It is recognised that mortuary attendants are subjected to significant pressures, which may result in psychological problems.8 Their work environment exposes them to several work-related dangers including chemical hazards (from chemicals used for embalming), physical strains (from the lifting of heavy corpses), biological hazards from body fluids if appropriate Personal Protective Equipment is not used, work-related emotional and psychological stress (unpleasant smells from portions of bodies that may have been burned, putrefied or fragmented) and hazardous environments that may result in hearing and sight problems, electric shock, burns and fractures or dislocations.9,10

Now, we are no more mortuary men. We are now transition managers. We prepare the body we do a lot about the body. Formerly you see mortuary man, but now it is transitional managers. They have been calling us mortuary men, but now our name is transition managers. STERNUM


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Hmm, our work cut across a lot because first of all, when people die in the hospital, we go in to carry them and bring them to the mortuary for preservation. Some of them are brought from home.ILIUM

I am saying further directives because when a person passes on, we cannot wait and leave the body in the ward for other patients to witness. We wait for the family because they will decide whether to take the body home or put it in the mortuary before we work on the body.FEMUR

First of all, in Ghana, there is no programme for mortuary attendants. As a layman not knowing anything about the work, I went to learn how to do it from people who were already on the job.ILIUM

Other participants, however, indicated that a minimum of senior high school education was required for employment as a mortuary attendant by some institutions, as literacy is a key requirement for employment in these facilities.

The study revealed that the mortuary attendants work around the clock. There was no mention of a shift system considering people die at any time. Due to this, they have no time to do any extra job to get additional money to support their meagre salary to sustain their families.

Depending on the state in which they received the corpse, the mortuary attendants prepared it by either suturing pieces together; removed excess gas and fluid from the abdomen; or remove the foetuses of pregnant deceased women. Mortuary attendants also took on the additional role of cleaning the mortuary environment in their departments. The scope of work described by mortuary attendants suggests that their roles cover a wide range of vital services in the transition process. They are crucial in maintaining the dignity of the dead by ensuring that corpses are well preserved and handed over to bereaved families in a presentable manner for burial. The preservation of the dignity of the dead is an important aspect of human society and after-life care.2

Again, in Ghana, there is currently no standardised educational programme for people intending to become mortuary attendants. Considering that mortuary attendants play a crucial role in the transition process, they ought to have working knowledge in human anatomy and physiology to understand the structure and function of the human bodies they work on. Despite the little emphasis placed on formal education and training requirements, participants acknowledged the importance of formal education to the success of their work. These findings are consistent with previous studies which found that most mortuary attendants in developing countries are not well educated and thus lack the needed knowledge to observe safety protocols and precautions.6,24,25 It is also revealed in research by Adisah-Atta and Dim26 that little attention is paid to the training of death care workers providing end-of-life services.

In addition, they lamented the limited opportunities for continuous professional development training to remain relevant in the job. The lack of formal training and CPD opportunities could place the life of even mortuary attendants at risk because they lack the basic education and training to carry out their work which could affect their knowledge and skill regarding the handling of infectious corpses and dangerous chemicals. A similar study in Gauteng Province, South Africa found that most mortuary attendants did not understand the concept of hazards pointing to a lack of adequate knowledge regarding their work.27 This finding is not different from studies conducted by Molewa,27 in Kenya, who also found that mortuary attendants lacked training on infection prevention and control. The mortuary environment is a high-risk one loaded with various lethal disease-causing organisms.28,29 Hence the widespread occupational health concerns among this group of health workers globally.27,30

On the contrary, studies in mortuaries in the Port Harcourt area in Nigeria found that most mortuary attendants had undergone training on mortuary-associated hazards and also had good working knowledge on health hazards and safety precautions.31 Thus, mortuary attendants need to be knowledgeable about the chemicals used for embalming and the associated occupational hazards as well as the necessary protection to abate the dangers associated with their field of work.

The study findings also revealed that the employment of all mortuary attendants was not based on any standardised prerequisite education or training. In other jurisdictions, mortuary attendants are required to have at least a high school diploma or General Educational Development, while some employers require a minimum of a 2-year associate degree in Mortuary Science.2,32 In another study conducted by Altaf Pervez, Zameer Ahmad and Asif Jamil,33 it was further revealed that healthcare institutions should take the training of staff seriously including medico-legal issues on autopsy. Again, Adisah-Atta and Dim26 note that it is important to train and equip the mortuary workers to make them feel comfortable at work and accomplish a lot for the facilities they work for. Regardless of their initial training, there is a pressing need for regular training programmes to help mortuary workers keep up with standard occupational health precautionary measures.29

The results from the study showed that participants underwent prearranged internship/apprenticeship at their current or similar facilities before being employed, with the duration ranging from three months to two years. Participants believed that for anyone to become a mortuary attendant, one should have undergone some sort of apprenticeship or have some prior experience in a health facility. This finding is in line with a study by Kessler, Heron, Dopson, Magee, Swain and Askham34 who stated that apprenticeship is capacity building as it nurtures or provides growth to an individual in an institution. This gives direction and develops a supportive practice and system for those seeking to establish a clear career pathway. On the contrary, Cordner, Bouwer and Tidball-Binz35 noted that in some cases people do not need apprenticeship to perform certain tasks. These researchers indicated that volunteers without formal training could take care and properly dispose of corpses that were highly infectious during the Ebola epidemic.

Finally, the study revealed that the conditions of service of mortuary attendants were not commensurate with the demands of their work. Mortuary attendants in Ghana are poorly remunerated and lack adequate medical care in most facilities. Most of them are casual workers paid from the internally generated funds of their facilities and are not on the government payroll hence do not benefit from privileges that come with being full-time employees. Participants were unhappy that their remuneration did not measure up to the work they do. They complained that they worked around the clock and thus had no time to engage in any additional work to supplement their income. Interviews with some mortuary attendants found that they are sometimes recruited and paid meagre salaries from internally generated funds of their facilities and that because they lacked formal training and education it is nearly impossible for them to seek career progression and promotion.36

He was so overwhelmed with the excitement that day that he could neither sleep nor eat until the day of interview. But his joy was soon short-lived when on the day he was to resume work, he was asked after being interviewed at the General Hospital to go to the mortuary section of the hospital and get familiarized with the environment he would be working. At first, my heart skipped and I thought I did not hear the officer right.

Soon, they finally got to their destination, the destination he never wished for. Relating how he felt, Ruphus said: when we did not branch at the last building to the mortuary and we proceeded instead towards the building labeled, mortuary, I had a feeling that I was no longer the one walking but I kept moving, whatever the force that was pushing me, I could not say up till today.

Explaining what his job entails, the 45-year-old man said he has been assigned to different jobs in the mortuary. This ranged from washing of corpses, keeping watch over them at night to sanitizing the environment to guide against unpleasant odour around the mortuary and embalming corpses, a knowledge he later acquired, which is now fetching him money.

Conclusion:  This study has unveiled the negative effects of formalin on morgue attendants, which is likely to cause long-time health problems. It is therefore recommended that all mortuaries in Ghana should be assisted with protective equipment, in-service training, and practice of universal safety to help reduce risks associated with chemical hazards, especially formalin. There should be regular surveillance in the mortuaries and workers be screened regularly.

The job of a mortuary attendant or mortician is only for those that have heart, following the myths and mysteries that border on bizarre occurrences in morgues, especially spine-chilling behaviours of corpses. In this report, some daring attendants who defied all odds to take to the job, share gripping experiences with Daily Trust.  2351a5e196

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