The best place to die

By Agnes E. Nantaba

A collaboration between a funeral service provider and a hospital is changing perceptions about death

Hospitals are designed to care for the living; either by providing treatment for their ailments or, in cases where the end is unavoidable; to help them as best they can until the inevitable happens.  Hospitals are not designed to handle death.  That is a reality most of us realise at the last minute, when the diagnosis, and treatment and rehabilitation has failed, and our friend, relative, or colleague is dead. Then we enter a new world which even most medical personnel find strange.

Our dead loved will be sent to the mortuary and we might have to pay a visit to that place. It is a world far removed from the well-lit wards, with flowers and get-well cards, and happy smiling nurses and doctors of the living. Usually the mortuary is a tiny, dank, cold, and dim-lit place with a grim-faced mortician and a pathologist trained more in handling the dead than the living.

But it does not have to be that way.   Realising this, Mengo Hospital; a church-founded facility on Namirembe Hill in Kampala and A-Plus Funeral Management, a private company are partnering to provide a different experience to the bereaved.  A statement attributed to Richard Kiboneka, the chairman board of governors at Mengo Hospital sums up the motivation for the collaboration.

Kiboneka said: “The partnership would see Mengo staff concentrate on saving lives” and, implicitly letting another set of professionals concentrate on handling the dead. The result is the newly named Mengo Funeral Parlour. It is the old hospital mortuary but under new management.

Meeting new demands

Right from the outside, the parlour’s exterior gives a hint that this is no ordinary mortuary. Its surrounding is well maintained, with spacious well-kept gardens, and ample parking for those attending the visitation or funeral.   Visitors and mourners are greeted by staffs who usher them into the viewing area, meeting room, or reception lounge. There is a sense that the cultural imperative and human obligation of treating the dead with honour and dignity is being met.

“It is not only about creating an impression,” said Kata Kateregga, the A-Plus general manager, in an interview with the Independent, “It is also an assurance that the person assisting you really knows how to help and is there to support you in your decisions at a very difficult time.”

Kateregga says he is motivated by the belief that the ability to make it through the death of a loved one can be challenging, and the bereaved need the right treatment to make it through the tough times.   “There are some hospitals with very nice morgues, but some of them are not nice and being dimly lit and not as clean as the rest of the hospital.  I guess since only the dead would ever be in these rooms it was less of a priority for them to spend money to make them nice,” he says.  In contrast, even the resident pathologist and embalmers that you meet at Mengo Hospital Funeral Parlour are not only pleasant but also knowledgeable and exude confidence in their abilities.

It is the only funeral home in Uganda that has space set aside for people to gather at a visitation. This area contains a space to display the body in a casket to visitors who may pay their respects there. Where necessary, makeup artists are used to restore and make the departed presentable for an “open casket” service. One can also conduct funeral and memorial services for their departed loved ones at the parlour.

This is designed to cater for the new tradition of a wake which is flourishing. The traditional bureaucracy of moving the body to church on the eve of burial is vanishing in favour of keeping the person at a funeral parlour overnight, laid out in an open coffin, or on a bed, surrounded by family, friends, and a steady flow of sympathisers often queuing out of the door and around the parlour.

Seeking more partnership

All these facilities have only been possible with a Shs500 million investment by A-Plus Funeral Management in a partnership with Mengo hospital.  The partnership comes in at a time when many hospitals cannot maintain the standards of mortuaries given the high costs involved.

Social services providers have come in to bridge the gap through turning to business partnerships to provide the critical infrastructure and equipment investment required. The Head of Business at A-Plus, Michael Zaake, says the partnership seeks to boost healthcare delivery systems with private investors taking on the responsibility of equipping and managing mortuaries to relieve hospitals of the obscure task of handling the dead. He says there is a move to refurbish more mortuaries in Mbarara, Gulu and Tororo hospitals.

“The response in using these services has tremendously improved ever since we revamped the mortuary and it’s something very positive that we want to roll out elsewhere,” says Zaake.

“For Mengo hospital, we installed among others modern body treatment equipment, constructed storage facilities (cold and dressing rooms) and trained human resource in doing post-mortem,” Zaake explains.

Government hospitals lag behind

Kateregga says A-Plus Funeral Management sent proposals to several private hospitals proposals to have their mortuary refurbished and managed as a partnership. However, possibly because of the unusual nature of the offer, only Mengo Hospital took it up.  Within one year of taking up the offer, the works on the mortuary were complete. It has now been in operation for about a year.  Most mortuaries at especially government hospitals in Uganda do not meet the standards expected in handling the dead. Most face myriad challenges and revamping mortuaries appears not to be among their priorities. With this development in private hospitals, it remains unclear how government hospitals intend to tackle the issue.

In 2013, then-minister of Health, Dr. Elioda Tumwesigye, proposed the privatisation of mortuaries in public hospitals. Although in a sense this amounts to government absconding its duties, there is a sense that it is better for the private sector to offer a decent service and charge for it than pretend that the mortuary service is free and yet in reality people have to pay unregulated fees for a horrible service.