In tropical countries human burial typically occurs soon after death and the final act of interment is triggered by the smell of bodily decomposition. That is particularly true in rural areas where traditional practices persist and refrigeration is absent. During the period between death and burial, family and community members gather to mourn close to the corpse. This approach is very different from funerary practices in many urbanised Western societies where visual contact with the body may be minimal and burial dissociated from decomposition. The importance of understanding traditional funerary practices in West Africa has recently been highlighted by the outbreak of the viral haemorrhagic fever Ebola in Guinea, Liberia, Sierra Leone and Nigeria. That is because physical contact with the corpse forms part of traditional funerals and has been implicated in Ebola transmission. What is more, research into such practices in rural West Africa may be hindered by secret societies with special cultural knowledge which closely control access to and proceedings at funerals.
This report describes one finding from a study of the cause of death in 84 adults belonging to the Manjako tribe of Northern Guinea Bissau. The Manjako adhere firmly to faith in traditional spiritual forces, sometimes in parallel with Catholicism. The present study was undertaken using verbal autopsy (VA) interviews, an established method for identifying cause of death in countries where there is no formal registration of demographic statistics. VA uses a
standardised structured questionnaire to interview those who cared for the deceased in their final illness in order to identify likely cause of death from accounts of symptoms, signs and treatments received. This structured way to interview participants’ beliefs about clinically relevant events before death is distinct from more widely used qualitative methods, such as that of Grounded Theory Method. As a result, data tends to be briefer and focused around the presence or absence of specific signs and symptoms. Most interviews were conducted in the local language Manjako, including the one described below.
During this interview an informant reported that his late father had always claimed he was never going to be ill and that “people would find him dead, but never ill‟. This assertion was, indeed, reported to be true for he ultimately died suddenly and alone, in his mid-80s. When specifically asked the cause of his death, the son responded that his father had “returned to the Lord’s house‟. He also reported that at the funeral his father’s body lasted for four days before needing to be buried, instead of the “normal‟ two day duration. This confirmed, according to the son, that his father “possessed an excellent body: because normally few people can reach this time without smelling bad‟.
This observation supports the notion that the period between death and burial holds significance for the bereaved beyond its intense experience of pain and loss. In cultures where the corpse is visible and can be touched, that encounter provides first-hand, irrefutable evidence of a loved one’s death and the opportunity for a final physical adieu. Although distressing, this observance may provide long-term emotional and spiritual benefits. Such a notion is supported by the present account which suggests that an additional function of this period is to re-interpret the deceased person in the context of their life and death. In this case, resisting decomposition for four days was interpreted as proof, and a marker of, ante-mortem bodily strength. What is more, the family drew comfort from the mythical strength of a man who fought illness not only in life (by living in a healthy state to a grand age) but also in death by defying bodily destruction longer than others.
This suggests that in rural Guinea Bissau an individual’s physical and mental fortitude in life is understood to extend into death and that being present at the wake promotes cultural re-interpretation of the deceased individual in a positive way. Two powerful changes to life in West Africa, however, threaten traditional funerary practices and grieving processes in a way likely to negate their psychological benefits. First, is mass migration from rural Africa to urban areas and abroad. Second, are strategies to contain the ongoing Ebola epidemic in parts of West Africa, for instance preventing physical contact with bodies and enforcing rapid burial. These will have important implications for the psychological wellbeing of bereaved families, in particular individuals who are unable to be present at – or closely involved in – funerals. Further research is, therefore, required into funerary practices in rural West Africa to examine the impact of rapid social change and epidemiological transition. That should explore how communities can adapt their rituals to meet these challenges in a way that preserves traditional mythology alongside promoting psychological wellbeing and protecting physical health.
Maxwell Cooper is Senior Lecturer in Primary Care at Sussex University. He has wide ranging interests in health in Africa. His most recent publication is David Lawrence, Helen Smith, Enoch Magala, and Maxwell Cooper (2014) Young People’s Opinions about Herbal Medicines in a Sub-urban District of Southern Uganda, International Health.
Sarah Cooper is a doctor and Registrar in Neurology who was worked and published extensively on aspects of tropical medicine.