Karuna Hospice Services

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Cultural diversity is a relatively new phenomenon in Australia but according to Australian Bureau of Statistics figures for the 2001 Census 4.1 million (22%) of Australian residents and 601,693 (17.1) per cent of Queensland residents were born overseas.This project, Cultural Perspectives on Death, was developed to explore the different practices for the dead that can occur within faith groups. Previous research has provided valuable information about the beliefs and practices of different faith groups , but it is easy to assume that practices at the time of death will be the same for all practitioners of a particular faith regardless of their cultural background.

Because death is such a sensitive subject and because it can be a very difficult time for families who are experiencing the death of a loved one, we hope to add to community awareness and sensitivity about the range of beliefs and practices in our community relating to death and dying.

The project did not set out to be exhaustive. We could not hope to cover all the religious traditions that are practiced in Australia, nor all cultural traditions. We chose three major religions, Buddhism, Islam and Christianity and interviewed individuals from different cultural groups to learn about their specific traditions and practices for people who are dying or who have died. Through this we hope to raise awareness in the wider community and the medical profession and the funeral industry - anyone who may come into contact with families during such a difficult time.

It is our hope that this information will be of benefit in increasing understanding, and that, when a death occurs, it will encourage people to ask what actions or procedures are appropriate, in order to be sensitive to the needs and traditions of people from multicultural communities.

Tibetan Buddhists

Tibetan Buddhists place a great deal of emphasis on preparing their mind for death and on making the process of dying as peaceful as possible. Geshe Tashi Tsering, a Tibetan lama (teacher) who has been in Australia at Chenrezig Buddhist Institute for 15 years, explained that the best way for someone to prepare for death is to have a positive, virtuous state of mind such as loving kindness or compassion so that their mind is at ease. If they have faith, something they place their trust in and turn to, it is good for the family and friends to help them bring that to mind, to think of that source of faith and trust. And if they have a particular spiritual practice they are familiar with, it is important to help them with that.

Drolma, a Tibetan woman who came to Australia with her husband, Jampa in 1996, with their children and grandchild arriving soon after, explained how Tibetan families strongly prefer that a loved one who is dying be at home rather than in hospital in the last stages of their life, so that the family could care for them, help to keep their mind peaceful and calm and provide a quiet environment.

A photo of a highly respected lama such as the Dalai Lama would be placed next to their loved one to comfort them and inspire them to pray and meditate as much as they are able. Many prayers and offering ceremonies would be performed before and after death, in the temple or by monks coming to the family home. These prayers and ceremonies would be done to help the dying person have a good rebirth in their next life - with a good family, a strong healthy body and to help them practice Buddhism well in the future and if possible become a monk or nun. Drolma discussed how recognising and accepting that we are all going to die and doing daily spiritual practice throughout one’s life is seen as the best preparation for death by the Tibetans. They also use the experience of their sickness to recognise the suffering of others, to pray for others and pray to take on the suffering of others.

Relatives, close friends and neighbours would be very involved in the care of the dying person and the family before and after death - visiting each day, preparing food, organising shopping and organising offerings to be made at the Buddhist temple on behalf of the person. Everyone involved would be very careful not to disturb the mind of the dying person, for example not crying near them during the last stages so that their mind can stay calm and concentrate on prayers or reciting mantras. They would also place a small Mani pill in the mouth of the person as a blessing - these are pills which have been blessed by the recitation of millions of mantras of compassion (Om Mani Padme Hum) by many monks and nuns and also blessed by the Dalai Lama.

After death the person’s body would be washed by the family with saffron water, and a special candle offering (butter lamp) would be kept burning in the house for as long as the body remains there, until it is taken to be cremated.

Geshe Tashi Tsering pointed out that it is good to allow the body to remain undisturbed to allow the subtle process of the consciousness leaving the body to continue without disruption. Traditionally in Tibet the body would not be moved for up to three days while this process occurs, unless a smell begins to come from the body which is one of the signs that the consciousness has left. The body is treated with great care and draped with a “khata”, a white offering scarf.

During the weeks following the death, while the person is in the ‘intermediate state’ (a state of transition between one life and the next), special ceremonies are performed each week until they take their next rebirth within 49 days. The family and the community continue to make offerings at the temple on behalf of the person.

Drolma discussed one very interesting practice done by Tibetan Buddhists which is to record the exact time of death and then contact a Tibetan astrologer to determine the best day for the funeral / cremation, and to determine what specific offering and prayer ceremonies need to be done for that person. A lama would also be requested to perform a ‘Powa’ practice once death has occurred - this involves transferring the consciousness of the person to ensure they have a good rebirth.

If the person died in an accident or very suddenly and there was no time to prepare for death with a peaceful mind, the family would request the lama to do a special fire puja to help the consciousness of the person become peaceful. There are various other practices which lamas can do to benefit the person and help them achieve a positive rebirth, and it is also believed that prayers by the immediate family who have a strong connection with the loved one are particularly powerful and beneficial.

Geshe Tashi Tsering also mentioned how beneficial it is for the family to practice generosity and do virtuous actions on behalf the person who has died. For example, making donations and dedicating for the benefit of their loved one.

Chinese Buddhists

Although both are Buddhist, the Tibetan and Chinese traditions and rituals vary. Reverend Shan, a Buddhist nun originally from Taiwan and now living in Australia at the Chung Tian Temple, described how Chinese families come to the temple to talk with a Buddhist nun or monk for advice on how to deal with the dying process and death of a loved one. The nun or monk would also visit the dying person in hospital or at home to guide them and would recite prayers and sutras and perform gentle chanting of Amitabha Buddha’s name and Kwan Yin’s name, to bring blessings, comfort and calmness. This is especially helpful in facing fear, reducing pain and creating a peaceful environment and a peaceful mind. The family and dying person are encouraged to join in the chanting and prayers if they are able.

There is great emphasis in the Chinese culture for families to be together during this time, and especially for adult children to return home to see a parent before they pass away.
Relatives, friends and community members are all involved in helping the family, taking turns to care for the patient, to visit them in hospital or at home, to prepare food and give support both before and after the death. They also respect the need to create a very peaceful environment and not to disturb the person in any way so that they can remain calm during the final stages.

One practice in the Chinese tradition occurs after the death of the person when Buddhist nuns or monks and family and community members go to the hospital to continue the chanting of Amitabha Buddha’s name for 8 hours. This is to help create peaceful conditions for the consciousness to leave the body, which occurs some time after the heart and the breathing have stopped. Rev. Shan discussed how peaceful the room becomes with the chanting and how inspired the families are to continue with their Buddhist practices through this experience.

A service is conducted at the funeral director’s as the person’s body is put into the coffin and the body is draped by a special quilt with mantras (prayers) printed on it. Most families prefer cremation with a Buddhist funeral service - the ashes are normally stored later in a special pagoda at the temple.

Rev. Shan explained that after the funeral there is a service at the temple each week for 49 days. Families are encouraged to participate in this and recite mantras for their loved one. Sometimes family members will also chant scriptures at home, eat only vegetarian food and wear simple clothes for the 49 days. Each year according to the Chinese lunar calendar, a service is conducted for all those who have passed away and many families come to the temple to show respect for their ancestors and to pray for them.

Vietnamese Buddhists

There is a great deal of emphasis put on spiritual practices before death in the Tibetan and Chinese traditions, including nuns and monks visiting the dying person and the family to offer guidance and prayers. However, in the Vietnamese Buddhist tradition prayers are not done until after the death has occurred and nuns and monks are not usually involved in hospital or home visits. It is only after death that the family contact the temple to arrange for prayers to be done and involve the nuns and monks.

Nga Hayden has contact with many community members through her work at The Vietnamese Community in Australia, Queensland Chapter. Nga described how in Vietnam people would normally die at home, not in a hospital, and the family would wash the body and dress their loved one in white clothes. The elderly would show the young ones how to care for the body respectfully. Living in a different culture means things have changed, but Nga said there are some funeral directors who understand the Vietnamese culture and now allow the family to come and dress the person at the funeral director’s.

After the person has died, relatives come and help with cooking and shopping but not before the death - usually just the immediate family is involved before death according to Nga. Some Vietnamese families prefer cremation and some prefer burial but either way it does not occur until 3 days after the death. Prayers at the temple are done for those 3 days, and again after 7 days and then every half moon continuing for 3 months, mainly to Amitabha Buddha and Kwan Yin. A photo of the person is put up in the family home, incense is lit and further prayers are done at home.

Muslims from different countries

It was interesting to speak with Muslims from various cultures to hear how closely connected their rituals and traditions are to each other - the practices of the Muslim faith are very similar across different cultures and countries. I spoke with Taher Forotan, an Afghan Muslim man; Fatima Abdel Karim, an Egyptian Muslim woman; Sheriff Yusuf, a young Muslim man from Somalia in Africa; and Imam Yusuf Peer who is a leader in the Islamic community.

There were many similarities in their descriptions of dealing with death. The importance of the family and faith in all aspects of living and dying for a Muslim became very apparent as we talked together. Imam Yusuf Peer discussed how life and death are seen as a test of a person’s actions according to the teachings of the Qu’ran, the sacred book of Muslims. There are precise spiritual practices to be done in helping someone prepare for death and in praying for them after death. The dying person is reminded to die as a Muslim, repeating the words which bear testimony to their belief in Allah as the one God and Mohammed as His Messenger. It is important that other Muslims are with the dying person in hospital or at home, to help them in this practice of dying in a state of faith, to pray for them using guidelines from the Qu’ran, requesting forgiveness for them and turning their face towards Mecca, which is the direction of prayer for Muslims.

Taher Forotan, from Afghanistan, pointed out that dying in a hospital setting may be difficult for some people, especially if the family is new to Australia and not well established here. Most people would prefer to die at home if possible, surrounded by family and friends. This was emphasised also by Sheriff Yusuf, from Somalia, who talked about how important the family’s involvement is in the entire process of caring for a loved one while they are ill and during the final stages of dying. The family surrounds the dying person, talks with them, comforts them and does not isolate them in any way. Fatima Abdel Karim, from Egypt, reinforced how important it is to support the dying person in their faith no matter where they are. She said: “Where is God - he’s everywhere, in the hospital, at home, on the road, where ever your death is. Where you die doesn’t matter, as long as you have the support of people around you, the family, and you can remember the articles of faith.”

There are specific rituals that need to be performed after a death has happened which the family traditionally do - washing the body very carefully and respectfully with camphor in the water; wrapping the body in a particular way with pieces of white cotton cloth; preparing the body for burial in a very clean way. Men are washed and wrapped by men; women are washed and wrapped by women. When it is a wife that has died, the husband can wash and wrap his wife, and vice versa. When it is a child that has died, the washing and wrapping can be done by either an adult male or female, according to the family’s wishes. There are prayers recited from the Qu’ran and prayers asking for forgiveness and mercy during these stages of preparation, by family members, other community members and by the Imam at the Mosque.

One of the things emphasised by Imam Yusuf Peer, and also by each person I spoke with, was that Muslims must definitely be buried, not cremated, and the burial must happen as soon as possible after the death. During the burial, the body is placed directly in the ground without a coffin. Taher Forotan described how members of the Afghan Muslim community help to carry the body to the grave, even for just a few steps, and that there are specific rituals performed at the graveside also. Sheriff Yusuf talked of how Somali Muslims cover the body with cloth, but that, according to Somali culture, there must be no cloth under the body - it must be directly touching the earth, lying on the right side.

Many community members attend the funeral and support the family according to Fatima Abdel Karim - the more who attend the better it is for the person, especially with the funeral prayers. It is very much a community event. She described how prayers are done not just for the person who has died but also for the family and others, those who have died before, those who are present and those who are not present, young, old, male, female, for all.

Muslims have a strong belief that life and death are determined by the will of Allah (God). This is a comforting factor in their faith in dealing with death, both for the dying person and for the family because it removes the possibility of questioning and doubt why the death has happened.

Imam Yusuf Peer spoke of the official mourning period as three days, during which time many people visit the family, bringing food and helping in any way they can, and continuing with prayers for the person.

In the Afghan community there is another ceremony on the 7th night following the death, again after 40 days and also one year later when the family and community members come together. Sheriff Yusuf described how in the Somali community a wife whose husband has died would not leave the house for 40 days, wearing only white. Fatima Abdel Karim said the Qu’ran states a wife should stay at home for 4 months and 10 days and after this period she is able to remarry.

Islam encourages patience during the time following a death and for continued prayers, with an understanding that everyone will eventually die. Remembering death is a way to inspire positive actions and spiritual practice. Imam Yusuf Peer points out that in entering the cemetery Muslims say “Peace be with you oh dwellers of the grave. You have preceded us. We, by the will of Allah, shall be joining you.”

Samoan Christians

In speaking with Hanamenn Hunt, a respected Chief within the Samoan community in Queensland, and a Multicultural Liaison Officer with Caboolture Shire Council, it became clear that not just their Christian beliefs but also deeply rooted Samoan cultural traditions are very influential in dealing with death and dying.

When someone is dying and after they have died, there is a strong community response, a united effort to support the family. People travel overseas from Samoa and other countries to be with the family in Australia and provide cultural, emotional and monetary help. They pool their resources to cover the costs of the funeral and other expenses. They are very involved in helping to organise the funeral service and the family service, a traditional event which happens the day before the funeral.

During the final days of the person’s life, people are gathered and there is a constant caring for the dying person, whether they are at home or in hospital. According to Samoan culture it is an important time for everyone to be present, which can sometimes be difficult in a hospital situation when there are many immediate and extended family members involved in caring for their loved one. There is a great need for cultural sensitivity on the part of doctors and nurses to accommodate the traditional needs of Samoan families. Generally the family prefers to have their loved one at home so that they can care for them as closely as possible.

Hanamenn also discussed how continued spiritual support is also offered by the priest or pastor who usually visits morning and night to say prayers with the family and care for their spiritual needs. Members of the congregation and other Christian denominations in the community will also visit to offer prayers and sing hymns and songs at the family home.

After the person has died and has been embalmed, the body is brought back home where a constant flow of visitors come and go to show their respects and offer gifts and further support to the family. This happens in a traditional way with particular protocols. Chiefs gather at the home during this time, dressed traditionally, greeting the visitors and acting as the gatekeepers, making sure that things flow according to custom. There is an exchange of gifts from the family to all of those who have offered support. This is to show their appreciation and give something back in exchange for all the help they have received. The family may offer gifts of food, fine mats, money or other items.

At the family service at the church on the day before the funeral, family and community members give testimonies on the life of the person and sing hymns. And then on the actual funeral day the pastors or priests lead the prayers at the funeral service. Traditionally Samoans use burial and not cremation. Hanamenn pointed out that the Samoan community have great respect for their culture and are very proud of their traditions - this is reflected in the unified response they show when there is a death in the community and the care and support they give to the families involved.

Ethiopian Orthodox Christians

Lemlem Abraha, an Ethiopian Christian and mother of two, and her nephew, Hadushalem Fasseha provided information about their community’s practices. Lemlem came to Australia in 1992 and Hadushalem arrived in 2003. They describe how many people now die in hospital, not at home, and that it is different from her birth place in that the community here is relatively small. There are not as many families to provide support needed in caring for someone at home and the hospitals are much better equipped here. Older members of the community prefer to die at home but young people raised in Australia are different.

Lemlem said she prefers the direct honesty of the Australian hospital system in telling people the details of their illness, and said that often in the hospitals in Ethiopia people would not be told they were dying or doctors would tell just the family. Lemlem felt that many Ethiopians would still prefer to hear of the death of a close family member from a member of the extended family or from a community member.

When there is a death in the community, people come together to support the family with food, emotional support and whatever is needed. The priest visits the dying person to read the Bible, say prayers, using their baptism name, and to help them find forgiveness and resolve any issues before dying. If community members are waiting with the family they will immediately begin to care for the bereaved as soon as they hear the crying that signifies death has occurred. Traditionally the crying is very loud, and may involve the bereaved pulling their hair as an expression of grief.

Following the death, traditionally the body would be washed and dressed by relatives before the burial and wherever possible Ethiopians still wish to perform this role. The body is washed with water that has green leaves in it. Body hair is shaved. The body is laid out in a traditional way. They eyes, nostrils and mouth are closed. The legs are straightened and placed together. The hands are put together, with fingers placed between the legs. If the deceased person is a priest the arms will be placed across the chest. White string is used to keep the body in the correct position. The big toes, calves and thighs are tied together to ensure the correct position for the legs. The string will also be used around the deceased person’s head to ensure the mouth is properly closed. Finally new white cloth is used to wrap the body. If the body is not properly prepared for burial traditional Ethiopians believe bad things will happen, and it will be a subject of talk in the community.

People gather for a number of days to be with the family constantly, to sleep with them, and cry with them. Traditionally loved ones would stay with the family for 3 days. However these customs are difficult to observe in Australia because the community is small, people have jobs and the neighbours are disturbed by the prolonged loud crying. The entire community will visit the family during the three week mourning period to express sorrow, with close friends visiting often. They will bring food and cook for the family as well as performing household chores.

Ideally the body is buried on the day of death or the day after. Many prayers are done in the church in a service that takes several hours. There is a special service after 12 days, after 30 days, 40 days, 6 months, 8 months, and after one year, and each year on the anniversary the priest does further prayers.

Sudanese Christians

John Kor Diew and Chuol Rambang Luoth Lawford are both originally from Sudan. John is now studying (social work) at university and Chuol Rambang Luoth Lawford is an elder.

For the Sudanese community it is important that when a person is dying the elders of the community and the clergy are called. They give support to the family and close relatives in addition to praying for the person. Children are not usually part of this process - they are kept apart from anything that may be distressing to them.

John discussed how the Sudanese Christian belief that death is a transformation into a new life brings comfort for the dying person. As people gather they continue to pray for forgiveness for the person and that his or her soul will be at peace. John also discussed how death is regarded as very private and that people would prefer to be at home during this time.

Choul Rambang Luoth Lawford explained that in Sudan traditionally there is no means to preserve the body after death, so burial would normally take place immediately, even on the same day. In Australia there is not the same urgency to do this and more time can be taken for funeral preparations. The body is washed and shaved completely, always traditionally done by an elder man if it is man who has died and by an elder woman if it is a woman who has died. Cremation is never used.

People gather for about three days after the burial with the family to talk about the life of the person. Often a wife whose husband has died will continue to wear black for a year.
John pointed out that in the mourning period the community will reflect what the family is going through and how the close relatives of the person are mourning their loved one. If the person who died was someone who contributed a lot to the community or is someone the family are mourning very deeply, the community will reflect that and will continue to provide support for weeks or months to the family. The elders will offer
advice if needed to help bring people through this time.

Thanks
Karuna Hospice Services thanks all those who participated in this project by making time available to provide information about this sensitive topic. Thanks also go to Multicultural Affairs Queensland, Department of Premier and Cabinet, from whom funding for the project was obtained.