Mortuaries jam-packed, lacking basic facilities, say overworked staff
Government apathy and disinterest among medical students have increased the workload among doctors and attenders in forensic research departments across city hospitals. Medicos want the department shifted under Home Ministry to improve situation.
Chennai
Postmortem is a crucial part of medico-legal cases for the police to prove or disprove anything before a court of law, though they might have collected a number of other evidences. The report issued by the police surgeon in any unnatural death can alter the course of investigation by police or prosecution in the court. However, forensic medicine department authorities at government hospitals rue that the department fails to get the necessary importance in terms of funds and research. The experts also demand to shift it to Home Ministry for better facilities in coordination with the forensic research department.
The government hospitals in the city perform at least 10-15 autopsies every day, with limited number of autopsy tables and attenders. The autopsy attenders and doctors also state that the government hospitals are flooded with autopsy cases and overrun the actual capacity of the autopsy rooms.
“As per the government norms, there should be only 300 postmortems in a year performed by an individual, but we do more than 600 cases a year. There are about 3,000 cases performed in a year at Rajiv Gandhi Government General Hospital mortuary. We are in need of more number of modernised instruments and equipment to perform these cases better. Basic infrastructure such as ventilators, proper drainage, gloves, increased size of autopsy rooms, 24x7 cold storage facilities need to be improved in government hospitals in the State,” said Dr K Tamilmani, head of forensic medicine department, Rajiv Gandhi Government General Hospital, Chennai.
“There are many pending cases of deaths after hospitalisation for more than a month. Clinical factors reveal the cause of death but forensic department is burdened with such cases. Overload can be reduced by removing these unnecessary cases, giving us more time for improving the quality of postmortem and making it detailed,” added Dr Tamilmani.
The lack of manpower is also highlighted to be a problem behind the overload of cases in forensic department, but medicos say that the department is neglected by the government.
“In other countries, only certified police surgeons are allowed to do autopsies. But in our country, the eligibility to do autopsy is an MBBS degree. In the state, the number of certified forensic experts are so less that the regular doctors attending the patients are also made to perform postmortems in the districts. Even in Chennai, there are other government hospitals where postmortems are done, but police personnel always prefer hospitals such as Rajiv Gandhi Government General Hospital, Kilpauk Medical College and Government Royapettah Hospital since the autopsy is done by qualified professionals there. There is a vast difference between postmortems done by regular doctors and experts,” said another forensic department doctor on condition of anonymity. The official also added that they are loaded with unnecessary cases of DNA and viscera tests. “It is one of the reasons why certain reports take time,” added the professor.
“The mortuaries at city government hospitals are unlike what one sees in the movies and web series. Our mortuaries lack basic infrastructure and manpower in the first place. The Directorate of Medical Education needs to increase the postgraduate seats in the forensic medicine department so that more number of students can join the stream,” said a postgraduate student in forensic medicine department at Kilpauk Medical College.
However, it is noticed that PG students do not opt for the forensic department voluntarily but end up at forensic medicine department when they do not have other options. Some of the students even shift to other department citing various reasons because of the lack of infrastructure and research opportunities, say medicos.
The forensic experts point out that medico legal case reports are often delayed by the other government departments and lack of coordination among them also raises various problems of record maintenance and sample storage. The experts say that state health department has various schemes and insurance coverage for those who are undergoing treatment, but there are none for the deceased or their families.
“The focus of health department is to cure and treat people who are sick, so corpses are not really been given the same attention. Likewise, there are honourary titles and even better incentives in other departments of medicine, but forensic wing does not have any such incentive. This is another reason why less number of medicos opt for this department,” said Dr R Selvakumar, head of forensic department at Kilpauk Medical College.
He also says that if the department is shifted to the Home Ministry, more funds can be allocated for improved research and betterfacilities.
Autopsy reveals cause of death, helps in probe: Cops
There are times when murders are disguised as suicides and accidents. The real cause of death can by established only by a post-mortem examination. So the role of doctors performing autopsy is very crucial in investigation, said Assistant Commissioner S Lakshmanan (Flower Bazaar).
“For example, if somebody is found hanging in their house, we cannot simply take it for granted and close the case as a suicide. There is every possibility that he or she could have been poisoned or attacked before being hanged, which only an autopsy can confirm,” says the officer.
“Even the assault could be established with the external injuries, without the post-mortem report, it would be difficult to argue in the court. Similarly, when a couple of men are arrested for hacking a person to death, postmortem can even pinpoint whose attack among the accused led to the victim’s death based on which we number the accused as primary and secondary suspects,” says the Assistant Commissioner.
He adds that all the investigation officers probing unnatural deaths will be present while the doctor is performing the autopsy. In some cases, where there is no suspicion and postmortem is seen as a mere formality, police may not be present at the mortuary. “If the doctors conducting postmortem have any doubts, they have every right to visit the scene of crime, study the place and get their queries answered by police,” said another official.
Common Problems
- The government hospitals in the city perform at least 10-15 autopsy cases every day
- As per the government norms, there should be only 300 postmortems in a year performed by an individual, but we do more than 600 cases a year, say doctors
- There are about 3,000 cases performed in a year at Rajiv Gandhi Government General Hospital mortuary
- Basic infrastructure such as ventilators, proper drainage, gloves, increased size of autopsy rooms, 24x7 cold storage facilities need to be improved in hospitals, say medicos
- The forensic experts point out that medico legal case reports are often delayed by the other government departments and lack of coordination them also raises various problems of record maintenance and sample storage
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