MANILA - The coronavirus disease 2019 (COVID-19) pandemic that hit the Philippines left some of those in the funeral service industry overwhelmed at the start, as it did the country's health sector, according to accounts of some workers.
Funeral parlors were caught ill-equipped for the handling and processing of remains of those who succumbed to the disease, workers recently said.
Erman de Jose, a driver attendant in a funeral home in Makati City, said he feels nervous and anxious whenever he and crematory specialist Jorge Mano pick up dead bodies of COVID-19 patients.
“Minsan po, yung kinuha po namin na body, hindi po nakaayos nang balot. Tapos minsan papahanap po sa amin kung saan po yung body na kukunin namin. Eh kung madampot o mabuksan namin eh COVID case po yun, mas delikado po sa amin. Dapat ayusin nila,” he shared.
(Sometimes, when we pick-up a cadaver, it's not wrapped properly. Sometimes, they make us search for the body we're retrieving. What if the body we picked up or open was a COVID case? It's dangerous for us. They should fix that.)
De Jose said it is important for cadavers in the hospital to be labeled properly with name tags.
“Dapat may name tag na siya, hindi yung bubuksan mo pa siya kung siya nga yung kukunin po namin,” he said.
(There should be a name tag, so we don't have to open and check if it's indeed the cadaver that were picking-up.)
Mano said this is why they always make sure to wear complete personal protective equipment (PPEs) when processing cadavers.
From getting the dead body to cremation, the duo makes sure to also disinfect the ambulance, crematorium and all facilities.
“Hindi po namin alam kung sino po yung carrier. Kahit po doon, lahat po ng mga hinahawakan nila, maaring nandun po yung virus. Kaya 'pag may pipick-upin po kami, nagkukumpleto na po kami ng PPE, tapos todo ingat po,” Mano said.
(We don't know who the carrier is. The virus could even be on all the things they touched. That's why, when we're picking up a cadaver, we make sure that were wearing complete PPEs and then be extra careful.)
“Kasi po, hindi po namin alam minsan, COVID case po yung kini-cremate namin. Tapos minsan, nakalagay PUI lang. Yun pala pagdating ng gabi, COVID case na po pala ang result, ide-declare na,” he added.
(Sometimes, we don't know if the body we're cremating was a COVID case. Sometimes they just put PUI there. Then later in the day, it's declared to be COVID-positive.)
Antonio Puyat, general manager of the funeral parlor where de Jose and Mano work, said his personnel initially used raincoats in place of medical-grade PPEs.
“Our first case, we were very surprised because the hospital was in a panic. And when we inquired about the death certificate, we read that it was high risk pneumonia,” Puyat shared.
The manager said he made a decision to accept and process the bodies to serve the country during this time of crisis.
“Because we don’t understand how COVID works. So, just one case... I don't blame the employees. Some of them just said that 'Sir, wag na lang natin kunin, pasa na lang natin sa ibang funeraria'. But I made a decision to say “No, we have to serve our country,” he said.
(Sir, let's not accept and just pass that to other funeral shops.)
Puyat admitted they were not prepared during the lockdown.
They were not able to stock up on gasoline used for cremation. They also did not know the standard protocol for handling bodies of patients who died because of the virus.
“How to cremate, how to pick up the bodies. But we give our people the best protection. In fact, in this first case, they didn’t have the death certificates ready. The body has to stay with us overnight,” Puyat said.
His staff also couldn’t report to work because of the lockdown.
“Because of the lockdown, we lost almost half of our staff. Because there is no public transportation, they couldn't come to work. At the start of the lockdown, no one approached us to tell us what’s going to happen. No one was able to stock up on gear. And we are all humans. We are scared. W have our own families,” he said.
Eventually, funeral service providers gained more knowledge and became better equipped in handling COVID-19 cadavers.
“I think the hospitals are so stretched with their services. The resources are also stretched. And when they see our people come in full PPE gear, they just ask our staff, hanapin n'yo na lang yung patay dyan, or open up the body bags, and check if this is the one you’re picking up,” Puyat said.
(Just look for the dead there.)
They also require bodies to be wrapped in a double bag, and the zippers properly taped.
“That’s the only time we pick up. Because if not, then I'm putting my staff at risk. So, the same way, we are willing to serve the country, we also want to give protection to our people, because they also have families. Tao din naman sila,” Puyat said.
The funeral manager said the government should have laid down protocols on how to handle cadavers of COVID-19 patients and those considered as PUIs.
“Maybe if we are all given the proper warning, or we were included in some talks, I think this kind of delay or fear would also not happen,” Puyat said.
To date, the funeral parlor was able to cremate 50 remains of COVID-19 patients and 150 for PUIs.
Senator Nancy Binay said the Inter Agency Task Force should respond and give clear guidelines and protocol, including cadaver management, storage, cremation and assistance to the grieving families.
"Sa ngayon pa lang, sana i-resolba na natin ito. Ano ang pwede nating magawang ayuda sa mga pamilya? Paano kung walang-wala? Paano ang pambayad sa punerarya para sa cremation? Sino ang mag-aasikaso ng mga requirement? Paano na kung wala na gustong tumanggap na crematorium?” Binay said.
(We should resolve this now. What assistance can we offer families? What if they are poor? How will they pay the funeral parlor for the cremation? Who will take care of the requirements? What if no crematorium accepts?)
In the last week of March, the government released guidelines on the handling of the remains of COVID-19 fatalities and warned funeral service facilities with penalties if they refuse to provide services.
Local government units are tasked to designate funeral service facilities that could handle the remains of COVID-19 fatalities, and to provide financial aid to families of the deceased, Cabinet Secretary Karlo Nograles said.
The cash grant aims to cover logistics, fuel, and other expenses that will be incurred in the funeral process, he explained. The remains should be cremated within 12 hours.
If the deceased is a Muslim, Interior Secretary Eduardo Año said the body of the deceased Muslim should be placed in an air-tight sealed bag and buried in the nearest Muslim cemetery within 12 hours with Muslim rites.
There are 60 crematoriums in the country, of which 90% are privately-owned.
Public crematoriums are located in the cities of Manila, Pasay, Mandaluyong, Quezon, Dasmariñas and Antipolo. Five of the 6 public crematoriums are operational, and able to process 3-5 bodies a day.