Toxicology backlog in SA delays burials, leaves grieving mother in limbo

Four months. This is how long Elizabeth Simelane from Soshanguve, north of Pretoria has been waiting for the state to release her son’s body for burial. 

“I am old and very sick. My fear is dying while his body lies in a government morgue,” she says.  

The remains of her son, Steve, have been lying at Pretoria Forensic Pathology Service. The 41 year old’s decomposed body was found in the Zambezi area outside Tshwane on 2 December last year. 

The bereaved mother has been told that her son’s body can’t be released for burial until a post-mortem is completed. 

A senior official in the Gauteng health department who asked not to be identified as he is not allowed to speak to the media says Simelane’s case is not an isolated one. 

“We receive a number of complaints from families who cannot bury their members because of pending toxicology cases,” he says.

Waiting for answers

This is the situation thousands of families like the Simelane’s currently face as the country is battling with 38,974 toxicology backlog cases. Samples collected are meant to be tested within 90 days. Tests not completed within this period are classified as backlog. 

The official Health-e spoke to says that the backlog dates as far back as 2007. 

At this stage it’s not known what Steve died of. In South Africa, all unnatural deaths are investigated by forensic pathology services. Unnatural causes of deaths including poisoning, sudden unexpected death with no history of any sickness, drunk driving and drug overdose requires extensive scientific investigations which include harvesting of organ tissues for toxicology testing.

Toxicology testing is done by the National Health Laboratory Services’ (NHLS) forensic chemistry laboratories

“The results from the toxicology test helps the forensic pathologist analyse the evidence, ascertain the cause of death and prepare an autopsy report,” explains NHLS spokesperson Mzimasi Gcukumana. 

Once the autopsy or post mortem report is prepared, a death certificate can be issued by the Department of Home Affairs. The remains can then be released to a family for burial. 

“Delays in finalising the toxicology report may result in the autopsy report not being released on time,” says Gcukumana.

Reasons for the delays

There are only four forensic chemistry laboratories in South Africa. These are in Cape Town, Durban, Johannesburg and Pretoria. The Durban lab is not currently performing toxicology tests, as plans are underway to expand the facility. So, in effect, only three laboratories in the country are conducting toxicology tests. These labs service the police, mortuaries, health departments, municipalities and the National Prosecuting Authority (NPA) nationwide. 

“The current backlog at the Cape Town forensic chemistry laboratory is 6,792 cases; with Johannesburg and Pretoria laboratories at 15,358 and 16,824 cases respectively,”  says Gcukumana. 

“Several factors have contributed to the backlogs that developed at the three laboratories. These include incomplete information on the request forms, inadequate infrastructure, ageing analytic equipment, and shortages in human resources.”

Power cuts and water shortages are also among the problems. 

The NPA in Gauteng could not provide the number of cases delayed by toxicology reports.

“We do not keep records of these statistics. However, we can confirm that toxicology backlogs do cause delays in criminal cases and we are working closely with the stakeholders to resolve such challenges,” spokesperson Phindi Louw says. 

Gcukamama says strategies are in place to reduce the backlog. 

“To contribute to the increase in laboratory processing, we will focus on increasing laboratory space availability throughout the laboratories. We also aim at having  functional analytical instrument availability in sufficient numbers and appropriate staff complement. We will make use of overtime and shift systems for the best possible human resource management,” he explains. 

However the Gauteng department says Simelane’s case is delayed due to outstanding DNA results and not a Toxicology report.

“The legal framework that governs the functions of the forensic pathology service prohibits the release of remains if the identity is not confirmed either visually or scientifically if the body is not visually identifiable,”

says department spokesperson Motalatale Modiba.

“The remains were severely decomposed, and fingerprint analysis was also not an option due to advanced decomposition. The remains will be released upon receipt of positive DNA results which confirm the alleged is related to the remains in our facility.”

Looking for closure

Health-e News has been communicating with Simelane via text and phone calls. But we desperately wanted to sit down and hear her whole story. She agreed for us to visit her home in Soshanguve one afternoon in March. 

But on the morning of our scheduled visit she sent a despondent WhatsApp message: 

“Will that help me to bury him?? I’m not being rude sisi (sister)but I have been through a lot. All I need now is to burry (sic) my son, that’s all. I’m not in good condition, I’m struggling.” 

Simelane says she’s been going to the mortuary almost daily over the past four months hoping for her son’s body to be released, with no luck.

“I have to take taxis to go to the hospital and still come back with no answer. My son was the breadwinner and the R30 I spend travelling to and from the hospital is too much. I am depressed and not coping mentally,” she says.

“It has been a horrible four months for me and my family. I am unable to bury my son. It is also very frustrating that I can’t see his body because it is badly decomposed,” she says. “We are broken at how the police and government officials are handling the matter. All I want is to close this case and lay my son to rest.” – Health-e News

This story has been updated to included response from the Gauteng health department.

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