RMCH forensic medicine unit struggling with low manpower, facilities

The Forensic Medicine and Toxicology Department of the Rajshahi Medical College Hospital (RMCH) is not well equipped with a modern pathology lab, cooling chamber and adequate pathologists — all of which are necessary to perform quality autopsies and produce accurate reports.

There is a two-storey morgue at the back of the Rajshahi Medical College building but it also lacks modern amenities with no adequate water supply or drainage system.

A number of domes, those who help pathologists with the autopsy, are currently working at the morgue but none of them were officially appointed or properly trained by physicians, said forensic doctors.

Dr Kafil Uddin, head of Forensic Medicine at RMCH, said, "Forensic medicine units have not yet been introduced in the newly established medical colleges, but all the old ones have this unit. However, the mortuaries of old medical colleges are in a bad condition and not properly managed."

"There is no modern laboratory where pathology tests, x-rays, and DNA tests can be done on the bodies. As a result, doctors cannot provide quality reports even if they want to. Even in this modern age, autopsy reports are often prepared based on observational capacity alone," Kafil Uddin said.

Forensic doctors at RMCH said the Forensic Medicine unit is understaffed but has to perform five to eight autopsies per day. 

Currently, there are five physicians working in the department. Among them is an associate professor, who is currently serving as the head of the department.

But the problem is, on top of performing post-mortem examinations on bodies, they have to attend academic activities with medical students. 

Apart from performing post-mortems, these forensic physicians often have to go to different districts to testify in cases and they said it has become very difficult for them to manage both academic and medicolegal aspects.

"We do not get remuneration according to the type of work we do and the kind of pressure we handle day to day. To testify in a case, one has to attend the court at one's own expense. Junior doctors are not interested in studying forensic medicine anymore as they see no bright future here," said Kafil Uddin.

"It takes a long time to get promoted. No new positions are being created for doctors. There is no post of Associate Professor or Assistant Professor. Apart from academic work, medicolegal work also requires a lot of time. There is no holiday even on Eid. But there is no incentive compared to the work doctors here do," he said.

Visiting the RMCH morgue, a pathologist was seen working with the domes to perform an autopsy on a man who committed suicide. Relatives of the deceased are waiting outside.

A dome named Roni told The Business Standard, "We get no salary from the college as we are not employed. Hence, we have to make ends meet with the tips given by the relatives of the deceased."

Roni said he did not get any training for autopsies anywhere and learned to cut open bodies from his father who learned it from his father.

Cleaners from other departments of the hospital often perform the role of dome, he said.

The only freezing machine in this department for storing dead bodies broke down a few years ago, where eight bodies could be stored at once. Now, bodies have to be kept in the only morgue of RMCH, Dr Kafil Uddin said.

The head of the RMCH Forensic Medicine Department also called for the creation of new posts, recruitment of sufficient manpower, training of domes and increase of incentives per case.

RMCH Principal Professor Dr Md Nowshad Ali told TBS, "There is an acute shortage of forensic doctors and we have been pressing the government for fresh recruitments. We have also been asking the government to appoint trained domes for the last 10 years. But none of that happened yet. We did not even get an allocation for fixing the old freezer or buying a new one."