No place for the dead

The recent report of the dilapidated condition of the lone morgue at the District Hospital in Nagaland’ State capital Kohima carried by this newspaper is not just an act of gross irresponsibility but reflects the overall neglect of public health by successive governments and other stakeholders. 

The report (see ‘THE UGLY TRUTH: Kohima’s only morgue in shambles,’ The Morung Express, November 21) noted that the three-room morgue which serves the entire district of Kohima has been lying in neglect for years and the ‘forlorn building’ – resembles an abandoned residence or even a haunted house. It is haunted by negligence, extreme callousness and ‘deliberate indifference’ from various stakeholders, including the public. 

As noted in the report, a morgue, by definition, is a place where dead bodies are kept in the refrigerated body store and examined in the post mortem room or that awaits identification or removal for autopsy or respectful burial, cremation or other methods. In addition to standard facilities like spacing, ventilation, air conditioning, infection control etc, the report quoting the Indian Health Facility Guidelines, among others, noted that the unit/morgue should be located in the same building as the main health facility, away from any public area to ensure that it is appropriately screened from visibility. 

It was, by design, incorporated to contrast the existing facility at the Naga Hospital Kohima Authority (NHAK), whose morgue was found to be defying the definition by any stretch of the imagination.

Besides, the WHO’s recommendations on the organisation of the mortuary also stipulate that the morgue should be a secure building and should have the following four sections: — reception room; — viewing room; — storage chamber for bodies (not suitable for viewing); — room for records and for storing personal effects.

This is in contrast to what Nagaland’s Department of Health and Family Welfare eloquent introduction of the department on its website. Health in its widest definition, it proclaimed, means the total well-being of a person – Physical, Mental, Social and Spiritual and a basic human right that every individual of all societies deserves.

“Understanding the importance of health... the Department...has been endeavouring to provide comprehensive healthcare in the State, especially to the rural areas and vulnerable sections of the society,” it declared. The reality is desensitising, to say the least.

It is concerning given the status of the NHAK in the State’s healthcare system starting as a 10-bedded dispensary in the1905-06, to being conferred autonomous status by the Government of Nagaland in 2003. The objective, on paper, was to develop it into a “centre of excellence for providing the best health care facility at an affordable rate to the people at their very own doorstep.” As per the department, since then the NHAK has been functioning as a “District Hospital, Autonomous multi-speciality hospital and as the State’s only referral Centre.”  

The shambles of the morgue is more concerning due to the fact the NHAK was supposed to be the first-ever hospital in Nagaland to be given the International Organization for Standardization (ISO) 9001:2008 certificate by the Indian Register Quality System way back in 2011. It makes NHAK the pioneer in setting quality standards to bring quality services to every individual in the healthcare industry in Nagaland, the Department had vaunted. 

A doctor at the NHAK, as per the news report, said that several representations have been submitted regarding the morgue. Evidently, these representations are hitting ‘dead-end.’

It is most concerning when the State is battling a highly infectious pandemic where possibilities of disease spreading from dead bodies exist and there is a need for a secure and safe mortuary in case of any eventualities. Equally concerning is the issue of medico-legal cases (MLC), when deaths occurring in any of the clinical areas are ‘mandatorily sent to the mortuary,” under standard guidelines. Presumably, there are alternative arrangements. 

Devoid of any ‘working’ morgue, several central as well as state’s guidelines on disposal of dead bodies during the current crisis, seems surreal. The present case is a wake-up call and the concerned authorities and other stakeholders should collectively ensure that there is a ‘place for the dead’ and total well-being– Physical, Mental, Social and Spiritual and a basic human right’ of every individual, as pledged, is ensured.