Categories
Burial Death + Disaster

Japan Begins Mass Burials

Hasty Burial for the Dead Collides With Tradition
Michael Wines, The New York Times (March 24, 2011)
Families of the tsunami’s victims faced a mass burial in a seaport town in northeast Japan, where mathematical reality has made cremation impossible.

99%. That is the number which kept going through my head when I saw the tidal wave sweeping through northeast Japan.

99% of all Japanese dead are cremated. Indeed, Japan is always at the top of international indexes on annual cremation rates.

But when I saw the remnants of those Japanese villages, I knew that there would be too many dead bodies for the local crematoria– in the event those crematoria were even functional.

It has taken a while for this kind of story to finally emerge from Japan, but the New York Times is now reporting on mass burials of the dead. The turn to mass burials is a radical break for contemporary Japanese funereal traditions, but when confronted with the sheer numbers of dead, little choice remained.

There is one section of the article which I take slight exception to. Towards the end of the entire article, which is well reported, the following point is made:

It was the bureaucracy’s best effort to imbue Wednesday’s interments with the dignity of genuine funerals rather than what they were: an unavoidable response to a potential public health problem. Later in the day, Buddhist monks would come to the site to pray over the graves.

The often cited fear of potential public health problems is not entirely accurate. Last year, in the aftermath of the Haiti earthquake, the Death Reference Desk discussed the widely held misconception that dead bodies pose a public health concern. It is true that people working around masses of dead bodies should wear normal protective gear (gloves, masks, etc.) but those bodies aren not going to rampantly spread disease.

Meg wrote a particularly insightful piece on this very topic: The (un)Diseased Dead.

All this said, I understand the push for burial. Dead bodies decompose and they smell and all of this can compound the broader tragedy.

It is also important to note that Japanese officials appear to be doing something which stands in stark contrast to the Haiti situation: the dead are being identified before burial. Thousands of dead bodies were buried in Haiti without any ID’ing of the corpses. Identifying each of the bodies is important for many of the families and it helps establish who is known to be dead vs. missing and presumed dead.

As usual, we will keep an eye on this particular facet of the Japanese disaster.

Out of respect for the dead.

Categories
Burial Death + Disaster

The Last Post on Haiti’s Dead

In Haiti, A Proper Burial is in Short Supply
Frances Robles, Nadege Charles and Elinor J. Breche, Miami Herald (January 25, 2010)

This will be the last post, for a while, on the dead bodies in Haiti. I decided to run this Miami Herald article because it does a good job of summing up the problems the Haitian people are facing. None of what has happened will be resolved anytime soon and this article highlights that fact.

Categories
Burial Death + Disaster

Envisioning the Death Toll in Haiti

Haiti’s Many Troubles Keep Bodies Uncounted
Simon Romero and Neil MacFarquhar, New York Times (January 21, 2010)

Haiti quake toll ‘may be 200,000’
BBC News (January 18, 2010)

I have a hunch that for years to come, the final death toll in Haiti will remain unknown. As the tagline for the above New York Times article states: The simple truth is that no accurate death toll exists. This isn’t some keen observation on my part, rather mass fatality situations are always difficult to tabulate. And the situation in Haiti is offering up its own unique problems, such as the sheer volume of corpses, and the rapid burial of those dead bodies without any record keeping system.

During this week alone, the numbers of dead have fluctuated by several tens of thousands at a time. The BBC News article at the top quotes a US General who says the death toll may reach 200,000. That was on Monday of this week. By Thursday, the New York Times had an article which pointed out logically (if not tragically) that tabulating the death toll will be extremely difficult.

Regardless of the final, agreed upon death toll, another problem with these fluctuating body counts involves the question of human perception. In a nutshell, how can people understand a number such as 100,000 or 200,000? What do that many dead bodies look like?

I’ve thought about this question over the years, since it seems that part of the problem with any really large death toll is that it becomes so big that it can’t be envisioned.

The one way that I have figured out how to describe these numbers is by using a concept which I call the Stadium Equation. In order to understand how many bodies 100,000 or 200,000 represents, imagine yourself standing in the middle of a packed stadium. Then imagine everyone sitting around you as a dead body x the total (or projected) number of dead bodies.

This Wikipedia page lists American athletic stadiums and each stadium’s seating capacity.

In the UK, Wembley stadium (above) seats 90,000.

Categories
Burial Death + Disaster

The (un)Diseased Dead

Infectious Disease Risks from Dead Bodies Following Natural Disasters (pdf)
Oliver Morgan, Pan American Journal of Public Health, 2004;15(5):307–12.

In the wake of the deaths from the Haiti Earthquate — 200,000 at the most recent estimate — officials are struggling to provide appropriate and respectful body disposal. In an earlier post John mentioned the common misconception that dead bodies carry disease. Bodies are especially horrific in such quantities and conditions, with the persistent and inescapable smell of death. The otherwise natural inclination to mourn and respect the dead is overpowered by the sense of urgency to obliterate the reminder and ongoing reality of this collective trauma.

Enter mass graves: a “solution” that offers out of sight, out of mind — but little by way of preventing disease, as it’s not actually a legitimate threat to public health. A 2004 literature review (linked above) from the Pan American Health Organization on the management of dead bodies in disaster situations available offers some insight:

Victims of natural disasters usually die from trauma and are unlikely to have acute or “epidemic-causing” infections. This indicates that the risk that dead bodies pose for the public is extremely small. However, persons who are involved in close contact with the dead — such as military personnel, rescue workers, volunteers, and others — may be exposed to chronic infectious hazards, including hepatitis B virus, hepatitis C virus, HIV, enteric pathogens, and Mycobacterium tuberculosis. Suitable precautions for these persons include training, use of body bags and disposable gloves, good hygiene practice, and vaccination for hepatitis B and tuberculosis. Disposal of bodies should respect local custom and practice where possible. …

Concern that dead bodies are infectious can be considered a “natural” reaction by persons wanting to protect themselves from disease. However, clear information about the risks is needed so that responsible local authorities ensure that the bodies of disaster victims are handled appropriately and with due respect.

An editorial in the same journal issue (“Epidemics Caused by Dead Bodies: a Disaster Myth That Does Not Want to Die”) argues that expedient mass burial does have an effect on public health — not by preventing disease, but by exacerbating grief and endangering mental health:

Denying the right to identify the deceased or suppressing the means to track the body for proper grieving adds to the mental health risks facing the affected population.

It’s hard to say what has a worse impact over time: being surrounded by unburied, dead strangers for an extended period, or never being able to find the body of a deceased loved one. I’m willing to bet the latter.

Categories
Burial Cemeteries Death + Disaster

Haiti’s Anonymous Dead

As Haitians Flee, the Dead Go Uncounted
Damien Cave, New York Times (January 18, 2010)

Last home of country’s most famous families turns from place of respect and mourning into installation of horror
Ed Pilkington, The Guardian (January 18, 2010)

Following up on yesterday’s Haiti earthquake post, these New York Times and Guardian articles expand upon the rushed burial of the dead.

Categories
Burial Cemeteries Death + Disaster

The Impossibility of Identifying the Dead in Haiti

How can a country in the grip of an apocalyptic tragedy deal in a dignified way with its victims?
Paul Harris, The Guardian (January 17, 2010)

The current stories emanating from Haiti are incomprehensibly awful. This Guardian article uses the word apocalyptic and that seems utterly appropriate.

A crisis situation of this enormity is compounded by the sheer number of immediate human needs. One of those key requirements is the rapid identification, removal, and burial of dead bodies. The problem in Haiti is that an already weak infrastructure is unable to handle the number of dead bodies produced by the earthquake. In this crisis situation, the normalized rules for handling the dead cannot cope with all the corpses.

And yet, something must be done with the dead bodies.

Part of the assistance being sent by the United States involves dispatching Disaster Mortuary Organizational Response Teams or DMORT groups to Haiti. DMORT is part of the US Department of Health and Human Services and specializes in handling mass fatality situations. These are the kinds of individuals on DMORT Teams (as listed on the HHS website):

funeral directors, medical examiners, coroners, pathologists, forensic anthropologists, medical records technicians and transcribers, finger print specialists, forensic odontologists, dental assistants, x-ray technicians, mental health specialists, computer professionals, administrative support staff, and security and investigative personnel.

Here is an article about a University of Florida Forensic Entomologist, Dr. Jason Byrd, who is already in Haiti with a DMORT group.

Private companies are also sending groups to Haiti. The main provider of mass disaster/fatality services in the private sector is Kenyon International Emergency Services. Kenyon is based in Houston, TX and owned by Service Corporation International (SCI). SCI is the largest global provider of funeral, cemetery, and cremation services and got into the mass fatality business in the mid-2000’s. I will write more about SCI and Kenyon at a later date.

For right now, both DMORT and Kenyon will be attempting to do the following things:

1.) Identify any of the dead that they can
2.) bury the dead in an organized fashion
3.) use a tagging system of some kind so that the dead can be (possibly) identified at a later date.

These tasks are made vastly more complicated by the rush to bury bodies in mass graves. There is a common misconception that dead bodies spread disease. That’s not entirely true and this CNN article covers these points. What dead bodies do create is a terrible smell. Decomposing dead bodies are also difficult to look at. When you multiply these problems by 100,000 dead bodies (this is just the body count estimate at this point) then immediate disposal of the corpses becomes easier to understand.

The following video clip from CNN sums up the situation: