On decorpsification

Yeah, I made that word up. But you knew that.

On the 12th of January, 2010, the island nation of Haiti suffered a magnitude 7 earthquake that took living conditions in that already poor society into the realm of the unimaginable. Reports at the time hinted at conditions that were positively Boschian.

“There is no dignity in death for most victims of Tuesday’s devastating earthquake, only an anonymous final resting place alongside thousands of others in stench-filled pits carved from the red earth. Bulldozers close the ground back over them when the graves are full.

“Decomposing bodies are first picked from the ground and hurled into trucks operating as makeshift mass hearses that are driving around the city. The vehicles then head for the mass graves, back up to the holes and empty out their contents” (http://www.telegraph.co.uk/news/worldnews/centralamericaandthecaribbean/haiti/7005477/Haiti-earthquake-thousands-of-bodies-are-dumped-in-stench-filled-mass-graves.html).

At the time, public health officials were quick to warn that the bodies did not pose a great risk to the living (at least no greater than the living posed to one another). “The risk is absolutely minimal, unless there is disease in the population. This [hastily dumping bodies in pits prior to ensuring identification] is a mistake and a waste of resources,” according to Sir Nicholas Young, British Red Cross chief executive (http://webcache.googleusercontent.com/search?q=cache:Hq6U0oQjdNUJ:news.bbc.co.uk/2/hi/8465464.stm+haiti+corpses+disease&cd=1&hl=en&ct=clnk&gl=us&source=www.google.com). Similarly, the WHO suggested that “It is important to convey to all parties that corpses do not represent a public health threat. When death is due to the initial impact of the event and not because of disease, dead bodies have not been associated with outbreaks” (http://www.newscientist.com/blogs/shortsharpscience/2010/01/bodies-piling-up-in-haiti.html).

Now, fast forward a year or so. Cholera sweeps Haiti, and the already strained health infrastructure cannot cope. What a difference a year makes. “Stacked with body bags full of corpses of cholera victims, a converted flatbed truck and a colorful tap-tap taxi swerved into the yard of the mayor’s office and their drivers asked where to bury the dead.

“‘Get out of here. Get out of here before they start throwing stones,’ a city hall employee screamed, her voice panicky, her hands flaring.

“A crowd started circling. Three poorly armed police officers showed up and announced more were on the way. Then the city hall employee jumped into a car and motioned the corpse vehicles to follow. The angry crowd shouted and began throwing rocks” (http://www.miamiherald.com/2010/11/19/1934890/living-fear-the-dead-in-cholera.html).

Public health worker Rochefort Saint-Louis warned that “the bodies are very dangerous. ‘People throw them in the street and they have fluid inside them,’ he says. ‘If the fluid comes out and you step on it,’ he adds, you could track it home. You might put your hands in your mouth or your kid could touch your shoes” (http://www.theworld.org/2011/01/dealing-with-haitis-cholera-victims/).

So, which is it? Corpses that need identification and that pose no harm to public health, or corpses that are dripping with infectious material? Well, both, obviously. A natural disaster produces the first, an epidemic the second.

Which brings me to my point: what does a bioterrorism episode produce? Amid the chaos and confusion and terror that would attend such an event, what do we do with the dead bodies? Venerate them? Identify them? Bulldoze them? Burn them? The real problem will be that our options will be limited, and the time will be short, especially if we are dealing with an infectious disease. And it may be that the situation will be far worse than cholera, with diseases like Ebola causing bleeding out and diseases like bubonic plague leading to bursting buboes.

Even handling the corpses, getting them onto a pyre, would be a death sentence, not unlike that visited upon some of the heroes of Fukushima. And the magnitude of the problem would daunt even a well-organized mortuary service. If the body won’t come to the fire, you could take the fire to the body, although in that instance having multiple burning bodies that were randomly sited would not necessarily be conducive to keeping what remained of an urban infrastructure intact.

No, this is a problem for decorpsification. Getting rid of bodies the Green way, without contributing to the ever-present problem of global warming (sardonic alert). A local company (whose name undoubtedly does not need to be mentioned in connection with this grisly post) produces an awesome product known as MELT. From the product brochure: “The MELT System is a hands-free technology for the rapid digestion of fresh or frozen tissue. No homogenization is required. Samples can be lysed easily in a closed-tube format without cross-contamination … using a novel formulation that includes … a cocktail of powerful catabolic enzymes.”

Yessssss. We have the technology. But instead of the milligram scale described in the brochure, how do we scale this up to the megagram level? Can we in fact have big sprayer trucks roaming the streets, hermetically sealed, hosing down the bodies and causing them, and most importantly their attendant diseases to … melt? Who knows. It is unlikely that I’ll be funded to do this in the near future, because, well, like we like to say about Presidential candidate Bachmann: crazy!

But I hope that some careful planner out there is in fact thinking about this, and that somewhere there is a fleet of trucks or planes or hovercraft loaded with enzymes or bacteria. Probably not, since we can’t even have an intelligent conversation about educating the public about bioterrorism without careening into a TMZ-like media feeding frenzy. But still, it would be nice to know that we don’t have to allow the Very Bad situation that is inevitably going to rain down upon us to become even worse. We can stop at Guernica, without going all the way to The Garden of Earthly Delights.

 

- originally posted on Wednesday, June 29th, 2011