International repatriation of mortal remains
What will the ‘new normal’ look like for the international funeral repatriation sector, and how are the specialists in the industry preparing for it? Robin Gauldie reports
Since package tourism took off half a century ago, the medical assistance and repatriation industry has tracked the steady growth of international travel. So too has the funeral repatriation sector.
Although international travel has been affected by other disease outbreaks in the past decade, Covid-19 is the first pandemic to have an impact on every aspect of global activity, and the specialist funeral repatriation sector has not been immune. It has, however, demonstrated innovation and flexibility at every turn. The pandemic has tested the resilience of international funeral director companies and has provided the sector as a whole with the opportunity to hone its agility.
Lessons have been learned that will stand funeral repatriation companies in good stead when the inevitable next pandemic strikes. Thinking outside the box will be key, and indications are that the industry, forced to adapt at all levels, has stepped up and has already become more robust.
Lockdown easing, but how will it work?
As lockdowns ease, international travel could swell from a trickle to a flood when pent-up demand from consumers is fully unleashed. Destination countries are desperate to reopen their doors to visitors from major tourism sources like the UK and Germany, and the European Commission expects that around 70 per cent of European Union (EU) adults will have been vaccinated by autumn 2021.
The World Health Organization (WHO) says proof of vaccination should not be required for international travel, citing limited evidence that vaccination against Covid-19 reduces people’s ability to transmit the virus. The EU seems to agree. All 27 EU countries have agreed to co-operate on creating a Digital Green Certificate, which will allow those who have fully recovered from Covid-19, have tested negative for the virus or have been full vaccinated, to travel freely.
The European Commission proposes that the certificates should be suspended once the WHO declares the end of the Covid-19 pandemic.
Funeral directors are adept at complex procedural changes
The funeral repatriation sector is already practised at dealing with a plethora of paperwork, including death certificates and proof of freedom from infection, but Covid-19 has tested their skills. Companies were able to draw on the experience of dealing with earlier outbreaks of diseases such as swine flu (H1N1), bird flu (H5N1) and in the 2014-2016 outbreak of the Ebola virus, but from the beginning of the pandemic it was apparent that assistance companies, medical evacuation companies and global international funeral directors would face an array of new logistical challenges.
As repatriation companies discovered the documentation required by countries at either end of the funeral repatriation process were liable to change at very short notice.
During the first wave of the pandemic, many public offices and embassies were short-staffed due to local lockdowns, causing delays to the repatriation process. Drastically reduced passenger flight schedules and higher fares created further logistical issues, but repatriation companies were able to overcome this by using cargo flights, which continued to operate almost as before.
Chaotic response from governments hinders repatriations
The consensus among industry experts is that the governments’ chaotic response to the pandemic posed new challenges for the funeral repatriation sector. During the early stages of the pandemic, conflicting responses created obstacles to repatriation processes. Poor understanding of the risk of contagion from deceased bodies complicated matters, with ritual washing and embalming the body prohibited.
“We can speak of a real and instantaneous impact during the first wave of Covid-19 in the first quarter of 2020, with border closures, the immediate closure of air links and the emergence of strict administrative restrictions for deceased persons who were carriers of the virus at the time of death,” said Dominic Vernhes, CEO of Paris-based Anubis International Assistance, a dedicated funeral assistance platform.
Many repatriation cases were already being prepared when borders were closed, leaving funeral directors stuck with the dilemma of how to store remains until they could be returned to the deceased's home country.
In some countries, such as Belgium, long-term storage in a cold chamber in a public mortuary is permitted for several months. France, which before the pandemic authorised such storage for only six days, extended this to 21 days in response to the crisis. Other alternatives include temporary burial with later exhumation for repatriation, final burial in the country of death, or cremation and later shipment of ashes to the deceased’s home country – solutions that many families found unsatisfactory. Insurers also faced unexpected contractual constraints, including the extra cost of financing a local burial or cremation when repatriation was impossible.r, Albin International Repatriation.
Some countries required additional documentation, such as a ‘free from Covid’ certificate, or a waiver from the receiving country. Others banned embalming of those who died with Covid-19, while some airlines refused to carry embalmed remains. Others allowed repatriation to take place without embalming. Some permitted both inbound and outbound repatriation, while others barred repatriations outright, leaving relatives of the deceased with the option of a local burial or cremation. One result was a significant increase in the number of cremations.
“Governments in the early stages of the pandemic were extremely strict with their rules and regulations for the management of deceased with a confirmed or suspected cause of death of Covid-19,” said Fiona Greenwood of Rowland Brothers International, a UK-based international funeral repatriation specialist.
“In some countries only direct burial or cremations were authorised. Cremated remains were kept with the overseas funeral director until restrictions were lifted and the repatriation could take place. This still depended on flight availability as many airlines ceased operating various routes or reduced their number of flights. Timelines for repatriation were greatly increased,” she added.
“Consideration also had to be given regarding the country where repatriation was taking place to – as well as the rules and regulations in place at the time. It may have been possible to repatriate out of the country where the death occurred, but not into the country where repatriating to. Under these circumstances, the deceased was stored with the overseas funeral director until repatriation arrangements were able to go ahead.”
After an initially confused response, stakeholders have risen to the challenge of the steep learning curve caused by the pandemic. Embassies, governments, and airlines have begun to understand the complexities faced when obtaining the many documents needed for repatriation. Funeral directors on the ground have been able to apply for paperwork digitally and to email permits instead of being required to collect them in person. Repatriation companies agree, though, that progress is still needed on moving away from hand-delivered hard-copy documents to digital documentation – a development that will save time and money even when the pandemic has passed.
“The situation has improved, but some countries are still experiencing long delays in obtaining the necessary documentation,” said Emerson de Luca, Managing Directo
How effectively has the funeral repatriation sector responded?
“The industry has become more robust and has demonstrated it can operate under the most challenging times it has faced in recent history,” de Luca added.
Providers in Asia that had previously learned from their experiences when dealing with the SARS outbreak also had several months’ experience of dealing with Covid-19 before the pandemic reached the rest of the world, and so were able to share vital insight into best practice and guidance with other stakeholders.
Samuel Tester says Homeland International has learned to take a case-by-case approach, underpinned by local government guidance. “Traditionally, repatriation can be a lengthy drawn-out process with many documents required from different parties; it can be incredibly bureaucratic,” he told ITIJ. “I hope that in the future we can continue to see this flexibility and as a sector can start working towards simplifying the repatriation processes around
the world.”
Meanwhile, the events of 2021 have highlighted the need for harmonisation of funeral legislation across international borders to ease the repatriation process. Even within the EU, there are multiple disparities. Some countries mandate embalming and a zinc casket, while others insist on neither. Even the required thickness of the coffin varies.
Transportation of a body in a bioseal bag, standard practice in many EU countries, is prohibited in France. Cremation was legalised in Greece only in late 2019, shortly before the outbreak of the pandemic, and is still not permissible in Cyprus. Cremation is also a faith issue for observant Muslims.
Even after the pandemic is over, repatriation companies may place more emphasis on offering clients the simpler options of cremation or of burial in the country where death has occurred.
Insurance companies are also likely to rethink their contracting fees in the future, after being stuck with the additional contractual costs of funeral repatriation during Covid, such as extra paperwork, storage of remains, and air transport costs, which in some cases at the peak of the pandemic reportedly jumped by as much as 200 per cent.
Overall, it seems the funeral repatriation sector has learned to think on its feet and react flexibly to a rapidly changing regulatory environment. What the ‘new normal’ will look like when the pandemic ends remains to be seen, but useful lessons have certainly been learned from the events of 2020 and 2021.