TABLE.
Burial team supervisors’ assessments on burial team composition, practices, challenges, and needs, by district — Sierra Leone, October 1–10, 2014
| District | No. of trained burial teams | No. of persons per team | No. of functional burial teams | How being alerted to a request for a body collection | Average body collection per day | Bodies collected within 24 hours | Cemetery or community burials | Swabs performed by laboratory technician | Challenges and needs |
|---|---|---|---|---|---|---|---|---|---|
| Kambia | 1 | 8 (includes grave digger) | 1 | Receiving calls from community and holding center | 1–2 | Yes | Both | No swabs | Would like 1–2 more teams and a coordinator |
| Port Loko | 7 (5 are emergency responder teams, district is split into 2 zones; 3 chiefdoms per team) | 7 (only 2 supervisors) | 7 | Through hotline | 15 | Mostly, except when vehicle challenges occur | Cemetery for bodies collected from health facilities and community burials; district-level grave digger stays at cemetery | Just started October 1 | Just received WHO vehicles but might not be sufficient for rough roads; also only 3 of the teams are being paid regularly |
| Bombali | 2 (3rd team being trained) | 11 | 2 | Getting called directly by community and by surveillance team | 10–15 | 80% | Cemetery 2–3 miles from Makeni and community | Swab team just started on October 2 | Getting support from WHO but still need strong vehicles |
| Koinadugu | 1 (2nd team being trained) | Team 1 = 8 (includes grave digger) | 1 | Called by surveillance team | 2 bodies total | Community | Yes; both bodies were swabbed and negative | Getting 2 more vehicles next week, waiting for 2nd team to start after training | |
| Tonkolili | 1 | 8 | 11 (disagreement on recognition of burial teams) | Most bodies are from holding center, not community | 3 (12 bodies buried in total) | Not all | Cemetery | Not coordinated | Additional teams are working and being paid, but only one has been trained by MOH and it is the only one the supervisor recognizes; need vehicles and more compensation for cemetery land owners |
| Kono | Cannot be reached | ||||||||
| Kenema | 4 | 6 (no supervisor) | 3 | By holding center or surveillance team | 6–7 from holding center, 4 from community; has decreased since treatment center moved | 1–3 days; road access challenges cause delays | All bodies from treatment center buried in Red Cross Cemetery; other cemetery full | Yes; either laboratory technician goes with or they bring body to mortuary, but do not wait for results | Need more vehicles and sometimes the surveillance team uses their sprayers for their surveillance team visits |
| Kailahun | 2 IFRC 4 MOH | 8 | 2 | By DMO and MSF | ≥200 bodies buried to date | Cemetery | Technician just started following IFRC burial teams | Improve communication and coordination between DMO and IFRC | |
| Bo | 4 | 8 | 4 | Surveillance team | 4 | 1–3 days | Cemetery | Yes | Doing OK since WHO sent vehicles; gaining community confidence with swabs |
| Training 5th team this week | Includes grave digger | Getting 4–7 calls per day | Since swabs introduced 2 weeks ago (September 22) | ||||||
| Pujehun | 2, as per the DMO | 8; includes a grave digger | 8 confirmed deaths (unknown); often do not have a body to collect in a given week | Would like more vehicles that can handle rough terrain, fuel, and refresher training | |||||
| Bonthe | 2 | 8 | 1; only have 1 vehicle to get burial team to site, but then they do not transport body anywhere; it is carried to the community site | Do not have a hotline, community leaders call DHMT | 1–2 per week; only 2 bodies collected total | Delays because of road conditions | Community | Sometimes laboratory technician shows up to body | Need vehicles appropriate for body transport and need new spraying equipment, theirs keeps breaking |
| Moyamba | 14 | 8 | 2 | Getting called directly by community and by hotline | 3–4 per day | 1–2 days because distance to get to bodies is far | Both | Only bodies in Moyamba town are swabbed | Would like support for at least 3 more teams, would like vehicles that can handle difficult terrain, fuel; also rainy season is now so would like rain gear |
| 1 trained per chiefdom | Includes grave digger | MOH only paying 2 of the teams | From community and holding center | Additional burial team members being trained to collect swabs, October 9 | |||||
| Western Area | 11 | 12 | 10 | Hotline and called directly | 30–40; approximately 20 buried in King Tom Cemetery daily | No | Cemetery | Some still waiting for results before burying body | Need more burial teams, vehicles, and improved communication and coordination |
Abbreviations: WHO = World Health Organization; MOH = Ministry of Health and Sanitation, Sierra Leone; DMO = District Medical Officer; MSF = Médecins Sans Frontières; IFRC = International Federation of Red Cross and Red Crescent Societies; DHMT = District Health Management Team.