A row broke out this week between the governments of the Eastern Cape and the Western Cape about the movement of people and bodies returning to their rural homes for burial. It was alleged that corpses and people from the Western Cape, which has become the country’s Covid-19 hotspot, waited on the side of the road for days for the results of virus tests taken at roadblocks.
At the same time, geo-mapping indicates that the virus is approaching far-flung areas of the Eastern Cape such as the former Transkei.
The row between the provinces and the latest data on the spread of the virus, which came as President Cyril Ramaphosa was set to embark on a visit to both provinces this week, has highlighted the need for practicable, compassionate protocols so that families can travel and bury their loved ones in culturally appropriate and safe ways.
In response, social scientists, academics and provincial officials want to work together to produce what anthropologist Paul Richards calls a “people’s science” for funeral rites — people themselves decide on a set of behavioural practices that meet both cultural and health needs, with the support of the government.
The initiative is based on lessons from Brazil and West Africa, as well as South Africa’s experience of HIV, which show how people can either internalise the death and harm wreaked by the spread of potentially lethal viruses, or come together to produce a “people’s science” to try to manage the outcomes more effectively.
In the 1990s, anthropologist Nancy Scheper-Hughes produced an unsettling ethnography of death, violence and hope in a shantytown in northeastern Brazil. Her book, Death Without Weeping, was concerned with how shockingly high levels of infant mortality were hidden from public view by the ways in which women and families coped with this reality.
Scheper-Hughes noted that young women refused to name their children to protect themselves and their families from the pain of having to deal with the full effect of pervasive death. She argued that by delaying the attribution of social and cultural identities to children, such as through naming and baptism, these mothers were better prepared to deal with the almost inevitable loss of one or more of their infants.
In his 2016 study of the Ebola virus in West Africa, Ebola: How a People’s Science Helped End an Epidemic, Richards noted that social behaviour changed radically and rapidly as people quickly learned that their behaviour regarding household care, social proximity and intimacy were deadly. Adjustments were made that, he argued, resulted in a “people’s science” that ultimately managed to contain the spread of Ebola.
As poor people come face to face with Covid-19 in South Africa in 2020, it might be useful to think about what kind of response to death will be most likely in this context. Will death be concealed as has been the case with HIV? Will questions of family honour and shame predominate? How will bodies be viewed and cared for? Where will the bodies be buried? And, what kind of “people’s science” will emerge to contain the spread of the disease?
These questions lie on the road ahead. It is difficult to say how South Africans will respond to the pandemic, because there is no evidence to suggest that Covid-19 and its lethal prospects have yet been internalised. In the townships, masks still appear to be worn more as fashion items, or to comply, rather than as tools for survival.
Death without weeping
The evidence from the HIV pandemic suggests that, at its height, South Africa initially went down the road of denialism and cultural concealment rather than confrontation. The internalisation of the biomedical implications of HIV took a while to take root. The journey started with the denialism of then-president Thabo Mbeki’s government, when the state questioned the core findings of the dominant Western biomedical model.
But even after the state acknowledged that HIV was not just a disease of poverty and could not be cured by improved nutrition, there was still popular denialism through folk theories of causality and connection. These varied from the belief that traditional healers could “HIV-proof” people to the idea that condoms caused rather than prevented the virus’s spread.
A key issue was the question of shame and the reluctance of families to disclose the actual cause of death. Obituaries and death notices were carefully worded to disguise any association with the dreaded disease. Those who were grievously ill were often also removed from the cities and sent to die in the countryside.
The net result was a kind of “death without weeping” in which the extent of the disease’s toll was hidden, and even refuted. This did not make the effect of people dying and their deaths any less traumatic for the families, nor did it free them of the burden of caring for the sick and burying the dead. But it did help them deal with the question of shame.
There has also been no effective “people’s science” to stop the spread of HIV in the country. One of the reasons for this is that men and women have remained divided in their approaches to the disease.
Women have generally been much more receptive to the evidence of Western science and have been keen to adjust their behaviours to minimise risk. Men, on the other hand, have been less prepared to talk about the disease or to accept changes to their sexual behaviours and social practices.
Dumping dead bodies
In contrast to these socialised responses to death and disease, recent reports from Latin America on Covid-19 describe how bodies are wrapped in plastic and dumped on the street and there’s been mounting anger and unrest in areas where the poor live.
Meanwhile, the Eastern Cape government recently indicated that it opposed receiving infected bodies from the Western Cape and would need to be compensated if they were to cross the provincial border. This suggests that fewer bodies will move to the countryside, placing pressure on oversubscribed urban cemeteries.
It is also clear that the denialism associated with HIV will not accompany Covid-19. It is not shameful to be accidentally in the same air space as an infected person. It does not involve forms of intimacy that are regarded as socially inappropriate or compromising. It also does not involve the complexities of contested notions of gender identity and sexuality.
As a result, there are greater possibilities for consensus at the local level for a set of democratically produced behaviours to manage the disease. For this to happen, it is critical that street-level organisations and households internalise the impending dangers and do their best to advise people of the everyday protocols that can minimise these.
There will be many deaths in the coming months, despite the measures that have been taken and may be taken. And, if death is accompanied by weeping, and the cause of death is not disguised or withheld from public scrutiny, then there will be anger and outrage that may be directed elsewhere, as individuals refuse to bear the blame for their own infection.
In this regard, the Covid-19 experience will be overtly political, because the disease is likely to be socialised in a different way to that of other pandemics.
Yet, there is also a greater chance of an effective “people’s science” emerging with Covid-19 than with HIV because, by comparison, it lacks the social complexity of infection and transmission.
For this reason, the state must urgently support urban and rural households and civic organisations in playing a greater role in managing and preventing the disease.
In addition, the state might start to plan for how to respond when the numbers of the dead surge in crowded, poor areas such as townships and informal shack settlements.
Careful attention will need to be given to the dignity of death and to culturally appropriate burial in the city if the level of public anger is to be contained.
It seems clear that the families of the deceased will be less prepared to bear the burden of Covid-19 than they have been with HIV. They will expect the state to do more.
Professor Leslie Bank is research director in the Inclusive Economic Development Unit at the Human Sciences Research Council