All the funerals I have attended in Germany have had something in common: they were private, low-key, and formal. A few years ago, Sarah took me to a funeral in Kisumu. The funeral I witnessed was the opposite. Recently, many people shared the video of a funeral in Siaya on social media. The deceased died of Covid-19. The funeral, however, portrayed a different reality to that which Luo people know and uphold.
The body was unloaded by ghoulish-looking morgue workers from a pick-up truck in a body bag at 2 am. He was then buried into a shallow grave. In the absence of his immediate family. His burial sparked wide outrage among members of his community. Kenyans on social media decried the lack of dignity and respect for culture. Some of them also talked about being emotionally distressed by it. Family members went to court to request an exhumation and a new, more decent burial.
The morgue attendants, public health officers, and police who enforced the burial generally acted well within public health orders to contain the spread of Covid-19. However, they worked in the absence of a clear government directive for body disposal.
Many Kenyans familiar with the case felt that how the burial was carried out was mostly unnecessary, devoid of empathy, and left much to be desired. One can only imagine how heavy the grief of hisdeath weighs on his family members. His death and burial exposed a rarely considered part of outbreak management: body disposal. The need for culturally sensitive and safe practices for body disposal is likely to be a big issue in the coming months, as the number of Covid-19 deaths in Kenya and on the continent will rise. Funerals and burials for loved ones are highly guarded and emotive ceremonies, as can be seen from the reactions of the family and the community in this incident. The emotions might even outweigh adherence to rational public health control directives.
The 2018 DR Congo Ebola Virus Disease epidemic gives a snapshot of what happens if governments and international organisations disrespect cultural values around funerals. Initially, most of the dead bodies were disposed of in a similar way to the Siaya case.
Locals viewed the handling of corpses as alien. They were irate, making funerals flashpoints of violence and resistance, endangering the lives of facilitating health and security personnel. Out of fear that their loved ones might be subjected to a similar unworthy funeral that denies local values and customs, affected families hid their dead relatives. Due to social resistance to safe medical burials, traditional burial rites continued. This practice exposed more people to the virus.
What we learned from the Ebola crisis is that most community members value some form of involvement in the creation and implementation of public control measures related to funerals. They feel respected and adhere to the guidelines more easily.
Eventually, the World Health Organisation, the DR Congo Ministry of Health, community members, as well as implementation partners revised the burial measures. The revised directives better reflected the community perspectives marrying public health measures with local customs, thereby increasing community acceptance of safe medical burials and reducing the spread of Ebola.
Kenya’s Ministry of Health has released a Covid-19 victim burial directive. The directive informs Kenyans that funerals will be different this time. It allows for consultation and involvement of family members, a community member, and a religious leader at the graveside -- though only at safe distances. The directive also allows for burial in a coffin, with family consent, in the most empathetic way possible.
The directive, though important, may not be enough to reduce the number of Covid-19 infections of people who contracted the virus during a traditional burial procedure. Before the directive can create a positive change, open questions will need to be resolved. Do local communities feel ownership? Does the directive reflect specific needs on the ground? How will community members and enforcers be informed about the guidelines? Are bereaved family members willing to adhere to the directive during a time of mental distress?
The national government drafted the burial directive in an armchair fashion, leaving out the perspective of community members.
Local health professionals, mortuary attendants, and security personnel should be trained to act in empathic ways to deal with non-compliance. Additionally, their capacity should be built in the form of counselling and information service for the bereaved and their communities.
Anyone can be affected by the virus. However, what can be planned is how burials can respect both public health measures and traditional values. This coupling would create public goodwill in following the government burial directive.
Sarah O. Atieno and Rick Wolthusen via email