As the current epidemic of bubonic plague grows in Madagascar, threatening to spread beyond the borders, a strange local ritual of dancing with the bones of dead relatives may be behind the pace of the unprecedented outbreak.
Bubonic plague is endemic to Madagascar, but this year the annual outbreak has grown into an epidemic that has health organizations scrambling to prevent a global pandemic. Normally, Madagascar has an average of 400 cases diagnosed annually, but this year is exceptional, with 124 deaths since August outbreak and an additional 1,200 cases diagnosed.
In previous years, the plague was the bubonic strain of the disease, transmitted and carried by rat-borne fleas, with outbreaks isolated to rural villages. The current epidemic is the pneumonic strain, showing up in urban centers, transmitted via coughing or sneezing. It can be fatal within 12-24 hours and if untreated, has a 100 percent mortality rate.
To contain the spread of the disease, health officials have prohibited large public gatherings and are monitoring all travel points, but the epidemic has been exacerbated by an ancient ritual the Malagasies are loathe to give up: the Dance of the Dead.
According to the locals, a dead person passes into the next world only after his body completely decomposes. Until that time, he occasionally needs to communicate with family and friends. In keeping with this belief, the people of Madagascar have a strong tradition of gathering in the cemeteries to disinter the bones of their relatives, wrap the remains in festive shrouds, and dance with the bones accompanied by festive music.
The bizarre ritual, called famadihana, or Dance With the Dead, is accompanied by animal sacrifices, and the meat is used for a graveside feasts. The mats used to carry the dead are taken home; storing them under a bed is supposed to bring luck to the person who sleeps on the bed.
As disturbing as this ritual is, there was no reason for authorities to step in to prevent it until recently. The epidemic of bubonic plague made contact with the dead a dangerous affair.
“If a person dies of pneumonic plague and is then interred in a tomb that is subsequently opened for a famadihana, the bacteria can still be transmitted and contaminate whoever handles the body,” Willy Randriamarotia, the chief of staff in Madagascar’s health ministry, told AFP.
Health officials are working to prevent the spread of bubonic plague through the Dance of the Dead. The government has instituted rules stating that plague victims must be buried in anonymous mausoleums, not in tombs that can be reopened.
The connection between plague and the Dance of the Dead has long been suspected. The Madagascar countryside is usually hit by plagues when late-summer brushfires drive rats into villages, and again when early winter flooding does the same. But health ministry epidemiologists have observed that the plague season also coincides with the period when famadihana ceremonies are held from July to October.
Despite warnings from officials, some locals refuse to give up the tradition.
“I don’t want to imagine the dead like forgotten objects. They gave us life,” Helene Raveloharisoa, a regular at the ritual, told AFP. “I will always practise the turning of the bones of my ancestors – plague or no plague. The plague is a lie.”
Some Malagasies suspect the government has ulterior motives for prohibiting the ritual.
“The government in power is short of money for the next presidential poll, so they invent things to get cash from lenders,” said Josephine Ralisiarisoa to AFP. “I have participated in at least 15 famadihana ceremonies in my life. And I’ve never caught the plague.”
— AFP news agency (@AFP) October 26, 2017
The disease is showing up mostly in urban centers and several cases have turned up in the neighboring country of Seychelles. International health organizations are preparing for the worst, setting up centers to treat the disease in the nine East African nations adjacent to Madagascar.
The World Health Organization (WHO) originally described the risk of a multinational pandemic as very low but, as the epidemic in Madagascar grows, has upgraded that assessment.
“Due to the increased risk of further spread and the severe nature of the disease, the overall risk at the national level is considered very high,” the WHO said in a its latest statement.
Their concern is well-founded. Bubonic plague in the 14th century, also known as the Black Death, was one of the most devastating pandemics in human history, resulting in the deaths of an estimated 75 to 200 million people in Eurasia and in Europe, or roughly one-third of the world population.