No 'body' to learn from: COVID-19 outbreak impacts private medical colleges’ demand for cadavers

The COVID19 outbreak and subsequent lockdown has also impacted private medical colleges demand for cadavers from postmortem centres under the police surgeon and direct donors Most of these private medical colleges MBBS BAMS and BHMS need cadavers for academic training for first and secondyear medical studentsmidday in its articles titled lsquoFrontline warriors that nobody cares aboutrsquo dated April 20 2021 and subsequent lsquoUnclaimed bodies need clearance for disposalrsquo dated April 21 2021 had highlighted the grim situation of unclaimed bodies piling up in city mortuaries and the working conditions of two workers and a copDr Indrajit Khandekar professor of Forensic Medicine and ToxicologyApart from unidentified and unclaimed bodies a major chunk of unclaimed noninfectious and nondecomposed bodies those cases where death is due to natural reasons and no autopsy is done are sent to medical colleges in and around MMR region and across Maharashtra So far six private medical colleges requests for cadavers are awaiting police clearanceConfirming the same Police Surgeon Dr S M Patil said ldquoUsually we get requests from even government and private medical colleges like DY Patil Terna YMT Medical colleges etc and also other private medical colleges in Wardha Sangamner etc We have around 16 governmentrun and around 106 private including ayurvedichomeopathy etc medical colleges in Maharashtra to provide cadavers only if the Medical Education Department has registered these colleges under the Bombay Anatomy Act 1949 and after these colleges have obtained a No Objection Certificate NOC from an Assistant Commissioner of Police ACP who has the magisterial power for obtaining such unclaimedunidentified bodiesrdquoAmol Deshmukh technical advisor on forensics to the stateldquoAs per our record last year between January and December 2020 due to COVID19 only 30 unclaimed bodies were sent to some of these medical colleges and this year January till date 2021 we have received cadaver requirement requests from six of the medical colleges but due to COVID we have not been able to dispatch any so far On an average every medical college demands around 10 to 12 cadavers to teach their firstyear medical students human anatomy and also for second year MBBS students to understand Forensic Medicine and Toxicology explained Dr PatilAsked about the cost Dr Patil explained ldquoWe usually charge a nominal fee of R1500 per cadaver and this is towards the cost of embalming the process of preserving the body to delay the natural process of breakdown of cells post death The transportation ambulance charges have to be taken care of by the concerned medical college On an average 450 unknown unidentified bodies are given to medical colleges not only in Maharashtra but also to medical colleges in Bijapur in Karnataka and in Puducherry which also adheres to the Bombay Anatomy Act added Dr PatilDr T P Lahane director Directorate of Medical Education and Research said ldquoCadavers are usually given to medical colleges as per their registration under the Bombay Anatomy Act An inspection committee visits the medical college and inspects their premises for preserving the cadaver A report is submitted to the government accordingly and only then as per the availability of cadavers which are donated by relatives they are given to the medical college against nominal fees We do not use bodies which are decomposed or bodies on which autopsies have been conducted for medical collegesA senior forensic surgeon said ldquoOnly those unclaimed and unidentified bodies wherein the deceased died of natural causes and which have due certification from the civicgovernment hospital doctor saying there is no foul play nor any external injury can be used by the medical college For education purposes such cadavers can be given to medical colleges only after obtaining due NOC from an police officer of the rank Assistant Commissioner of Police ACP Post the abolishment of the coroner system in Bombay in June 1999 the magistrate power of coroner is now vested with the ACP to certify such unclaimed bodies and the police surgeon needs to approve such requests from private medical collegesrdquoAsked the reason as to why medical colleges dont use technology digital teaching to teach autopsy and human anatomy Dr Indrajit Khandekar professor of Forensic Medicine and Toxicology at Mahatma Gandhi Institute of Medical Sciences Sewagram said ldquoBodies are essential for medical teaching Digital teaching can be used but not as a replacement for teaching on an actual body My experience suggests that every body is unique and we may get some additional information or features that we may not have seen before This new feature information is helpful for medical teaching Another aspect of teaching on a body It will remove fear from medical students about death and bodies That will help them to cope up with the situation when death occurs before them while managing a patientrdquoAnd how they get the cadavar Dr Khandekar said ldquoWe get cadavers from relatives of the dead and we usually conduct drives to educate people about donating bodies and hence we do not have to rely on any other source to get cadaversrdquoAmol Deshmukh technical advisor to government of Maharashtra on Forensics said It is high time that technology is used for identification of bodies piling up in mortuaries The body disposal process raises the risk of contaminating other bodies and the staff working in mortuary The Ministry of Home Affairs should reconsider the usage of Aadhar data registered with UIDAI in special pandemic and disaster crises for future identification of the deceased This is the only way amidst a pandemic where the front line warrior and law enforcing agencies are already preoccupied with maintaining the stringent norms for public safety and seldom have time for identifying unclaimed bodies thereby delaying the entire process Such technological support will only ease their work and unclaimed bodies can be disposed of at the earliestrdquoA retired senior IPS officer echoed a similar view stating ldquoIt is always aimed that the earlier the body is identified it is better The death might have happened due to various reasons which could be natural or unnatural Since already Aadhaar cards have been allotted to crores of people they should make it a point to have such cards or identity with them always this will bring down the number of unknown and unidentified bodies drasticallyrdquoHow states handle unclaimed bodiesGoamiddot Only case of homicidal accidentalsuicidal death the body is referred for postmortemmiddot No postmortem required in other casesmiddot Standing order no 396 is followed in case of disposal of unclaimed dead bodiesmiddot Dead bodies are kept for 72 hours in mortuarymiddot Request are made for arrangement for cremation if sent to municipal authoritiesmiddot Body of foreign national is preserved for 30 days to inform concerned consulateKeralamiddot Municipal authority is the repository of existing rules for disposal of unclaimed dead bodiesmiddot Police have to complete formalities before handing over the body to the municipal authorities to arrange burialMaharashtramiddot Unclaimed bodies are disposed of as per the provision laid under section 5 of the Bombay Anatomy Act of 1949 the coroner act got abolished in the year 1999 and now the power is given to the Assistant Commissioner of Policemiddot The police officer is responsible to ensure that the body is covered properly and not exposed to the public view if it is lying in a street or public placemiddot If police reports that no relatives were traced the police after 7 days are supposed to dispose of the bodymiddot The postmortem report copy original is kept at the postmortem center copy sent to BMC and police station where Accidental Death is registeredJt CP LampO Vishwas Nangre Patil with Police Naik D P WarePolice Naik felicitatedPolice Naik D P Ware attached to Motor Transport Wing of Mumbai Police Nagpada was felicitated by Jt CP LampO Vishwas Nangre Patil for his relentless service of past 20 years of disposing of unclaimed unidentified bodies with dignity He has so far disposed of over 50000 bodies and nearly 50 COVID19 afflicted bodies in the past one year A cash prize of R5000 a memento and certificate were given to Ware on Thursday by the Jt CP LampO midday had written about him on April 21 in Frontline warriors that nobody cares aboutWe are proud of you PNC Dnyandev Ware Your name denotes Dnyanoba who wrote Dnyaneshwari and surname Ware which coincides with Wari which is a sacred annual gala to worship Vithoba But let me tell you your work is far far more important and humanitarian and has made us extremely proud said the senior cop