Birgunj in Parsa District is an economic hub, almost regarded as the economic capital of the country. It was till a year ago the major gateway for goods that need to be imported into Nepal from India, but this custom responsibility has now been more evenly shared with other cities along our southern border. And as crimes and criminal activity is nothing new in the whole country, this district too has its fair share of an ever-increasing rate of unnatural and suspicious death and other criminal activities many of which are passed on to the medico-legal work force, police and doctors in the district.
Almost all of the medico-legal work, including autopsy work, is carried out at the Narayani Sub-Regional Hospital. This is the system followed in practically all the districts of the country. Due to the lack of proper infrastructure and qualified manpower for medico-legal services in all the district and zonal government hospitals in Nepal, everyone here agrees that the medico-legal service sector in the districts is just as bad as the crime situation in the whole of the country.
How is the infrastructure? Well, the autopsy room itself is a small 12 by 10 feet dark chamber almost suffocatingly resembling a dark haunted room from a horror movie. Everything is done with the instrument available – one scalpel; but, thank God, there is at least a two-door freeze available in the room of this two-roomed mortuary. This infrastructure might be sufficient in the government’s perspective, but everyone else knows that this situation cannot be worse than it is. It is all the more difficult for me to witness this dire situation here in Birgunj, having worked at the BPKIHS mortuary while undergoing my post-graduation.
And the manpower? Well, they perform autopsies out of compulsion. Conducting autopsies is a responsibilty of all government doctors, even if they do not have any medico-legal training or a post-graduate degree in forensic medicine. Given the infrastructure and their busy schedule at the hospital and at the private clinics, the doctors’ disinterest is obvious, and justifiable. They are not to blame for this poor situation.
And how are the autopsies done? Well, trying to determine the cause of death depends much more upon the history than upon the findings of the dissection performed.
Now, what is my problem? Claiming to be an expert in medico-legal work and being a helpless duck as an observer while the medico-legal work is being conducted in this pitiful situation brings tears to my eyes. I am not exaggerating. As an honest citizen of this country, I just wish one thing, proper justice to all, dead or alive. And this is not possible without things being done in a proper way. In simple words, an autopsy should not be performed by medical graduates without post-graduate training in forensic medicine when there is an adequate pool of forensic medicine graduates in the country today, in this 21st century!
What else? Well, undergraduate medical students in our medical college need proper exposure to proper autopsy work. This is impossible here at the Narayani Hospital at present.
What have we done to help things out? We had requested the government of Nepal, via our chairman often times, to allow medico-legal work to be performed at the NMCTH. I personally talked about it with the doctor involved in autopsy work at the Narayani Hospital. Well, the truth is that all of us members of MeLeSon are not up in the policy making ladder! I agree my efforts are minimal compared to what some of our collegues did and continue to do for the same. Hats off to you for setting an example. I wish this could happen here too.
What is the solution? Well, upgrading the infrastructure at the Narayani Hospital and having an expert to work there for better exposure to our students would be very desirable. Giving the responsibility of the medico-legal work of the Parsa District to the NMCTH would be a better solution if the government is truely committed to law and order, to abolishing ‘dandahinta’ and to providing justice to all, to both the living and the dead.
Last but not the least, I would like to thank our president of MeLeSon for encouraging me and helping me to lighten up the situation of medico-legal work here to some extent. And no offence to anybody is intended while expressing my thought in this article.