‘I just want to make dead bodies look good- COVID-19 and Koku the undertaker

It is midday on Thursday and Koku has packed his sewing machine. He must dash to the mortuary to start his weekend job.

Embalming, which is part of the works of undertakers, is the preservation of human remains against decomposition.

Experts say dead bodies spread diseases as they decompose so undertakers disinfect and prepare them to last longer.

The undertaker, primarily, is to make the corpse, shadowy alive, look aesthetically good and sometimes trendy for viewing.

In this part of the world, where funerals are perhaps gloated, corpses dressed and positioned in various ways to depict the profession of the dead, the market for the mortician is significantly huge.

Embalmers in developed countries hold certificates in Mortuary Science Degree Programmes, with many going into apprenticeship for years before obtaining licenses.

But Koku says what is needed is courage and not a degree – “I just want to make dead bodies look good and I feel better than a scientist.”

The teenager says though he is not a beautician, his knowledge of clothing and skills in tailoring make him the choice for many clients.

“Tailoring is good but with this one, the money is quick and big. I get Gh¢800.00 or GH¢1000.00 every weekend or sometimes, GH¢3000.00 when I dress chiefs and big people – that’s why I pack my machine on Thursdays,” he explains.

Freedom, also known as, “Don’t push me”, is seen relaxing on a hearse in front of a mortuary. “This is an emotional job,” he says, and stresses that the, “the only qualification is brazen courage!”

He says he started working as an undertaker at age eleven (11) when he was in class four, after his auntie introduced him to the job of ‘showing love to the dead’.

He is now 23, and says, it is a calling and brags about having trained seven young men, two of them, both teens, were working with him.

Checks by the Ghana News Agency (GNA) reveal that a good number of people in the undertaking job are teens, mainly boys, with some hooked on narcotic substances.

Watching them work with enthusiasm for many is intriguing, especially if the person is working on more than one body in a day. It can also be spooky.


COVID-19


Unfortunately, it appears it is business as usual for undertakers who go about their jobs without any protective equipment in the wake of COVID-19.

At one mortuary, the GNA observed that while ‘Aziz’ – not his real name – was bathing a dead body, the wastewater was splashing on him.

He probably did not notice it, had taken it as a norm or maybe was too drunk to be bothered.

He told the GNA that the chemicals –soda water, disinfectants, lemon and perfume that he had mixed to bath the body were “strong”, so he was safe.

At another mortuary, the undertaker had no protective gear apart from a nose-mask and was seen suturing a wound on the dead body, after wearing a torn surgical glove.

Checks show that occasionally, they run out of surgical gloves and thus use their bare hands to prepare the bodies, with just a sprinkle of talcum powder in their palms.

Aziz agrees that sometimes they touch the eyes, mouths and noses while preparing the bodies, but quickly adds, “God is protecting us.”

The situation is calamitous in the countryside, where more young people have appointed themselves ‘professional undertakers’ through inheritance or only weeks of apprenticeship, with hardly any knowledge on handling COVID-19 dead bodies.

The situation is even dire in communities and villages where the causes of deaths may not be known and with the possibility of many COVID-19 dead bodies being buried unreported.

Here, most undertakers are exposed to perfumes and aerosols and also have physical contacts with corpses when dressing them. Many simply wash reusable materials used in preparing these corpses with their bare hands.

Experts say corpses of COVID-19 patients are more infectious than those living with it because the virus leaves the corpse in search of a new host to infect.

Research has shown that the virus, when not treated well in the body, can affect the liver, kidney, brain tissues and reproductive organs.

It also easily changes into different and more resistant strains, which undertakers could be prone to if care is not taken.

Professor Yao Tettey, a Pathologist at the Korle-Bu Teaching Hospital, says undertakers are exposed not to only COVID-19 but Tuberculosis and other infectious diseases, especially when the cause of death is not known.

He explains that during the “body reconstruction” undertakers could be infected if embalming fluids or creams do not have the right proportion of chemicals-“for instance if they inhale concentrated formalin, they can have upper respiratory problems…It is carcinogenic.”

Dr. Simon Naporo, a Senior Specialist Pathologist and Head of Pathology Department, Greater Accra Regional Hospital, says undertakers are at higher risk because they are not working in formal establishments.

Unfortunately, the training on the handling of COVID-19 bodies is being limited to mortuary workers.

This perhaps is because undertakers are not well organised and their activities not coordinated by state regulatory institutions, though they are rendering vital health services.

It is, therefore, time the Mortuaries and Funeral Facilities Law, which regulates the operation of cemeteries is implemented to standardise the system.

Mr Mathew Kyeremeh, acting Chief Executive of the Mortuary and Funeral Facilities Agency (MoFFA) describes the situation as worrying and hints at plans to start collecting data on undertakers in the country for professional training.

He says the Agency licenses, controls and regulates facilities and practitioners connected with the storage, transportation and disposal of all human remains, including body parts in the clinical process.

Mr Kyeremeh asks practitioners to, therefore, contact the Agency through www.moffa.gov.gh, email-info@moffa.gov.gh and on 0302956550/0302960940.

If well regulated, the sector can bring in some revenue to local assemblies, especially now that the ban on funerals and burials have been relaxed, and would ultimately help stop the spread of COVID-19.

Already, the Environmental Health Office in the Ho-West District has taken the lead in training undertakers in that District in the wake of COVID-19, but a lot more needs to be done in regulating their work.

The practitioners need to be oriented on safe practices when handling COVID-19 corpses and must be dressed appropriately.

For instance, experts say they must be in coverall dresses-impermeable attires that cover most parts of the body, leaving the face, hands and feet.

It is also recommended that they have three sets of hand gloves- the normal latex hand glove, gynaecological hand gloves and utility hand gloves.

They are also to wear wellington boots, nose masks, goggles, or face shields and ‘hair net’ and also have chlorine solution for disinfecting dead bodies before and after handling.

Finally, undertakers like Koku, must be screened periodically for early detection and treatment of COVID-19 cases, especially as the country is recording many community cases.