lecture 14: body 3 in the midst of a pandemic

Musonda does his research in Zambia, focusing on

labour conditions in the mining industry

• The article is strongly based in anthropological theory but also has a highly personal perspective, drawing on Musonda’s own experiences

  • Thus it includes an aspect of autoethnography (analysis of one’s own responses and behaviour), an interesting but fairly uncommon approach in anthropology

Anthropology of epidemics & pandemics: Studies are very broad and have included:

• Work with AIDS patients and their support networks – looking at resilience, activism

• Studies of mortuary practices during outbreaks of Ebola and other diseases

• Public health, addressing needs of bereaved

• Many studies focusing on the past

  • bioarchaeology of epidemics

Epidemics and pandemics in history: More recent epidemics and pandemics can offer us unexpected and interesting parallels to recent events

• 1885 Montreal smallpox outbreak

• In Canada, public responses to the 1918-19 influenza pandemic complicated by some familiar issues

1885 Montreal smallpox outbreak

• Vaccination known since 1790s, very dependable by 1880s

• An anti-vaccination movement still developed

• Adherents included alternative medicine practitioners, libertarians

• Political polarization reduced vaccine uptake by the French-speaking community, resulting in higher mortality

In Canada, public responses to the 1918-19 influenza pandemic were complicated by some familiar issues:

• Objections against masking that seem driven in part by the mask as a visible symbol of pandemic measures

• Objections to closure of public spaces (e.g. movie theatres) due to feared economic impact and due to the role of these places as symbols of normal life

Epidemics and pandemics in bioarchaeology: Bioarchaeology also offers some information

• Illnesses like plague, smallpox and flu not visible on bone

  • Do not affect bone, or kill too quickly for visible bone reaction to form

  • Their presence is inferred from context or detected through DNA

• Context: mass burial may indicate epidemic though other evidence must be checked

  • DNA – allows detection of some diseases, has provided valuable information on evolution of plague

Mortuary impacts in modern communities: Studies of modern disease outbreaks show importance of mortuary practices

• E.g. Ebola, 2014-5, Sierra Leone

• Prohibition of private funerals for victims (the government performed burials instead) reflected urgent need to stop transmission

• However, government planners’ failure to consider how traditional funerals reflect key social values led to public resentment and perception of ‘safe burials’ as foreign

Mortuary impacts in modern communities: Social science research may seem like the last thing needed in an emergency but this study provided important insights:

• Reluctance to follow ‘safe burial’ guidelines not due to failure to understand the threat of Ebola – ‘better education’ wouldn’t help

• It’s important to consider the overall form and social function of a culture’s mortuary practices even in emergencies

• Respecting these as much as possible could improve adherence, also survivors’ mental health

Mortuary impacts of COVID-19: Studies of mourning and mortuary practices in COVID-19 may be understood in same context

• Help governments, health systems, other organizations to understand impacts on mental health and social ties

• Help design better responses to future crises

Mortuary impacts of COVID-19: Researchers discuss some fundamental changes

• Death ‘alone’ (without family/friends physically there) in hospitals, sometimes sedated

• Death (especially at peak periods) as ‘one of many’

• Departures from normative treatment of body

• Delayed treatment, storage in unconventional places/ways

• Funerals that departed from normative format and were attended by fewer/virtual mourners

• Altered commemoration practices

• Due to distancing, travel bans, other pandemic stresses

Musonda’s article is an anthropological study, but also a highly personal commentary on the COVID-19 epidemic in Zambia: Focuses on deaths in hospital and subsequent funerals

• This explains his choice of model – Street’s ‘sociotechnical assemblage’

• Street studied hospitals in the Global South

• Street saw these hospitals as social and technological ‘packages’ – they offer treatment, but this comes with all of the authority of biomedicine over health, the body and knowledge (this draws on ideas from Foucault covered in Lecture 4)

• Also often underfunded, places where “people must strive to make biomedicine work in conditions of institutional instability and medical uncertainty” (Street 2014)

Musonda describes a scarcity of everything in Zambian hospitals (including doctors, funding and equipment) that creates challenges for patients and their families:

• Patients rely heavily on their families, who bring daily supplies, provide basic care, and even negotiate for access to tests and equipment

• This is consistent with the general importance of kin networks to Zambian society, but had serious implications during COVID

• Medical system that was already stressed was stretched to near-failure

Normative ‘good deaths’ and funerals in Zambia include a lot of traits familiar to us from discussions of other cultures:

• If someone dies in hospital their death is confirmed, the family is given time with the body, and it is prepared and taken to a mortuary where the family is allowed to visit and touch it again to say goodbye

• The family is joined at their home by their social support network – family, neighbours and friends – who mourn with them

• If possible the funeral is delayed until all can attend

• Close family members prepare and dress the corpse

• The funeral is as lavish and well-attended as possible, showing respect for the deceased and for the mourners who attend

COVID restrictions reversed these in multiple ways:

• Deaths occurred with little acknowledgement from overworked personnel, usually with no family present to say goodbye

• Large home gatherings were prohibited

• Only minimal delay allowed between death and funeral

• Family members not allowed to prepare or dress the corpse

• Corpse wrapped in plastic, not dressed in carefully selected clothing

• Strict limits on funeral attendance

People also responded with various strategies to get around or compensate for restrictions

• Challenging, arguing with or ignoring medical staff

• Work-arounds like virtual visiting, virtual help for the ill (transferred funds) or alternative mortuary practices seen as more culturally acceptable (e.g. glass-topped coffins to allow viewing)

• Defiance of restrictions on gathering size

In general, COVID-19 funerals in many nations violated important expected norms

• Treatment of body sometimes not normative

  • Norms vary by culture/faith – prompt release to family or embalming and display both sometimes impossible

• Few people attending in person

  • Violates expectations that many will be there to say goodbye, also survivors’ obligations to honor dead

• In some cases no in-person funeral at all

Pandemic deaths exacerbate normal trauma of loss because they often violate some common expectations for good death

This is described by Musonda and also noted by researchers working in other communities, with common themes of:

• A unexpected and relatively sudden death

  • No time to prepare; death seen as ‘unfair’, ‘unlucky’ or ‘too soon’

• Death without family or friends present due to restrictions

  • Limited or no chance for the dying to express affection and say goodbye

  • Family’s obligation to comfort the dying denied

Pandemic mourners may feel their grief is minimized or ignored

• Death as one of many – if so many people are grieving or hurting in other ways, is the weight of one death diminished?

• Death may be associated with feelings of guilt or unreality

  • Not there to say goodbye; feelings of guilt over infection or ‘being spared’

• Deceased may be ‘blamed’ for behaviour including unvaccinated status

In some places and at some times, infrastructure for dealing with corpses overwhelmed

• Bodies waiting in morgues and funeral homes

  • Unacceptable time ‘on pause’, especially for faiths requiring prompt burial or cremation

• Bodies stored in refrigerator trucks

  • Corpses are being cared for, but in a place that’s not culturally expected/acceptable

• Bodies in wards and corridors – delay in separation of dead from space occupied by the living ill

  • Disruption also present for communities where dying were cared for at home

  • Bodies left waiting for care because morgues, funeral homes & cemeteries backed up

AoD may not help in any practical sense but does help us recognize our responses through concepts including:

• Importance of a good death, some common features of a good death

• Importance of identity in death

  • Versus anonymity of an isolated masked death

• Importance of normative funerals for recognizing kin and friend ties to deceased but also ties and relationships between the living

• Importance of the respectful handling of corpses and placing them in their own specific context

• Importance of the corpse itself as memory image, focus for grief