How COVID-19 pandemic is changing the Africa's elaborate burial rites, mourning and grieving.

There are diverse burial rites in Africa which have been practiced for decades depending on the deceased place of origin, culture, religion and the position held in the community. Unlike the developed countries where burials are usually conducted as private ceremonies, funerals in Africa are elaborate and are usually public ceremonies involving the entire members of families, friends and well-wishers. Religion and culture are usually the deciding factors when decisions are made on how the deceased should be buried but generally cremation is not commonly practiced in Africa. COVID-19 pandemic was generally accepted to originate from Wuhan in China and this pandemic has extended to Africa. Most countries in Africa responded to the COVID-19 pandemic by adopting the same strategies used by the Western countries in curbing the spread of the virus through the imposition of restrictions on movements, lock down and the introduction social distancing rules which are align to Africa way of living. These control strategies had put a lot of pressures on the weak mortuary services in Africa, altered the traditional methods of observing burial rites, mourning and grieving. COVID-19 pandemic has changed the various traditional ways Africans mourn grief and bury their love one. The dead bodies of people suspected or confirmed to have COVID-19 should be treated with respect, ensuring the rights of the dead to a dignifying burial are upheld while adhering to standard precautions including use of appropriate PPEs, hand hygiene before and after the burial procedure.

International Committee of the Red Cross (ICRC): Cemetery planning, preparation and management during COVID-19: A quick guide to proper documentation and disposition of the dead.

Based on its forensic capacity and experience gained worldwide from the management of the dead in emergencies, including epidemics, the International Committee of the Red Cross has been asked by the authorities and other relevant stakeholders in some of its operational contexts to advise on the planning, preparation and management of cemeteries during COVID19. The management of the dead process includes proper documentation and appropriate disposition, including temporary burials. If there is a sudden and significant increase in the number of deaths, local capacities can quickly become overwhelmed. This guidance, prepared for the COVID19 pandemic, can be applied to any incident involving mass fatalities when the local capacity to provide safe, appropriate and dignified burials is overwhelmed. Specifications on size, spacing, excavation depths, and information about other important considerations are provided. In addition, it provides recommendations on how to correctly map graves while ensuring the traceability and correct management of bodies in a cemetery. Procedures for receiving bodies, as well as measures to ensure the health and safety of relatives and cemetery staff are also covered in this guidance.

Advance Care Planning Engagement and End-of-life Preference Among Older Chinese Americans: Do Family Relationships and Immigrant Status Matter?

OBJECTIVES: To examine how immigrant status and family relationships are associated with advance care planning (ACP) engagement and end-of-life (EOL) preference in burial planning among older Chinese Americans, the largest subgroup of Asian Americans. DESIGN: Cross-sectional survey. SETTING: Communities in Honolulu, Hawai'i. PARTICIPANTS: Participants were 430 older Chinese Americans aged 55 years and older. MEASURES: Measures included ACP contemplation, ACP discussion, and EOL preference in burial planning, immigrant status, family cohesion, family conflict, demographic information, and health status. RESULTS: Results show that in comparison to foreign-born Chinese Americans, US-born Chinese Americans were more likely to have ACP contemplation [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.39-5.63], ACP discussion (OR 3.02, 95% CI 1.50-6.08), and preferences for burial plans at the end of life (OR 4.56, 95% CI 2.04-10.18). Family conflict increased the possibility of having ACP contemplation (OR 1.21, 95% CI 1.07-1.38), ACP discussion (OR 1.22, 95% CI 1.07-1.39), and EOL preference in burial planning (OR 1.22, 95% CI 1.04-1.42), whereas family cohesion was not associated with these study outcomes. CONCLUSIONS AND IMPLICATIONS: This study suggests that ACP should be adapted to be more culturally appropriate, especially in a time of coronavirus and xenophobia, such as framing ACP as a tool to help families reduce stress while fulfilling filial obligations, in order to ensure equitable access to ACP.