Safe and Dignified Burials in the Bundibugyo Outbreak: WASH Supply Requirements for Field Teams in DRC and Uganda

Burial teams in Ituri Province are operating in one of the most hazardous procurement gaps of the 2026 Ebola response — full PPE, chlorine solutions at two concentrations, body bags, and decontamination water are all needed at the point of burial, which is often a village with no piped water, no nearby stockist, and deteriorating road access as the rainy season advances.

On 16 May 2026, WHO declared the Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo and Uganda a Public Health Emergency of International Concern (PHEIC). As of the outbreak declaration, 246 suspected cases and 80 deaths had been reported from three health zones in Ituri Province: Rwampara, Mongbwalu, and Bunia. WHO's Disease Outbreak News noted explicitly that "a large number of community deaths has been reported potentially associated with unsafe burial practices," pointing directly to one of the principal transmission drivers in this outbreak.

Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutic against Bundibugyo virus. With case fatality rates ranging from 30% to 50% in the two previous BVD outbreaks (2007 and 2012), the volume of deaths requiring safe management is significant. Response depends entirely on public health measures — and safe and dignified burial (SDB) is among the most critical. Burial without correct WASH protocols is transmission. Procurement failure at this step costs lives.

This post is written for WASH officers and logistics coordinators who are assembling SDB supply packages for teams deploying to eastern DRC, northern Uganda, or border districts of South Sudan under cross-border preparedness obligations.

Quick answers for field teams:

• WHO specifies 0.5% chlorine solution (5,000 mg/L) for spraying bodies, surfaces, and equipment during Bundibugyo virus SDB operations

• 0.05% chlorine solution (500 mg/L) is required for PPE doffing stations and handwashing by burial team members

• HTH calcium hypochlorite (65–70% available chlorine) is the field-standard source for preparing both concentrations on site from powder

• A minimum 30-minute contact time is required for chlorine solutions to inactivate Ebola-family viruses on contaminated surfaces

• Each burial operation requires on-site water storage for decontamination — collapsible bladder tanks are the standard deployment format where no piped supply exists

• SDB kit components include: heavy-duty gloves, impermeable gown, impermeable apron, boots, face shield, mask, double body bags, chlorine, sprayers, and shovels

Why Unsafe Burials Are a Transmission Driver in This Outbreak

BVD spreads through direct contact with blood, secretions, and other bodily fluids of infected individuals, and through contact with contaminated surfaces. The WHO Disease Outbreak News for this outbreak states that transmission is "particularly amplified in health-care settings when infection prevention and control measures are inadequate, and during unsafe burial practices involving direct contact with the deceased."

Research from the 2014–2016 West Africa Ebola epidemic estimated that at least 20% of new infections were linked to funerals and burials. In contexts like Ituri Province — where traditional funeral rites involve washing and touching the body, where health literacy is limited, and where burial team coverage is thin relative to the geographic spread of cases — the proportion attributable to community deaths can be even higher.

The four-week detection gap in this outbreak (symptom onset of the presumed index case on 24 April; laboratory confirmation on 14 May) means that community transmission was occurring before any SDB protocols were in place. Multiple contacts became symptomatic and died before isolation. In Mongbwalu and Rwampara health zones, community deaths remain under investigation. Each of those deaths is a burial event. Each burial event without correct chlorine use and PPE is a transmission event waiting to happen.

WHO's advice to DRC and Uganda is unambiguous: "Ensure funerals and burials are conducted by well-trained personnel, with provision made for the presence of the family and cultural practices, and in accordance with national health regulations, to reduce the risk of Bundibugyo virus infection."

The Chlorine Supply Requirement: Two Concentrations, One Source

Field teams preparing SDB kits need to stock and prepare chlorine solutions at two distinct concentrations. The distinction is critical and must be communicated clearly to burial team supervisors.

A 0.5% chlorine solution (equivalent to 5,000 mg/L or 5,000 ppm) is used to spray and decontaminate the body, the body bag exterior after sealing, bedding and surfaces in the room where a patient died, and vehicles used for body transfer. This concentration is sufficient to inactivate Bundibugyo virus on surfaces that are relatively free of organic matter.

A 0.05% chlorine solution (500 mg/L) is used at handwashing and PPE doffing stations. WHO guidance specifies this lower concentration for skin contact, because 0.5% is corrosive to skin with repeated exposure. Doffing stations must be set up at the burial site before operations begin — not after.

Both solutions are prepared on site from calcium hypochlorite powder. HTH calcium hypochlorite, at 65–70% available chlorine, is the operationally preferred source because it is stable at high pH, has a longer shelf life than liquid sodium hypochlorite, and is logistically easier to store and transport in powder form — particularly relevant in a context where supply lines to Ituri Province are constrained by conflict and limited road access.

A study published in PLOS ONE on chlorine shelf-life in Ebola response settings found that freshly prepared solutions degrade over time, particularly in sunlight and heat. For field teams operating in tropical conditions, this means chlorine solutions should be prepared fresh daily, and residual chlorine concentration should be verified at point of use with a chlorine test kit. Pre-made solutions transported over long distances in transparent containers are unreliable.

Field teams ordering chlorine stock should calculate consumption for the full projected response period and order buffer stock of at least 50% above projected need, accounting for solution degradation, spills, and the unpredictability of outbreak trajectory. Specialized Logistics Solutions (SLS) holds pre-positioned stock of HTH calcium hypochlorite drums in Juba and Kampala. Procurement teams working in eastern DRC or northern Uganda can contact the team at sales@maji-safi.org for rapid dispatch options. For full details on available WASH products, including chlorine and water treatment supplies, see the SLS product catalogue.

Water Storage at Burial Sites: The Bladder Tank Requirement

An SDB operation requires water on site — for preparing chlorine solutions, operating doffing stations, and decontaminating equipment after burial. In Mongbwalu, Rwampara, and rural areas of Ituri Province, piped water supply is absent or unreliable. Trucked water is often the only option, and it must be stored close to the operating area.

Collapsible bladder tanks are the standard field solution for this requirement. They transport flat, deploy in under an hour without tools or permanent infrastructure, and are available in sizes from 1,000 to 20,000 litres. For an SDB team operating at a single burial site, a 1,000 to 2,000 litre unit positioned at the doffing station perimeter provides adequate operational water for a single-day operation with sufficient buffer for chlorine solution preparation.

Where teams are establishing a temporary staging point for multiple operations over several days — as would be the case for a rapid response team working across multiple villages in Rwampara health zone — a larger primary tank of 5,000 to 10,000 litres alongside smaller satellite units at each doffing point is the standard configuration. The IFRC implementation guide for safe and dignified burials specifies that hand-washing facilities with sufficient water must be available at the burial site before the team begins work.

Butyl Products (UK) water bladders, distributed by Specialized Logistics Solutions (SLS) in the East and Central Africa region, are available in a range of sizes and rated for potable water storage in field conditions. For teams requiring rapid procurement in Kampala or Juba, these can be integrated into an SDB supply package and dispatched alongside chlorine stock. See the full range of WASH products available through SLS.

PPE and Kit Composition: What WHO and IFRC Specify

The WHO and IFRC safe and dignified burial protocols are explicit about the minimum PPE standard for burial team members. Each team member must don full PPE before approaching the body: heavy-duty rubber gloves (double-gloved where possible), an impermeable gown, an impermeable apron, closed shoes or rubber boots, a face shield, a mask, and ideally a head cover. No element is optional. The impermeable apron over the gown is specified because gowns alone are not fluid-resistant against splashing during body handling.

The doffing sequence is equally specified and must be practiced before deployment. WHO guidance on PPE for filovirus outbreaks states that removing PPE incorrectly — particularly gloves — is one of the most common exposure routes for health workers. Burial team supervisors must verify that each team member can complete the doffing sequence correctly before any operation.

The body bag requirement is double-bagging: the body is placed in a sealed inner bag, which is then wiped down with 0.5% chlorine solution and placed inside a second outer bag. Both bags must be puncture- and leak-resistant. The exterior of the outer bag is sprayed again with 0.5% chlorine before any contact for transport or burial. The burial grave depth is a minimum of two metres.

Disposal of single-use PPE at the burial site follows the same protocol as ETU waste: all used single-use materials are placed in designated waste bags and burned or buried in a designated pit on site. No used PPE is transported off-site in open containers.

For NGO teams and rapid response units sourcing complete SDB kits or individual components in the East Africa region, SLS can advise on current stock availability and lead times through Kampala. The contact page is the fastest route for procurement queries during an active outbreak response.

South Sudan Border Preparedness: What Cross-Border Obligations Require

Ituri Province borders South Sudan directly. WHO's advice to countries with land borders adjoining DRC is clear: unaffected states must urgently enhance preparedness, including active surveillance across health facilities with active zero reporting, enhancement of community surveillance for clusters of unexplained deaths, and confirmed access to a qualified diagnostic laboratory for BVD.

South Sudan's cross-border preparedness obligation extends to SDB readiness. Any confirmed or suspected BVD case arriving across the DRC-South Sudan border who dies in a health facility or community requires immediate application of SDB protocols. Prepositioning SDB kits in border health zones — including Yei, Nimule, and the Equatoria border corridor — is not aspirational planning: it is the minimum standard.

WASH officers working under OCHA South Sudan's humanitarian framework and the WASH Cluster should already be factoring SDB chlorine stock into their current procurement cycle. The rainy season access window for road delivery to remote border areas is narrowing. Air freight to Juba remains available year-round, and Specialized Logistics Solutions (SLS) holds stock in Juba available for same-week dispatch. For programmatic planning, the pumps and equipment and WASH products pages cover SLS's full range of field-deployable logistics assets across the region.

What This Means for Your Programme

The Bundibugyo outbreak in Ituri Province is an active PHEIC with no licensed vaccine and no approved therapeutic. Transmission is occurring through unsafe burials. The WASH supply requirement for safe and dignified burial operations — chlorine at two concentrations, portable water storage, and full PPE — is technically straightforward but logistically demanding in a conflict-affected, low-infrastructure context with constrained supply chains.

Procurement teams working in DRC, Uganda, and South Sudan should not treat SDB supply as a secondary consideration behind ETU construction and IPC kits for clinical settings. In a community-transmission context, every household death is a burial event. Every burial event is a WASH event. The gap between a correctly stocked SDB team and a family attempting burial without protocols is, in the context of BVD with a 30–50% case fatality rate, the gap between containment and amplification.

Specialized Logistics Solutions (SLS) holds pre-positioned stock of HTH calcium hypochlorite drums, Aquatabs 67mg, and Butyl Products water bladders in Juba and Kampala, available for rapid dispatch. Contact the team at sales@maji-safi.org.

Frequently Asked Questions

What chlorine concentration do I use to spray an Ebola-family body during a safe burial?

Use 0.5% chlorine solution (5,000 mg/L). This is prepared from calcium hypochlorite powder (HTH, 65–70% available chlorine) mixed to concentration on site. Spray the body before bagging, the exterior of each sealed body bag after closing, and all surfaces and equipment that came into contact with the body. Allow a minimum 30-minute contact time on surfaces before handling.

Can I use Aquatabs to prepare the chlorine solutions needed for Bundibugyo virus SDB operations?

Aquatabs 67mg are designed for drinking water treatment and produce low-concentration chlorine solutions. They are not the appropriate product for preparing 0.5% decontamination solutions. HTH calcium hypochlorite powder is the correct source for SDB decontamination solutions. Aquatabs have a role in the water supply chain for the SDB team — ensuring the water used to prepare chlorine solutions and at handwashing stations is safe — but they do not replace HTH for surface decontamination.

How much water does a single SDB operation require?

There is no single WHO figure for a complete burial operation, but a practical field estimate for a team of four members operating at a single grave site with a doffing station is 200–400 litres. This covers: chlorine solution preparation (0.5% for decontamination, 0.05% for handwashing), PPE doffing for four team members, cleaning of sprayers and equipment, and a safety buffer. For multi-day operations or multiple sites per day, size water storage accordingly. A 1,000-litre bladder tank is the minimum practical unit for a two-day staging point.

What happens to used PPE and waste from a burial operation?

All single-use PPE — gloves, gowns, aprons, masks, face shields — is placed in clearly labeled, sealed waste bags and burned or buried in a dedicated waste pit at the burial site. Nothing is transported off-site in open containers. Reusable items such as rubber boots are decontaminated with 0.5% chlorine solution before removal from the operational area. Shovels and sprayers are washed with 0.5% chlorine solution and left to air dry.

Does Bundibugyo virus transmit through water?

No. WHO guidance states there is no evidence for transmission of Ebola-family viruses via drinking water contaminated by faeces or urine, and that the virus is unlikely to survive for extended periods outside the body. The water supply risk in SDB operations is not waterborne transmission — it is ensuring adequate clean water is available for the chlorine solutions and handwashing that interrupt contact transmission. Safe water supply is an enabling condition for correct SDB practice, not a direct transmission route.