Sudanese ethics in Death and dying

Muslims

• Traditionally Muslims need to bury their deceased within 24 hours

• After death the male body is washed by a male relative or Imam (holy man), and

  a female by a female relative or midwife

• The body is taken to the Mosque for cleansing and ritual preparation by the Imam

  (cleric) before it is taken to the cemetery

• Burial in a cemetery is required, not cremation

• Mourning lasts between 3 to 7 days

• Women wear black indefinitely but may remarry

  Southern Sudanese (Christian)

• The community and relatives gather around the deceased, segregated by gender (children do not view the corpse)

• Traditionally the body is washed by the family and wrapped in a mat of woven grass or a cow skin and buried. Sudanese in New Zealand may have developed different methods

• Burial in the local family site, is traditional. Bodies are not usually cremated

• Mourning is in isolation in the family home for 40 days and is usually ended by a

  ritual sacrifice to cleanse the mourning spirits

• Husbands are free to remarry, sometimes the deceased’s sister so she can care

  for the children

• The widow remains part of the husband’s family and may be taken as wife by the

  deceased’s brother, but the children will take the name of the deceased husband

  HEALTH RISKS

  According to the Perumal (2010) report on MELAA people living in the Auckland Region, key health concerns for African people include:

• Diabetes (significantly higher prevalence than Europeans, including associated hospitalizations)

• Respiratory diseases (asthma for females, and pneumonia)

• High HIV (23% of all the people diagnosed as HIV positive in the Northern region

  from 1996-2009 were African)

• Asthma, especially women

• TB (highest rate of hospitalization within MELAA group)

• Cellulitis (highest rate of PAH amongst females from all ethnicities)

• Kidney and urinary infections (highest amongst all Other females)

• Low vitamin D deficiency (particularly women and girls which may be due to

  avoidance of sun and because of dress code to cover up)

• Malnutrition (due to prolonged periods of war)

• Obesity after suffering malnutrition

• Lack of sufficient physical exercise (may be prohibitive for some women with

  conservative dress and behavioural expectations)

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Social issues affecting health

• Isolation (including older people who spend a lot of time alone at home)

• Unemployment and poverty (many have significant financial issues and

  difficulties finding work)

• Loss of standing in society

• Being marginalized (race, cultural difference, clothes, education and refugee

  experiences)

• Cultural adjustments impacted further by the lack of support from usual networks

  of family and community

• Experiencing racial discrimination based on ethnicity (within own cultures)

• Stigma of mental health, HIV and disability often means no societal support, and

  no disclosure of issues

  Mental Health issues (particularly PTSD and depression):

• African communities experience a disproportionately higher rate of mental health illness compared with the rest of New Zealand, largely due to their earlier life experiences and potential exposure to torture, violence, rape and harassment

• There may be strong emotions of grief and loss for family, culture, and country especially following refugee experiences

• Experiencing discrimination is strongly linked to high levels of anxiety and depression which negatively affects Post Traumatic Stress Disorders (PTSD)

• Mental illness is stigmatised which results in limited use of appropriate assessment and treatment services, especially in smaller communities

  Unexmundi (August 2014) lists the following major diseases for people living in Sudan:

• Hepatitis A and E

• Typhoid fever

• Malaria

• Dengue Fever

• Yellow Fever

• Japanese Encephalitis

• African Trypanosomiasis

• Cutaneous Leishmaniasis

• Plague

• Crimean-Congo hemorrhagic fever

• Rift Valley fever

• Chikungunya

• Leptospirosis

• Schistosomiasis

• Lassa fever

• Meningococcal meningitis

• Rabies

  In addition, the incidence of malnutrition is extremely high resulting from prolonged war and severe famines.