Frequently Asked Questions on the Management of Cadavers

Given the widespread interest in the topic of management of dead bodies, PAHO/WHO, the ICRC and a broad group of global experts have collaborated to produce practical decision-making guidelines on this delicate and difficult task. These frequently-asked questions are an example of the kind of information contained in a the publication Management of Dead Bodies after Disasters: A Field Manual for First Responders.

Information for the Public

1. Do dead bodies cause epidemics?
Dead bodies from natural disasters do not cause epidemics. This is because victims of natural disasters die from trauma, drowning or fire. They do not have epidemic causing diseases such as cholera, typhoid, malaria or plague when they die.

2. What are the health risks for the public?
The risk to the general public is negligible. They do not touch or handle dead bodies. However, there is a small risk of diarrhoea from drinking water contaminated by faecal material from dead bodies. Routine disinfection of drinking water is sufficient to prevent water borne diseases.

3. Can dead bodies contaminate water?
Potentially – yes. Dead bodies often leak faeces, which may contaminate rivers or other water sources with diarrhoeal diseases. However, people will generally avoid drinking water from any source they think has had dead bodies in it.

4. Is spraying bodies with disinfectant or lime powder effective?
No, it is not effective. It does not increase decomposition or reduce the risk of disease.

5. Local officials and journalists say there is a risk of disease from dead bodies. Are they correct?
No. The risk from dead bodies after natural disasters is misunderstood by many professionals or the media. Even local or expatriate health workers are often misinformed and contribute to the spread of rumours.

Information for Workers

6. Is there a risk for those handling the dead bodies?
For people handling the bodies (rescue workers, mortuary workers, etc.), there is a small risk from tuberculosis, hepatitis B and C, HIV and diarrhoeal diseases. However, these diseases do not last more than two days in a dead body (except for HIV that may survive up to six days). These risks can be reduced by wearing rubber boots and gloves and practicing basic hygiene (washing hands).

7. Should workers wear a mask?
The smell from decaying bodies is unpleasant, but it is NOT a health risk in well ventilated spaces/areas and wearing a mask is not required on health grounds. However, workers may feel better psychologically if they are using masks. The public should not be actively encouraged to wear masks. 

8. How urgent is the collection of dead bodies?
Body collection is NOT the most urgent task after a natural disaster. The priority is to care for survivors. There is no significant public health risk associated with the presence of dead bodies. Nevertheless, bodies should be collected as soon as possible and taken away for identification.

9. Should mass graves be used to quickly dispose of the bodies?
NO. Rapid mass burial of victims is not justified on public health grounds. Rushing to dispose of bodies without proper identification does more harm than good. Mass and commingled burials (pit burials) traumatize families and communities and may have serious legal consequences (i.e., inability to recover and identify remains).

10. What should the authorities do with the bodies?
Bodies should be collected and stored, either using refrigerated containers, dry ice or temporary burial. Identification should be attempted for all human remains. Photographs should be taken and descriptive information recorded for each body. Remains should be stored (i.e. using refrigeration) or buried temporarily to allow the possibility of an expert forensic investigation in the future.

11. What is are the potential mental health issues?
The overwhelming desire of relatives (from all religions and cultures) is to identify their loved ones. All efforts to identify human remains will help. Grieving and traditional individual burial are important factors for the personal and communal recovery or healing process.

12. How should bodies of foreigners be managed?
Families of visitors killed in a disaster are more likely to insist on the identification and repatriation of the bodies. Proper identification has serious economic and diplomatic implications. Bodies must be kept for identification. Foreign consulates and embassies should be informed and INTERPOL contacted for assistance.

Information for Responders

13. I am a volunteer, how can I help?
To be helpful you should advocate for the proper recovery and management of bodies and assist in recording necessary information. You might also assist with the recovery and disposal of the dead, under direction and responsibility of a recognised coordinating authority. However, you would first need to be briefed, advised, equipped and supported for this difficult task.

14. I am a NGO, how can I help?
Providing support for families and collection of information in collaboration with the coordinating authority will best help the surviving relatives. You may also advocate for proper identification and treatment of the dead. NGOs should not be asked to carry out the identification of dead bodies, unless they are highly specialized for this task and work for and under direct supervision and responsibility of a legal authority.

15. I am a health professional, how can I help?
The survivors need you more than the dead do, but any professional help in fighting the myth of epidemics caused by dead bodies which may lead to their hasty disposal will be appreciated. Talk about this to your colleagues and any members of the mass media who may be misinformed.

16. I am a journalist, how can I help?
Your help is most critical. If you hear comments or statements regarding the need for mass burial or incineration of bodies to avoid epidemics, challenge them. Consult WHO locally. Quote this and other publications. Please do not jump on the band wagon of alarmist rumours. Be professional.