Inadequate infrastructure and maintenance at government mortuaries, many of which have failed to meet inspection standards, highlight the grim conditions under which staff conduct autopsies and South Africans have to identify bodies.
In reply to questions by the DA in Parliament, Health Minister Joe Phaahla admitted that only 62 of the 118 forensic pathology units, or state mortuaries, were awarded certificates of competence – as reported in MedicalBrief last week.
Broken fridges, unhygienic working conditions and poor medical waste management were among the reasons given for 46 sites failing to reach the grade. Inspection results were not available for 10 of the units.
Provincial Health Departments manage forensic pathology services that are required to conduct medico-legal investigations for all non-natural deaths, like those due to homicide, accidents, drug overdoses and medical errors.
The mortuaries don’t have capacity to conduct many of the tests required for complex cases, so blood alcohol tests and toxicology analysis are provided by the National Health Laboratory Service (NHLS), while DNA tests are done by the SA Police Service.
Mortuaries that fail inspection standards are not shuttered, but must submit plans indicating how they intend to rectify problems, Gauteng Health Department acting head of communications Khutso Rabothata told BusinessLIVE.
Gauteng’s forensic pathology service compiles 1 500 to 1 800 autopsy reports a month. It has a backlog of about 16 000 cases dating to 2007, due to outstanding “ancillary investigation results”, said Rabothata, referring to tests conducted by the NHLS and SAPS.
Although nine of Gauteng’s 10 forensic pathology units were issued with certificates of competence, conditions were so poor it raised questions about the standards against which they were being measured, said Jeanine Vellema, former clinical head of the clinical department of forensic pathology for the southern cluster of Gauteng forensic pathology service.
Inadequate infrastructure and lack of maintenance had created extremely difficult working conditions and a distressing environment that traumatised the families, she said.
Broken
“It is an awful environment in which to identify a body, and should not smell as if 10 cows have died in there because bodies are decomposing because fridges have broken.”
She said SA’s forensic pathologists were trained in a challenging environment and had acquired the skills to conduct autopsies in suboptimal conditions, but were often prevented from finalising reports because of delays in tests requested from the SAPS and NHLS.
While the NHLS had virtually eliminated its blood-alcohol test backlog, it was still battling a significant toxicology backlog, conceded NHLS COO for strategic initiatives Clothilde Oliphant.
The Health Minister told Parliament last month that the NHLS toxicology test backlog stood at 39 874, up from 35 766 the year before.
The NHLS had recently hired additional analysts and acquired more laboratory space in Pretoria.
BusinessLIVE article – State mortuaries are in a disgusting condition (Restricted access)
See more from MedicalBrief archives:
Half of SA’s forensic pathology units fail competency tests
Forensic pathology staff protest conditions
Gauteng Health forensic backlog dates back to 2007