BURIAL, MOURNING, AND THE SOCIAL ORGANIZATION OF CARE IN THE 2026 BUNDIBUGYO VIRUS DISEASE OUTBREAK IN THE DEMOCRATIC REPUBLIC OF THE CONGO A desk-based qualitative synthesis

Background Burial is among the most epidemiologically consequential and socially sensitive components of Ebola response. During the 2026 outbreak of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo, public-health agencies documented confrontations with burial teams, rumours about empty or opened coffins, questions about why families could not see or touch the dead, and delays in safe and dignified burial operations. These events were often described as community resistance. This paper instead examines burial as a moral, relational and practical process through which families care for the dead, organise grief, negotiate authority and restore social order. Methods We conducted a desk-based qualitative synthesis of outbreak-specific materials available up to 5 August 2026, including World Health Organization and Africa Centres for Disease Control and Prevention reports, infodemic monitoring, key-message guidance, Red Cross reporting, social-science syntheses and a 2026 contextual note on funeral practices in Ituri. These were triangulated with peer-reviewed studies of safe and dignified burial, burial workers, gendered caregiving and community feedback from earlier Ebola outbreaks. Sources were coded for the social stages of burial, family authority, ritual obligations, gendered labour, conflict points, operational delays, adaptations and behavioural consequences. Findings Burial was not a single technical act but a sequence extending from end-of-life care and body preparation to viewing, transport, prayer, interment and continued mourning. The legitimacy of safe burial depended on whether families could identify the body, understand each procedure, retain recognised roles and participate in decisions about clothing, burial place, religious observance and commemoration. Conflict concentrated around rapid removal without explanation, limited visual access, uncertainty about testing and decontamination, delays in burial-team arrival, the presence of unfamiliar responders and procedures perceived as disrespectful. Women and relatives of the same sex as the deceased appeared especially exposed through caregiving and body preparation, although the available outbreak data could not quantify gender-specific risk. Locally recruited teams, family liaison, safe visual confirmation, ritual substitution, timely response and grief-sensitive communication were the most consistently supported adaptations. Interpretation Dignity and infection control are not competing objectives. A burial becomes epidemiologically effective when it is socially recognisable as a burial and when families have defensible reasons to trust what is happening to the body. Safe and dignified burial should therefore be managed as a negotiated care pathway, with timeliness, family participation, body-identification assurance, gender-sensitive risk assessment and family satisfaction treated as operational performance indicators.