WASH Cluster – Management of Dead Bodies
DB
Session Plan
DB- Management of Dead Bodies
Timetable
DB –
Management of
dead bodies
1hr 30 mins
Session-at-a-Glance
Session Activities
Introduction and Objective setting
Discussion on the public health importance
of dead bodies in terms of risks to the public
and those responsible for handling the dead
Approx. Time
5 mins
30 mins
Instructional Activity
Powerpoint presentation
Plenary
discussion
and
powerpoint
Group exercise on managing dead bodies
20 mins
Group Work
Presentation of group work
10 mins
One group to present back
using flipchart paper
Presentation by facilitator on key aspects of
managing dead bodies with focus on
protecting body handlers, methods of
disposal and selection of burial sites.
10 mins
Powerpoint
Presentation by facilitator on management of
highly infectious bodies ie Cholera or Ebola
10 mins
Powerpoint
Discussion to establish if session objectives
have been met
5 mins
Powerpoint
Total time
1 hr 30 mins
Session Aims

To put the issue of dead bodies into a public health perspective (including psycho-social
aspects) and understand the basics of managing dead bodies in the first phase following a
disaster.
Session Objectives
By the end of the session participants will be able to:

Describe the relative importance of dead bodies in an emergency (health risks to the public
and those handling the dead)

Develop an action plan to manage dead bodies in a practical sense following a disaster

List 3 extra precautions needed in dealing with those who have died from a highly infectious
disease such as cholera or Ebola.
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WASH Cluster – Management of Dead Bodies
DB
Session Materials



Computer and projector
Flip chart paper and pens
Handout - Special Precautions for dealing with dead bodies in relation to Cholera, Ebola,
SARS, Typhus/Plague, Tuberculosis and HIV/AIDS.
Key Learning Points
 Dead bodies are generally speaking not a major public health risk in the immediate
aftermath of a disaster
 Dead bodies require careful management and those that have died from highly infectious
causes need extra special attention in their management.
Facilitator Guidance
•
PAHO et al, Management of Dead Bodies after Disasters: A field manual for first responders,
2006
•
MSF, Infection Control in Health Care Settings, First Edition, 2006.
•
Harvey, Peter., Baghri, Sohrab., and Reed, Bob., Emergency Sanitation, Assessment and
Programme Design, WEDC, Loughborough University 2002
•
UNHCR, Handbook for Emergencies, Third Edition, February 2007. (Pg 277)
•
Davis, Jan., and Lambert, Robert., Engineering in Emergencies, A practical guide for relief
workers. 2nd Edition, RedR/IT, 2002 (Pg 182-183)
•
Disposal of Dead Bodies in emergency conditions, WHO, Technical Note No. 8 Draft Revised
7.1.05
Session plan
Read the slide
Read the slide
Read the slide
Session Plan – DB
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WASH Cluster – Management of Dead Bodies
DB
Read the slide
Read the slide
Generate discussion to see who in the group would prioritise the needs of
survivors over the disposal of the dead. In general the dead do not pose
a major physical public health risk no matter what the type of emergency
be it a complex emergency, earthquake or flood when the victims have
died from some sort of trauma such as injury, drowning or fire and not
from a disease.
Seek to establish if any of the group identify those who have died from
highly infectious diseases (a disease epidemic type of emergency) such
as cholera as of major public health importance. Seek to establish what
other highly infectious diseases are important in this regard – examples
include Cholera, Ebola, Typhus, Plague and Marburg.
Read the Quote
Note: There is the potential risk to drinking water supplies contaminated
by faecal matter released from dead bodies. However this risk is as yet
undocumented.
Ask the question
The psychological trauma of losing loved one and witnessing death on a
large scale is at the very least distressing. Therefore the collection of
corpses following a disaster is an important consideration to minimise this
distress.
The hasty collection and disposal of corpses (in the mistaken belief that
these dead will create an epidemic) can also have severe long term
mental health consequences and legal problems for the relatives of the
victims. It can be traumatic for relatives if they don’t know if a person
has died or not and if they have died where there remains are buried. If
they can’t prove someone is dead this may cause legal problems.
Read the quote
It is not necessary to rush the disposal of bodies (burials or cremations).
This does not allow for the correct identification and record taking of the
details of the dead. Nor does it give the time for the bereaved to carry
out the ceremonial and cultural practices, which would normally occur
after a death. This is important in helping people deal with the
psychological impact and allowing time for such practices to take place
helps the process of disaster recovery. (Source: Dispoal of Dead Bodies
in emergency conditions, WHO, Technical Note No.8, Draft revised
Session Plan – DB
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WASH Cluster – Management of Dead Bodies
DB
7.1.05)
Ask the question
Purpose of slide is to get group to think about the specifics of dealing
with the dead if they have a responsibility for it regardless of where it fits
within the general list of public health priorities.
Read the slide
Individuals handling remains have a small risk through contact with blood
and faeces (bodies often leak faeces after death)
Note: most infectious organisms do not survive beyond 48 hours in a
dead body. An exception is HIV, which has been found six days post
mortem.
There are non-infectious risks such as injury from working in collapsed
buildings.
Tetanus is another risk from working in such hazardous environments.
Organise group into their working groups
While groups are working they should be directed to think about the
specifics of collecting dead bodies.
In particular they should be asked to provide details on how staff
collecting dead bodies are protected from health and safety risks. This
would include personal protective equipment such as heavy duty gloves
and boots, facilities to wash their hands with soap and water after
handling dead bodies, the availability of first aid for team members who
may have an accident and tetanus vaccination for workers with
vaccination cover.
The hot season factor will bring added urgency to the task and with the
population being Christian this will raise questions about the method of
disposal
The following page outlines the key steps to managing dead bodies and
group can be referred to PAHO manual for greater detail.
Read the slide
These are the key steps to be followed as outlined in the PAHO Manual
The affected people in scenario were Christian and therefore burial would
have been the method of disposal utilised.
Next slide will focus more specifically on Disposal, an issue of major
concern for WASH people.
Session Plan – DB
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WASH Cluster – Management of Dead Bodies
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Read the slide
Ask the question
Group should identify burial as the preferred option over cremation for
the reasons outlined on Pg 21 of PAHO manual.
Burial helps preserve evidence for future forensic investigation if
required.
Cremation will destroy evidence for future identification, large amounts of
fuel are needed, logistically difficult to arrange the cremation of large
numbers of dead bodies.
May largely depend on cultural and religious norms of the population
affected.
Ask the question
Key points to refer to are sufficient space, soil conditions and highest
point of the water table. Again see Pg 21 of PAHO manual. You may also
make reference to the distance of burial sites from water sources and
specific aspects around grave construction
Ask the question
Group should be asked to consider their work as WASH people not only in
the general environment as in the Goma example but also the work they
may undertake if working on WASH at a Health Care setting specifically
like an isolation centre for Cholera victims.
Read the slide and distribute handout
Group to receive handout on the Special Precautions for dealing with
dead bodies in relation to Cholera, Ebola, SARS, Typhus/Plague,
Tuberculosis and HIV/AIDS.
Read this summary of key recommendations for WASH people
Question group to ask if the specific objectives of the session have been
met and if there are any final questions.
Session Plan – DB
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WASH Cluster – Management of Dead Bodies
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Read the slide and ask group if objective has been met
Refer to these key references
Session Plan – DB
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