Contrary to popular belief, epidemics do not occur spontaneously after a natural disaster

Sep 26 2004

Contrary to popular belief, epidemics do not occur spontaneously after a natural disaster, and dead bodies will not lead to catastrophic outbreaks of exotic diseases, according to disaster experts at the Pan American Health Organization (PAHO).

The belief that dead bodies pose a serious health threat often leads authorities to take misguided action, such as mass burials, which can add to the burden of suffering already experienced by survivors. This theme arose Thursday following reports that the death count in Haiti due to flooding from Tropical Storm Jeanne has now climbed above 1,013.

PAHO, which serves as the regional office for the World Health Organization, has mobilized teams of disaster coordinators, physicians, sanitary and civil engineers, health systems experts, and relief supply management personnel to assist in disaster relief efforts in Haiti. PAHO/WHO has an office in the capital.

The key to preventing diseases is improving sanitary conditions and informing people, PAHO experts emphasize.

"Unfortunately, we continue to see the use of mass graves and mass cremations to dispose of bodies quickly, based on the myth that they pose a high threat of disease outbreaks," PAHO Director Mirta Roses writes in the introduction to a PAHO book "Management of Dead Bodies in Disaster Situations" (currently available only in Spanish). The fact is that infectious agents do not survive long in dead bodies.

"The worst part of this is that these actions are taken without respecting the processes of identifying and preserving bodies, something that not only goes against cultural norms and religious beliefs but also has social, psychological, emotional, economic and legal consequences that add to the suffering directly caused by the disaster."

Dead bodies must be managed in such a way that it is eventually possible to identify them, say PAHO experts.

"Denying the right to identify the deceased or suppressing the means to track the body for proper grieving adds to the mental health risks facing the affected population," writes Dr. Claude de Ville, former head of the PAHO disaster program, in an editorial in the May 2004 issue of the Pan American Journal of Public Health. "The inability to mourn a close relative, the lingering doubt on the whereabouts of the disappeared, and the legal limbo of the surviving spouse or child all contribute to the many potential mental health problems associated with disasters and the difficult rehabilitation process that follows."

Dr. Jean Luc Poncelet, chief of PAHO's Emergency Preparedness and Disaster Relief program, adds: "What also happens is that these forced burials hurt the credibility of the authorities."

PAHO has developed a list of recommendations regarding the management of cadavers in the aftermath of disasters:

• Ensure that citizens have complete access to bodies and provide as much support as possible for their final disposal.
• Burials should be carried out in such a way as to allow later retrieval of bodies. This means that burials in mass graves and mass cremations should be avoided under any circumstances.
• Burials in mass graves and mass cremations are unnecessary, as they violate the human rights of families and survivors.
• Generally speaking, the risk of epidemics as a result of cadavers is negligible. Dead bodies pose less risk of contagion than a person who is alive and infected.
• Avoid subjecting relief personnel and the general population to mass vaccination against diseases supposedly transmitted by cadavers.
• Respect cultural and religious beliefs, even when the identities of the dead are unknown, showing respect for the beliefs of those at the site of the tragedy.
• The identification of bodies is a technical process to be carried out regardless of their numbers, in accordance with established procedures. Departing from these procedures can produce legal consequences that may result in survivors presenting claims for material and mental damages.