Unidentified bodies in mortuaries: How the Gauteng Health Department’s plans and promises are falling short

To help families find and identify their loved ones, the Gauteng Department of Health has developed an Internet Identification System meant to record and help track, and report demographic data of deceased persons. (Photo: nypost.com / Wikipedia)

By Thabo Molelekwa for Spotlight

4 May 2021

Last year, there were more than a thousand unidentified and unclaimed bodies in Gauteng mortuaries. What are health authorities doing to address this?

In 2020, the Gauteng Health Department recorded 1,173 unidentified bodies in the province’s 11 forensic pathology service mortuaries. The mortuary in Germiston recorded the most unidentified bodies, with 400, followed by Johannesburg with 169, Pretoria with 117 and Diepkloof with 103.

Democratic Alliance MPL Jack Bloom tells Spotlight these are all deaths that are thought to be due to unnatural causes, which is why they end up in a state mortuary.

“If they don’t have any form of identification on them, it is difficult to contact the family. Many of these bodies are probably foreigners with no local family. Tragically, in some cases the body is identified but is unclaimed because the family cannot afford to bury them,” says Bloom, adding that the government tries not to keep bodies for more than 30 days as they may run out of capacity and space.

According to the CEO of Gauteng Pathology Services, Dr Paul Morule, various attempts are made to identify deceased persons.

“When attempting to identify the deceased or finding the next of kin, information is sent to the SAPS or the media on how the deceased is suspected to have died, where the remains of the deceased were found, what time, which day, month or year, what season, weather conditions, and landmarks. Any marks or tattoos on the body and looks, what the deceased was wearing, what was in the deceased’s possession, a photo of the deceased is often very helpful,” says Morule.

Even though the 1,173 number of unidentified bodies may seem high on the face of it, Morule says the capacity in South Africa and especially in Gauteng has been fairly reliable to keep the number of unidentified bodies at a reasonable level.

According to findings of a retrospective review done of bodies in the Salt River Mortuary in Cape Town published in the South African Medical Journal (SAMJ), identification in South Africa “is primarily performed through visual confirmation by the next of kin or a legal guardian” or secondary identifiers which include scars or tattoos. Where in some cases visual confirmation proves challenging, fingerprints or DNA testing may be done to identify the deceased.

But what if there is no body?

For some, like Yibanathi Mrawuzeli’s family from Rondebult on the East Rand in Gauteng, the process can be much more cumbersome. For two years, they have been looking for their missing son in over five Gauteng health facilities (hospitals and mortuaries).

Identification of a deceased in South Africa can also be done by secondary identifiers such as scars or tattoos and also fingerprints and DNA testing. (Photo: Alan Levine / Flickr)

The disappearance of Yibanathi Mrawuzeli

Two years ago on 20 February, Yibanathi, who will be 30 years old this year, was diagnosed with acute psychosis and admitted to Thelle Mogoerane Hospital in Vosloorus.

“On the 21st we got a call from the hospital telling us that my son has disappeared, they don’t know where he is,” says Mrawuzeli’s mother, Pholela Mketsi.

According to Mketsi, people from the hospital said her son was fastened to his bed and that they do not know how he untied himself and disappeared.

She says they have looked in over five government hospitals and mortuaries in Gauteng, including the busiest mortuaries in Germiston and Johannesburg.

“Going to different government facilities to try and identify my son has been a very traumatic and heartbreaking experience for me. We looked all over without any success,” says Mketsi.

In early March 2019, after posting photos of their son on social media platforms, the family received an anonymous call telling them that Mrawuzeli’s remains are at Bertha Gxowa Hospital in Germiston.

“This person said he was an employee [at] Bertha Gxowa, but decided to remain anonymous. He assured me that the body that he saw at the mortuary was the very same person we have posted on social media,” she says.

The family went to Bertha Gxowa Hospital’s mortuary but did not find their son. When they traced the number, they found that it was a number from Thelle Mogoerane Hospital. “That was a most painful and confusing time for us. We did not know who or what to believe anymore,” she adds.

Mketsi says they also provided DNA samples to the Pretoria Forensic Pathology services to match with unidentified bodies there.

Yibanathi Mrawuzeli’s family has been looking for him for the past two years after he went missing from a hospital. (Photo: Supplied / Spotlight)

Gauteng Health responds

But according to the Gauteng Department of Health, the patient absconded while waiting to be assessed by a medical doctor. They searched for him in the hospital but didn’t find him.

Spokesperson for the Department of Health in Gauteng Kwara Kekana says, “Transport was arranged by the hospital to visit different areas where the family thought the patient could be, as well as other hospitals. They were accompanied by the hospital’s social worker and nurse.”

Responding to the anonymous call the family claims they received, Kekana says that the family reported to Thelle Mogoerane Hospital and said that they received a call from Bertha Gxowa Hospital. “They were transported to Bertha Gxowa with a nurse from the facility for follow-up.”

After many attempts were made to find Mrawuzeli, Kekana says, the matter was handed over to the SAPS and a missing person case was opened.

Mrawuzeli is still missing with his family not knowing if he is dead or alive.

The challenges of bodies without names

Regulations to the National Health Act relating to the management of human remains stipulate that when a body is not identified within 30 days after death, the body becomes the responsibility of the state. (Photo: thexpressng.com / Wikipedia)

In an article published in the journal Forensic Science International: Reports, researchers from the University of Cape Town write that challenges with identification can be attributed to several factors, one being South Africa’s high murder rate with more than 15,000 murders committed annually in the last decade. The high number of undocumented foreign nationals and labour migration between rural and urban centres all make these people vulnerable to crime, so when they go missing, it is often not immediately reported. As a result, remains can be discovered after a long time, where postmortem changes have occurred, such as decomposition or skeletonisation. In the book Forensic Anthropology and Medicine, João Pinheiro defines skeletonisation as the final stage of decomposition when all soft tissue is removed from the bones and when a corpse has decayed to the point that the skeleton is exposed, which makes identification challenging.

Regulations to the National Health Act relating to the management of human remains stipulate that when a body is not identified within 30 days after death, the body becomes the responsibility of the state (government). Thereafter, the government handles the arrangement of a pauper’s burial.

In an earlier interview with the SABC, Deputy Director-General of Gauteng Hospital Services Dr Modupe Modisane said unclaimed bodies are buried in marked graves, meaning that should a family show up after the burial, the body can be exhumed for a proper burial.

He said it was a misconception that these bodies are buried in unmarked graves.

According to Morule, “internet-based information is being introduced, and it is hoped [this] will assist in promoting earlier identification of unknown deceased [persons]”.

Plans and promises

To curb these and other challenges many people go through in an attempt to find and identify their loved ones, the Gauteng Department of Health has for some years been developing an Internet Identification System meant to record, track, and report demographic data of the deceased persons, and generate autopsy, and toxicology reports.

“We hope that the new identification system will help more families like us,” Mketsi says, “instead of going up and down spending money on transport without success. People will just identify their loved ones online before they go to that facility,” she says.

But according to Bloom, it has taken the provincial health department over a decade to launch this system. Bloom says the system was first promised in 2006 and that the former Gauteng Health MEC Qedani Mahlangu promised that it would be up and running in 2016.

This did not happen.

When asked about this system in the Gauteng Legislature in 2019, former Health MEC Dr Bandile Masuku then promised the Internet Identification System will be up and running as soon as the mortuary information system was set, which, back then, was expected to be the end of October 2019. “The internet site is contemplated to be operational at the beginning of 2020/21 financial year,” Masuku said.

This, too, did not happen as planned.

In March this year, current MEC for Health in Gauteng Dr Nomathemba Mokgethi in a statement said the development of this system is currently at “an advanced stage”.

According to Mokgethi, the handover process of the Forensic Pathology Services Information Management System from the e-Government unit and the developer to Gauteng Health has started.

What may provide some hope for mothers like Mketsi, is that the second phase of this system will also provide for missing persons.

“Implementation of a Forensics Pathology Information Management System, whose second phase entails the development of a Missing Person Website, will make the identification of unknown and unclaimed bodies much easier,” Mokgethi said.

Bodies that have been admitted to Gauteng Provincial Government Forensic Pathology Service Mortuaries and not identified after seven days will be listed on the Internet Identification System. “Special features on the body, [such] as tattoos, clothing and possessions will be used in such cases and not the body itself,” Morule told Spotlight. DM/MC

This article was produced by Spotlight – health journalism in the public interest.

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