Nipah Victims: Duty Of Afterlife Care

Clad in full-body personal protection gear, sealed visors, double gloves and N95 masks, they bore the palls of the dead to their biers as a city struck dumb by terror looked on. Dr R.S. Gopakumar, health officer with the Kozhikode Corporation, led the team that cremated 12 of the 14 people who died due to the Nipah virus in Kozhikode, Kerala. With no known cure, the disease took on apocalyptic hues as the city shut down and locals and the bereaved, fearing for their lives, shied away from handling the bodies of the departed. That’s when Gopakumar stepped in, duty bound, to cremate the dead, an ard­uous task that stretched from May 21 to June 3.

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The National Institute of Virology, Pune had confirmed on May 20 that the disease was Nipah, and a protocol on how to manage the dead in accordance with the guidelines for non-communicable diseases (NCDs) was issued on May 22. But alarm had spread among the people, and the staff at Kozhikode Mavoor Cre­mat­orium, ref­used to han­dle the bodies—as did the victims’ bereaved relations.

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In that moment when death stalked the city, Gopakumar was called to deal with the situation. The 41-year-old from Thiru­van­antha­puram had alr­eady handled a couple of Nipah-suspected dec­eased when he was brought into the task force constituted by the health department. He was ready to take charge.

“Shylaja teacher (K.K. Shylaja, Kerala’s health minister) had INS­isted that the bodies should be managed as per the NCD guidelines and I felt that I had to do my duty to control the spread of the disease. When a body is cremated at temperatures of 150 degrees centigrade, the chances of viral and bacterial survival are nil. Sabith and Salih’s father Moosa’s burial was the first I handled (brothers Sabith and Salih were among the first inf­ected). As per the protocol, there should be no water bodies nearby for a burial, and the pit should be 10 feet deep. The body should be sealed in airtight bags over and over and there should be minimum people present. Though I had seen death often, this was the first time I had encountered something on this scale. In all, we managed 12 dead bodies, of which two were burials. Dr Reema Sahay from the National Institute of Virology, an expert on Ebola victims, was there to guide us at every step during Moosa’s burial. We had to prepare ourselves beforehand, and clean down completely after cremations to protect ourselves,” says Gopakumar.

Led by Gopakumar, the team had to follow instructions to remove all jewellery, mobile phones and other material from their persons, and wear personal protective gear, goggles and two layers of gloves while handling the body; afterwards, each member of the team, as well as relatives who had attended, were sprayed down with deep bleach or phenol before they stripped down. The clothes were washed in alcohol-based solutions and then incinerated at the hospital. The personnel then had to bathe in hot water to kill any virus on their bodies. “We had to do everything from being pallbearers to saying the funeral rites,” adds Gopakumar. “At times I felt mentally and emotionally drained at the sight of so much pain and helplessness, but we wanted the dead to have a dignified funeral and we ensured that.”

Though the virus is now contained and Kozhikode has limped back to normal with schools reopening and streets busy, for a brief while, the government and medical personnel were battling an invisible, seemingly immortal enemy, with no ammunition. The state government’s ability to contain the spread of the disease won it accolades—but that came later. Before that, the authorities had a lot on their hands: the sick had to be quarantined, those who came into contact with them had to be monitored on a daily basis, and the dead had to be cremated as per protocol. Kozhikode district collector U.V. Jose tells Outlook, “No new cases have been reported in the last few days. All who were in contact with victims, both relatives and hospital personnel, are monitored on a daily basis. Nipah paralysed all sectors and though we cannot put a figure to the quantum of economic loss, it was steep—but it is all over now.”

By Minu Ittyipe in Kochi