Why Do Indonesians Keep Taking Back the Bodies of COVID-19 Patients by Force?

On Tuesday, a crowd of scores of people stopped an ambulance carrying the body of a recently deceased COVID-19 patient in Pamekasan Regency, Madura, East Java.

Paramedics and the driver tried to placate the crowd, but the mob threatened to set the ambulance on fire if they didn’t do as they said and hand over the body. The ambulance passengers eventually surrendered, and, adding insult to injury, the mob stripped them of their personal protective equipment.

According to news site Kompas, the members of the crowd identified themselves as family members and neighbors of the deceased, and were apparently unable to accept the fact he died of coronavirus.

“These people wanted to bury the body without COVID-19 protocols, because they don’t want [to acknowledge] anyone in their area to be exposed to COVID-19,” Syaiful Hidayat, leader of the COVID-19 task force leader at Smart Pamekasan Regional Hospital, told the media.

As extreme as the incident in East Java may seem, it’s only one of a string of cases in which people forcibly recovered the bodies of family members who died of COVID-19, determined to bury them without the mandated protocols.

Earlier this month, a family in Gresik, East Java, took the body of a deceased patient-under-observation from Walisongo Hospital because they refused to believe their relative truly had COVID-19.

“My in-law suffered from low hemoglobin, not COVID-19. We’ve never had contact with those infected with coronavirus,” a relative of the deceased named Heri told Suara.

The head of Balongpanggang Medical Centre, Dr. Eko Hariyanto, said there was little he could do to dissuade them. When family members turn up to recover a body, he said, they usually bring a crowd.

"The hospital did not dare to take action to directly implement the COVID-19 funeral protocol because it did not get permission from the family," Hariyanto said.

On the same day as the Gresik incident, the body of another deceased patient-under-observation was taken by force from R.K. Charitas Hospital in Palembang, South Sumatra. The family brought their dead relative back home in the back of a public minibus, wrapped in a shroud.

Kresna Tuti, head of public relations at R.K. Charitas, said the family refused to have the body buried with COVID-19 protocols. At around noon that day, Tuti said, they burst into the patient’s room and carried it away.

A similar incident on June 11 at a hospital in South Sulawesi, meanwhile, was thwarted by hospital staff, Indonesian Armed Forces (TNI) personnel, and police.

The person-under-observation’s husband, Andi Baso, told BBC Indonesia, that he felt “betrayed” by the COVID-19 task force, claiming that after authorities buried his wife according to protocols, a swab test came back negative.

“She was buried with no family present. You can’t imagine how painful it is for us and our kids to receive such social sanctions from others,” Baso said, adding he wanted to bring his wife home “so we could free her from the stigma.”

For most Indonesians, it’s important to perform proper burial, as it’s how they show respect to the deceased for the last time, Amika Wardana, a sociologist at Yogyakarta State University, told VICE News. Burial practices should ideally be in accordance with community norms, and conflicts can arise if the rituals are not done properly.

“Funerals and religious rituals cannot be separated. It’s very sacred, and has to be done properly,” Wardana said. “They now have to abandon these sacred processions because he or she was dead of COVID-19.”

Drajat Tri Kartono, a sociologist at Sebelas Maret University (UNS), agreed, noting there were conflicting values between the government and community approach.

“While the government moves formally, the community prioritized the socio-cultural factors,” Kartono told Kompas. Failing to live up to one’s funerary obligations, he added, could see one “punished with social sanctions, for example being [seen as] a child who does not respect their parents.”

But one question remains: Are the strict protocols on burials worth all the conflict?

In a March guide on dealing with the bodies of COVID-19 patients, the WHO notes that the disease is not generally transmitted by cadavers, though it allows that given how much is still unknown about the disease, “more precautions may be used.” Hospital staffers and morticians are advised to wear personal protective equipment when dealing with the body.

The WHO also notes, however, that the “dignity of the dead, their cultural and religious traditions, and their families should be respected and protected throughout,” but family members should be given “clear instructions not to touch or kiss the body.”

Kartono, for his part, suggested that the government try to reach a compromise with patients’ families, like allowing one of the family members to help with the handling of their loved ones’ body, while still following the rules.

“For example, the medical team can give a chance to one family member to wash their relative’s body. They must wear complete PPE while doing so,” he said.

Hermawan Putra, of the Indonesian Society of Health Experts (IAKMI), said the government should be more sensitive to locals’ wishes.

“Doing it the strict way will only be counterproductive. I see extreme reactions to rejection, so the local government should consider local wisdom for resolving conflict,” Putra told Detik.

And shame also plays a role. Despite the massive education campaign related to COVID-19, a lot of Indonesians still view being infected by the coronavirus as a sort of deviance.

“Families take their relatives’ body by force because they want to break the stigma,” Putra said.