Barely half of SA’s state mortuaries have met inspection standards, highlighting the grim conditions under which staff conduct autopsies and relatives are required to identify bodies.
In a reply to questions by the DA in parliament, health minister Joe Phaahla revealed that only 62 of SA’s 118 forensic pathology units, or state mortuaries, were awarded certificates of competence.
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.
“It is very troubling that so many pathology units are not compliant due to infrastructure failures, and that they also do not have adequate personal protective equipment,” said DA shadow health minister Michele Clarke.
“It is crucial that government ensures that all facilities not only comply with norms and standards, but that staff have the resources to conduct their work safely. They need to get to the bottom of why adequate resources are not supplied, as well as the reasons for the infrastructure failures,” she said.
The poor state of the forensic pathology laboratories compromised the health system’s capacity to assist law enforcement investigate criminal cases, she said, noting that more than 7,700 murders were committed in SA in the last three months of 2023.
Provincial health departments manage forensic pathology services that are required to conduct medico-legal investigations for all non-natural deaths, such as those due to homicide, accidents, drug overdoses and medical errors.
These mortuaries do not have the capacity to conduct many of the tests required for complex cases. Blood alcohol tests and toxicology analysis is provided by the National Health Laboratory Service (NHLS), while DNA tests are carried out by the SA Police Service (SAPS).
Mortuaries that fail inspection standards are not shuttered, but must submit plans indicating how they intend to rectify problems, said Gauteng health department acting head of communications Khutso Rabothata.
Gauteng is home to about a quarter of SA’s population and its forensic pathology service compiles 1,500 to 1,800 autopsy reports a month. It has a backlog of about 16,000 cases that date back to 2007, due to outstanding “ancillary investigation results”, said Rabothata, referring to tests conducted by the NHLS and SAPS.
Nine of Gauteng’s 10 forensic pathology units were issued with certificates of competence, according to the health minister. But conditions at these mortuaries 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 to identify a body in. It should not smell like 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 they were often prevented from finalising reports due to delays in tests requested from the SAPS and NHLS, she said.
While the NHLS had virtually eliminated its blood-alcohol test backlog, it was still grappling with 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. A test that is not completed within 90 days is classed as a backlog.
The NHLS had taken measures to tackle the backlog, including hiring additional analysts and the acquisition of extra laboratory space in Pretoria, said Oliphant.
CORRECTION: April 11 2024
This story has been amended to clarify that the murder figures referred to by Michele Clark are for the third quarter of the 2023/2024 fiscal year, and not the past year.
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