Life after death in the time of covid-19

The covid-19 pandemic, and corresponding health restrictions placed on hospitals and funerals in South Africa, have completely changed the way we grieve and say goodbye to our loved ones. 

“Standing there in the cemetery, looking at the deep holes all around me, I just remember being overwhelmed with anxiety,” recalled Margarida Khadhraoui about the day of her brother’s burial.

“They’re probably all filled now,” she reflected.

Khadhraoui, a 50-year-old mother of two young boys, is just one of the many South Africans who have experienced loss during the covid-19 lockdown period, which began in March. The nationwide lockdown was characterised by various health restrictions, with one being a ban on all hospital visitations to prevent new coronavirus infections. These health restrictions compromised people in different ways, but for many it affectedtheir last moments with their loved ones, along with their grieving process.

Lost final moments

The ban on hospital visitations remained throughout the duration of South Africa’s strictest levels of lockdown, being levels five, four and three. In August some hospitals began to allow visitations, with News 24 reporting that covid-19 patients at the “end of life” stages would be allowed visitors, but still in line with strict safety protocols.

Khadhraoui was not so lucky. Her brother, Alvaro Jose Oliveira Goncalves, passed away right before such exceptions were established, so she was unable to visit him before he died.

“The most difficult part of it all was that when my brother was admitted, we weren’t able to visit him. Usually when someone is ill, you go see them and it almost gives them that push to fight and carry on, but we couldn’t,” said Khadhraoui.

Khadhraoui remembered her brother having flu-like symptoms a few days before he was admitted to hospital, but he had not thought a covid-19 test was necessary. He assured Khadhraoui that he was fine and, because he had no pre-existing issues that would put him at a higher risk for covid-19, she let it go.

Early one Friday morning in late July, Khadhraoui received a distressed phone call from her sister-in-law, who exclaimed, “Margi, Alvaro can’t breathe!”

Khadhraoui told Wits Vuvuzela, “It was all so sudden. He had some symptoms, but he was fine, and then her couldn’t breathe two days later. We managed to get the paramedics to the house that morning.”

She added, “His oxygen level was at 56, which is really bad. Your normal level should sit at 94 or 95, so they immediately put him on oxygen and rushed him to the hospital.”

Goncalves was first diagnosed with bacterial pneumonia, which is an infection in the lungs caused by bacteria. It was later confirmed that he had tested positive for the coronavirus as well. Goncalves stayed in Linksfield Hospital for two weeks, and remained on a ventilator throughout.

The day before he passed, he was intubated and placed in an induced coma.

“I knew he wasn’t going to make it. I could feel it. I told my husband, ‘my brother’s leaving us,’ and I got the phone call 10 minutes later,” said Khadhraoui.

While rummaging through her bag for tissues to conceal tear-filled eyes, she said, “I couldn’t be there to hold his hand, tell him that I’m there for him or tell him to not be scared. I don’t think he necessarily needed it … I was the one that needed it.”

Stefanie Bove, a clinical psychologist of 16 years, explained that the covid-19 restrictions, and new circumstances created by the pandemic, will have an effect on the grieving process experienced by individuals who have lost loved ones.

“Grieving under these circumstances will definitely affect one’s general mental wellbeing, more so than usual. And the restrictions will play a role in the prolonged grieving process,” said Bove.

Bove, who consults for Saheti School in Senderwood and has her own private practice in the Bedfordview area, confirmed that she has had more people coming in for grief counselling than before the start of the pandemic.

Bove told Wits Vuvuzela, “I think that most grief now will result in complicated grief because there are so many new factors that have come into play. For example, not being able to have contact with loved ones or not really being able to say goodbye.”

Complicated grief refers to a prolonged grieving process, as described by Mayo Clinic, an American academic healthcare company. It is associated with, for example, difficulty in recovering from loss and resuming one’s normal life.

While psychologists may have different versions of what a normal grieving period is, Bove explained that a normal grieving period usually lasts three months. With the new circumstances created by the pandemic, however, Bove believes new factors have made it more complex and difficult to predict.

Khadhraoui recognised the covid-19 health restrictions, which prevented her from seeing her brother, as a big challenge for her.

“I needed that comfort,’’ she said. ‘‘I still struggle to come to terms with the fact that he is gone. And I don’t know if I’ll ever get over it.”

Rushed goodbyes

Another area disrupted by the covid-19 pandemic and lockdown restrictions in South Africa was the funeral industry.

The health restrictions placed on funerals denied many South Africans control over the way in which they laid their loved ones to rest. Funerals play a big role in how we say goodbye to our loved ones and so, according to Bove, can also have implications on ones grieving process.

“Rituals are so important because it’s essentially saying goodbye officially. Covid has meant that those rituals are thwarted, resulting in an even deeper sense of loss of control, and death already has that effect,” said Bove.

In many religions, white candles are often lit during funerals or after someone has died, as a symbol of remembrance for the soul that has passed on and in order to strengthen prayers. Photo: Catia De Castro.

The first restrictions placed on funerals began before lockdown, on March 15, when President Cyril Ramaphosa announced a national state of disaster. Restrictions included a limit of 50 attendants at funerals. When lockdown began, further restrictions were added to the government gazette, such as a one-hour limit on funeral services and a ban on night vigils.

South Africa is known for its cultural diversity and so naturally there are many different funeral rituals. Consequently, health restrictions have disrupted these rituals.

Nelisiwe Makaringe, a 19-year-old first-year student at the University of Johannesburg, studying public management and governance, was affected by these restrictions during her nephew’s funeral.

Makaringe and her nephew, Sifiso Mo’koena, were the same age and grew up together. She often referred to him as her brother when talking.  Mo’koena passed away suddenly in May from an unknown cause.

“He became really sick one day and started having cramps in his stomach, so he went to Thelle Mogoerane Hospital [in Vosloorus]. We still don’t know what his cause of death was because the hospital records say, ‘natural death’, but he was negative for covid,” said Makaringe.

Although Mo’koena did not pass away from the coronavirus, Makaringe disclosed that the family was still affected by the pandemic due to the funeral restrictions, as some of their African and Christian rituals were not allowed.

Makaringe told Wits Vuvuzela, “With African homes, the deceased usually comes home in the casket a day before and stays overnight at the home. We then have the funeral and memorial the next morning, and afterwards people usually cook and have a celebration. We weren’t able to do any of that.”

Makaringe said the inability to bury Mo’koena the way they had hoped to, had an impact on the way she and her family have grieved.

“The funeral was so rushed. We weren’t even able to have a memorial service. How can you have a funeral in one hour?” exclaimed Makaringe, an air of frustration in her voice.

“I was very close to him and I feel like I wasn’t able to say goodbye. We weren’t able to grieve properly.”

“Afterwards, I felt like he hadn’t died,” Makaringe added.

Funeral home workers have been on the front lines during the lockdown, so they have witnessed the way in which families have been affected by funeral restrictions.

Willem Schuwte, an assistant manager at AVBOB Funeral Parlour for the Johannesburg Central Business District branch, has been involved in funeral arrangements during the lockdown period and has had to interact with, and assist, families throughout.

AVBOB is one of the few funeral parlours that offer grief counselling to the families they assist.

Schuwte told Wits Vuvuzela, “A lot more people have requested [grieving counsellors] during lockdown. I definitely think that families have been affected by these restrictions.”

Dealing with families during this time has been extremely challenging for Schuwte due to the families’ reluctance to accept the new health restrictions. Schuwte explained that the body should go straight from the mortuary to the grave site, as outlined by covid-19 health regulations in South Africa.

“[The new process] doesn’t fit in with some beliefs, and families don’t always understand or want to comply when they are told that their loved one can’t be transported or buried the way they want,” said Schuwte.

Bove reiterated the importance of funerals in relation to grief. She said, “When you’re not given a chance to attend or pay your last respects correctly, it complicates the grieving process.”

 

Technology: A saving grace

Technology has proved to be helpful in many ways amid the pandemic. One such way has been through the ability to livestream funerals when family members or friends have been unable to attend.

Schuwte has seen many families utilise technology to livestream funerals via Zoom, Facebook and other online platforms. He said, “A lot of families have been livestreaming. It’s become the new norm, and I think it’s a trend that’s going to stick around.”

Livestreaming funerals has not only provided a way for those who cannot attend to say goodbye to their loved one, but has also eliminated the high risk of being exposed to the coronavirus when attending physically.

The high risk of funeral gatherings has been continuously seen throughout the lockdown period in South Africa. During the initial level-five lockdown period, three funerals in Eastern Cape accounted for more than 200 covid-19 cases, as reported by News 24.

Sumentha Naidoo, a 45-year-old mother of three and logistics manager at Whirlpool (a home appliances company), personally experienced the benefits of technology when she was able to attend her uncle’s funeral online.

Naidoo’s 71-year-old uncle passed away from the coronavirus in August. He had previously attended a family member’s funeral and his family believes he was exposed to the virus there. Due to the unfortunate circumstances, the family decided it would be best to have the funeral via Zoom.

“The family did it over Zoom because they didn’t want to put anyone in that position, especially since my uncle had gotten the virus from a funeral,” Naidoo told Wits Vuvuzela.

She added, “We would’ve been scared too, because we (Naidoo, her husband and children) had just recovered from the virus ourselves.”

Sumentha Naidoo acknowledged the difficultly of not having, or being able to give, physical comfort following the death of a loved one during the national lockdown in South Africa. Pictured: Sumentha Naidoo and husband, Jogi Naidoo. Photo: Catia De Castro

Naidoo explained that, although technology had been extremely useful, she wished there was no need for it, as physical support and comfort are important when grieving.

“With Christians, but especially in our Indian culture, friends and family come together the very same night someone dies. There are always people around, and that support is so important. The family was missing that embrace of a loved one, and it’s a big part of mourning,” said Naidoo.

Bove highlighted the way covid-19 restrictions have changed the expected behaviour at funerals and prevented people from conveying compassion during the sensitive period after loss.

“Social distancing makes it so difficult when you’re not able to extend normal gestures of love and care. And even afterwards, there’s no celebration. This could all prolong the normal grieving process,” said Bove.

Many South Africans have experienced loss under the already stressful context of the global pandemic, but all have been unique in their own personal way.

Khadhraoui struggled to hold back tears and subtly wiped her nose as she described her experience.

Tearfully she said, “We were only a year apart but, being the oldest, I was almost like a mother to him. Whenever there was a crisis, he knew, ‘Margi will fix it’. I felt like it was my responsibility to look after him, and I couldn’t even be there to hold his hand.”

FEATURED IMAGE: The Braamfontein Cemetary in Johannesburg remained quiet over the weekend of October 31, despite the rise in deaths during the covid-19 pandemic. Photo: Catia De Castro.

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Foreigners in Johannesburg struggle under pandemic regulations

Covid-19 and the subsequent lockdown have had a devastating impact on many business owners and employees. Included in this scenario are foreign nationals and undocumented people who have had to try to pick themselves up in usually packed commercial trade areas such as Fordsburg and China Mall, experiencing low recovery .

The ability to easily find parking on the usually packed and busy streets of Fordsburg on a Saturday where road rage, traffic and double parking were a staple no more, was already a tell-tale sign of the devastating effect the covid-19 pandemic has had on businesses and their employees. 

Many were forced to shut their doors for over three months, with no source of income, after the hard lockdown was implemented in South Africa on March 27. This resulted in more than three million jobs being lost between February and April, and over 1.5 million people who had jobs but no pay, according to a Nids-Cram survey of 7 000 people. Some were able to keep their businesses and jobs, but are still far from full recovery.

Fordsburg, a hub for foreign-owned businesses and migrant workers, started off as a place where locals and foreigners would sell goods in the open Fordsburg Square flea market. This created an affordable marketplace for selling a variety of items such as fruits and vegetables, Indian and Pakistani spices, replica clothing items and pirated DVDs.  

The opportunities for foreigners grew with the influx of shoppers looking for affordable haircuts, groceries, food stalls and established restaurants. The conflicting aromas of the different restaurants were soon overtaken by the scent of curries and chicken tikkathe sweet smell of hubbly bubbly flavours, and incense as Indian, Pakistani, Bangladeshi and Egyptian nationals saw the growth of the commercial trade in the area. This allowed foreigners to generate sufficient revenue to open shops, and created a sense of community and a piece of their home countries as they drew on their common nationalities.  

South Africa in general has been an economic magnet for many migrants searching for better job opportunities, but a true indication of the numbers is hard to quantify. It is estimated by the African Centre for Migration and Society that there were two million international migrants of working age (15-64) in South Africa in 2017, representing 5.3% of the country’s labour force. The International Organisation for Immigration’s (IOM’s2020 World Migration report estimates that this number is as high as 4.2 million as of 2019, accounting for 7.2% of the population.

A couple scorned by lockdown woes 

With the lockdown, however, Fordsburg has struggled to regain its allure. On the now desolate Park Drive stands a beauty parlour that was forced to close its doors for three months due to its “non-essential” status. Only those that provided food, medicine, banking services, healthcare, fuel, internet and municipal services could remain open.  

The parlour owner, Samim Patel, does threading, waxing, facials and cuts hair. But upon entering her shop, now overflowing with her one-year-old’s toys, she was found sitting in anticipation, for just one customer to walk in. Looking out at the empty streets, a slow reminiscent smile spread over her face as she said, “Before the lockdown, we never even had the time to eat. I even remember those days when I used to have a biscuit and water and carry on working, because there was no time to eat.”   

I don’t really get customers anymore. Sometimes I get R20 and sometimes nothing at all

Her shop of seven years, which used to open from 8am to 8pm, now with the lack of foot traffic sometimes opens at 10am and closes at 3pm.  

Regardless of many businesses opening their doors again, the fear of contracting covid-19 has overpowered the desire to seek grooming. Samim’s smile quickly vanished as she brought herself back to the present, “I don’t really get customers anymore. Sometimes I get R20 and sometimes nothing at all. I had regular customers for 10, 12 years. They’ll phone or message and ask how am I, how’s the baby, but they don’t want to come because they’re scared of covid.” 

Sameer Patel, her husband, felt the full brunt of the lockdown as his one-year-old business venture went up in smoke. He had to completely close down his newly established curtain shops in Ormonde and Boksburg. The word “tension” was uttered frequently, and his face crumpled when asked about his shops. Both he and his wife struggled with sleeping and eating because of the stress over the future of their businesses.  

“It’s a terrible feeling. I can’t sleep,” he said as his face turned red, sweat streamed down his forehead and his fists clenched. 

Terrified that her shop could close too, and with the burden of owing thousands in accumulating rent, Samim said, “Some of the nights I couldn’t even sleep. I didn’t know what was going to happen. There’s food on the table, but you can’t eat because you’re stressing. Until today, days are like that.” 

Sameer was reluctant to speak about the loss, but the little he did say caused water to well up in the bottom of his eyesFighting to hold back his tears as they threatened to fall, he said, “I don’t want to talk about it because it’s really stressing me. I was opening a big business and bought a truck for it, but it didn’t work just because of the lockdown. I sold all the things under cost, so it’s actually costing me more than R500 000.” His employees were paid with whatever he had left, and went back to previous work. 

The lockdown affected the economy immensely as South Africa’s GDP contracted by 51% in quarter two. The government, to minimise the impact of covid-19, offered relief to businesses in the form of the Debt Relief Fund and the Unemployment Insurance Fund (UIF). A special covid-19 social relief of distress grant of R350 a month was also set up for those that lost employment.  

The Debt Relief Fund was aimed at small businesses that experienced financial difficulties during the lockdown. The requirements, however, automatically excluded this group as businesses had to be 100% owned by South African citizens, at least 70% of the employees had to be South African nationals and they had to be tax-compliant and registered with SARS. Sameer and Samim, armed with only work permits, were not eligible for this fund. 

The many hoops to jump through

Many shops located in one of Fordsburg’s main attractionsthe Oriental Plaza, saw the same fate as the lockdown took the familiar overcrowding of shoppers away. Built in the 1970s as a shopping centre for Indian traders, because of its low prices it became a haven for bargain hunters where finding space to even walk, was difficult. Bursting with a multitude of shops, the Plaza sells curtains, kitchenware, colourful fabrics and traditional Indian clothes. 

Opposite the now strangely deserted parking lot of the Plaza stands a small barber shop, which can house only three customers at a time. Outside the barber shop sits 46-year-old Indian national Imtiyaz Shaik, with his single employee standing in the doorway with the same look of anticipation and desperation as Samim. 

Malawian national, Etoo Kuiuwangu, learnt how to make all types of Indian cuisine when he came to South Africa in 2014 in the hopes that he could build his repertoire of skills and always be employable. He prepares the different curries, biryanis, butter chicken and mixes and rolls out the roti dough at Sheth’s Chinal Mall restaurant. Photo: Zainab Patel.

The lockdown led to a 26% increase in food insecurity and hunger, due to income shocks and job losses. The Nids-Cram survey found that 47% of respondents reported that their households ran out of money to buy food in April 2020.  

Shaik has three children, and worry occupied his days as he experienced difficulty buying groceries, paying school fees and the uncertainty that still surrounds his barber shop. But with the help of his friends and clients bringing him groceries during that time, he was able to get by. 

The UIF provided funds to registered companies unable to pay their employees. This meant that foreign nationals who were not legally documented or legally employed were not eligible to receive this. As of October 27, R1.6 billion has been paid to declared foreign nationals, but there are still delays, with them receiving their payments much later than their South African counterparts. The reasoning provided by the UIF was that its system uses ID numbers and does not recognise passport numbers, as well as extra verification processes required for foreign nationals. 

Instructions on how to apply for government relief, and the rules pertaining to who could receive it, caused confusion among some foreign nationals. Shaik explained, “The government announced that they want to help, but actually we don’t know the process and rules of going to government for help. They said they were going to give you a link to go through. But I try, I try, how many times I try to get through the link, but I can’t get it right.” 

No work no pay

The China Mall in Crown Mines, like the Plaza, is perfectly designed for foreigners as it allows shop owners to conduct business under the radar with many who do not pay tax. Bordered by large containers of goods, China Mall is famous for its cheap products ranging from clothes and bridal wear to toys, homeware and electronics. It is also where traders come to buy in bulk, with the cheap wholesale prices. 

China Mall has been largely affected by the pandemic due to the stigma surrounding the mall and Chinese nationals. Finding parking was abnormally easy when visiting this bargain-filled mall, which has now seen an influx of PPE and infrared thermometers occupying several shops. Many shops that it previously housed are non-existent due to the loss of customers and the high rentals, ranging from R20 000 to R90 000, depending on size. This is due to the intense competition in the mall and the high volumes of passing trade, where whoever offers to pay more rent gets the space. 

Located west of the mall is a food court owned mainly by foreign nationals and which shut down in February, before the lockdown, because of that stigma. One of the businesses was Anish Sheth’s fast food restaurant, which left him and his employees without a salary for four months. This is because he pays his employees on a per day basis, as most of his employees are undocumented and therefore do not want to be on the employees register. This automatically excludes them from the UIF, Debt Relief Fund and R350 grant.   

UN DESA estimates there are 100 000 Malawian and 376 668 Mozambican migrant workers in South Africa, driven by the prospect of better jobs and escaping the poverty of their home countriesEtoo Kuiuwangu, an undocumented Malawian national, and Malemu Baleaa, an undocumented Mozambican national, work for Sheth making all types of Indian food in an aroma-filled, tiny corner next to the main kitchen of the restaurant. 

It’s very difficult, because when you don’t have any money it’s fucked up

Mozambican national, Malemu Baleaa, starts the fire to make the naan (flatbread) for the day. He works non-stop for nine hours from Monday to Sunday making rotis, chicken tikka, parathas and naan in this tiny green corner where him and Kuiuwangu prepare the food at the restaurant. Photo: Zainab Patel

Kuiuwanga spoke of receiving no money during this time. “It’s very difficult, because when you don’t have any money it’s fucked up. There’s not even supper, sometimes.” He had to lend from people to try and look after his wife and two-year-old son.  

Baleaa, who has been working there for 13 years, expressed the same, with having to look after three children. “During the lockdown I took credit from someone. Now I’m working so I can pay them. It’s a little bit better now, but it’s not yet 100%.” 

I just came to work because I don’t have any choice. I’m going to do what? Nothing

The financial impact of those months of complete shutdown, according to Sheth, resulted in a loss of approximately R800 000. “Now, as a business, it’s not like before because people are still scared to come to the restaurant, especially China Mall.” He explained that they are not making their turnover, which was previously about R300 000 a month. With an average loss of R100 000, their turnover now ranges from R180 000 to R190 000. 

Given their undocumented status, Kuiuwanga was stoic about his non-payment during that time, but displayed a tinge of anger when speaking about it. “I’m working here for five years, but I never get anything. So when he [Sheth] opened in May, I just came to work because I don’t have any choice. I’m going to do what? Nothing.” He is using the money that he is making now to slowly pay back the loan he took out

Some business owners, like Samim and Shaik, await the new year in hopes that it will return to normal, using what little income they make nowSheth extended his restaurant hours from nine hours to 12. “Recovery is nothing. Still we are struggling and battling with reversing all of that [the financial impact of the lockdown].”  

Others, like Sameer, have sought employment elsewhere. He went from owning his own curtain shops to working isomeone else’s curtain shop: “You have to do anything, anyhow, because if you have a family you can’t just sit with your hands, you have to do something to get food for your family and everything else.” 

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