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From paperwork to embalming, Tokyo mortuary firm handles cross-border death with care

by

Kyodo

This is the second in a two-part series on Airhearse International’s body repatriation business.

Legal recognition of a death in Japan can be a complicated process, but even more so if you happen to be a foreign national with few ties to the country.

Procedures and legal requirements for reporting deaths must be carried out step by step before preparations can even begin to have a person’s remains repatriated.

Helping families navigate this initial paperwork is the starting point for Airhearse International Inc., a six-person operation led by President Rie Kimura that exclusively handles the transport of bodies and human remains to and from Japan.

A death certificate, including the person’s place of death, must be submitted to municipal government authorities within seven days, preferably by the next of kin, following the issuance of a medical death certificate from a hospital or a postmortem certificate from the police.

But complications can arise, for example, in cases of a deceased foreign national with no registered domicile in Japan — or when there is no way of contacting the family abroad — said Kimura. She added that in some cases, provisions of family law passed in 1947, which she calls outdated, can make matters even worse.

Foreign embassies or consulates in Japan will often assist in contacting the families of the deceased — particularly in difficult cases — to relay the sad news.

“If there is no registered domicile in Japan, the person’s nationality is entered (on the death certificate) instead,” Kimura, 56, said in a recent interview, adding that the key is finding who will submit the death certificate.

“For example, if the person is a backpacker or someone who comes to Japan on business and dies, and the family is abroad, then what can you do?” she said, adding that if necessary they will scan the original death certificate and send it by email to the family abroad.

Families are then asked to sign the document and send it back to Japan so the paperwork can be processed.

Kimura argued that the section designated on the form for the submitter is outdated because the people listed, including landlords or land management administrators, usually have no connection with the deceased, further complicating the process. This goes for foreign nationals and Japanese alike.

“Nowadays, unlike a long time ago, landlords don’t live below their tenants. They live somewhere else and so have never met the person staying in their apartment. So, of course, they are reluctant to put their names, addresses and the like on a death certificate. Recently many just flatly refuse to do this.”

In any case, it is not until the death certificate has been submitted that a person’s death is legally recognized by Japanese authorities and the next steps can be taken, Kimura said. “So even if there is a body, this paper, the death certificate, speaks in place of the deceased.”

But arrangements for the bereaved are even more complex. The U.S. Embassy and Consulates in Japan website, for example, lists 11 points, including decisions regarding the disposition of remains, transmitting of funds, and even a timetable for cremation or embalming, based on circumstances surrounding a death.

Whereas cremation and shipment of ashes to the United States can cost around $6,200, the price for shipment of a body is about $14,000 due to the high cost of air freight and embalming, the website states.

Airhearse, like other mortuary or funeral services in Japan, is listed on the website, although no endorsements are offered.

Those who cannot afford the high price of transporting a body intact might opt for cremation, in which case they can make legal arrangements to transport their loved one’s ashes as carry-on or checked luggage.

Kimura said many funeral parlors, since they are not accustomed to international repatriation, fail to meet compliance requirements. Families who are unaware of this, she said, might turn to the cheaper option — leading in many cases to problems such as insufficient documents submitted to the home country or even badly decomposed bodies.

Embalming with care

Airhearse operates with a contracted embalmer off-site from its office in the restricted cargo area of Tokyo’s Haneda airport. Done correctly, the preservation technique, which came into widespread use during the Civil War in the United States, forestalls the decomposition of the body.

Kimura explained the process of injecting embalming chemicals, such as formalin and phenol, into blood vessels to circulate “like the blood used to,” and cavity embalming, which refers to the replacement of internal fluids inside organ body cavities with concentrated chemicals that contain formaldehyde.

“From the thick blood vessels we transport the chemicals and massage them in by hand to reach the capillaries in the tips of the fingers,” she said. In the case of some accidents, she said, “We also use a large cotton pad to soak the chemicals inside from outside the body and make sure they are absorbed throughout.”

She said it is important for the chemicals to take effect. Due to airplane cabin pressure at high altitudes, fluid leakage will occur in a majority of cases. Airhearse’s job is to carry out the necessary treatment, including the application of cosmetics and redressing, to ensure a better presentation of the deceased for family and friends.

“In our lingo, we say that ‘the medicine has taken hold.’ The chemical agents will all flow out due to air pressure if (they haven’t), but as long as the medicine has taken hold and is absorbed in the skin, the chemicals become settled in the body and will not leak.”

So along with the intricate paperwork involved, in cases where it is requested, Airhearse will simultaneously get permission in writing from families to have embalming performed. “Once we have reached this point, we can arrange for a flight and fix a schedule.”

Airline regulations stipulate that coffins be hermetically sealed and are at times subject to airport X-rays to ensure they contain nothing other than a body.

Because no international standards for embalming exist, and with an assortment of professionals as well as contractors sometimes lacking skills to perform the procedures, Kimura said the result can at times be disastrous.

She described a situation where a Filipino woman who died in a bus accident in Japan was improperly embalmed at a funeral parlor in Osaka and repatriated to the Philippines. Since the Osaka funeral parlor had also failed to make arrangements with a mortuary service abroad, the family was forced to greet the deceased at the airport.

“Once they release the body, it’s like sayonara. There is no responsibility. That is not international hearse repatriation,” Kimura said, adding that once the deceased has landed in the home country, that is when the real work begins.

In the end, the bus firm’s insurance company requested Airhearse’s assistance to make arrangements with a funeral parlor in the Philippines. But a daughter of the deceased woman who had gone to the airport to confirm the body discovered to her horror that not only was her mother in a “wooden box,” but a large amount of the embalming chemicals had leaked out.

“The body had to be redone from scratch and placed in a proper coffin,” Kimura said. “So the funeral parlor we arranged for in the Philippines took care of embalming the body for one full day and redid everything. And then the ceremony could begin.”

Aside from the technical aspects of international body repatriation, Kimura also offers her own philosophy on death and dying.

On the rear door of a company truck is a picture of two angels carrying a coffin aloft with the words “Angel Freight” written in decorative script below.

The logo, the vision of Kimura, represents the spiritual embodiment of the six-person operation that exclusively handles the transport of bodies and human remains across international borders.

Used as a preparation area for bodies of the deceased — mainly Japanese who have passed away overseas and been brought home — the truck is parked in the airport cargo terminal with another smaller microbus and three white hearse minivans.

Directly adjacent is a building where wooden coffins that once contained the bodies of Japanese nationals from overseas are broken down by staff for disposal. Nearby, embalmed bodies being prepared for repatriation from Japan are stored in a refrigerator. On a shelf is a kamidana (a Shinto altar) where respects are paid to the dead.

“I think I am somewhat special,” Kimura said. “It doesn’t matter if I knew the dead person or not. There is no, ‘Oh my God, here is a dead person and this is how the person died.’ It’s almost as if I am being led (by a force) to this job.”

Kimura, whose introduction to the mortuary business began as a single mother in 1998, when she took part-time work handing out mourners’ gifts at a funeral parlor, began studying international body repatriation under business founder Masami Yamashina in 2000 before taking up the mantle as president three years later.

Her dyed short hairstyle, colorful makeup and affable nature are not what one would expect from an undertaker. Kimura’s philosophy on dignity in death, about which she almost feels “as if I were possessed,” would seem to be guided by a higher power.

For Kimura, the weight of responsibility she feels is tantamount to Moses parting the Red Sea in the movie “The Ten Commandments.”

“But whatever the person’s religion, whether they were a really bad or good person, once they have passed away, their soul isn’t bad,” she said.

Giving dignity in death

The Airhearse vehicle concept, namely the truck hearse, was born following the 2004 Indian Ocean earthquake and tsunami, when the company managers realized that if something like that were to happen again, they would need a vehicle with sufficient capacity for “when a large number of people arrive back.”

But fundraising difficulties, especially without corporate backing, and complications obtaining vehicle components meant it took until 2012 to have the truck built.

“When the (2016) Bangladesh terror attack happened, there were several people who came back, so that truck really played a large role. This is the dignity that we must give to the deceased,” said Kimura, whose two adult children work for the company. Her daughter, Ayano, is chief of repatriation control.

Rather than being a religious symbol, Kimura said the original logo idea was to show the deceased taking a journey borne by angels. As Airhearse is in the human remains cargo repatriation business, this naturally became “Angel Freight” in English.

Although it does not resemble a typical hearse, “coffins only” is written in small Japanese characters on the driver’s door to make clear its purpose. The vehicle can carry eight coffins and has a stainless steel loading platform.

The ceiling inside has ventilation ducts and pulleys to maneuver the coffins. There are two autopsy tables that slide out of a front wall compartment and six large drawers where instruments are kept.

Coffins are unloaded or loaded onto commercial aircraft by subcontracted companies. In rare cases, such as with a returning charter flight, the truck will be used to collect a coffin directly from a cargo transporter.

Atsushi Furuya, 51, who drives the truck and is in his seventh year at Airhearse, is the chief of the repatriation driver team. He said his job, which also entails assisting with the preparation of bodies, is first and foremost to adhere to Japan’s traffic laws and avoid accidents that might further damage the deceased.

Furuya originally worked as a newspaper delivery driver but decided to apply for a job at Airhearse when his mother died. “I had made a promise to my parents to be a decent person, and when my mother died I was drawn to this occupation. I knew it was a job where I could contribute to society.

“Dying is an everyday occurrence. But in Japan, there is a practice of avoiding (the issue). When I joined this company I learned that death will come to everyone — there was nothing scary about it.”

Aside from dealing with the various weather conditions while on the road, Furuya also explained the difficulties of coping with different countries’ embalming procedures, some of which are relatively substandard, when bodies return.

“If the amount of chemicals used is too much, it can really irritate your eyes and throat,” he said.

Kimura added, “There are times when the deceased has decayed badly because the body has not been properly embalmed abroad. … They might have just put some plastic bags in the casket and just sprinkled the chemicals in there. Our job is to remove the body from the casket and wash off the chemicals,” and properly carry out the embalming procedure.

Furuya said the most satisfying part of his job is reuniting the deceased with the next of kin, Japanese or foreign.

“Families really show their appreciation that they were able to properly say their good-byes to the deceased. I also feel very happy when I hear we got an email from families abroad thanking us for getting their loved ones home in proper condition,” he said.

Airhearse has been an associate member of the Netherlands-based World Organization of Funeral Operatives since 2006.

The organization, which promotes international understanding among the world’s funeral service professionals to achieve uniform standards and regulations for international repatriation, will have Akinori Matsui, the president of the All Japan Funeral Directors Co-operation, as its next president, from 2018 to 2020. The World Organization of Funeral Operatives will host its 2020 international convention in Japan.

Amy Chow, 51, a board member for the Association for Death Education and Counseling and an associate professor of social sciences at the University of Hong Kong, specializes in thanatology, the scientific study of death and bereavement. She said companies like Airhearse play an important role in helping people deal with loss.

“From a psychological point of view, we believe that if you don’t have a chance to see the body, it is very difficult to accept the reality of death. It is a step to initiate the bereavement process,” Chow, a former bereavement counselor, said by phone.

Looking forward, because of its attention to compliance, Airhearse sees itself as the standard-bearer of international body repatriation in Japan.

“Within all the funeral parlors, I see our company as being preeminent, the only one doing what we do,” Kimura said. “But what I want to do as our company continues into the future is grow our overseas network and deepen our exchanges and trust with those colleagues,” she said, adding that she hopes to create an association in Japan similar to the World Organization of Funeral Operatives to improve the “legal framework” for foreign nationals who die.

“In Japan, we are the only ones who really have the knowledge, know-how and skills to carry out this very special international repatriation service,” she said.