This little piece is primarily aimed at the tourist, the expat and anybody who plans to or inadvertently manages to die around PG. As medical doctors, we are familiar enough with death to treat it from a practical medical point of view: there is, or there will be a dead body to sort out. This article is not intended for actual Belizeans or people who have been here long enough to be Belizeans; the local attitude to death is much more practical and everybody knows how to handle it.
Many people have many views on life and death and many don’t like to talk about it at all. I’m talking about it now because dealing with death is part of my profession and no matter what or no matter who you are, if you die close to me (Say Punta Gorda and surrounds), I will hear about it, plus or minus, be involved in having to deal with it. From a purely practical point of view, I would like to make some suggestions about how a person can make this process easier not only for themselves but for the friends, family and strangers which may be dragged into the event. It is obvious that at a time like this there is great pain and suffering to many people and this is unavoidable; so, I’m not going to address this aspect of the situation.
This is the basic procedure of what needs to happen in PG and surrounds:
- The Body needs to be taken to the Hospital for certification. Only hospital doctors have the necessary forms and paperwork to certify somebody dead. I don’t know if this is law or whether the bureaucratic machinery just makes it difficult for private or non-hospital doctors to get the paperwork. The death certificate will be needed for many things, including the release of the body from the morgue for burial.
- The transport of the body to the hospital must be done in a pick-up truck or ute, or an ambulance. Bodies cannot be transported in closed vehicles. Not sure why but I can think of many interesting reasons.
- The police may or may not be involved. At all the deaths I have had to be present, the police ended up always being involved but this is likely to be due to the fact that the deceased was a foreigner. Usually the appropriate embassy, high commission, whatever, will also have to know about it, especially if the remains will have to be sent overseas.
This is quite straightforward and if there are no problems, everything will proceed without any fuss. The only thing that the authorities care about is whether a crime has been committed (like murder); usually the absence of “foul play” is evident to everybody and there should be no other involvement with the police other than making a quick statement for the person who transported the body. Of course, if people insist on acting in an obstructive way with the authorities, this is where headaches and stress can occur but then the person fully deserves it for behaving badly. If foul play is suspected then an autopsy will have to occur (which may take many days to organise) and then the police will be involved (I don’t know what happens after this if a crime is suspected).
So, what does all of this mean? It means that if you are staying in PG you need to ask yourself four questions:
- Do you know that you are dying? If you are terminally ill, there is really no excuse, you, your friends and your family should know what your end-of-life decisions are. You should be organised enough to know how and where you are going to die, what level of involvement the medical authorities are going to have at the time, and all your friends and family know what it is you want and how it is going to happen.
- Do you want to be treated in PG Hospital? So many people are scared of PG Hospital, I don’t understand why. The place is clean, you are treated with dignity and if you are going there to die because there is nobody to look after you and help you out it will be fine. The advantage is that you will already be there when you die and nobody will have to transport you.
- Do you want to die at home? If home is overseas then get out of here. Otherwise you can die quietly at home without a fuss and without bothering anybody. You can (and should) be organised and pay somebody to check in on you (if you do not have any friends or family to help you out) in say two to three days and take your remains to the hospital. Whatever you do, don’t pitch-up at a friend or quasi-friend and dump yourself on their doorstep, say you are dying and then refuse to go to hospital. It is not right to die at somebody else’s house if it can be at all helped as it can make the authorities nervous because it can look like foul play…don’t put this burden upon anybody. If you don’t want to go to the hospital to die, then don’t go bother somebody else because all they can do is take you to hospital.
- What do I want in case of misadventure? Don’t want to die here, don’t want to go to hospital, don’t want anything to do with anything here. First of all, maybe you should not be here in the first place but if you insist then make sure you have some sort of Medical Evacuation Insurance or Travel Insurance which will allow you to access the private medical system until you are stabilized enough to be whisked away to your country of origin. This is a kindness to everybody involved if there is no way that you would be willing to stay here should anything happen.
How you answer these questions determines exactly what is going to happen to you. Know what you want in advance and let somebody close to you know as well so that there are no additional problems during what will undoubtedly be a difficult time.
If you are one of my patients, you really should let me know what you want, if I haven’t already asked you. If you are not my patient, you should really tell your doctor (in Belize). It is easier for me as a doctor to make things run smoothly for you if I know things ahead of time rather than getting a “HELP!” call at some odd hour from a friend or stranger asking me what to do with you when I don’t even know who you are, let alone what your wishes are.