The neglect of mortuaries in any place is a most distressing piece of news. Sadly, in recent months reports from several hospitals in Sri Lanka have described the careless neglect of mortuaries there. The latest comes from Anuradhapura, the country’s most ancient and sacred city. It is worth setting out in full the report published in the Sunday Observer of 4 January 2004, titled `Anuradhapura morgue dead, patients and staff suffer’, by Athula Bandara:
The staff and patients of the Anuradhapura Hospital have to undergo much hardship due to the odour from putrefying bodies, as the freezers at the mortuary do not work.
Although two new freezer units, each which has four drawers in which only four bodies can be placed, were installed three and a half years ago, one had malfunctioned earlier and the other had ceased functioning from January 2, bringing all functions of the morgue to a standstill.
Consultant [Judicial Medical Officer] of the hospital Dr D L Waidyaratne said that although one body should be placed in one drawer at a time, they have no choice but to place two bodies in one drawer. Unidentified bodies as well as bodies awaiting court orders for post mortems have to be kept outside in polythene bags, as new bodies brought to the morgue are given preference. The bodies left outside are decomposed, infested with maggots and flies swarm over them, posing a threat to the patients at the hospital.
Due to these reasons Judicial Medical Officers at the hospital say they have no choice but to suspend carrying out all post mortems. Medical Superintendent of the hospital Dr. Laksman Gamlath said the hospital authorities have decided not to accept bodies brought from outside for post mortems on court orders but to transfer such bodies to the Kurunegala Hospital morgue. Dr. Gamlath further said that as the freezers are not in a condition to be repaired the hospital has to suspend all functions of the morgue until new freezers are installed.
A source inside said that although the provincial health authorities had been informed that the equipment was below standard when it was being installed, the authorities paid no heed. He further said that the North Central Provincial Health Ministry had imported this equipment from India and it broke down quickly.
Mortuaries and culture
In the immediate hours after the death of a loved one the family suffers the shock and sadness of their loss. For them, the dead body is the most sacred thing that exists at that moment. To pay respect to their loved one, they will do all they can to keep the body in a pleasant condition. When friends and associates read the obituaries the first thing that comes to mind is to go and pay their last respects. Whether the body is buried or cremated, culture requires the utmost respect in the manner it is dealt with, which should extend to how the body is treated in the mortuary, before being handed over to the family. To do otherwise is an enormous affront in any culture. Allowing bodies to rot and decay in a mortuary is a high act of inhumanity.
Mortuaries and the law
A dead body requiring examination for legal purposes is the last and best evidence of any foul play. The loss of evidence due to decay can permanently damage a case in a court of law. Usually, the law requires qualified and licensed judicial medical officers to examine and report on the state of a dead body. If a doctor is unable to carry out such examinations due to decay, it may be the deathblow to a criminal investigation.
These days there is much campaigning about the rights of victims of crime. One of the most important rights is for a victim of murder to have his dead body preserved in a manner that all necessary examinations can be made before it is buried or cremated. Where such examination is obstructed it amounts to a gross violation of the dead person’s rights. Hospitals have the duty to protect and preserve the bodies in their care. Where they mishandle bodies, they not only breach this duty but double the injustice caused to the person. To allow refrigerators to break down is not just a technical matter: it violates the most basic social obligations of the hospital authorities. To claim that the money and other resources do not exist for proper maintenance is no excuse. The state also has an obligation to provide these resources. Thus, in this case both the political and bureaucratic authorities have completely failed to do their duties.
The ultimate duty lies with the public. It is a shocking indictment of public attitudes to have many instances of gross neglect reported without them provoking angry mass protests. The public should be demanding enquiries and resignations, however, no visible protests have emerged. Organisations claiming to protect the rights of victims of crime have not even raised a murmur. Some newspapers that have devoted quite a lot of space to these rights have remained silent on this issue.
These days it is also fashionable to refer to the poor state of forensic science in the country as one of the main reasons that the authorities are unable to detect crime and convict criminals successfully. The Attorney General himself spoke on this matter at a recent lecture. However, the conditions of mortuaries are also part of the forensic science issue. If a body cannot even be preserved so that legal formalities can be undertaken, what hope is there for forensic science in the country? In fact, one achievement in Sri Lanka in the past was that competent doctors conducted proper post mortem inquiries at our hospitals. If even this has been lost, how can we expect other advances? Thus, mortuaries are a concern not only for the health authorities but also the legal authorities. It is within the power of the Attorney General to call for reports on the state of the country’s mortuaries, and take appropriate action to ensure that the neglect of the bodies contained therein is ended as a matter of professional urgency.
The Government of Sri Lanka should act to normalise the situation at Anuradhapura Hospital without delay. It should then study all the mortuaries in the country with a view to bringing about widespread improvements. The government also must apologise to the families of the deceased whose bodies have been desecrated, and compensate them for their suffering. Finally, the National Human Rights Commission should take up the matter as a serious violation of human rights. A report from the Commission would be useful to awaken public opinion.
