Johannesburg – Recent reports that untrained forensic officers
have conducted post-mortems unsupervised for the past 10 years are grossly
inaccurate, the National Forensic Pathology Service Committee said on
Friday.
In a lengthy statement, Chairman
Professor Gert Saayman said “irresponsible statements” by journalists, union
representatives and government officials will undoubtedly discourage other
medical professionals from entering the pathological field and demotivate the
few existing specialists.
“It is absurd to suggest
that the non-medically trained assistants at such autopsies have been responsible
for ‘conducting the autopsies’ or that they would be capable of orchestrating
the totality of such a required examination, and of compiling the technical
medical reports required for subsequent legal processes,” Saayman said.
On Wednesday News24 reported
that the portfolio committee on health heard that untrained officials have been
conducting post-mortems since 2006 when the service was placed under the
guardianship of the Health Department.
Read the article here: Drivers, cleaners conducted post-mortems in Gauteng since 2006
Democratic Alliance MP Patricia
Kopane, a member of the health portfolio committee, said the health department
gave the committee a "history" of how the crisis developed in South
African forensic services.
"Apparently these other
lay people [unqualified people], they also started to do this job they are not
trained to do, like dissecting the bodies and everything," Kopane said.
'Assisting'
Saayman, however, refuted this
statement saying that forensic officers merely assist with post-mortem
dissections.
“Despite the fact that these
assistants contribute to the medico-legal investigation, it should be stressed
that the doctor/pathologist at all times
is responsible for the overall and direct control of the autopsy process,”
Saayman said.
He said there are clear
differences between a forensic officer or assistant who is employed to assist
trained pathologists, and a qualified pathologist who conducts a
post-mortem.
It takes a minimum of thirteen
years of undergraduate training, vocational experience and postgraduate study,
with multiple intensive examinations, before a forensic pathologist is
qualified, Saayman said.
He said it is not unique to the
field of forensic pathology that assistants do
certain dissection procedures.
“[For example] when a
radiographer prepares the x-ray plates of a patient or performs a CT-scan,
he/she does not claim to be a radiologist (a specialist medical practitioner);
when a nurse inserts a catheter for a patient or administers an injection, that
does not make him/her a doctor,” Saayman said.
“When a scrub nurse or sister
assists a surgeon in performing an operation, that does not make of her a
surgeon and she cannot claim to have ‘performed the operation.’”
“In much the same way, it is a
reductionist and simplistic representation to contend that the mere cutting
open of or removal of tissues or organs from a body constitutes the ‘conducting
of a post mortem examination.’
Saayman, who is also the head
of forensic services at the University of Pretoria, said an accredited
qualification for forensic assistants was registered at South African
Qualifications Authority in 2007, but no South African tertiary academic
institution found it a viable qualification, possibly due to anticipated low
demand.
In-house training
Forensic officers who assist with post-mortems do however receive
initial and ongoing vocational in-house training by pathologists and senior
colleagues to better equip them to perform services, he said.
“It would indeed be preferable
or feasible for the Department of Health to employ persons who have relevant
higher qualifications (such as bachelors’ degrees in biomedical sciences and/or
anatomy) to render these services - if the available monetary resources would
allow for that,” Saayman said.
“In adequately resourced countries like the USA, Canada and the UK,
it is possible to employ only qualified graduates to render these services -
but this is probably not feasible in SA at this time.”
Also read: Unsupervised post-mortems conducted in WC due to overwhelming workloads - claim
Saayman said when the
mortuaries transferred to the Department of Health in 2006, many SAPS
assistants decided not to be transferred, but to remain within the police
service.
It was hence necessary for the department
to employ many new forensic officers, a substantial number of which at that
time had no prior specific experience of working in mortuaries.
“As such, it is possible that
some of these forensic officers had previously worked as drivers or as
assistants at funeral parlours, etc.”
Forensic Pathologists and other
medical practitioners are responsible for conducting approximately 70 000 to 80
000 post-mortems annually in South Africa, Saayman said.
He said there are between 50
and 60 qualified forensic pathologists in the country, but several hundred
others who have postgraduate qualifications
and diplomas in forensic pathology.
“South Africa has a massive
annual burden of non-natural deaths which require forensic medical examination
- having arguably the highest non-natural death rate in the world (at least for
countries not at war or beset by famine.”
"South African forensic
pathologists are recognised internationally for having been well trained and
being highly competent - and many of these locally trained pathologists now
occupy posts as senior pathologists or heads of medical
examiner or coroner offices in Canada, the USA, Australia and the UK, to name
but a few."
