle Emanuel, NPR News.
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