By Philip Ball
Nature

Mass graves not necessary for tsunami victims


In a field outside Banda Aceh, the Indonesian town devastated by the tsunami in the Indian Ocean, over a thousand dead bodies were unceremoniously bulldozed into a mass grave at the end of December.
 

The indignity of such burial methods adds to the suffering of the survivors and potentially robs them of a chance to identify the bodies of relatives and friends. But there seems to be no option. "We're facing a major health hazard if we leave them lying around," says Azwar Abu Bakar, acting governor of Aceh.

The tragedy is that this concern about the health risk posed by the dead is misplaced. A report issued last September by the Pan American Health Organization (PAHO) addressed the management of dead bodies in disaster situations. Its findings suggest that the corpses from the 26 December catastrophe pose no serious risk of spreading infection and disease.

Bodies should always be buried in a way that allows for later exhumation, says the PAHO report. "The use of common graves should be avoided in all circumstances," it recommends. The report calls mass burials "a violation of the human rights of the surviving family members".

Changing beliefs

Yet mass graves have already been used in the wake of the tsunami in Indonesia, Sri Lanka and Thailand, for fear that the bodies will otherwise cause epidemics of disease. In Thailand, Red Cross officials have been told to prepare a grave for 10,000 bodies (which is twice the current death toll announced by the Thai government). "This may look insensitive," says a Thai official, "but what else can we do?"

It is widely believed that swift burial is the only way to prevent the spread of diseases such as cholera. But that is a myth, the PAHO report reveals. Cholera does not appear spontaneously in the body of a person who did not have it to begin with. And although harmful bacteria or viruses in a corpse can in theory be spread by rats, flies, fleas and other animals, that doesn't tend to happen in practice.

The temperature of a body falls rapidly after death, so even the most resistant bacteria and viruses die quickly in an animal that has died, according to PAHO. Past experience shows that unburied dead bodies pose a negligible risk to those who do not come into physical contact with them. Handling of bodies by relief workers does, of course, require protective clothing.

Technical challenge

The report recommends that bodies be carefully reported and tagged before being placed in individual body bags. Whether this is practical for the vast numbers of fatalities in areas worst hit by the tsunami is another matter.

But the report claims that identifying large numbers of corpses is a "technical challenge that can be met, regardless of the number of victims, if the authorities act in accordance with specific procedures".
 

Jean-Luc Poncelet, head of the Disaster Preparedness and Emergency Response Association at PAHO, admits that not all their guidelines can be followed in regions with many fatalities. "There are some areas where the resources are not available," he says. But he adds that, in some places, efforts are under way to take fingerprints or collect DNA samples from dead bodies, so that relatives may at least get confirmation that a family member has died.

Poncelet accepts that changing beliefs about the need for mass graves will be a slow business. He points out that it took two or three decades for people in the Western world to understand that it is best not to move a person injured in a street accident, for example. "To change ideas at a global level takes a lot of time," he says.