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Updated 08 September 2014

What happens when you die?

If you want a picture of death in South Africa, you need look no further than the Salt River Forensic Pathology Laboratory in Cape Town.

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The Salt River Forensic Pathology Laboratory is one of the busiest forensic pathology labs in the country, processing largely inquest and homicide cases from around 35 police and satellite stations in the metro, spanning from Fish Hoek to Atlantis.

"We try to give the dead as much respect as possible. It's not only the dead, it's also the family of the dead that you've got to keep in mind at all times. You may be dealing with a criminal, but you can't let that affect the way you treat the family because they're not the criminal," says facility manager Wayne Mitten.

Mitten, a sturdy and capable-looking ex-policeman, has been working at the facility, a provincial health department entity, for the past 28 years and runs a tight ship.

The unit is responsible for body storage, post mortems and assisting the police process of identification.

10 to 15 bodies every day

Between 10 and 15 bodies arrive at the laboratory every day. That’s around 3300 bodies a year. The Tygerberg forensic pathology laboratory takes in bodies from other parts of the metro.

The busiest times are Sundays and Mondays, during June, July, August, and over the December holidays.

Mitten says death by accident or assault is more likely to happen when people get paid.

"Spikes in death happen around pay-day when people go out partying, drinking and doing things they wouldn’t normally do."

The largest number of bodies are picked up from Mitchells Plain, Manenberg and other areas on the Cape Flats.

The facility can hold 135 bodies, but a shipping container was brought onto the premises to fit an extra 50 bodies.

The unit has proved to be quite reliable and hardy, Mitten says.

The custard-coloured, brick and cement building sits between a factory and a stationery store, about six kilometres from central Cape Town.

The only glimpse of anything slightly related to death is the appearance of Devil's Peak above the factory buildings from the parking lot.

You walk up the ramp through a columned entrance into reception, which is not unlike the front desk at a hospital, except it is far quieter. The air does not smell of anything.

The only sign of death is a brown and dried out fern in a ceramic pot, one of three plants surrounding a non-functioning water display in an alcove opposite reception.

It has 28 forensic pathology officers, five shift leaders and supervisors and two chief forensic pathology officers, one of whom deals with investigation and the other with dissection.

At the crime scene

When a death is believed to have been caused by unnatural causes, the Cape Town Emergency Medical Services Metro control room will call a forensic pathology officer to collect the body.

This is only once the police have finished investigating the scene and all necessary documentation has been completed, including the declaration of death.

The police will open an inquest or a homicide docket.

"We need to preserve evidence and the deceased is classified as evidence, as an exhibit, because we will look for certain injuries and aspects," Mitten says.

In most cases, the forensic pathology officer is the eyes and ears of the pathologist and will gather all the evidence they can to help determine a cause of death.

They will arrive on scene in a special, marked van, and will wear a two piece with reflective strips, and chat to the police officers on scene and maybe witnesses to assist the investigation.

The body gets placed in a bag in an individual compartment in the van. To do this, the forensic pathology officer has to open the metal flap, extend the stretcher out and place the body into the niche using a hydraulic system. The space can hold only someone who weighs less than 150 kilograms, and even 130kg is a push.

The forensic pathology officer will communicate with the police when larger than normal bodies need to be removed. Special vans are available for this purpose.

Charred bodies curl up and sometimes also need a bigger van to accommodate their form.

When the body gets to Salt River, it is allocated a WC (Western Cape) number by the central online system. It is then placed on a 2.1 metre stainless steel shelf in the receiving fridge, which has a temperature of around five degrees Celsius, in preparation for post mortem.

Most staff will say the worst cases they deal with are those involving babies, children, elderly assault cases and violent crime.

They have access to counselling and Mitten sometimes formally refers staff he feels have been affected by certain cases.

"You know, a lot of people look for answers. You can pick that up very quickly by the cases they make themselves available for.

Mitten witnessed this staff behaviour when he was still employed as a shift supervisor within the police.

"I have had it in the past where a staff member's family member committed suicide and I picked up through the documentation that this individual is doing a lot of identifications, and most of them suicide cases. You can already pick up that there's a pattern and then we need to start asking questions."

Staff injuries common

Mitten says the most common staff injuries are back problems from lifting bodies and pricks or cuts sustained during the autopsy.

Pathologists are required to wear medical gloves. A chain-mail glove is then placed over the hand which is not holding the scalpel. A second glove pulls the chain-mail together.

When the autopsy is done, the injuries are sewn up as best as possible and the body is covered with a blanket.

It is put onto a trolley and wheeled into a one metre by two-and-a-half metre space known as the viewing room.

The identification process

Families are able to look through the viewing window, but cannot touch the body because of the possibility of infectious diseases.

"I normally try and say to the mother, if she’s coming for identification, or if I can see the father is really affected, rather don’t do a viewing here, you want to remember your son or whoever it is as you last saw them," Mitten says.

If the family member is too traumatised and the body is badly disfigured, the lab normally recommends that another family member views the body and identifies it.

The body can then be viewed by other family members at the funeral parlour after cosmetic reconstruction has taken place.

Many families are not in possession of the correct documentation to do the identification.

According to Mitten, a large number of South African births are not even registered, or the family is not in possession of identity documents, and this can cause a delay.

In these instances, the family will be referred to the investigating officer, who will establish the identity of the deceased via fingerprints or other investigation methods, such as DNA or dental records.

"That process can take extremely long. If it’s done via the police lab, the way it should be done, it can take up to six months," Mitten says.

"What we do, just for peace of mind, we allow them to go to the private pathologist which will take two or three days. The thing is, that’s only for people who have money. If they don’t have money, they have to follow the police process."

Some bodies never get identified because the deceased's family does not know where they are or they have no family or friends.

"We try and keep the ashes for a year, two years, so if a family member does come at a later stage, at least we can give it to them," Mitten says.

It is up to the investigating officer to put a notice in the local newspapers with details of where and when the body was found, as well as age and other descriptions.

The ashes are put into a small cardboard box with the WC number and placed in a stock cupboard.

Mitten says they are strict with undertakers and sometimes have to turn away incorrect cars being used as hearses or those without the proper registration and documentation.

There are many challenges to working in a stressful environment, but Mitten says it is important to switch off at the end of a work day.

"I've never had nightmares about this place or my work. The day I do, I will know that things are getting to me and that I need to seek help."

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