There was a similar situation with the first COVID-19 fatality a day previously in Kavre district. The 29-year-old young mother was taken in an ambulance to Dhulikhel Hospital but was dead on arrival. Some reports said health workers and ambulance drivers were reluctant to take the body for electric cremation, and the authorities had to rely on a security escort and volunteers.
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At the Infectious Disease Hospital in Teku, director Sagar Kumar Rajbhandari says handling a COVID-19 fatality can be done safely as long as precautions are followed.
“It is similar to handling a COVID-19 patient who is alive. Of course, one needs to be careful and be fully prepared with the PPE and other preventive measures,” he says.
So far 99 cases have been confirmed in Banke, 68 in a cluster in Narainapur alone. Prem Budha at the health post says the provincial government needs to send help following the steep rise in the COVID-19 patients in the municipality.
With two fatalities now linked to the COVID-19 in Nepal, the National Risk Reduction and Disaster Management Authority with the Ministry of Health have published the ‘Dead Body Management of COVID-19 Cases.’ (See box)
This is necessary because the virus can still survive on clothes of a deceased for a few hours, and this means families may not be able to say their last farewells in the traditional way.
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Says Rajbhandari at Teku Hospital: “The best way to handle a dead body with COVID-19 is to cremate it in order to avoid any kind of transmission. There are many cultural practices regarding the burial of the deceased, but if there is going to be a mass burial without proper preparation, there is also going to be high risk of transmission.”
The government has decided that all those who succumb to COVID-19 near Kathmandu will be cremated at the country’s only electric crematorium in Pashupati. This takes only 45 minutes for a body to be consumed, compared to four hours with firewood. The crematorium is also waiving the Rs4,000 fee for funerals for COVID-19 patients, and only two family members will be allowed to perform the last rites with proper precautions.
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The CEO of the Disaster Management Authority and the technical adviser of the Coronavirus Control and Management Committee Anil Pokhrel says the guidelines for managing bodies take into account religious sensibilities. “As long as the precautions are followed, I do not see why funeral services should be denied,” he says.
Precautions cited in the government’s COVID-19 guidelines have uncanny similarities to cultural practices and funeral rituals in Nepal’s religions, showing that traditional safe practices predate the pandemic.
Says cultural historian Ramesh Dhungel: “We have been practising traditional social distancing for centuries, and the reason we do it for 13 days is precisely to prevent transmission of infectious diseases to others following a funeral.”
Hindu death rituals require family members involved in funeral rites to maintain physical distance, wear new clothes, and eat food untouched by others for 13 days — which is equivalent to quarantine duration and practices.
Back in Banke, the focal person for coronavirus management Naresh Shrestha welcomes the guidelines because he says there are problems ensuring dignified funerals due to fear and stigma.
He adds: “The only electric crematorium is in Kathmandu, so we are preparing for the worst case scenario by adding capacity to funeral centres here.”
With Prem Bishowkarma in Banke.