The South African Cemeteries Association would like to advise the following with regards to the management of burials and cremations during the pandemic that we are facing as South Africans. We urge municipal officials to discuss and implement these protocols with cemetery staff whilst also adhering to the official guidelines from the National Department of Health.
Whilst cemetery and crematoria services are not listed as essential services it is our view that our current circumstances may challenge this fact and require us to review our classification of the service. The capacity of mortuary services to hold bodies which may unknowingly be infected may also pose a risk to personnel and public in the environment. People may also die of seemingly natural causes whilst unknowingly being infected.
In context of the above the following are suggested and recommended for the consideration of municipalities.
Burial and Cremation Services During Lockdown
Bookings to be spread to seven days of the week. i.e There are bookings that will be approved on weekdays to avoid weekend congestions. Documentation from undertakers should be scanned and emailed through with proof of payment at least 24 hours before the burial. All original documents to be kept with the undertaker.
Graves should be allocated in a scattered manner to avoid congestions of different processions.
Funeral procession should be limited to 30 minutes.
Whilst government regulations with regards to the Disaster Management Act refers to no more than 50 people at funerals consideration must be given to the total number of funerals that may occur within a cemetery and to ensure that number of people in total are kept to a minimum. This can be done by advising families to limit numbers to not more than 20.
Public ablution facilities to be sanitized after every use. Burial bookings will only be accommodated between 10:00 and 15:30 for both weekdays and weekends. Cemeteries must be manned for burials only with the minimum staff required for excavation and back filling as determined by the number of burials for the day. We recommend two staff for a burial.
The follow protocols discussed at training workshops held by SACA are also provided for consideration by municipal cemetery and crematoria staff.
INFECTION TRANSMISSION AND CONTROL
In order for an infection to spread, three elements are required:
- the parasite causing the infection has to have a source infection
- the parasite has to have a susceptible host (possibly you)
- the parasite requires a means of transmission
Infectious disease can spread in a variety of ways e.g. through the air, from direct or indirect contact with another person, soiled objects, skin or mucous membrane, saliva, urine, blood and body secretions and through sexual contact. To remember the most common way that infection is transmitted – remember the R A T.
R – Respiratory – some infections are spread when an infected person sneezes and coughs out tiny airborne droplets. The droplets in the air can be breathed in directly by another person, or indirectly enter another person through contact with contaminated surfaces and hands.
A – Alimentary – some infections are spread when microscopic amounts of faeces from an infected person with symptoms, or an infected person without symptoms (a carrier), are taken in by another person. The faeces might be passed directly from soiled hands to mouth or indirectly by way of soiled objects, surfaces, food or water.
T – Touch – some infections are spread directly when skin or mucous membrane comes into contact with other skin or mucous membrane. Infections are spread indirectly when skin or mucous membranes come into contact with contaminated objects or surfaces.
Infections are also spread by:
Saliva: Some infections are spread by direct contact with saliva (such as kissing) or indirect contact with contaminated objects (children sucking and sharing toys).
Urine: Some infections are spread when urine is transferred from soiled hands or objects to the mouth.
Sexually transmitted diseases: These diseases are most commonly transmitted by sexual contact.
Infection control techniques
These simple guidelines enable everyone to do something to avoid getting infections.
Careful hand washing:
Remember to wash your hands thoroughly with soap and warm or hot running water for at least 10 seconds:
- before preparing food
- between handling raw and ready to eat foods
- before eating
- after going to the toilet or touching anything soiled
Keep work equipment clean:
Keep equipment that comes into contact with potentially contaminated body fluid clean using disinfectant.
Keep your skin integrity:
- ensure that the skin on your hands remains soft and not cracked or peeling
- use moisturiser if necessary
- check nails and cuticle areas
- Wear PPE such as:
- ear protection
- eye cover
- foot cover
- hair cover
Managing exposure to body substances:
If any person has contact with body fluids, the following procedures should be observed:
- if body fluids get on the skin, irrespective of whether there are cuts or abrasions, wash well with soap and water
- if the eyes are splashed, rinse the area gently but thoroughly with water while the eyes are open
- if body fluids get in the mouth, spit it out and rinse the mouth with water several times
- incidents occurring at work should be reported immediately to your supervisor or occupational health and safety officer
Surface cleaning of body substances:
If body fluids are splashed onto a surface, the following cleaning procedures should be used:
- remove as much of the spill as possible with a paper towel or other disposable material
- clean the area with warm water and detergent, using a disposable cleaning cloth or sponge
- disinfect the area with a solution of household disinfectant
- remove and dispose of your gloves, paper towel and cleaning cloth in a sealed plastic bag after use; the plastic bag may then be thrown into the contaminated waste receptacle
- wash hands thoroughly with soap and warm water
Disposal of Contaminated Waste:
Contaminated wastes describe a range of items that we would work with when conducting exhumations or working in areas where you might be exposed to body fluids. When disposing of contaminated waste, it is crucial to:
- follow regulations pertaining to disposal of Contaminated Waste
- use only specific Contaminated Waste bags that have the ‘Biohazard’ logo
- always secure the Contaminated Waste bags with a strong, secure tie or tape securely
- always wear gloves when handling/moving Contaminated Waste
- either incinerate waste or place in a contaminated waste container
- Laundering contaminated clothing/garments:
- commercial laundering will sufficiently decontaminate any laundry that comes from gravedigging
- grossly contaminated laundry is to be treated as infectious waste and disposed of accordingly
Person-to-person spread, especially by soiled hands, is the major means of spreading infectious disease. Regular cleaning is vital to maintain a healthy working environment.
Cleaning with detergent and warm water will help maintain a clean and safe working environment. Remove all visible dirt as you clean. Clean up as you go.
We remain committed to keeping you informed and will provide updates as and when necessary.
Keep safe and healthy!
Mr Pepe Dass, Chairperson of South African Cemeteries Association.