Public health experts have warned that using ambulances meant for living patients to convey corpses could increase the risk of infection transmission, particularly when the deceased died from a communicable disease.
The experts said inadequate cleaning and disinfection of ambulances after transporting dead bodies could expose drivers, health workers, patients and other occupants to infectious agents.
Their warning followed the decision by the Akwa Ibom State Government to prohibit the use of ambulances for conveying corpses for burial.
The state Commissioner for Health, Dr Ekem John, announced the policy during a monthly media briefing, directing that corpses should instead be transported in hearses.
John warned that ambulances caught conveying corpses for burial, whether privately owned, government-operated or run by faith-based organisations, would be impounded.
“Corpses are carried by hearses and when you now use our ambulance to carry corpses, you are creating a public health threat to the rest of the public,” the commissioner said.
A Professor of Public Health and Epidemiology at the Lagos University Teaching Hospital, Idi-Araba, Adebayo Onajole, said the practice could have serious public health implications if the ambulance was not thoroughly decontaminated.
Onajole explained that bodies could release fluids after death and some of these fluids could contain infectious organisms, depending on the illness responsible for the death.
“If the ambulance is not always properly sterilised after being used for corpses, it has the opportunity to transport or transmit disease,” he said.
The epidemiologist said infections with high virulence could pose a particularly serious threat, citing Ebola as an example.
He advised ambulance operators to establish clear protocols for transporting corpses and, where resources permit, use separate vehicles for living patients and deceased persons.
“What we advocate is that for every patient, whether living or dead, the ambulance has to be properly sterilised, cleaned out, and disinfected,” Onajole said.
He stressed that clothing and other materials that came into contact with a corpse should also be appropriately cleaned or disinfected.
Corroborating him, a public health physician, Dr Austine Aipoh, said the cause of death was an important factor in determining the level of risk.
“It’s not all deaths that are problematic, but if the person dies of a communicable disease, especially highly communicable diseases, there is a possibility of contaminating the ambulance,” he said.
Aipoh explained that bodily fluids from a corpse could contaminate surfaces inside an ambulance and expose subsequent occupants if the vehicle was not properly decontaminated.
He cited diseases such as cholera and Ebola as examples of infections that could create significant concerns when dead bodies are improperly handled.
The National President of the Healthcare Providers’ Association of Nigeria said ambulance operators should make thorough decontamination part of their standard operating procedures.
He acknowledged that maintaining separate ambulances and hearses could be difficult and expensive for some operators but said the investment was necessary to protect patients and the wider public.
Aipoh also noted that there could be situations where a patient dies while being transported in an ambulance.
In such circumstances, he said the vehicle should undergo proper decontamination before it is returned to service.
The experts stressed that the central issue was not simply whether an ambulance had transported a corpse, but whether appropriate infection-prevention measures had been followed afterwards.
Onajole said states considering similar restrictions should take available resources into account before introducing policies that could be difficult to implement.
He recommended dedicated vehicles where possible, with one designated for living patients and another for transporting corpses.
The warning has renewed attention on infection prevention in Nigeria’s emergency medical transport system, where ambulances and hearses are sometimes used interchangeably.
The experts said proper handling of dead bodies, use of appropriate protective equipment, hygiene and thorough vehicle decontamination should remain standard practice to reduce avoidable public health risks.
