As the second wave of Covid-19 reaps its deadly harvest in many parts of South Africa, health facilities, funeral parlours, cemeteries and crematoriums are battling to cope.
KwaZulu-Natal premier Sihle Zikalala said on Sunday 17 January that his province was “witnessing death on a catastrophic scale that has never been seen in living memory. Covid-19 is leaving a trail of lives that have been shattered beyond anyone’s comprehension.”
At the time, 6 318 people had died from Covid-19 in the province and 276 794 had been infected, representing 21% of cases in South Africa. Zikalala said more than 8 723 health workers, including nurses and doctors, had tested positive and about 98 had died.
KwaZulu-Natal recorded more than 6 000 positive test results and 116 deaths from Covid-19-related complications on the day Zikalala issued the statistics. But many health experts say the figures could be up to three times higher as people fall ill, die at home and are buried without testing for Covid-19 or getting medical attention.
The impact of these deaths is being felt by families, health workers and facilities, and the funeral parlours, cemeteries and crematoriums charged with the bodies.
Funeral parlours are overrun and failing to fulfil their contractual obligation to bury the dead in a dignified manner. Cemeteries and crematoriums are overwhelmed, and staff fear contracting the virus.
Out of sites
Thembinkosi Ngcobo, the head of the eThekwini municipality’s parks, recreation and culture unit that oversees cemeteries, said Covid-19 had come at a time when the city was already running out of burial sites.
“I have been in this job for the past 20 years and I have never seen such a demand as we have been witnessing for the past few weeks. We are under pressure and we just don’t know what to do anymore. Some people are opting to bury their loved ones in rural areas outside the city limits, where regulations are not as tough and people can bury within their own yards,” he said.
The Queensburgh Cemetery in Durban is one of three that fall under the eThekwini municipality that is still allowing burials. Three funerals were taking place around midday on Monday 18 January.
“All are Covid-19 positive cases,” said one gravedigger, who asked not to be named as he is not permitted to speak to the media.
A grave here costs between R2 289 and R3 500, depending on if you bury on a weekday or a weekend.
“On average we had about four or five funerals a week. But just this weekend we had 50 funerals. I have spent decades working here and I tell you, we have never had to work this hard digging fresh graves. Now, every day, there are funerals,” he said.
Funeral parlours have been accused of using the pandemic as an excuse to charge the families of Covid-19 victims exorbitant fees, a charge they refute.
Msizi Gumede is the head of Ndaleka Funeral Services and a leading member of the Combined Nations Funeral Parlours Association. His premises are a block away from Durban’s main government morgue, the Gale Street State Mortuary.
Ndaleka Funeral Services’ mortuary can hold up to 80 bodies, but there were 200 bodies there on Monday 18 January. “We just had to increase the level of refrigeration,” said Gumede. Despite this effort, the stench was unbearable.
The government morgue up the road was also overflowing with bodies, according to workers there, as local hospitals store bodies at the facility before they are collected by family members or funeral parlours.
Gumede said funeral parlour owners and employees are at their wits’ end as they are under pressure from families but getting no support from the government.
“About 80% to 90% of the people we bury here are clear-cut Covid-19 cases. We have to spend more on PPE [personal protective equipment], on handling potentially infectious bodies, on fumigation and other added costs. Our funeral insurance underwriters have informed us that there is no more money in the kitty and we have to bury our members from our own pockets. We are living from hand to mouth and we cannot afford to bury so many people at one go.
“That is why we have had to increase our charges during this time, when burying Covid-19 victims. But families don’t understand this. To compound matters, there are no gravesites and the suppliers of coffins have simply run out of stock. They say they are working on 24-hour shifts, seven-days a week, but still cannot keep up to the demand,” said Gumede. And when stock is in short supply, prices rise, he added.
Gumede explained that mortuary staff receive injections monthly to safeguard them from diseases when handling infectious bodies.
There have been press reports about the bodies of Covid-19 victims being handed to the wrong family for burial. This, according to health workers and funeral parlour staff, has happened because the bodies of Covid-19 victims are “shrinked” – wrapped and sealed in plastic – to prevent the infection spreading to those who handle them. Errors have been discovered by family members daring enough to open the wrapping when the body shape appears wrong or they suspect the body they have received is the wrong sex or race.
Frontline staff and funeral parlour staff say they are under severe pressure and “mistakes happen”.
Chris Mthembu works for Ndabe Funeral Services in Durban. “We are scared of contracting coronavirus but we soldier on. If we don’t work, people will not be buried,” he said.
“If anything, Covid-19 has taught us to be extra careful when handling bodies of the dead. Before, we used to go to the mortuary with shorts and without protective gear. Now we don’t take things for granted. We are careful, as any day could be our last day on the job.”
Mthembu added that although no one in his company has contracted the virus, he knows of longstanding colleagues who have. “Fortunately, no one has died and they have recovered and are back at work.”
The coronavirus doesn’t discriminate
Covid-19 is cutting across race and class in KwaZulu-Natal. Families have converged on the privately owned and run Clare Estate Umgeni Hindu Crematorium, more so as one of the eThekwini municipality’s crematoriums – the Mobeni Heights Crematorium in south Durban – has been out of commission for more than a year.
The facility has three furnaces. It charges R2 000 to cremate the body of a non-Covid-19 victim and R2 500 for a Covid-19 victim.
Crematorium secretary Thegraj Kassie said the facility was cremating between 10 and 15 bodies a month a few months ago, but is now performing up to 40 cremations a day. “Our staff have to work from 6am up to 12 midnight and work seven days a week. We are even thinking of introducing a three-shift system as our staff cannot cope with the demand.”
The facility starts with Covid-19 cremations, from 6am to 9am, said Kassie. After that, a government inspector and his staff arrive to supervise fumigation and to ensure that the crematorium adheres to all health precautions. Then non-Covid-19 cremations are conducted until 4pm. After this, Covid-19 cremations resume until late at night.
“It is quite a risky business, but somebody has to do it,” said Kassie. “We try and protect our staff as much as possible.”
He added that a number of those cremated at the facility were outstanding doctors and nurses. “Covid-19 doesn’t discriminate. It takes you whether you are rich or poor, professional or layman.”
Funeral parlours are seeing a trend of children being left orphaned and destitute.
Thembinkosi Ngwane, and his wife Bongekile Ngwane, were from Folweni, south of Durban. Thembinkosi died at home on Tuesday 12 January two weeks ago after experiencing “severe flu”. His wife died a day later after exhibiting the same symptoms.
Their nephew, Bongani Nomazela, said the couple left behind four children. The youngest is eight years old and they now have no breadwinner and no one to care for them.
“It is very sad what Covid-19 has done to this family. We are still confused as to how the children will adapt to this new and sad reality,” he said.
No burial land
Pepe Dass, the chairperson of the South African Cemeteries Association, a non-profit organisation administered and managed by municipal officials, said many municipalities across the country, especially in pandemic hotspots, are barely coping with the high demand for burial sites.
The association issued guidelines in March last year, he said, informing municipalities about the impending problem and instructing them to identify public and private land for burial purposes. He said that if need be, municipalities should “be prepared to … annex properties and secure the land to bury people”.
Dass said the association is expecting deaths to spike during the peak of the second wave, and the situation to worsen further during the expected third wave of the pandemic in South Africa.
“For years before the pandemic, we have been running an awareness campaign to alert people that there is an acute shortage of burial space and communities must now consider other methods like cremations.
“It has been a very big hard sell to people who have traditionally been burying in the ground. But through awareness programmes, we are seeing more and more African people coming forward to cremate and we believe that this is the way to go. The future depends on it. Municipalities simply cannot find land to bury people,” said Dass.