Irish aid agency, Concern, responds to the Ebola crisis.From Samaritan's Purse

Freetown, Sierra Leone: Ibrahim don go, Ibrahim don go, Ibrahim don go…” The woman quietly intones the words, tears streaming down her cheeks. It’s a Saturday afternoon in the Bellier Park area of Freetown and the family and friends of Ibrahim Bangura gather outside his home as a medical burial team prepares to remove his body.

A 32-year-old taxi driver, and one of seven brothers and sisters, Ibrahim died in the early hours of the morning. “He worked all day yesterday and went to prayers at the mosque last night,” his brother William says quietly. “Then I got a call to say he was dead. I am sure he did not have Ebola.”

Everyone who dies in Freetown outside of a hospital must now have a medical burial – even if they did not display symptoms of Ebola. Tests are carried out on the bodies but it’s still unclear how many have succumbed to the virus. “There’s huge pressure on the system here and laboratories are stretched,” says Matthew Duffy, a Concern Worldwide emergency response manager.

He spends much of his time helping to strengthen information-gathering systems and providing support to the emergency response center set up to deal with the Ebola crisis. “The best estimates that we have are that about a third of the tests are positive.”

Information is crucial to tackling Ebola and much effort has gone into testing, contact tracing, and case management. A look at the situation board in the command center gives a clue as to some of the challenges facing the responders.

Read more: The Irish humanitarian response to the Ebola crisis in West Africa

“You can see here that this woman who came looking for treatment has now gone and we don’t know where,” says Saffie Morovia, communications manager at the center. And sure enough, the words “Ran away with child” paint a stark picture. “She may be sick, but is probably now back in the community somewhere,” adds Morovia.

Every call to the 117 hotline is logged here and each case tracked as closely as possible through the system of assessment, isolation, and treatment. Other notations on the board are chilling… “Laying on the street outside JFK School” and “Isolated on the street, weak.”

Because of the stigma attached to Ebola, there is little doubt that many families try to hide the symptoms of a loved one who has died. “She did not have Ebola” and “he was not sick” are assertions you will hear over and over again. And in many cases it’s true, but in these uncertain times there is no room for doubt.

“The best we can do is to ensure that people have at least some dignity in death,” says Concern’s Sheena McCann. She has been overseeing burial teams and the graveyard at Kingtom, where all controlled burials now take place.

“It can be unsettling and even frightening for families to see people in full protective gear coming to your house and taking your loved one away in a body bag. We make sure to talk to the families and explain what’s going on, and try to make it as dignified as possible.”

At Banana Water, a small community on the western shoreline of the city, Mohammad Barrie watches as a Concern burial team removes the body of seven-year-old Sulaiman from his home. “He was my only son,” he says, staring blankly out to sea. “Yesterday he was sitting right here in my lap and now he is dead.” Mr. Barrie says that Sulaiman had the symptoms of malaria, but no vomiting or diarrhea, and he was getting better.

Read more: Irish doctor in Nigeria insists there is hope for Ebola victims

The burial team lays the stretcher containing the small white body bag in the shade of a coconut tree, and the local Imam leads the neighborhood in a short prayer service. The team members, in the bright yellow suits and white face masks, join in. Then they take Sulaiman away for burial.

At Kingtom cemetery there is a huge amount of activity. Gravediggers are hard at work in the blazing sun, trying to keep up with the number of hearses and burial teams, which just keep coming. Across the fence on an adjacent site, a huge excavator is clearing the ground for new graves.

Nearly seventy burials will take place here today and it’s a huge challenge to maintain the dignity of the funeral process amid the constant activity. “We are trying to ensure that there is as little trauma for the families as is possible under the circumstances,” says Ms. McCann. “A limited number of people can come and watch from a safe distance and there is time for a short prayer service. We put a temporary marker on the plot, with the name and a reference number, and give each family a card with the details of the location.” She says that at a later date Concern will erect more permanent grave markers.

Back at Bellier Park, the body of Ibrahim Bangura is carried from his home and past his taxi parked outside. As the burial team leave the street, a chorus of anguished wailing fills the air. “Ibrahim don go, Ibrahim don go...” the woman continues to say over and over in the Krio language. Roughly translated, it means “Ibrahim has finished and gone.” 

To learn more about Concern Worldwide and the work they do in 25 countries around the world, click here