It is 11 April 2020 and Dumaria is dying.
The 56-year-old civil servant has started vomiting blood at Santa Elisabeth Hospital in the city of Medan, Indonesia and her family accept that there is nothing more that can be done medically to save her.
By 17 April, Dumaria will be dead.
Her family will only be able to see her from a distance, through two doors and one pane of glass, as her body is wrapped in three layers of plastic and hastily placed in a wooden coffin—also wrapped in plastic. At 2 a.m., her family will congregate 500 metres away from the ambulance that will drive to her final resting place, and say a prayer on the pavement outside the hospital.
Her husband and two sons will follow the ambulance as it winds through the inky night on its way to Simalingkar B Muslim Cemetery, and will be told to stand on a bluff overlooking the rows of graves rather than at the graveside. They will barely be able to see what is happening to their wife and mother, but they will know that whatever happens, happens quickly. The ambulance will draw up almost to the lip of the hole in which Dumaria is to be buried, and the crew will tip the coffin out of the back doors and into the earth.
Before they leave the hospital, the family will be handed a wooden cross and asked to write Dumaria’s name on it. The only thing her husband, Laurensius, will have to hand is a marker pen. “It’s a good thing I found it in my bag,” he tells New Naratif, with far more patience than one might expect.
The cross will be planted in the dome of earth that will cover Dumaria, and almost immediately break and fall over. There will be no prayers at the graveside and no chance to mourn properly. There will be no priest to say a final farewell to the devout Christian. Apart from the paramedics, all wearing hazmat suits, Dumaria will be alone, just as she was in the days that led up to her death.
She will lie under cross No. 4 in a mass grave that contains 37 bodies which have all been buried according to Indonesia’s COVID-19 protocols.
But Dumaria did not die of COVID-19. She had stage four colon cancer.
A Multitude of Sins
As of May 2020, Indonesia has over 12,000 coronavirus cases, over 900 deaths and a mortality rate of around 7%—one of the highest in the world.
Fewer than 100,000 people have been tested in a country with a population of 270 million—meaning that official figures likely only hint at the real scale of the problem—and Indonesia’s wholly incompetent response to the coronavirus pandemic rests not on one single failure, but on a multitude of sins from some of the most senior levels of government and beyond.
To date, these have included, but are not limited to: the president’s admission that key information was deliberately withheld “to avoid mass panic” in the early days of the outbreak; the vice-president’s suggestion that the populace should “keep praying” to avoid infection; the government’s failure to procure an adequate number of tests early on; the procurement of the untested and widely useless drug chloroquine; the maritime and investment minister’s comment about Indonesia’s safe position in the tropics; the in-fighting between provincial administrations and the central government; the lack of adequate contact tracing; the chronic lack of personal protective equipment (PPE); the COVID-19 Task Force spokesman’s declaration that the “poor should take care not to spread the virus”; the refusal to issue widespread lockdowns; the sluggish enactment of social distancing measures; the health minister’s complete ineptitude and previous career curing strokes using something called “brain flushing”; local officials’ use of free hand sanitiser as a promotional tool to seek re-election; the ludicrous decision to pay foreign social media influencers to save the tourism industry; the dithering about cancelling domestic and international flights; the additional dithering about cancelling the Eid-ul-Fitri holiday; the time the Disaster Mitigation Agency openly accused the Health Ministry of fudging the numbers; the lack of ventilators; the ridiculously low levels of testing; the relative absence of social welfare packages; and the president’s insistence that a medicinal drink called jamu would improve things.
Yet of all the government’s myriad sins, perhaps one of its most egregious is tipping people into COVID-19 mass graves for no clear reason.
The Masses
Simalingkar B Muslim Cemetery, on the outskirts of Medan, used to be covered in mango plantations and rice fields. Only a small plot was used for burials—there were maybe 50 graves at most. But when the virus started to take hold of Indonesia in March, an excavator was brought in to clear the remaining land and make way for the mass burials of COVID-19 victims.
Mimpin Bangun now guards the site. He worked as a grave digger at the Public Parks and Cemeteries Department in central Medan before he was relocated to Simalingkar B Muslim Cemetery and told to be onsite 24 hours a day until the outbreak abates. He lives in a small house on the cemetery grounds and is on call at all times—corpses now have to be interred within four hours of death according to COVID-19 protocols set up by the government. “I’m forced to accept that I have to stay here until this is over,” he says.
The cemetery’s mass graves are packed closely together, with Muslims buried in one row and Christians in another. COVID-19 has somehow managed to circumvent the strict religious norms that are so prevalent across Indonesia, where over 87% of the population is Muslim and people of different faiths are usually buried in completely seperate cemeteries. “The Muslims face the Kiblat (the direction of prayer),” says Bangun. “But it’s OK to bury both religions in the same place at this extraordinary time.”
When New Naratif first visits the cemetery on 21 April, there are 37 bodies buried in the mass graves, and the distinct smell of decomposition lingers in the air. A few weeks later, the graves appear to have doubled in number and 25 additional holes have been dug for incoming corpses, which are filled with water after a night of heavy rain. The stench of decomposition no longer pervades the atmosphere. Bangun refuses to answer questions about how many people are now buried here (39 according to official reports) and whether the cemetery has been using something like quicklime to mask the smell.
“I’m forced to accept that I have to stay here until this is over,” he says.
The bodies come at all times of the day and night, he says, sometimes in the early hours of the morning, brought by “the robots”—paramedics in hazmat suits—and accompanied by often tired and shell-shocked mourners. “The people who come here are always crying,” he adds. “Crying all the time because they can’t be with their family.”
According to Bangun, in addition to compounding a family’s sense of loss, a burial in a mass grave is seen as the “final humiliation” of the deceased.
Protocol
This “final humiliation” is the brainchild of the Indonesian COVID-19 Rapid Response Task Force in conjunction with the Ministry of Health who together drafted the COVID-19 protocols that have led to practices like the digging of mass graves which are seemingly at odds with those in most other countries.
Throughout history, mass graves have traditionally only been used in times of extremes to deal with a sudden influx of corpses resulting from war, mass murder, genocide or natural disasters. During pandemics such as the plague or Spanish flu, mass graves were used not only to process deaths in large numbers, but also to stem the spread of perceived contagion from corpses.
COVID-19 protocol in Indonesia errs on the side of extreme caution, starting when the patient is still alive and continuing throughout the deceased’s burial process—an extension of isolation measures followed to their natural but unnecessary conclusion.
In Indonesia, mass graves are now being used in much the same way, not just to bury large numbers of dead quickly, but to keep them all in one place away from the general populace—a kind of quasi-quarantine for corpses—despite the fact that health authorities in badly affected countries such as Italy have widely discredited the theory of posthumous COVID-19 transmission.
With that in mind, there would appear to be no need for Indonesia to wrap both bodies and coffins in plastic, or to prevent families from standing at a graveside in small numbers. Yet COVID-19 protocol in Indonesia errs on the side of extreme caution, starting when the patient is still alive and continuing throughout the deceased’s burial process—an extension of isolation measures followed to their natural but unnecessary conclusion.
In a further ramping up of COVID-19 protocols, the head of the COVID-19 Rapid Response Task Force, Doni Monardo, announced on 20 April that all suspected COVID-19 cases would be buried according to these protocols regardless of whether they had been tested for the disease, following a mix-up where a positive COVID-19 case was buried in a “standard” grave.
“Let’s avoid that happening again,” he said.
Fate
Dumaria ended up at Simalingkar B Muslim Cemetery not because she had any COVID-19 symptoms. In fact, she didn’t have a single one: no fever, no cough, no difficulty breathing, no chest pain.
Instead, it was her cancer that sealed her fate.
In March 2020, after complaining of stomach pain, she travelled to Penang, Malaysia where a scan revealed a tumour in her colon. Later that month, hoping for a more positive second opinion, she and her husband travelled to Jakarta where Dumaria was told that she was too weak to undergo chemotherapy and that the tumour had already metastasized.
The family returned to Medan, where Dumaria’s condition deteriorated further.
When she started begging for pain relief and asking for a priest, she was taken straight to a private hospital, but because she had travelled to both Malaysia and Jakarta—considered COVID-19 “hotspots” at the time—she was sent home. On 10 April, desperate for medical treatment, Dumaria went to another private hospital for a rapid blood test which came back negative for SARS-CoV-2, the virus that causes COVID-19. She wanted treatment for cancer and not coronavirus, which is why she paid for the tests herself and didn’t go to either of the two COVID-19 designated public hospitals, Martha Friska and Adam Malik, where treatment is free of charge. On 11 April, armed with the test result, she checked into Santa Elisabeth Hospital where another rapid blood test was performed. Again the result was negative for COVID-19. Following the test, the hospital agreed to admit her as long as she went straight into isolation due to her travel history.
She spent the next six days battling the final stages of colon cancer alone.
While in isolation, Dumaria was not allowed visitors and, according to her family, the doctors and nurses were scared to go near her, rationing visits and sometimes leaving her alone for hours at a time. Her husband and two sons could only communicate with her by video call, and one of the last conversations they had is forever captured in a screenshot in grainy but harrowing detail: Dumaria lies alone in a hospital bed—blood trickling out of the corner of her mouth. She is too weak to wipe it away and unable to press the button that will alert a nurse to her bedside.
“We offered to buy our own personal protective equipment [PPE] so that we could visit her one last time. Even if it was just for a few minutes. We thought it might lift her spirits a little,” her son Septro tells New Naratif.
According to Dumaria’s family, Santa Elisabeth Hospital refused their request.
At 11 p.m. on 17 April 2020, Dumaria’s family, exhausted from keeping vigil outside her isolation room, went home for the evening—only to be called back an hour later.
Dumaria had been pronounced dead.
They rushed back, planning the funeral and hoping to see Dumaria properly one last time before she made the journey to her final resting place. After all, she had never tested positive for coronavirus, and it seemed clear that she had finally succumbed to the colon cancer that ravaged her body for months.
The hospital disagreed, Laurensius tells New Naratif. Because she had been in isolation, she would be buried in a COVID-19 mass grave.
This was three days before the announcement by Doni Monardo about the bolstered COVID-19 protocols, so Santa Elisabeth Hospital could have released Dumaria’s body back to her family for a traditional burial. Yet, it did not.
“When we got there, they were already doing the wrapping,” Septro tells New Naratif, referring to the way in which Dumaria was cloaked in plastic sheeting.
When he says “wrapping”, he uses the English term instead of the Indonesian.
“Wrapping” is usually only used to describe the service offered at Indonesian airports of wrapping suitcases in sheets of plastic to prevent theft.
Endless Grief
Irna Minauli, a psychologist in Medan, explains that while it may take some time for the full psychological impact of COVID-19 burials to be known, families may stay trapped in a grief cycle for years to come if they have had to experience a loved one being interred in a mass grave.
“If we look at the concept of ‘grief theory’, families of people who have been buried in COVID-19 mass graves may experience a range of emotional and psychological issues in the future,” she says. “A common part of grief is denial, for example, which may be heightened if people can’t see their loved ones being buried in front of them.”
The cycle of grief could take much longer to play out for those who have lost loved ones during the pandemic, who may become stuck between blame and bargaining, asking themselves questions like, “Why did I take my mother to that hospital instead of letting her die at home?” or “Why did I choose that hospital and not another one?”
“The guilt of allowing a loved one to be buried in a mass grave, even if there was no choice in the matter, could make many people extremely agitated, and they may struggle to accept what has happened.”
Sucked up in a vortex of grief, rage and disappointment, people may fall into depression—exacerbated by the powerlessness that many now feel as social, religious and cultural norms are stripped away and replaced with the “new normal” dictated by governments. The final phase of the grief cycle, acceptance, may be a long time coming for those who have had the sanctity of a funeral taken away from them, particularly if they feel that they somehow played a part in this process, according to the psychologist.
“The guilt of allowing a loved one to be buried in a mass grave, even if there was no choice in the matter, could make many people extremely agitated, and they may struggle to accept what has happened. Then the cycle of grief will perpetuate over and over again, back through denial, anger, blame and bargaining,” says Minauli.
COVID-19 burials in Indonesia may soon become not just a public health issue, but a very real mental health one as well.
Negative
Ten days after she died, Dumaria’s coronavirus swab test also came back negative.
Her husband and sons felt vindicated, but not for obvious reasons. Actually, they tell New Naratif, they didn’t really care whether she had COVID-19 or not. Dumaria was dying of stage four cancer, regardless of whether coronavirus hastened her demise.
But the backlash since her death has been so vicious that the family now feels like the negative test result is some kind of victory. In life, Dumaria worked as a senior civil servant and enjoyed a fairly public profile in Medan. Perhaps due to her position, the local newspapers picked up the story and ran with it, citing unnamed “sources” speculating about Dumaria’s diagnosis, and not contacting her family for comment. While the story, which used Dumaria’s full name, was unseemly and based on speculation, her family were not particularly bothered by it—writing it off as silly gossip and bad journalism.
But it was the reaction it caused that affected them so deeply.
“We were just clickbait to the journalists,” says Dumaria’s son Christopher. “No one thought about the people behind the story and how much it might hurt them.”
As more and more friends and family were alerted to the article, they called not to offer their condolences, but to ask if it was true that either Dumaria or anyone else had COVID-19. “Those were literally the first words out of their mouths,” says Septro. “People didn’t even say ‘I’m so sorry for your loss.’”
The family felt like social outcasts at a time when they were already in mourning and victims of the tabloid press. “We were just clickbait to the journalists,” says Dumaria’s son Christopher. “No one thought about the people behind the story and how much it might hurt them.”
The stigma followed them everywhere. No one would come to the family home, making excuses about why they were too busy to pay their respects, and even their close neighbours avoided them. In the end, the family elected to undergo their own rapid blood tests which also all came back negative. To make a further point, they decided to self-isolate at home, even though doctors had given them no such directive.
“Just be more humane about it,” says Christopher when asked what he thinks the government should do about COVID-19 burials. “Let families follow religious practices in a safe way at funerals so that no one else has to go through what we did. So what if our mother did have COVID-19? It was the protocols that caused us to be judged and labelled because we had to keep clarifying our situation and explaining ourselves to everyone.”
In the family’s eyes, there is an extra sting in this tale because Dumaria did not have COVID-19, and she may not be the only person buried at Simalingkar B Muslim Cemetery who tested negative for the virus. 39 people have been buried in the mass graves in Medan, but only 16 people have died of COVID-19 in all of North Sumatra, according to government figures. But Dumaria’s family feel that no one should have to go through such a humiliating burial process, regardless of their health status.
“Just give people their dignity back,” says Christopher.
Stigma
According to Bakhrul Khair Amal, a professor of sociology at the State University of Medan (UNIMED), the new COVID-19 funeral protocols are a “social punishment” for the families that have to endure them.
“A funeral is sacred, death is sacred,” he tells New Naratif. “But now people are bullied, stigmatised and insulted while they are in mourning. Yet the country is doing nothing to stop the stigma.”
This stigma has already had real consequences across Indonesia, in addition to the kind of ostracisation and tabloid humiliation that Dumaria’s family had to weather. There have been a number of instances of people escaping from hospitals to avoid being potentially classified as COVID-19 cases, and reports of graveyards refusing to bury those who either tested positive for or were suspected of having coronavirus—even with the COVID-19 funeral protocols in place.
“There is no chance to pray and remember the dead now, but a funeral is the time when we remember a person most,” says Amal. “Now families in mourning are being looked upon as a problem and COVID-19 is used against them.”
The government “needs to show up” and change COVID-19 protocols so that the families of the deceased are given some chance to mourn with their loved ones, according to Amal.
“Suddenly, in the age of COVID-19, it’s as if death is something new that creates so much fear, which doesn’t make sense because we will all die, with or without this sickness,” he says. “A funeral should be a time when the dead are most loved and best remembered.”
“But now, in death, there is only the virus.”
