People on Palm Island cannot find room to bury their loved ones as increased deaths from suicide and chronic disease prematurely fill the island's cemetery.
Authorities are concerned people on the remote island in north Queensland missed out on essential care when healthcare workers were diverted to the COVID effort.
Palm Island Mayor Mislam Sam said it led to a rise in preventable deaths in the Indigenous community of roughly 3,000 people.
"I have one of the busiest cemeteries in this nation," he said.
"Having at least 50 funerals a year, those kinds of stats are unheard of in communities of a similar size."
Mr Sam said there had been a funeral on the island near Townsville almost every week for the past two years.
"When you're constantly lining up and paying your respects, it's taking a toll," he said.
Bodies buried on top of each other
The beach-side cemetery has space for around 500 graves, which authorities expected would be enough to last at least three more years.
But former grounds manager Lex Wotton said postponed care to treat long-running health issues had filled graves much faster than expected.
"We're burying people on top of each other," he said.
The Palm Island Aboriginal Shire Council has begun using X-ray technology to find unmarked graves at the current cemetery site, to get a clearer picture of how many more plots they can dig there.
"It's hard to try and control … there are a lot of health problems," Mr Wotton said.
"But this is what's really happening here."
Workforce shortage forces healthcare backlog
Like many Indigenous communities, residents on Palm Island are more than two-and-a-half times more susceptible to chronic diseases such as kidney disease, cardiovascular disease, diabetes, and cancer.
National Aboriginal Community Controlled Health Organisation (NACCHO) senior medical advisor Jason Agostino said treatment was made harder due to severe health staff shortages.
"If it's harder to get an appointment and it's more difficult to see people that know you … then managing your chronic disease becomes more complicated," Dr Agostino said.
"So what we're concerned about is people won't have chronic health concerns picked up earlier and they might have them picked up later when they're already a bit sick."
Sorry business every Thursday
When a person dies on Palm Island, streets empty and businesses close for "sorry business".
Community mentor Gavin Congoo said it was so common that residents anticipated the island being put on pause every Thursday.
"They've never seen so much death in such a short period of time," he said.
"There was one part where it was like two funerals a week; we just could not catch a break."
Mr Congoo believed the frequency of deaths was creating a fatal cycle for people with existing mental health conditions.
"It first started with all these deaths, then you had more and more deaths that weren't natural deaths," he said.
Dr Agostino said improving the health workforce was the only way to improve Closing the Gap outcomes for Indigenous Australians, a group that experienced psychological stress at a rate three times greater than the rest of the population.
Grave fears for climate change
Finding a resting place for Palm Island's dead and dying is also being complicated by climate change.
Already susceptible to monsoonal rains and king tides, authorities fear graves at the cemetery could soon become submerged by rising sea levels.
"We're going to have to look at ways … to protect some of those sites [and graves]," Mr Sam said.
The council has begun investigating potential sites for a new cemetery but said there was only so much vacant land available.
"It's going to have to be a conversation in the community," Mr Sam said.
For residents like Mr Congoo, it is a dilemma that must be resolved.
He said being buried on country was "something special".
"It's about who we are, where we're from; we get our strength from being on country, it's where our ancestors are," he said.
"My blood flows through Palm Island.
"There's no place like home."
