Autopsy reports take a year to deliver

Ashik Elahi, a private university student, died an unnatural death on May 21 last year in his girlfriend's house. His family members had to wait more than six months to confirm whether it was a suicide or murder.

Ashik's family suspected that a relative of his girlfriend might have killed him. That is why they opted for an autopsy report. However, they toiled and sweated before getting their hands on it in November that year – with the help of different influential people. The report confirmed it was a suicide.

A relative of Ashik's girlfriend said, "We knew that it was a suicide case. Nevertheless, we could not sleep properly until the autopsy report ascertained it. It is very unfortunate that the doctors took a long time to produce the report."

It can even take up to a year to deliver an autopsy report while it should not take more than a week to prepare one.

Doctors at the Forensic Medicine Department of Dhaka Medical College said they need nine to 12 months to prepare an autopsy report.

They link the long delay to the absence of a combined laboratory plus a shortage of expert doctors and necessary equipment.

On average, about eight to 10 autopsies are done a day at the Dhaka Medical College morgue.

The doctors collect specimens from a dead body and send them for histopathological and DNA tests.

Although they can give a primary report analysing the specimens, they have to wait for the two reports.

"We have to wait at least nine to 12 months for a histopathological report and three months for a DNA report. That is why autopsy report deliveries are always delayed," Sohel Mahmud, head of Dhaka Medical's Forensic Medicine Department, told The Business Standard.

"There is no modern equipment – not even an X-ray machine – or latest technology at the forensic department," he said.

"A combined forensic laboratory is necessary for autopsy reports to be delivered rapidly.

Actually, it is possible to deliver a post-mortem report within a week if everything is okay. However, unfortunately, it takes a year or more," he added.

Sometimes they cannot send a report on time because of delays in obtaining the histopathological report, he said.

There are only 25 forensic doctors at 31 government medical colleges in Bangladesh; while the demand is for at least 150 doctors.

No initiative has thus far been undertaken to increase the number of forensic doctors and the number of students studying forensic medicine is decreasing every year.

In the 2018-19 session, a total of 15 students were admitted to the forensic medicine departments of the government medical colleges. However, in the 2019-20 session, the number decreased to 13.

Sources at the medical colleges said forensic doctors have two types of job – one is to prepare autopsy reports and another is to teach medical students on forensic medicine.

Unfortunately, at least eight medical colleges – including Rajshahi, Rangpur, Barishal, Cox's Bazar, and Habiganj – have no forensic experts.

As a result, the students pass the MBBS courses without knowledge of forensics.

Dr Sohel Mahmud said the students who passed the MBBS courses are reluctant to study forensic medicine, resulting in an acute crisis of forensic experts in the country.

"Actually, forensic doctors cannot practice privately like doctors of different departments do. They are not remunerated for performing their duties. Rather, they are afraid of being assaulted by those who do not like the autopsy reports. They also have to go to courts in different parts of the country. These are some hassles the forensic doctors face," he said.

"I have visited almost all district courts with regards to autopsy reports. I have spent money from my salary on communications. Plus, there is not even a room inside a court to rest. Basically, we have no honour. So why would students study forensic medicine?" he asked.

In many cases, general MBBS doctors conduct autopsies in the districts where there are no medical colleges.

Autopsy reports of many murders across the country have led to public suspicion, outrage and controversy due to the shortage of forensic experts. Faulty autopsy reports have supposedly turned many murders into suicides.

According to forensic experts, only a forensic department can confirm incidents of murder and rape, and the age and gender of a dead person.

So, it is essential that there be a forensic department in every hospital of the country to help expedite court proceedings in murder and rape cases. If an autopsy report or a rape test is not properly submitted to the court, doubt is cast upon the justice for victims.

Dr Maksud Hasan of the Forensic Medicine Department in the Sir Salimullah Medical College told The Business Standard that every district must have at least one forensic doctor. Unfortunately, many medical colleges have no forensic doctors, despite all MBBS students having to study forensic medicine for their third year final examinations.

Acknowledging that there is a crisis of forensic doctors, Dr AHM Enayet Hossain, additional director general of the health directorate, told The Business Standard, "We are going to make a plan to attract students to study forensic medicine."