Just before the pandemic was announced, one of my colleagues suggested having a service-oriented enterprise with no gain and no loss. The enterprise will own a crematorium and provide funeral services with all religious rites. Little did we know that Covid-19 pandemic will come and such enterprise will be relevant!
Manipur has been engulfed with a culture of perverted grieving when someone dies, especially when the death is in a hospital. Many incidents had happened where family members refused to claim the bodies of the deceased from the hospitals and left them for days in demand of something. We have witnessed dead bodies even being brought to the homes of doctors and kept there in dramatic shows protest and demand. Can this be a way to show respect and love for the departed, I wonder. Whatever it is, most people now have an idea how impasses have been resolved and who suffers the consequences.
Now, we are hearing similar problems of perverted grieving every time someone dies during this Covid-19 pandemic. Bereavement has become more troublesome because of the pandemic. At times, family members are not able to visit or see their love ones during the last moments. Then, there are problems in getting the dead body in time because of inefficient implementation of Covid-19 SoPs. Once brought home, some family members, relatives and other close friends are not able to join the funeral process. Ceremonies are performed with restricted attendance. We are hearing issues in handling such situation by the district administration – lack of coordination among government departments and expenses being imposed allegedly to the bereaved family. Kenneth Doka, a professor of gerontology, calls this disenfranchised grief, where a person experiences a sense of loss but does not have a socially recognized right, role, or capacity to grieve. During this pandemic, it happens because of ignorance, fear of the Covid-19, restriction and behaviors of the health care providers as well as district administration (unintentional!), inefficient execution of the culturally insensitive Covid-19 SoPs.
Consequences of this perverted grieving could include various mental health problems of the bereaved family, depression being the most important one. It may lead to exacerbation of the other co-morbidities if the bereaved members suffer from any physical illness. It may create misunderstanding and grudge among the local populace.
During these hard times, one must try to know as much as possible about Covid-19 to allay the fears. One must adhere to the Covid-19 appropriate behaviors. One must try to be a little more culturally sensitive. Efforts should be made to make the whole process as personal as possible. The body bag may be made with transparent plastic sheet at the head end so that family members can see their love ones and bid goodbye. Involvement of the family members should be encouraged as far as possible. Community engagement process should include this issue. District administration and health department can identify people and train them specifically to handle such situation as quickly and compassionately as possible. State authority may bear the cost of transport and funeral expenses whenever needed.
The writer is Professor of Community Medicine and Dean of Academics, Regional Institute of Medical Sciences