Last week one of Karachi's prominent physicians passed away after contracting Covid-19. The last rites of this doctor were performed in a very simple and low-keyed manner and in line with the protocol laid out by the government.

His neighbour AZ* says she cannot get over the "impersonal" way in which he was laid to rest where those who loved him could not "see his face or be with his wife and son".

"My brother could not partake in the last rituals," she lamented, adding: "Had there been no lockdown, not just the lane where he lived, but the entire mohalla (neighbourhood) and beyond, would have joined in the namaz-i-janaza."

Since the pandemic, a certain protocol is being observed by all hospitals. At the isolation ward of Dow University of Health Sciences' Ojha campus, as soon as someone is confirmed positive and when he or she is admitted, this information is relayed to the Sindh government's health department. "In case of death, along with the relatives, government authorities are informed immediately and the Edhi Foundation's ambulance comes with a wooden coffin. We provide them with the PPE and they give ghusal (last bath) to the body on our premises, wrap the body, place it in the coffin and take it straight to the graveyard," says Dr Shobha Luxmi, who heads the isolation ward at the DUHS. Someone from the district health office is also present until the body is packed in the morgue and handed over to Edhi personnel, said an official from the comissioner's office requesting anonymity.

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But often the charity brings the body to its morgue to give the last bath. According to Mohammad Bilal, incharge of the ambulances section at the foundation, who remembers getting a call recently from a hospital regarding a Covid-19 death: "I sent our ambulance with three people — a driver and two others — dressed in PPE, who waited for the hospital authorities to hand them the disinfected and plastic wrapped body of the doctor. From there, the body was taken to the Edhi morgue in Korangi where his last bath was performed." He said this applied to most Covid-19 deaths.

"Of our three morgues, right now we are using two morgues, Sohrab Goth and Korangi — where we take the bodies of people who died of corona and bathe and enshroud them," says Bilal, the foundation's 48-year-old worker, who has been associated with the charity for some 30 years.

Tasked to supervise the burials of those who have died of Covid-19, Bilal says they have trained all their ghusal staff, some 20 or so, on how to don on and doff off the PPE (including shoes) and what precautions to take during the ghusal. "I and half a dozen workers received detailed briefing from the doctor incharge of Civil Hospital's isolation ward. He made sure we understood everything and when we went back, we briefed the rest," says Bilal.

All bodies of the deceased that the Edhi Foundation picks from home are handled as corona-suspect, as people often do not tell the truth because of the fear and the stigma attached to the disease, says Bilal. "Many do not even want to come to the morgue or the graveyard and then we perform all the last rituals," he adds.

The Edhi Foundation, has, for now, kept five ambulances out of its fleet of 350 in Karachi, just for picking up bodies of those who die from Covid-19. "We disinfect and then wash the ambulance after every round," says Bilal.

The last bath

According to Bilal, if a body has to be collected from the hospital, healthcare workers there have usually disinfected the body and put it in a plastic bag themselves.

"All the tubes and everything used on every single patient are disposed observing proper protocols in light of the highly contagious nature of the pathogen. There is a specific department for that," says Dr Luxmi.

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But if it is to be picked from a home, the Edhi workers spray it with a disinfectant, or if possible, wash it with bleach at the residence of the deceased; after that, they wait 30-minutes or so before covering the body in plastic and then putting in the ambulance. The body is then taken straight to the morgue where there is an area for the ghusal.

"The plastic is removed from the body, washed with water and soap, then the body is wrapped in plastic, then a white kafan (white sheet of shroud) and then again a plastic sheet and tied at the head and toe so the plastic does not slip. It is then put back in the ambulance and taken straight to the graveyard," says Bilal.

The stainless steel sheet on which the body is placed to be bathed is disinfected and washed thoroughly with detergent, as is the floor, he adds.

The body is then placed in a wooden coffin and put in the ambulance.

Namaz-i-janaza

Once they reach the graveyard, often the coffin remains in the ambulance and the imam and other attendants, usually four or five, perform the namaz-i-janaza facing it. "The box is then carried by the attendants (usually gravediggers and two Edhi workers) and lowered into the grave," says Bilal. "We've been asked to send two more people to help carry the coffin and we are now doing that as well," he adds. Everyone who enters the graveyard has to don the PPE.

But there is no restriction on where a Covid-19 deceased can be buried as had been noted in a press statement issued by the Karachi Metropolitan Corporation. The KMC had issued the statement after news reports quoting Mayor Waseem Akhtar earlier last month said that the corporation had reserved five cemeteries for Covid-19 victims and only their burial will take place in those. The five cemeteries named were Muhammad Shah graveyard in North Karachi, the Surjani graveyard, the Mawach Goth graveyard, the Korangi No.6 graveyard, and the Gulshan-i-Zia graveyard in Orangi Town.

The KMC has 41 of Karachi's estimated 200 registered graveyards under it. According to the corporation's graveyards director, Iqbal Pervez, the few bodies of Covid-19 that have been buried under his supervision have been buried wherever the relatives requested. "There is no restriction that Covid-19 bodies have to be buried in a particular graveyard," he says.

According to Pervez, graves for Covid-19 victims are bigger than the usual graves on account of the coffin. "They are eight feet long, seven feet deep, and four feet wide compared to a normal one which is seven feet long, five feet deep and three feet wide. It can take two gorkhans (gravediggers) about four to five hours to dig one up," he says, adding: "Due to the fear factor finding a gorkhan is becoming increasingly difficult and on top of that many refuse to touch the coffin, so now Edhi volunteers are doing that duty as well."

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"If the grave is ready, it doesn't take much time to pray and bury the dead," says Pervez. "There are no rose petals spread over the grave as that business is also closed," he says, admitting that it is a quiet, sombre and quick affair.

Sadly even when the family member(s) returns home, there is no one to share the grief with. "We could not send any meal to my deceased neighbour's family; I could not go and hug his wife and kid, go and do any collective dua (prayer) or share in their bereavement," says AZ. However, she says the family of the deceased has set a precedence and an example for those around them in abiding by safety regulations.

*. Person not named to protect privacy