This post was co-authored by members of CoMeSCov program who contributed to the development of research questions, data collection tools and data analysis: Firmin Kra, Francesca Mininel, Fleur Beauvieux, Carlotta Magnani , Sandrine Musso . (See bios below for affiliations).
The authors are researchers in the collective CoMeSCov research program: Containment and Health Measures to Limit Covid-19 Transmission: Social Experiences in France, Italy and the USA in the Time of a Pandemic, funded by REACTing (Research and Action: Targeting Emerging Infectious Disease) and the French National Research Agency (ANR grant ANR-20-COVI-000) All authors are also members of the Réseau Anthropologie des Épidémies Émergentes (RAEE).
This article has been translated to English by Kelley Sams.
“NOI DENUNCEREMO- Truth and justice for the victims of covid-19 comes from a need for justice and truth, to give peace to our dead who did not have dignified burials. Whoever made mistakes will have to answer our questions and assume their own responsibilities. We demand justice” -The association founding committee https://www.noidenunceremo.it/
In March 2020, in the midst of the covid-19 pandemic, Luca Fusco, his son Stefano, and son’s companion Arianna Dalba created a Facebook page dedicated to the memory of Luca’s father, Stefano’s grandfather, who had died of covid-19. The purpose of the page was to pay tribute to him, as funerals and any kind of commemoration had been banned nationally in accordance with disease containment measures. This was the only way to create a “space,” albeit virtual, to mourn the deceased with family and friends. Within hours, thousands of people had subscribed to the “NOI DENUNCEREMO – verità e giustizia per le vittime di covid-19” page, which eventually reached more than 60,000 members. The page, which collects a series of stories and tributes, along with its website that was subsequently created, soon developed into a collective movement.
From a page to a movement
This Facebook page has two functions. On the one hand, it brings relief to the relatives of the victims who find it difficult to accept the mass deaths caused by covid-19, which seem unjust and aberrant to them. These people find emotional support among the subscribers who like them have lost loved ones, and have lived a similarly dramatic experience. This allows them to acknowledge one another’s experiences, build trust, and share their pain, similar to early groups and associations of people living with HIV (Broqua C., 2018).
On the other hand, the group promotes an initiative, born out of civil society, which demands answers and wants to shed light on the responsibilities for the 16,802 dead that the Lombardy region has mourned since the beginning of the covid-19 pandemic in February 2020.[1] Lombardy was affected much more on average than the rest of the nation: it recorded half of the covid-19 deaths in Italy, despite having only one sixth of the national population.[2] Shortly after its creation, the group transformed into a formal association that was recognized by the state. Its primary function is to translate family stories into legal language. A group of lawyers, mostly from Bergamo, is active in the association. It is headed by Consuelo Locati, whose father’s body, after he died of covid, was taken out of the region in an army truck. 50 complaints were filed by the association with the Bergamo Public Prosecutor’s Office during the first “Denouncement Day” for the lack of clarity about the care and deaths of family members during the epidemic.
On this occasion, Luca Fusco spoke over telephone and in the media; his appearance was very dignified, sober and devoid of excess. He remained firm and quite dry when journals tried to minimize the responsibilities for the many deaths:
“Who was not in Bergamo cannot understand. There was only the sound of ambulances, helicopters and the bells ringing to death. We were in the front line, at the front, as if at war… With all these deaths, for which there were not even enough coffins, death was so fast. We didn’t participate in meetings on the balconies and in singing,[3] because we were mourning our dead. With us it was completely different than elsewhere in Italy. We were sacrificed, because of other interests, incapacity, mistakes “[interview, Bergamo, 10 June 2020]
During the first interview for this research program, as the researcher began to offer condolences, Fusco cut it short and said straightaway:
“We are in pain, of course, but above all, we are ‘incazzati’ [very angry [4]] about how the pandemic was managed in Bergamo and in the region.” [phone interview, 4 May 2020]
How did we get there?
The association first denounced negligence on the part of the regional and national authorities, who did not declare Val Seriana[5]and particularly the villages of Alzano Lombardo and Nembro (province of Bergamo) and also Orzinuovi (province of Brescia) a red zone (a zone of high prevalence requiring specific public health measures), which could have limited the cases and the dead. It also protested against the lack of personal protective equipment and the outcomes in elderly care facilities. The group also wanted to understand who had decided to hospitalize confirmed positive cases in nursing homes during the first phases of the epidemic, and why. These hospitalizations eventually led to the death of hundreds of elderly people. Another crucial point was the weakness of public health measures in the territory. One of the consequences of this weakness has been the collapse of hospitals, the still unknown number of people who died of covid-19 at home. In the view of the association, these people relied on nothing other than paracetamol and antibiotics for too long before being hospitalized, compromising any possibility of recovery.
Through their writing, members of the association shed light on the suffering that the victims and their families experienced. They describe how the deceased were separated forever in loneliness and pain. The sick died alone, frightened and unable to say goodbye to their loved ones. Families are condemned to live with a feeling of guilt that never leaves them, for having abandoned a father, a mother, a grandmother in the hands of an understaffed health service. The deaths of their loved ones were solitary, or accompanied by charitable caregivers who became their last improvised family before dying.
In each interview, and during the Facebook live sessions on Thursdays, Luca and Stefano Fusco, remind their audience of two major points: First, the association does not blame caregivers, as mentioned in its statutes (see note 5), whom they consider as victims who fought covid-19 “with bare hands,” with many of them dying to treat the sick. Another point is the demand for justice from the families of the victims. However, the association claims that it does not want to replace justice, or, worse, to conduct rapid legal trials on the internet, especially in the movement of popular justice that has become fashionable in in Italy at the moment.
Stefano Fusco affirms this point:
“We are apolitical. In our association there are people from the extreme right, as well as from the extreme left. We are neither lawyers, nor doctors. What we areinterested in is understanding the errors that have been made, if there are errors, and where are the responsibilities. And to ensure that something like this never happens again, for us, for our sons and for our great-grandsons. We also believe that shouting is of little use and that the same can be said calmly, and, like that, convey our goals.” [interview, Bergamo, July 8, 2020]
On a more personal level, what emerges above all from the hundreds of posts published on the association’s Facebook page and the interviews with its members is astonishment that something like this could have affected our Italian society.One of the Committee members, a young woman of Bergamo, who had lost her 65-year-old father, puts it this way:
“We had the impression of living in a Third World country: you call the emergency numbers [the doctor on duty] and they tell you that they cannot do anything. At the number to call the ambulance, they say that ‘they can only go out if my father has a respiratory attack,’ when he was passed out for an hour and a half. You ask them ‘I’m afraid my father will die at home,’ and nothing! It’s been a devastation for us and you wonder: ‘But where do we live? Is it possible that we have been reduced to this?’ The height of the desperation was when rescuers finally came looking for my father and asked my mother where the hospital was, because they did not know. This is what gives the idea of nothingness, of emptiness. They, like the caregivers, are heroes, for they were blindly thrown in. And that’s when you realize the drama that’s happening, the utter helplessness.’ [Phone interview, July 22, 2020]
Forms of guilt
The issue that emerges from posts on the Facebook page and website is the guilt of the families, the survivors. This is the case with Isabella, for example, who filed a lawsuit following the death of her father in a nursing home in Lombardy. During the interview, she held a photo of her father in her hands and recounted his tragic death after an ordeal that she memorialized through images and recordings. Shortly before he was no longer able to communicate with the family, her father begged:
“Come get me out of here, come save me! They don’t give me anything to eat or drink, and I stay stuck for days in bed without having my diapers changed.”
She expressed difficulty accepting what happened, because she sees no reasonable justification. Isabella insists on the feeling of guilt for having driven her father there, to die alone and in despair:
“He had confidence in us and the place seemed clean to us, as well . They told us that there were group fun activities, and it seemed to us a good place. But that was all wrong! They didn’t do any of that […] he was a grandfather, whom my children liked a lot. He used to go out with them. They went out to have ice cream together, just before entering the nursing home. [Interview, June 10, 2020]
Attacks on dignity
Another theme that often comes up in the words of the victims’ relatives is the loss of dignity that the deceased were forced to experience. Dina, a young woman who lost her father, says that after entering the emergency room on his own, “he spent three days in a chair with a 40° fever. And then, his condition began to deteriorate.” The same concept of neglected dignity is found in the words of Diego, a volunteer rescue worker, who describes the belongings of patients taken from their homes by ambulance as a way of reflecting upon their loss of dignity:
“A telephone, a 10 € cable and a 220V plug […] You really saw the man stripped of everything, of his relatives, of his dignity… What remains of him is a patient’s gown and a cable, the essence of a man…” [Interview, May 25, 2020].
The management of deceased bodies and their personal belongings is another painful issue that emerged during this dramatic period. These effects were the last material objects that the victims had touched in their isolation. Their families therefore attached great importance to them. However, in many cases the families never received the black plastic garbage bags that contained the objects that their loved ones possessed when they died; sometimes families received someone else’s bag by mistake. After receiving their loved one’s belongings, families felt the shock of opening the bag to discover clothes sometimes stained with blood that made them imagine with anguish the last hours of the lives of their relatives. Addressing these attacks on dignity is not part of the association’s mission, but it has made the population awareof the tragedy that was lived, supported by numerous interviews delivered by the members of the association and media attention.
The lack of funeral rituals
The tragedy of the covid-19 epidemic in Italy hit the Lombardy region very hard, especially the provinces of Bergamo and Brescia, “martyr” cities of the epidemic. According to the Noi Denunceremo association, this massacre could have been largely avoided[6]. Its members, as well as the entire Italian population, recall the parade of army trucks which, on the night of March 18 – subsequently declared “Memorial Day for the Victims of COVID-19” – transported hundreds of corpses to other towns for cremation. The Bergamo cemetery and crematoriums was not able to manage all of these deaths. Giovanni, a young volunteer rescue worker, described the emotional impact of this parade on the people of Bergamo:
“It killed the dignity of the people, to see all these dead sent to the crematoriums of northern Italy pass by, without being able to greet them, without being able to pay them homage with a dignified burial. [Interview, June 29, 2020].
It is precisely this lack of funeral rites that haunts the relatives of the victims who decided to join the association.[7]Among the measures put in place by the Italian government to contain the pandemic was the ban on all gatherings, including funerals and any kind of commemoration ceremony. Families were prevented not only mourning their dead, but also from having the comfort of having provided a dignified burial, after having been unable to do anything to keep this person alive.
On June 28, 2020, the President of the Italian Republic, Sergio Mattarella, paid tribute to the victims during a ceremony in the monumental cemetery of Bergamo in the presence of mayors from the Lombardy region. The very tense atmosphere hit and moved Luca Fusco, the only family representative present at the commemoration. At the same time, it created a debate within the association: some members wanted the invitation to be extended to a greater number of the victims’ families and expected the President to specifically address them with words of solidarity. During a Facebook Live session on Thursday night, Luca Fusco stated:
“During the notes of the Italian national anthem, some mayors wept silently, those whose villages had been most affected by the coronavirus. Then, during Gaetano Donizetti’s Requiem, a kind of peace descended on me and I felt that, finally, our dead rose up and walked towards a place of peace”.
During interviews, relatives expressed their concern that “their dead” died alone without having received a religious rite or having been accompanied by faith leaders. They also described imagining the deceased in a kind of limbo, a place of transition where they have no peace and where they cannot join others. The ceremony represented an effort to resolve this, even if the families of the victims and other members of the Noi Denunceremo association remained deeply upset. The ritual treatment of the dead as managed by parlors in contemporary Lombardy usually includes washing, preparation, exhibition at home or in the morgue, collective prayer evenings, burial, and the accompaniment of the coffin in the cemetery with a ‘man of God’ to give the last blessings. The absence of this important ritual seems to have been to some extent replaced by hundreds of memories and tributes posted on the association’s page, although the continued lack of “real” ceremony prevented families from fully expressing their mourning.
The association webpage as a substitute for funeral rituals
This lack of funeral rituals may explain why the social network collected numerous photos and messages of love for the victims and solidarity for their families within the span of a few months. One of the most striking aspects, when you scroll down the many posts on the page, is the number and variety of Internet users’ reactions: most of them are emoticons or GIFs of angels, hearts in tears, flowers, or images found on the Internet that convey the deep emotion of the members, the willingness to support each other and demonstrate solidarity (see below). It shows the spread of popular digital culture with its visual representations underlined by Italian and global references, mostly religious.
These visuals were also duplicated by families on social networks, where Facebook’s staff created a “care” emoticon, as support during the harshest period of the epidemic and containment.
The association’s website also collects letters sent to loved ones, as a link, an apology for “having abandoned them and sentenced them to die alone” (as described by the authors).[8] This feeling of abandonment reflects the function of the solid corpus of highly codified rites developed over the centuries that people can use to find balance after interruption by event of death, and which offers meaning and appeasement to those who remain.[9]
The epidemic erased farewells and deprived people of ritual mourning. It froze paininto an immutable present: a present devoid – at the time of confinement – of closeness to others, of the warmth of affect and of touch. New rituals were needed in order to make up for this absence, the darkness that people identify and, ultimately, the void, into which the dead who “died badly” were thrown. The vice president of the association spoke about a common experience, quoting a young man who had difficulty understanding the reason he had lost both parents and described what happened in a succession of images from a television series:
“There is no reason, in my opinion! It was like living an episode of the Avengers, when Thanos snaps his fingers and they all die, they all disappear. You are watching and your parents are no longer there! You don’t know where they are.” […] “Since you can’t see them, you don’t have the materialization of the mourning because you couldn’t see them in the hospital or in the cemetery [because of the confinement]. Among us, we all say we saw them get into the ambulance and come back in urns.” [Phone interview, July 22, 2020].
What binds the people who decided to join the Noi Denunceremo association is evident. They all experienced the same tragedy: the sudden disappearance of a person whom they could not accompany until the end, in some cases not knowing where this person’s remains were taken. Along with the feeling of solidarity as a fundamental component of the association, the group is driven by a deep desire to discover the truth and assign responsibility for these mass deaths. After filing the first 150 complaints during the two Denouncement Days before the Bergamo Procuratorate, the association announced a third day, scheduled for September 2020, when further complaints will be filed. In mid-July, a letter was sent to the President of the European Union, Ursula von der Leyen, in which the lawyers of the association mention “the untold signs of crimes against humanity,”[10] in particular for what happened in the Lombardy region and especially in the cities of Bergamo (6,000 dead) and Brescia (5,000 dead).
These initiatives and actions of the families of the victims are criticized by some, who fear that they distract from the real protagonists – the deceased. The aim of the association is neither to seek fame nor to attack caregivers, as mentioned earlier. Likewise, members do not demand money. Complaints are made with the help of lawyers who work for free. Only €5 is required to register with the association. Other associations, linked to political movements, had asked Luca and Stefano Fusco to merge with them, which they refused on the grounds that they are not interested in politics. What they want is to reach the truth, to establish responsibility for what led thousands of people to an absurd and lonely death, so that they can finally rest in peace, and that such a calamity does not happen again. The association also demands an assignment of responsibility to political administrators so that future public health efforts are managed in a more efficient and more egalitarian way, while respecting the dignity of people both living and dead.
The association in the era of “living with the virus”
Recently,Noi Denunceremocontacted and established a dialogue with an English association, “covid-19, Bereaved Families for Justice UK”, created on the same model with almost identical complaints: lack of creation of a red zone, insufficient public health response, stock shortages of medical equipment (as in other European countries), and the tragedy of nursing homes. At the same time, the attention that Noi Denunceremo received from the media outside Italy – which gives associations more importance than the Italian media do– introduced the idea of a larger association, at the European level, that would bring together the families of victims in the countries most affected by the pandemic on the continent. As the fear of a “second epidemic wave” spreads, it has become evident that failures in healthcare systems have not been sufficiently addressed and corrected by health authorities to ensure effective and dignified treatment for future patients, in Lombardy as well as other parts of Europe. Carlo Caduff (2020) highlights the need for major structural changes to manage an epidemic whose mortality is not only due to the pathogenicity of the virus, but also to the destruction of public and community services by neoliberal policies and ideology. Studying the social responses to the covid-19 epidemic through ethnography, as we will go on with Noi Denunceremo, allows us to study how these services are transformed, demanded, and challenged at the structural level on a longer time span.
The Noi Denunceremo association plays a major pioneering role in this regard, which should be compared with similar movements in other countries. Associations may occupy a different place in other countries, depending on the local commitment of parliamentary committees or public bodies, as well as the existence of lawsuits, or adaptations that were implemented during the crisis. The Noi Denunceremo association introduced a critical dimension which is essential for bringing into existence the model of “health democracy” (Hirsch, 2020), in line with the values of efficiency, equity, respect and autonomy, which underpin public health as a discipline at the global level. However, limiting the association to its political function would be too reductive in view of the important symbolic, social, and psychological function it provides to the living to give dignity and peace back to those who died from covid-19.
Acknowledgements
We thank Luca and Stefano Fusco and Arianna Dalba, for their willingness and kindness, for having accepted an anthropologist into their association, for the precious time they devoted to the research we are carrying out, and also for the contact with the “denuncianti” [members]. We would also like to thank Cristina Longhini, vice-president of Noi Denunceremo, for her precious conversation and availability, and finally, Consuelo Locati, chief lawyer of the association.
Chiara Alfieri is an anthropologist specialized in West African populations, medical anthropology, AIDS and anthropology of childhood, attached to IRD and LPED. During the covid-19 pandemic, she joined the CoMeSCoV project to conduct field work in her home region, Lombardy.
Alice Desclaux is a medical anthropologist working at TransVIHMI, Institut de recherche pour le Développement in Dakar, Senegal, with epidemics and pharmaceuticals in West Africa as main thematic fields.
Kelley Sams is a medical anthropologist who studies infectious disease elimination, health communication, and the circulation of medication. Her work as a researcher (LPED) on the CoMeSCoV research program focuses on the social responses to covid-19 in the USA.
Marc Egrot is a medical anthropologist attached to the LPED Aix-Marseille University, working on anthropological research on epidemics, pharmaceuticals and pesticides, mainly in Africa (Benin and Ivory Coast).
Francesca Mininel is medical anthropologist, who studies anthropologies of sexualities, of epidemics and of religion in relation to health. She is attached to the LPED Aix-Marseille University and to TransVIHMI, Institut de recherche pour le Développement. She has a postdoctoral position in the CoMeScov projet.
Firmin Kra is a PhD student in socio-anthropology at the University Alassane Ouattara. He is associated with CUB and LPED. His field of research includes funeral rites, epidemic prevention and response policies, and social marketing in health.
Fleur Beauvieux is a social historian working on epidemics, justice and vulnerabilities. She got her PhD at the EHESS in 2017 with a thesis about experiences during the plague in Marseille in 1720-1722, and is associate researcher at the Centre Norbert Elias and post-doctoral researcher at the LPED in Marseille on the CoMeScov program.
Carlotta Magnani is a PhD student in socio-anthropology at the Centre Norbert Elias, EHESS Marseille. She is associated with LPED. Her researches interests include homeless people’s health, social constructions of emotions and social experiences of epidemic policies.
Sandrine Musso is a social anthropologist teaching in Aix Marseille University and working in Centre Norbert Elias (Marseille), engaged in research on migration and health, social history and aids memories, deservingness and social inequalities in access and experiences of medicine and healthcare.
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Caduff C., 2020, What Went Wrong: Corona and the World after the Full Stop, Medical Anthropology Quarterly, https://doi.org/10.1111/maq.12599
Costanzo G., 2020, La Valle nel virus, Milano, Edizioni Underground.
Freud S., 2005, Deuil et mélancolie, Œuvres complètes, Volume XIII, 1914-1915, Paris, PUF
Hertz R., 1970 « Étude sur la représentation de l’idée de mort », Sociologie religieuse et folklore, Paris, PUF
Hirsch E., 2020. Covid-19. Ces derniers mois, la démocratie sanitaire bafouée. Le Monde, 19-20/07/2020, p. 28.
Kra F.,Taverne B., Kra F., Akindès F., Laborde-Balen G., Sow K, Egrot M., 2020, L’anthropologie impliquée à l’Hôpital en contexte d’épidémie à Covid – 19, Note produite par des membres du Réseau anthropologie des épidémies émergentes (RAEE), des professionnels de l’Hôpital Européen de Marseille et de l’équipe de recherche du programme CoMeScov, https://theconversation.com/lanthropologie-impliquee-a-lhopital-en-contexte-depidemie-de-covid-19-pour-accompagner-les-fins-de-vie-et-les-deces-hospitalier-145815
Laderman G., 2003, Rest in Peace : A Cultural History of Death and the Funeral Home in Twentieth-Century America, Oxford University Press.
Pizza G., 2020, Before and after (in and from Italy), In, Somatosphere, 10 May 2020.
Taverne B., Kra F., Akindès F., Laborde-Balen G., Sow K, Egrot M., et l’équipe CoMeScov, 2020, Comment réinventer les rites funéraires en temps de Covid-19 ? The Conversation, 13 May 2020, https://theconversation.com/comment-reinventer-les-rites-funeraires-en-temps-de-covid-19-136707.
Notes
[1]This figure, along with the national death toll (34,213) is as of July 29, 2020. The updated figures are available at www.regione.lombardia.itand Ministero della salute, www.salute.gov.it/nuovocoronavirus. Lombardy has 10,103,969 inhabitants (ISTAT http://dati.istat.it/Index.aspx)and Italy 60,244,639 (ISTAT http://dati.istat.it/Index.aspx).
[2]Lombardy is Italy’s leading region economically and industrially. Its health system (Pizza, 2020) has always represented “excellence”, even if for more than 20 years, neo-liberal policies and systematic reduction in public health funding have led to a very sharp deterioration in the health supply: the pandemic has come to shed light on its dysfunctioning. The journalist Roberto Saviano, in his April 12, 2020 article published in Le Monde, entitled “Weakness is to believe oneself invincible”, reviews the history of the region and the relationships between economy, public health and private health, scandals, which form the backdrop to this health crisis.
[3]He alludes to the popular demonstrations of solidarity for caregivers observed in several countries. From the foundation of the association, its management committee affirmed in its statutes that the association would never implement actions aimed at holding health personnel responsible, and that its lawyers would not take charge of requests for this nature.
[4] Term in Italian that is difficult to translate, close to “pissed off”.
[5]Val Seriana is a valley close to Bergamo, dotted with companies and businesses, about 400, with an annual turnover of around 680 million euros (Il Fatto Quotidiano, 4 april 2020). It is, in fact, one of the richest and most productive areas in the whole country. At the beginning of March, the Istituto Superiore della Sanità (ISS), indicated two municipalities in the Valley, Alzano Lombardo and Nembro, as high-risk areas for the spread of contagion and recommended the establishment of a red zone. Everything was ready, a few hundred people including soldiers, Carabinieri and Civil Protection volunteers were already on site with all the necessary infrastructures to set up the check-points, close the passes and isolate the two towns. But then, nothing more, in a reshuffling of responsibilities between the government region and the Lombardy Region, the latter put under strong pressure by Confindustria (italian confederation of industry). Because of the non-establishment of this red zone, and the number of infections and deaths that followed, the Bergamo Public Prosecutor’s Office opened an investigation in order to establish the possible responsibilities that led to this choice and further permitted the extension of the epidemic.For a detailed history from within the valley, cf. Costanzo 2020.
[6]About this, a State document has caused a stir. The report of General Pier Paolo Lunelli: a large study circulated in the media mainly thanks to the association, shows how 10,000 deaths out of over 35,000, in Italy, could have been avoided, updating the epidemic plan, defined “old and obsolete” and stopped in 2006. This report should be presented, in the next months, to the prosecutors who investigate the alleged errors in the management by Italian authorities of the emergency related to covid epidemic (Qui Finanza, 14 August 2020).
[7]On the need for appropriate funeral rites during the COVID pandemic, seeBormolini G.,2020; Laderman G., 2003,Taverne B et al.,2020; Kra F.,et al., 2020.
[8] Reading through the facebook page, immediately, brings to mind the moving, unspeakable testimonies written by the relatives of the AIDS dead, and become an artistic monument, “The Patchwork of the names” http://www.aidsmemorial.org/
[9] Freud (1915) and Hertz (1970) were the first to introduce the expression “work of mourning”. Based on observations from populations of Borneo, Robert Hertz speaks of “double funerals”. The first phase consists of gradually separating the dead from the living through the treatment of the body. This leads to a second phase, during which the soul, now freed from bodily constraints, can join the other deceased who are already part of the ancestors, now protective and benevolent towards humans.
[10] cf. The Guardian, 2020, “Bereaved urge EU chief to supervise Italian coronavirus inquiry”, 13 July 2020.
