In a nation where fewer than two per cent of deaths are registered, an increase in burials may be one of the first signs that a killer disease is on the loose.

The programme was set up to monitor deaths related to HIV/AIDS a decade ago. Now doctor Bilal monitors for a spike in fatalities linked to Covid-19.

He has yet to see one, but projects like his are being set up in other African countries where many deaths go unrecorded, making it hard to assess the scale of a disease. In some cases, nations are dusting off programs set up during Ebola outbreaks.