Mounting debt stifles funeral homes during pandemic

FUNERAL HOMES will meet very soon to discuss changes in protocols for covid19 burials, as well as formulating a list of funeral agencies that will be able to store the bodies of those who have died of covid19.

At the beginning of the pandemic it was mandated that all covid19 patients' bodies should be cremated, but that policy changed.

But now, with the increase in cases and deaths, funeral homes are considering reverting strictly to cremation.

Sunday Newsday spoke with president of the Association of Funeral Professionals of TT Keith Belgrove, who said his association will meet to discuss the changes.

"We will be reviewing the list and the criteria to be on the list. One of the main criteria will be being a member of the association."

Belgrove said his association is working with a committee appointed by the Ministry of Health to address the proper way to dispose of the bodies given the change from cremation only to include burial. He said burials have always been allowed to take place in Tobago because it lacks a cremation site.

Muslims in Trinidad are also given an exemption but are being buried only at one cemetery, in east Trinidad.

He added that at the beginning of the pandemic, his association, in collaboration with the Health Ministry, compiled a list of funeral homes to handle covid19 deaths, including storing the bodies. This initial list, he said, was now reduced to a few, with one funeral home predominantly storing the bodies.

Sunday Newsday was told that Belgrove’s, Simpson’s, Dass, Armstrong’s, Clark and Battoo, Boodoo’s, Shyam’s and Allen's Funeral Home, were listed as the authorised agencies to store and dispose of covid19 patients' bodies.

Belgrove, who did not identify the initial list, said some of those on it deviated from the cremation-only rule and the list was changed and eventually morphed into the shorter one above.

Relatives of those who have died from complications associated with covid19 can choose any funeral agency they want, but only selected funeral agencies can remove the bodies from where they died.

Another funeral director, who did not want himself or his company identified, said the list shrank because of a failure to pay other agencies.

He corroborated Belgrove’s claim, saying “the main man right now” has a funeral parlour in East Trinidad and is the only agency being called to collect covid19 bodies. Families are not obligated, however, to use his service for burials and cremation.

The list, the funeral director said, is the second after other agencies began removing covid19 patients' bodies. The increase in funeral agencies vying for the bodies created accounting problems within the various regional health authorities, he said, as there was no contractual agreement with any of the agencies.

To fix this, the association is hoping to prepare a list of acceptable agencies to remove and store the bodies.

The Health Ministry's most recent guidelines said all funeral homes that deal with covid19 must have the required PPE (personal protective equipment). All removal vehicles must have a closed space for the body and be outfitted with non-fabric seats. The funeral home must also have a preparation room with adequate ventilation and a working cooler.

Staff dealing directly with covid19 cases are required to have: "Goggles, N95 or equivalent masks, long-sleeved gowns, non-sterile nitrile gloves, soap and water, standard body bag 7mil or higher depending on body weight, disinfectant soaked absorbent cotton, safety boots, spray bottle containing disinfectant, biohazard bag, impervious plastic bag and any other PPE as may be required," the ministry stipulated

Health Ministry guidelines also say all funerals are limited to a maximum of five attendees, including the religious officiant.

In addition, "There should be speedy burial/cremation of the deceased. The burial/cremation should occur within 24-48 hours of the body arriving at the funeral home. Religious leaders should be encouraged to limit the rites and ceremony to a maximum of 30 minutes."

In spite of the guidelines, funeral homes say owing to the increase in cases, they are storing bodies for as long as two weeks. In some cases the bodies are kept at the behest of relatives who are unable to attend funeral services because they are in quarantine.

The Health Ministry's memorandum said there covid19 body bag must not be opened, the bodies must not washed or embalmed, and any pallbearers must wear PPE.

This is also reportedly not being adhered to, as some funeral homes are washing the bodies and changing the clothes of the dead, at the request of relatives. The unnamed funeral director said his company washed bodies and changed clothes, and believed others did as well.

He was adamant, though, that no embalming is taking place, although he believes there are funeral agencies that could do this.

On the breaches in guidelines, he said: "Let me tell you something: money talks and bulls--t walks. For the right price, you can get anything in this world.

"In the US they are embalming covid19 bodies, and many of the funeral homes in TT operate at that standard and can do that. Right now, we are going old school and providing coffins with a viewing window. Long time it used to be a peep-hole."

A manager at another funeral home, who also asked not to be named, said it was also building coffins with a glass window to show the face of the dead person for final viewing. She too said the storage time was being extended, not only at the request of relatives, but depending on the availability of crematoria.

"The Health Ministry seems to be making it up as they go along. The present regulation worked fine when four people died in a month," she said.

To solve the issues of backlogs, one funeral director is calling for outdoor cremations to resume for covid19 cases. Carlyle Mulchan, director at Dass Funeral Home, said it was awaiting the go-ahead from the Health Ministry to have outdoor cremations in keeping with Hindu practices.

"We are optimistic that we will be able to resume that. We need space to conduct cremation to avoid overloading of the crematorium," he said, adding that all protocols will be observed.

The ashes of loved ones, the Health Ministry said, are not contaminated, so relatives are allowed to keep them.

Risky business for workers

The funeral director also complained that funeral homes are running out of PPE and other materials because of a shortage of US dollars and increased prices. He added that for covid19 cases, funeral agencies are doubling body bags, depleting their stock faster.

Covid19-victims' bodies are stored in a separate refrigerator from all others.

He said the increase in prices for their tools of the trade and growing debt is crippling the industry. He himself, he said, is faced with having to mortgage his home to pay staff and suppliers.

"Just recently we had a home death with covid19, and when my men went there everyone was sick. I am putting my life at risk, my men lives at risk, their families and my business. And I am not compensated in a timely manner."

He added that each covid19 body removal is billed between $2,000 and $3,000, which does not include daily storage fee. The removal cost is borne by the State. Some are paid for through the National Security Ministry and others through the Health Ministry. The removal of unnatural deaths such as murders and accidents are paid for by the Ministry of National Security and natural deaths or deaths not immediately determined to be unnatural are paid for by the Health Ministry through the various regional health authorities. Covid19 cases are paid for by the Health Ministry

He added: “We hoping to get paid, because
the government has a history of taking services and not paying.
The PPE suits, that was $100 and something for one suit, now it’s $200 and $300 for one suit, and we have to use that whether we are retrieving a covid19 body or not.

"We are providing a service and we would like to get some kind of payment, because a lot of us were promised.”

He said the funeral homes are aware that the government is under pressure, but they too have bills to pay.

“How are you expecting us to provide a high level of service when we cannot even survive and provide it for ourselves?

"When things get bad and we start to pick up bodies with industrial plastic and we head down to the Forensic Science Centre and telling them we have no body bags, they will want to refuse us. If it is you are forcing our hand and backing us into a position where we cannot provide the service properly, what are we supposed to do?”

He warned that with increasing prices of basic equipment and increasing debt, TT is headed for a public health hazard.

$14,000 for covid19 funerals

Speaking in the Senate last November, Health Minister Terrence Deyalsingh said 18 funeral homes were handling covid19 final rites. He said then that the costs of a funeral ranged from $1,500 to $7, 575 and were borne by the relevant regional health authorities and families.

Some families received bills of up to $16,000 for covid19 funerals.

The funeral director said the figure quoted by Deyalsingh is a drop in the bucket compared to the actual cost of a covid19 funeral.

He said: “Maximum, I think it costs between $13,000 and $14,000. You have to stay within that budget per funeral. But if the customer chooses to take something more elaborate, I guess they can just add something on to it.

“We got instructions that the funeral homes were supposed to take care of the burial and cremation costs and we will then now have to pay the crematorium, which is at Long Circular, out of pocket.

"We are hoping to get back the money, and that’s why certain members, including myself, are in the position we are, because we are asked to pay for the whole service, store the body, provide PPE, body bags, solutions to protect ourselves and staff."

The director said he is now owed $1.6 million overall and there are others who are owed similar amounts and more. Of that figure, he said about $70,000-$80,000 is related to covid19, and the rest is for other services provided to the Government.

Another change as a result of the pandemic is that funeral homes can now register deaths. With the increases in covid19 deaths, the Registrar General's Department is now allowing funeral homes to register them if the next of kin are in quarantine.

Usually, deaths must be registered within five days by the next of kin.

In a media release last week, the department said if the next of kin is quarantined, the Government will allow for another relative and/or the funeral agency to do so with copies of the required documents.