Vol 1 Number 1
October 2010
Patron
Prof. Stephen Cordner
Victorian Institute of
Forensic Medicine, Monash
University, Melbourne,
Australia
ANFM Interim Committee
A/Prof Steve R Naidoo
Nelson Mandela School of
Medicine
University of KwaZulu
Natal, Durban, South Africa
naidoosr@ukzn.ac.za
Dr Kaone Panzirah-
Mabaka
Forensic Pathologist
Botswana Police Service
E-mail: kpanzirah-
mabaka@gov.bw ,
panzirah@hotmail.com
Dr A Makata
Mwinyimtwana
Consultant Forensic &
Histopathologist
Head of Forensic Unit (T)
Ministry of Health, Tanzania
amakata2001@yahoo.com
Prof WO Odesanmi
Forensic Pathologist
College of Health Sciences
Obafemi Awolowo
University, Ile-Ife, Nigeria
odesanmi@yahoo.co.uk
Dr Sylvester Onzivua
Forensic and Anatomical
Pathologist
Mulaga National Referral
Hospital, Kampala, Uganda
sonzivua@yahoo.com,
sonzivua@chs.mak.ac.ug
ANFM Interim
Secretariat:
Dr Kaone Panzirah-
Mabaka
Private Bag 0400
Gaborone, Botswana
e-mail: kpanzirah-
mabaka@gov.bw
Newsletter – African Network of Forensic Medicine
NEWSLETTER
African Network of
Forensic Medicine (ANFM)
Editors: Prof Steve Naidoo, Dr Kaone Panzirah-Mabaka
CONTENTS PAGE
Message from Patron 1
Editorial 2
Inaugural Forum photograph 3
Report on Inaugural Forum: Dr Kaone Panzirah-Mabaka 3
Forensic Services in Tanzania: Dr Ahmed Makata 5
Case Report – Commotion Cordis: Dr Kaone Panzirah-Mabaka 9
Case Report – A Ugandan Kinship analysis: Dr Sylvester Onzivua 10
News / Notices 10
“Spice” - synthetic marijuana: O L Mokgwathi (student) 11
Practical technique: Fingerprints in decomposing bodies 12
Organizing a Conference in Africa: Kate Bean 13
Interim Committee members 14
MESSAGE FROM THE PATRON Professor Stephen Cordner
It is wonderful to be writing a brief introduction to the newsletter of the
African Network for Forensic Medicine. Networks are crucial for the
development of any activity, but particularly for ones such as forensic
medicine. It is insufficiently appreciated by all, bar those who practise
forensic medicine, just how small the discipline is. In Australia, the Royal
College of Pathologists has 2,500 fellows, of whom about 35 are forensic
pathologists. For a variety of reasons, and despite great popularity in main
stream media and television, our medical colleagues do not find themselves
attracted to the discipline: there are no queues of doctors waiting to practise
forensic medicine!! So we need to build our own forensic medicine
communities to nourish the discipline, and ourselves, and to present a united
front on those occasions when governments and international institutions
want to speak to forensic medicine. It is a credit to the ANFM, Prof Naidoo and
the committee that this newsletter has come into existence. But it is important
that you, the reader, do not become a passive consumer, but engage actively
with the Network. It is that engagement that will sustain the network, and
enrich the professional lives of its members for the benefit of justice and
health in communities across the continent.
Your network, I know, is already engaged actively in planning for events next
year. I am certainly looking forward to them, and I know others are beginning
to see the development of momentum and movement in forensic medicine in
Africa.
With very best wishes, and until we meet,
Stephen Cordner
Vol 1 No 1 October 2010 Page 1
EDITORIAL A/Prof Steve R Naidoo
Dear Colleague
It is my pleasure to introduce to you the
Newsletter of the African Network of
Forensic Medicine (ANFM) recently formed
in Gaborone, Botswana on the 20th May 2010,
on a joint initiative by the Victorian Institute
of Forensic Medicine (Monash University,
Melbourne, Australia) and the Australian
Federal Police (AFP), supported by the
Botswana Police Services and their Forensic
Science Laboratory. We concurred that an
African network should be formed and a
newsletter was necessary to start with.
This is a start for us to work together in the
region, and all African forensic health
practitioners, both doing clinical forensic and
forensic pathology work, are encouraged to
network towards sharing ideas, experiences,
techniques, teaching and training where
needed, sharing best practices, information,
and events. For example, trafficking in body
parts in Africa is known to occur between its
very own countries. The high continental
incidences of sexual violence and HIV/AIDS
beg for common and shared strategies for
policies and guidelines for the forensic
healthcare of survivors. Of course, a mass
casualty incident always is a possibility.
In this first Newsletter, Dr Kaone Panzirah-
Mabaka (co-editor) reports on the Inaugural
Forum in detail, as well as on our immediate
plans for the ANFM. We have not yet
finalised matters such as membership and
constitution. Our structure, including the
network name, should be ratified at our first
formal ANFM meeting next year. Support for
the ANFM is important and depends upon us
all. Delegates from Africa who attended the
Forum should be their country’s ANFM
representative, drive membership and also
circulate the Newsletter to all other forensic
colleagues in their own region.
Newsletter – African Network of Forensic Medicine
The format of the Newsletter has been left
open, and it needs your contributions,
whatever these may be. This first issue has
some academic topics as not much
information has been collected. However, we
would like to see a large proportion of the
newsletter committed to what is happening
on the continent and region, for it to be
newsworthy and serve the Network. So, my
plea to colleagues in Africa is: please send
whatever items of news, events and
information through for inclusion. It is hoped
that the newsletter be a quarterly issue.
In this issue, Ahmed Makata of Tanzania
shares enlightening detail and a viewpoint on
forensic medical services in Tanzania.
Perhaps we could have a similar article on a
specific region for each newsletter. Other
contributions include short reports on
sudden death by commotio cordis in
Gaborone by Kaone Panzirah-Mabaka, DNA
profiling from Y-chromosome analysis in
Uganda by Sylvester Onzivua, synthetic
marijuana usage by Mokgwathi, a Botswana
medical student and on fingerprints from
decomposing bodies. Kate Bean (VIFM) gives
her personal insight on organizing the
Inaugural Forum in Gaborone, as part of the
VIFM external initiatives. Thank you, Kate!
The INPALMS 2010 Conference at New Delhi,
India, between the 25th and 30th October will
be attended by many at the Botswana Form,
in particular colleagues from the VIFM. To
that end, AFP and VIFM support has enabled
attendance of three members of the ANFM
interim committee, Drs Onzivua, Makata and
Naidoo, to represent the ANFM and engage
with planning the way ahead for the ANFM
and for the First ANFM African meeting
planned for Kampala, Uganda next year.
We hope to hear from you soon, and best
regards.
Steve Naidoo
Vol 1 No 1 October 2010 Page 2
Group photograph of delegates at the INAUGURAL FORUM IN FORENSIC PATHOLOGY IN AFRICA
on 18-20th May 2010, at the Gaborone Sun, Gaborone, Botswana

Back row: A/Prof David Wells, Dr Matthew Lynch, Prof Gert Saayman, Dr Richard Bassed, Luis
Fondebrider, Dr Michael Pesanai, Dr Alex Olumbe, Dr Njue Moses Gachoki, Dr Charles Dzamalala,
Dr Solomon F Woldetsadik, Dr L Modukanele, Justice Marc Rosenberg, Dr Soren Blau, Dr Carolina
Comuana

Middle Row: Prof Steve Naidoo, Dr Man Mohan Reddy, Dr Salvator Mapunda, Dr Kaone Panzirah-
Mabaka, Dr P EPrabhakar, Dr Mukendi Kayembe, Dr C. Moorosi, Dr Sylvester Onzivua

Sitting : Dr Michael Pollanen, Prof Williams O Odesanmi, Ms Kate Bean, Deputy Commissioner
Kenny Kapinga, Prof Stephen Cordner, Commisoner of Police Mr Thebeyame Tsimako, Minister (of
Defence and Security) Mr Ramadeluka Seretse, Hon J Coldrey QC, Deputy Commisioner Bagopi,
AFP Agent Tim Fisher, Dr Faith Galebole, Dr Helen Baboloki Tumediso-Magora, Dr A Makata
Mwinyimtwana
[Not in photo: Dr Morris Tidball-Binz, ICRC]

EDITORIAL REPORT Australian Federal Police (AFP), who both

INAUGURAL FORUM IN FORENSIC
PATHOLOGY IN AFRICA - Dr K Panzirah-
Mabaka
All eyes were glued upon Gaborone,
capital of Botswana, when forensic
pathologists from several southern and
east African countries gathered for an
inaugural forum on forensic pathology in
Africa. This event was sponsored by the
government of Australia and supported
by the government of Botswana.
The Forum was part of a joint initiative
between the Victorian Institute of
Forensic Medicine (VIFM) and the
have a partnership towards capacity
building and development in forensic
medicine and science and had launched a
four year programme striving to enhance
forensic pathology services in Africa
through sponsored post graduate
training.
Historically, Africa has been confronted
by conflict causing the death of many
people and nations have struggled to
implement and maintain the rule of law.
Effective forensic pathology services
operate in a proper legal framework, this
being not complete in all of Africa.

Newsletter – African Network of Forensic Medicine Vol 1 No 1 October 2010 Page 3

The aim was to convene a forum
comprising of forensic pathologists from
Southern Africa and international
Forensic Medicine experts to discuss the
diversity of forensic pathology practices
in Africa, including, problems faced by
forensic pathologists in their practice,
identify areas for capacity building,
develop focused training to already
practicing forensic pathologists or
improving particular forensic skills.
The theme of the forum was “Forensic
Pathology: Medico-Legal Death
Investigations”. The Forum recognised
the need for interaction in a region which
is rapidly developing but facing immense
challenges in forensic medicine and
science. It showed the similarity of the
burdens of crime, violence and unnatural
death, but varying forensic medical
systems in Africa. Human resource and
training needs are common challenges.
The 3-day meeting was formally opened
by the Botswana Minister of Defence and
Security Mr Ramadeluka Seretse, and
Commissioner of Police Mr Thebeyame
Tsimako officially welcomed the
delegates. Prof Stephen Cordner, Director
of the Victorian Institute of Forensic
Medicine, led the delegates through the
objectives and the expected outcome of
the conference and facilitation of the
proceedings. The assistance of the
Director of the Forensic Laboratory, Dr
Helen Baboloki Tumediso-Magora, was
valuable towards the facilitating success
of the event.
Approximately 10 international delegates
attended the forum, including 7
representatives from the VIFM, the
International Committee of the Red Cross
(ICRC), the World Health Organisation
(WHO), the Argentine Forensic
Newsletter – African Network of Forensic Medicine
Anthropology team (EAAF), and Ontario
Forensic Pathology Services, Canada. A
delegate from the International Criminal
Court (ICC) at the Hague was unable to
attend.
African delegates in attendance came
from Botswana, Tanzania, Nigeria,
Uganda, Malawi, Lesotho, Swaziland,
South Africa, Mozambique, Kenya, and
Zimbabwe. Delegates from Zambia,
Namibia, the DRC and other countries
were unable to attend.
Esteemed members of the judiciary in
Australia (Justice John Coldrey) and
Canada (Justice Marc Rosenberg) made
presentations that highlighted the value
of forensic medical evidence and the role
it played in maintaining the rule of law in
a land, wherever that may be.
Topics covered included Comparative
Medico-Legal Death Investigation
Processes, Disaster Victim Identification,
Forensic Pathology Practice in Africa, and
Sexual Assault.
The outcome of the forum was the
formation of the African Network of
Forensic Medicine (ANFM). It was
decided at this forum that networking be
initiated where members could share
information and ideas and through which
forensic practitioners in Africa would
communicate.
An interim committee to drive the
mandate of the association was selected
at the conference. The committee is led by
Professor Steve Naidoo as the interim
chairman. (See page 10 for interim
committee members). A synopsis of
decisions which have been made this far
include:
Vol 1 No 1 October 2010 Page 4
• A first ANFM meeting: The meeting is
planned for Kampala, Uganda in
September 2011, about a week before
the International Association of
Forensic Sciences (IAFS) Triennial
Congress in Portugal. The ICRC,
represented in person by Dr Morris
Tidball-Binz at the Forum, has pledged
their logistical and other support for
this.
• Newsletter: The network will
produce a regular (perhaps quarterly)
newsletter, first by end of October
2010(this current issue). Every
member is encouraged to contribute.
• Membership Drive: Members to start
sensitising colleagues in their
respective countries about
membership and participation.
• Links: with existing networks and
organisations with similar initiatives
across the continent and elsewhere.
• Developing standards of forensic
practice for Africa
• Education and Training: The AFP
and VIFM have made suggestions for
further workshops on sexual violence
and for HIV/AIDS for next year.
________________________________________________
FORUM
FORENSIC SERVICES IN
TANZANIA
Dr.Ahmed .Makata,
Ministry of Health, Tanzania
In this the 21st Century and where other
countries have made scientific
advancements, Tanzania, one of the
developing African countries, has
regretfully not yet developed its forensic
services to a level that is able to provide
Newsletter – African Network of Forensic Medicine
timely, high-quality and high-value
forensic mortuary services supporting the
under staffed hospitals and other
advanced Health Centers which are
scattered almost all over the sparsely
populated but vast country of about forty
million people. Its citizens should expect
to have delivery of a forensic technical
service which is able to keep abreast of its
rapid modern developments.
The core business of the forensic
technical service is to provide a complete
and comprehensive range of specialist
forensic technical services to the hospitals
this includes radiography, DNA, tracing
and technical support or to conduct
research in forensic pathology, clinical
forensic medicine, toxicology, forensic
science and associated fields.
Research and development
contributing to advancement of
knowledge and capacity in forensic
pathology techniques is essential. We in
Tanzania have, so far, two well-trained
forensic doctors who have specialized in
forensic technical services in training
acquired from the Victorian Institute of
Forensic Medicine (VIFM) in Australia,
and from Japan. As one example,
radiography beyond plain X-rays and
using MRI and CT plays an important role
in the post-mortem examinations,
especially in explosive and other deaths
for metal detection and other pathological
findings. In Australia, forensic
technicians are trained in radiography
and hold limited licenses from the
Department of Human Services
The development of quality assurance
programs for the mortuary, updating
policies and guidelines, with technical
manuals, are important in ensuring
consistent high quality services. This
Vol 1 No 1 October 2010 Page 5
emphasizes the importance the mortuary
places on quality of work and continuous
improvement. In Australia, the forensic
pathology service utilises Mortuary
Technicians specifically trained to
maintain and monitor a quality assurance
program in the mortuary.
Health care in Tanzania is, like in many
African countries, a challenge, with too
few health professionals. Tanzania has a
range of health personnel including
(Registered) medical officers, assistant
(Licensed) medical officers, and clinical
officers (medical assistants). Registered
medical officers have training to MD
degree level, assistant medical officers do
not have an MD, and clinical officers do
not have degree level training. The
assistant medical officer is taken as a
higher category with more years of
training than medical assistants. The
medical assistant is a secondary
education candidate who can then
upgrade to an assistant medical officer
after 3 years of training.
There are about 15 Anatomical
Pathologists, two qualified Forensic
Pathologists and two Oral Pathologists in
Tanzania, a country with about 40 million
people.
Oversight of Forensic Pathology and
mortuary services in Tanzania – this is
the role of the Ministry of Health and
Social Welfare and the Ministry of Home
Affairs, under the consultant Forensic and
Histopathologist. Hospital mortuaries
operate under the officers in charge of
those hospitals but at the Muhimbili
National Hospital there is a Mortuary
Manager supervised by the Head of
Laboratory Services who works under the
Director of Clinical Support Services
(DCSS). There is one mortuary in each of
the 21 Regional Government Hospitals as
well as in each of the 128
Newsletter – African Network of Forensic Medicine
District/Designated District Hospitals as
well as in the main armed forces
hospitals. Furthermore, at least 5 private
hospitals do have morgues. There are no
funeral homes in Tanzania.
Certification vs. current practice:
All Registered Medical Practitioners
(Pathologists inclusive) are allowed to
conduct autopsies and certify death.
However, in practice even Assistant
Medical Officers-(AMOs) and, where there
is none, even Clinical Officers are
performing autopsies and witnessing in
courts of law. Since there is a big
discrepancy between the number of
pathologists and even medical officers in
relation to the population size, the best
hope currently is to increase the Forensic
capacity of AMOs by training them as
these are much more available in rural
and remote settings. One way of
achieving that is through establishing an
injury surveillance center as well as
including basics of forensic pathology in
their curriculum which not the case
currently.
Death Certification
What currently happens is that doctors
certify death and issue burial permits
upon conducting an autopsy examination
(medical examination). These burial
permits are then forwarded by the next-
of-kin to the Registration, Insolvency and
Trusteeship Agency (RITA) which then
issues a death certificate after paying a
minimum fee.
For non-fatal injuries a PF3 form is issued
by the Police which is then filled by a
doctor/auxiliary upon recovery. This
allows the victim to pursue a case, and
seek compensation where required. For
post-mortem examination of fatal
injuries, a PF99 form is issued by the
Vol 1 No 1 October 2010 Page 6
Police Force ordering the medical
officer/examiner to conduct an autopsy.
The doctor then fills a post-mortem
report thus allowing the state to pursue a
case if it sees fit and also relatives may
claim compensation. Where toxic injury
is suspected or where the cause of death
cannot be determined with certainty, the
doctor conducting the autopsy collects
select human tissues for toxicological
evaluation by the Government’s Chemist
Agency this is accompanied by a request
form.
The Autopsy
In Tanzania, like in many parts of the
world, the subject of autopsies is a poorly
understood part of the health and justice
system, This is not surprising given that
most people are uncomfortable talking or
thinking about death, and that autopsies
directly confront death in a very intimate
way. Moreover, forensic pathologists are
considered by the society as if they are
specifically “doctors for the dead” and not
for the living.
An autopsy or necropsy is also known as
‘a post- mortem examination’ and entails
a thorough external and internal
examination of a body, using techniques
similar to those employed during very
major surgery – certainly a mortuary is
where an autopsy takes place, it bears
some resemblance to an operating
theatre. During an autopsy all internal
organs, including the brain, are normally
removed, dissected, examined and small
samples taken for examination under a
microscope or for other testing ( for
example, for infection or the presence of
drugs). In some cases it may be necessary
to take a whole organ for further
examination sometimes days or weeks
later, in order to more fully investigate
how the person died.
Newsletter – African Network of Forensic Medicine
Broader benefits of the medico-legal
autopsy
As a result of this lack of awareness,
public health benefits of the medico-legal
autopsy are under-appreciated and
under-valued by the health care sector.
This could otherwise be more successful
in attracting funding to establish an
‘adverse medical event’ research group to
review a wide range of deaths that
frequently occur, especially in developing
countries. With the assistance of forensic
pathologists who provide Police or
Coroner with vital information of the
nature of adverse events in hospitals, the
root cause of problems in the delivery of
healthcare in those cases could be better
identified and addressed.
Public awareness and response to recent
media exposure of shortcomings in
autopsy practices in Britain and now in
Australia make it clear that greater public
knowledge enables a more informed
evaluation of what has been happening.
The training of postgraduates should be
developed with a more formal system of
activities that includes experience of the
day to day work of this division of
forensic science as well as exposure to
other related forensic medical and
scientific disciplines.
However, the absence of sufficient
funding in this sort of training has
tremendously reduced forensic casework
capacity and restricted the range of
postgraduate supervision provided in this
developing country with an ever growing
population now desiring advanced health
care as well as a forensic technical
service.
Death is inevitable and has many causes;
we cannot escape it. Thousands and
thousands of autopsies are carried out
Vol 1 No 1 October 2010 Page 7
each year. These include homicides,
suicides, accidents and ‘natural’ deaths
where a person dies unexpectedly and a
doctor is unable to complete a death
certificate because the cause of death is
unknown.
Autopsies are performed mostly by
pathologists who are doctors who have
specialized in investigating disease.
Coroners (legally trained magistrates and
not, as popularly believed, doctors) and
specifically Police officers have legal
control over bodies where the death has
been reported to him or her. It is up to
the coroner to direct an autopsy, and
although next-of-kin are informed, their
consent to an autopsy is not required.
The law requires coroners to make
findings about the identity of the
deceased, the medical cause of death, and
the circumstance of the death (for
example, was it an accident or a suicide?).
The autopsy is therefore a mainstay of a
coronial or police death investigation.
A few autopsies done by hospital
pathologists are performed with consent
of next-of-kin so that the family and the
treating doctors can better understand all
of the disease the patient had, and
whether it was managed properly.
Whenever an autopsy, whether coronial
or hospital, is performed both
information and tissue (which includes
organs) become available. These can be
put to substantial beneficial uses for both
surviving family members and the wider
community. Benefits include organ and
tissue donation for therapeutic, research
and teaching purposes. No one would
dispute desirability of these beneficial
uses. In bringing them about there has to
be broad community acceptance. This is
Newsletter – African Network of Forensic Medicine
the area where current public concern
has been focused.
The capacity for national altruism and
humanity or selflessness of families in the
midst of personal tragedy is impressive
and can be demonstrated by the majority
of those victims who may be approached
and agree to cooperate voluntarily and at
their own free will for scientific and
therapeutic purposes. It is to be hoped
that these processes could be monitored
and evaluated by qualified medico-legal
and ethics experts from recognized
institutions or medical schools and
universities, in accordance with evolving
community attitudes, so that in another
decade or so, we will continue to operate
with the support of the community at
large. In the final analysis, an autopsy is a
significant event, and we have an
obligation to ensure that as many of its
potential benefits as possible are realized
in this current century.
Clinical Forensic Services
It is also expected the forensic technical
service will fully provide a range of
clinical services. These should include
cases of adult physical assault; adult
sexual assault; pediatric forensic
medicine, cases of child physical and
sexual abuse; custodial medicine, issues
of fitness for interview; injury
interpretation and the obtaining of
biological samples; traffic medicine, with
issues of the effects of medical conditions,
alcohol and drug effects on driving skills
and the obtaining of biological specimens;
allegations of police assault, and
assessment of complainants, all provided
in conjunction with Prosecutor’s office. In
addition, the service also provides for
psychiatric services, including assessment
of the mental state of suspects and others
who come to police attention._
Vol 1 No 1 October 2010 Page 8
CASE REPORT 1
COMMOTIO CORDIS
Dr Kaone Panzirah-Mabaka
An autopsy was conducted on a 12 year
old boy who was apparently well until the
fatal day at school whilst playing “tug of
war”, a game in which to groups of
individuals in a line up and pull a thick
string in opposite directions. According
to reports from other children, when the
less strong group gave way, the stronger
group suddenly fell. Whilst those in the
winning group got up to celebrate one
child from the losing group did not get up.
No CPR was conducted.
Autopsy revealed a child of normal body
morphometry with only a faint area of
bruising of the left side of the chest. No
positive finding of injury or structural
cardiac abnormalities of the heart was
evident on internal examination. The
cause of death was concluded as possible
cardiac concussion (“commotio cordis”).
The diagnosis of cardiac concussion has
well defined characteristics that clearly
distinguish it from cardiac contusion.
“Commotio cordis” ("agitation of the
heart" in Latin) is a disruption of heart
rhythm that occurs as a result of a blow to
the precordial region at a critical time
during the cardiac rhythm cycle. It is
neither related to mechanical damage to
the heart muscle or surrounding organs
nor the result of heart disease.
Apparently only 15% of victims survive.
Newsletter – African Network of Forensic Medicine
It generally results from a sudden and
blunt impact to the precordial area that
alters the normal cardiac electrical
activity and causes cardiac arrest without
evidence of anatomical and structural
cardiac injuries. The impact is apparently
generally low energy and low speed.
Death is caused by cardiac arrhythmia.
There is evidence that ventricular
fibrilation is the most common in fatal
cases. A traumatic impact localized
during the period of ventricular
repolarisation is said to be the cause.
Diagnosis of cardiac concussion requires
absence of any form of traumatic injury,
with the exclusion of a possible small
subcutaneous/muscular contusive lesion
on the left thoracic side in the shape of a
generally circular or oval ecchymosis
related to the object that caused the
impact.
The U.S. Minnesota Commotio Cordis
registry1 recognizes cases of cardiac
concussion of the basis of well defined
diagnostic criteria that include blunt
thoracic trauma testified for by the
immediateness of cardiovascular collapse
and documentation about the traumatic
event, absence of structural alterations to
sternum and ribs, such as for example,
fractures, as well as of the heart, and
absence of preexistent cardiac
abnormality.
This pathological entity is not cardiac
contusion which commonly can occur
following rapid deceleration that causes
impact of the heart against the sternum
and crush injury in which the heart is
compressed between the sternum and the
thoracic vertebrae. Of note are the
particular thoracic conformations of
children which make them vulnerable to
Vol 1 No 1 October 2010 Page 9
cardiac concussion rather that cardiac
contusion.
Further questioning of the child who was
in front of the deceased revealed that the
live child’s elbow may have come in
contact with the deceased’s chest; he
recalled feeling numbness on the right
hand, probably referable to striking the
ulnar nerve at the elbow joint.
1. Madias C, Maron BJ, Weinstock J, Estes NA
3rd, Link MS. Commotio cordis--sudden
cardiac death with chest wall impact. J
Cardiovasc Electrophysiol. 2007 Jan;
18(1):115-22.
__________________________________________________
NEWS
Dr Carolina Comuana, who represented
Mozambique at the Inaugural Forum in
May, is currently in Spain, training in
forensic pathology, toxicology and
molecular biology, returning to
Mozambique in mid-2011.
_______________________________________________
CASE REPORT 2
A UGANDAN KINSHIP ANALYSIS
Dr Sylvester Onzivua
DNA paternity tests are not uncommon
cases that land on the desk of a forensic
pathologist. I had an opportunity to
encounter a unique and challenging case
in April 2009. I was approached by a
Ugandan family to establish by DNA
analysis the relationship between five
children and the head of the family who
had died three years earlier. The family,
however, requested that this be done
without exhumation of the remains of the
deceased. In any case the body of the
deceased had been embalmed with
Newsletter – African Network of Forensic Medicine
formaldehyde and we have not had any
success with DNA extraction from
exhumed bodies.
The deceased at the time of his death had
‘twenty’ known children. In the three
years following his death, five other
children, two boys and three girls, also
claimed he was their father. These twenty
five children were from twenty one
different mothers; one mother had four
children while another had two children
one of whom the husband had denied as
his own. The rest of the mothers had one
child each.
Nine of the ‘true’ children were willing
and available to provide blood samples
for DNA analysis. These included five
boys and four girls. Three of the mothers
were also willing and available to provide
blood samples for the analysis. One of the
three girls whose paternity was being
questioned objected to the test as she
believed no test would be reliable without
the exhumation of the remains of their
father.
Blood samples were flown to the Lancet
Central Laboratory in Johannesburg in the
Republic of South Africa. The tests were
performed using the Powerplex Y-STR kit
and Powerplex 16 STR kit. The tests were
analysed on an ABI Prism 3100 Genetic
Analyser. The results of the Y
chromosome analysis of blood of the
seven male members of the family using Y
Chromosome-Specific STRs were as
follows (see overleaf):
NOTICES:
Readers are encouraged to contribute to the
newsletter. These could be in the form of regional
events and developments, news, articles, other
educational contributions, letters or questions or
general comments of educational nature. Send
any submissions to Dr Panzirah-Mabaka at
kpanzirah-mabaka@gov.bw
Vol 1 No 1 October 2010 Page 10
 QS-1 AS-1 AS-2 AS-3 AS-4 AS-5 QS-2
DYS391 10 10 10 10 10 10 10
DYS3891 13 13 13 13 13 13 12
DYS439 12 12 12 12 12 12 12
DYS38911 31 30 30 31 30 30 28
DYS438 12 11 11 12 11 11 11
DYS437 14 14 14 14 14 14 14
DYS19 15 16 16 15 16 16 16
DYS392 11 11 11 11 11 11 11
DYS393 13 13 13 13 13 13 13
DYS390 21 21 21 21 21 21 21
DYS385a/b 16/19 14/18 14/18 16/18 14/18 14/18 17/18

Table: Results of Y-chromosome analysis complicated by many new emerging

(QS =Questioned Son AS = Assumed Son)
The results of the Y-chromosome analysis
indicated that the assumed sons AS-1, AS-
2, AS-4 and AS-5 were not of the same
patrilineage as questioned sons QS-1, QS-
2 and assumed son AS-3. AS-3 was the
heir apparent. We could not help noticing
that QS-1 and AS-3 had near identical Y-
Chromosome genes except for one locus.
A kinship analysis of the girls was
performed using the DNA-VIEW software
program. It excluded the two questioned
girls as half siblings to the other girls and
AS-1, AS-2, AS-4 and AS-5.
CONCLUSION: A paternity
kinship analysis can reliably be done
using a Y-STR and the DNA-
VIEW software program even in the
absence of a genetic profile of the father.
_______________________________________________
REVIEW
“SPICE”: SYNTHETIC MARIJUANA
Othusitse Lawrence Mokgwathi, final year
medical student
The war on fighting and curbing illegal
drugs is never easy. It has been
drugs. A drug popularly known as SPICE
or K2 is the most recent one to emerge.
Most people have not heard of SPICE, and
the worst part of it is that, it is “legal” in
some parts of the world. It could be
grown as a herbal tree and either given
the synthetic compound as a fertiliser or
the chemical sprayed to the leaves weeks
before harvesting time. This herbal
mixture with synthetic cannabinoids is
smoked just like marijuana plant gives the
same physiological effects as marijuana.
The drug does not test positive for
cannabis or other illegal drugs using GC-
MS or LC-MS screening.
There has not been much research on this
drug, but it appears the drug has more
dangerous side effects compared to
garden variety cannabis. SPICE appears
to have many negative side effects that
marijuana does not have, such as anxiety
attacks, hallucinations, nausea, and a
chemical dependency.
Synthetic cannabis has been around for
some time since the 1990’s but did not get
attention until early 2000. With its
emergence in Europe, it triggered some
research; this led to banning in some

Newsletter – African Network of Forensic Medicine Vol 1 No 1 October 2010 Page 11

countries such as Germany, France, modification and successful application of
Sweden and the UK. In some countries it a simple everyday technique that puts the
is still legal. available evidence in a deteriorating body
to its best use.
Since it is not normally detected by
routine testing, knowledge about this With the skin-slippage seen with wet
drug by the general public, lawmakers decomposition and bloating after a post-
and law enforcing officers is very mortem interval of a few days, the entire
important. Currently in Botswana like the skin of the hand (and also the feet) may
rest of Africa the drug is not tested for. slip off the limb and digits like a glove
Our lab has told us that they have just would do. The author experienced
tested a herb which was brought for exactly the same on multiple occasions
chemical analysis and the plant did not with his casework, and in the following
test positive for anything. The figures also depicts how he had used this
investigator was apparently insisting that technique in a case to obtain very good
there must be something because after and usable fingerprints for identification
smoking this herb individuals exhibit purposes.
symptoms similar to marijuana. Could
this drug be in Botswana already?
Without detection techniques and
regulation, its impact on the public could
be devastating.
Othusitse Lawrence Mokgwathi is a final
year Monash Medical Student currently
doing a forensic pathology rotation in
Botswana.
________________________________________________
PRACTICAL TECHNIQUE
PRINTS FROM THE SHED SKIN OF
CADAVER HANDS IN
DECOMPOSING BODIES
Steve R Naidoo.

A colleague, University of Cape Town Prof

GJ (Deon) Knobel, described the “indirect
cadaver hand skin-glove method” of
taking of fingerprints in a decomposed
body in an article in the South African
Medical Journal of September 20051. The shed “glove”, although delicate and
tears easily, may be slipped onto the
The technique is by no means new, and fingers and palm to obtain usable prints.
has described by many writers in texts
and manuals of forensic technique. The author describes a weird and rather
However, Knobel’s article reiterates by eerie feeling in “wearing the hand” of the
simple illustration the very practical deceased during this exercise. The

Newsletter – African Network of Forensic Medicine Vol 1 No 1 October 2010 Page 12

“glove” comes off complete with the
fingernails! The lesson to be learned is
that good prints may still be obtained
from the shed skin, which should not
simply be discarded aside.
The thin and delicate skin does split easily
and, in “pulling on the glove” onto your
latex-gloved hand, care must be taken to
insert the fingers carefully and snugly
into the “sleeves” of the fingers and slip
the skin gently onto the web spaces and
palms before the prints are tried, as the
skin is quite slippery and slides to one
side or the other when taking the
impressions.
There are several additional techniques
(and variations of these) described for the
reconditioning of fingers in putrefying
bodies, where the skin of the fingers and
palms are in very poor condition for
standard printing techniques. Soft, soggy
skin wrinkled by damp but still pliable
may need reconstitution by careful
inflation of the fingerpads. Fingerpads
distorted by hardened, shriveled skin due
to mummification may need careful
rehydration by a variety of chemical
techniques to render the skin pliable and
soft enough for printing2, 3. The latter
phenomenon was also seen in the
author’s own experiences with the
examination of bodies after prolonged
refrigeration (several months) in the
morgue itself.
The forensic principle of accessing all
available evidence for the benefit of the
identification process, so important a part
of the forensic pathological autopsy
examination, must always be borne in
mind by doctors practicing forensic
pathology. Mortuary technicians and
autopsy assistants should be aware and
familiar with techniques for
Newsletter – African Network of Forensic Medicine
fingerprinting in varied conditions of
preservation of the corpse.
References:
1. Knobel GJ. Taking fingerprints from a
decomposed body using the ‘indirect
cadaver hand skin-glove method’. S Afr
Med J 2005; 95: 665-666
2. Zugibe FT, Costello JT. A New Method for
Softening Mummified Fingers. Journal of
Forensic Sciences 1986; 31: 726-731.
3. Haglund WD. A Technique to Enhance
Fingerprinting of Mummified Fingers.
Journal of Forensic Sciences 1988;
33:1244-1248.
_______________________________________________
ORGANISING A CONFERENCE IN
AFRICA
By Kate Bean
Arriving in Botswana my first impression
was”WOW”! Wonderfully warm, friendly
and welcoming faces and so much space!
The trip to the hotel was fascinating. So
much of Gaborone reminded me of
Melbourne - lots of open land, detached
houses and vast paddocks.
I was very excited as finally I was going to
meet all the friends I had made in
planning the “Inaugural Forensic
pathology Forum”; numerous email and
telephone conversations with the
Business Centre and the Botswana Forum
Committee, designing and printing our
brochures and programs; input and
presentations from many delegates from
all over Africa; and catching up with
Botswana friends from my previous visit.
And have I mentioned the amazing food?
Such fond memories of my first trip and
the fabulous smoked fish in milk, the
Vol 1 No 1 October 2010 Page 13
yummy pap and stewed beef. No wonder
my jeans were stretched to the max when
I got home!
This time my trip was enriched by all the
wonderful, excited and enthusiastic
participants who attended the forum
from all over your vast continent. I was
showered with lovely souvenirs and the
warmth and friendship extended to me
left me feeling that this was a very special
time in my life.
I remember one comment which for me
sums up the overall feeling of the forum.
One of the delegates told me that in all his
years as a forensic pathologist he had
never had the opportunity to attend a
forum, or in fact meet his colleagues
outside his region. And now he had a
network of friends and colleagues, both
throughout Africa as well as
internationally, to discuss similar issues
or request a further opinion.
We had the most wonderful “Official
Dinner” with fabulous food, absolutely
beautiful dancing and music. In addition I
was entertained by the Police
Commissioner whose daughter is married
and living in Australia. What a small
world!
Prof Steve
Naidoo, Dr Kaone
Durban, SA Panzirah-
Mabaka,
Gaborone,
Botswana
Newsletter – African Network of Forensic Medicine
One of the major outcomes was the
establishment by the delegates of the
African Network of Forensic Medicine
with Prof Cordner as the Patron. The
Chair and committee representatives will
be attending INPALMS in Delhi in October
2010 and presenting ANFM to a global
audience, as well as actively participating
in the pre-planning for an Australian
Federal Police-funded sexual violence
workshop and a further forensic
pathology forum, supported by AFP and
the International Committee of the Red
Cross, both planned for Africa in 2011.
Leaving Botswana I was struck by what a
unique experience this had been. I had
come to a strange country as a visitor and
be made to feel so welcome that there
was no sense of yearning for home. I now
often contemplate during my frantic
work-days of what life may offer me if one
day I decide to return forever. Don’t
tempt me……it just may happen! Thank
you to all of you for such wonderful
memories.
Kate Bean is the Manager: International
Programs at the VIFM.
_______________________________________________
INTERIM COMMITTEE OF THE ANFM
Dr Ahmed Dr
Makata Prof
Sylvester
Mwinyimt Williams O
Onzivua,
wana, Dar- Odesanmi,
Kampala,
es-Salaam, Ife-Ife,
Uganda
Tanzania Nigeria
Vol 1 No 1 October 2010 Page 14