Le we Subject; ENQUIRY REPORT REGARDING THE INCIDE! was reported in electronic, after reporting of the incident, Hospital / Medical University alon Chief Seeretary, South Punjab, Secretary, P2Zy Deparment, South Punjab notified a 06-member committee under th The Secretary, Specialized HealthCare & Medical Education Department, South Punjab, OF _¥ EAD DODIES LYING OPEN ON THE ROOFTOP OF ANATOMY DEPARTM ISHTAR MEDICAL UNIVERSITY, MULTAN. ‘The incident of dead bodies lying on the rooftop of Nishtar Hospital, Multan social and print media on 12% -13% of October, 2022, Soon Secretary, SH&MED, South Punjab visited Nishtar g officers of the department. On direction of Additional Specialized Healtheare & Medical Education e convenorship of Additional Secretary (General), SHC&ME Department, South.Punjab containing representatives of Nishtar Hospital / Medical University and district administration, Multan to inquire into the matter in the light of SOPs issued by the Home Department Punjab vide NO. SO (1S-I) 10-11/2013 dated: 4® March, 2014 (Annex-A). ‘Legal Position: + Home Department, Government of the Punjab on direction of Lahore High Court Lahore devised SOPs for registration and tracking of all unidentified dead bodies; Home department notified procedures for registration and tracking of unidentified dead bodies vide Notification dated 04-03-2014, which, inter alia, provide that SHO will bring the dead bodies to the concemed hospital for post mortem / examination. Afterthe post mortem and other legal formalities, the SHO under rules 5-38 of Police Rules 1934 (on the basis of non-identification) will hand over the dead body to the Head of Anatomy Department. After proper handing over / taking wer, the same will mitt t rough Head of the Institution. + SOPs dated 04-03-2014 issued by Home Department further provide that in case unclaimed dead bodies aze not required for imparting medical instructions, in line with Rules 25-28 of the Police Rules 1934, the body may be handed over to any willing charitable society for burial. + SOP for burial of unidentified bodies provide that: a) unidentified dead bodies will be buried in a graveyard within the Union Council of the concerned Police Stationjointly by the SHO and the Secretary, Union Council concemed, b) in case ‘unidentified body handed over to a charitable organization for burial, concerned 6 Sceretary UC will still be associated with the burlal proceedings, and ¢) grave of the unidentified dead body will be marked and recorded In a separate burial register with the SHO and at the office of the Union Council. Proceedings: The committee held its Ist meeting on 14-10-2022 at NMU, Multan and 24 meeting was convened in the SHC&MED, South Punjab Secretariat, Multan on 15-10-22 (Annex-B), The committee perused the record regarding receipt of ‘unidentified/ unclaimed dead bodies at Anatomy department, NMU, Multan and found Dy that: Since start of the medical education at Nishtar Medical College Multan in 1953, the students are being provided exposure/training on human dead bodies. Perusal of the available record shows that from Jan, 2009 to October, 2022, a wial of 6100 unidentified dead bodies were received, out of which 4947 were returned to the Police, 1041 were placed at rooms specified for placement of unclaimed bodies situated at rooftop of anatomy department and 112 were preserved for Medical Education purpose (Annex-C), . ‘Statement of the HOD of Anatomy Department, NMU, Multan. ‘The Committee recorded the statement of Mrs, Mariam Ashraf, Professor / Chairperson Department of Anatomy, NMU, Multan, She stated that the dead bodies on the rooftop of NMU, Multan campus are kept to decay and putrely. They are kept in the rooms constructed on the rooftop. Due to negligence of the s Attendants / Chowkidars on duty, said dead bodies were not transferred to the rooms. As a matter of procedure, decomposing dead bodies are kept in the rooms on the rooftop so that their soft tissues i.e. muscles, organs etc. are completely decomposed and their bones are retrieved for teaching of medical students (Annex-D). -. Findings: After perusal of the SOPs issued by the Home Department and record about dead bodies recelved in the Anatomy Department, NMU, Multan for placement in3 Mortuary/purpose-built rooms for process by Forensic & Toxicology Department, it has ‘*ranspired that: & a) 04 unidentified/unclaimed dead bodies were recelved by the staff of Anatomy department as per following details: Body Post Gonder/Ag Pollco Station Ne Mot | 1-09-2022 | Male/S2-99 Seetal Marl years shah Rukn-e- | — 07-09-2022 | Male/40 " i Sojjad Nasir, years om Chowkidar Male/30-35 Muhammad ae Sejies Nace Female/| ‘Abdul Raut, zaffarabad | * | 7 [Cuoniides Analysis of statements of Chowkidara reveal that Body No O1 was received by Ghulam Abbas, Chowkidar that was decayed, foul smelling and full of maggots. He kept it in the purpose-built room at 6:50 pm on 01-09-22. Officials of Forensic Department brought it out on 06-09-22 at 13:00 hours in presence of Muhammad Alram, Constable, P/S Sectal Manri and did not place the body back in the said room. The body was not in a condition to be used for medical teaching purposes. Body No 02 was received by Muhammad Sajjad Nasir, Chowkidar in a decayed condition and was kept itin the purpose-built room at 12:55 AM on 07-09-2022. ‘ASI Shoukat Hussain, No, 1415, Shah Ruln-c-Alam Police Station, Multan prought dead body directly in Anatomy Department on the said date. The body was not in a condition to-be used for medical teaching purposes. Body No 03 was received by Muhammad Sajjad Nasir, Chowkidar in a condition that his both arms were amputated and neck was transected. Constable No. 3548/C, Akhtar All, Seetal Mari, Police Station, Multan brought dead body Chowkidarc ww ‘ directly In Anatomy Department on 03-10-2022 at 12:30 AM, The body was not ina condition to be used far medical teneliing UPON: Rody No. O4 wan received by Abshit Rauf, Chowkilar whieh wan foul emeliing, swollen and fall of maggots, Conatable No. Muraflarabad Pollce Multan brought dead body: dlreetly In a condlt Chow! 1218/¢, Tari, In Anatomy Depnrtment on Station, 04-10-2022 at 05:50 PM. The body wns not on to be uned for medical teaching PUTPOSER, tannex-D) when the site was Visited by the Committee Members, open airon the rooftop. However, remnants of many dead bos up in roms which should have been buried 3 Per SOPs. no dead body was lying In diea were found piled instead of placing the, dead bodies in the b) The Chowkidars as mentioned above, structed on the rooftop of Anatomy purpose-built rooms (03 in number) con depareneat for putrefaction, placed the same on rooftop openly. They are primarily responsible for this Inpse. Chowkidars showed unethical negligence by not placing the same in rooms to avoid desecration of human dead bodies. ¢) Ther is lack of coordination between officials of Health, Police ‘and Local Government department which led to delay in burial of unidentified dead bodies not required for medical education purposes. Anatomy Department has not even designated a Gazetted Officer as focal person for keeping liaison with the SHO and Secretary Union Council concerned. ) Neither tke Head of Anatomy Department contacted the administration of Nishtar Medical University / concerned police officials for taking away the 04 recently received dead bodies for burial which were not required for medical education nor the concemed SHOs approached the HOD Anatomy Department for return of the dead bodies afier lapse of 04 weeks as per SOPs notified by the Home Department, Punjab. ¢) SOPs issued by the Home Department require that the SHO alter getting the specimens of the dead body wil] submit the same for DNA test to a notified forensic unit. In the instant case DNA tests of these bodies have not been carried out. 4) No internal SOPs for ré i ecelpt and burial of unidentified/unclaimed bodies have been framed by the administration of NMU,Conclusion: {The following officers /officials are, prima facie, responsible for not implementing SOPs dated 04-03-2014 issued by the Home department in discharge of their dutie No Name of officer/official Mrs, Mariam Ashraf, Professor / Chairperson Department of] Anatomy, NMU, Multan, Obsorvations Falled (0 designate @ focal person for proper handling of the dead bodies. i, Failed to contact administration of NMU/concerned SHOs of Police Stations for taking back dead bodies which were not required for medical education. Failed to place the said 04 dead bodies inside the rooms and left + Mubammad Sajjad Nasir, | them opesi on the roof, Chowkidar Ghulam Abbas, Chowlddar Abdul Rauf, Chowkidar TP Saeed Sial, SHO, Police | Failed to keep proper liaison and Station Scetal Maar, cae did not take back the dead bodies which were not required for = Umer Farooq, SHO Police ee eg medical teaching for burial after Colony, Multan. lapse of 4 weeks as per SOPs of | Home Department. ‘The use of unclaimed / unidentified human dead bodies for teaching purposes is a practice common in most countries of the world including Pakistan. The dead bodies w/ / / not required for medical educnti : ter ch Tea teoheanoen ention nre returned by the health authorities to the police gor ies received on / after 01-09-2022 were not handed over to Police for burinl by the officials of Anatomy department. Health department is not responsible for burial of these dend bodies, As per point (J) (a) of SOPs notified by the Home Department dated 04-03-2014, burial of such dead bodies Is the responaibllity of SHO & Secretary Union Council. In the instant case, Chowkddara failed to place the dead bodies nt designated rooms of Anatomy. However, the administration of Medical College / University also lacked supervision and no body checked where these dead bodies were kept. The concerned SHOs did not keep liaison with official of Anatomy Department for burial after lapse of 28 days’ time specified in SOPs. Recommendations: a) In view of the above, the following recommendations are made! 1. Ve, NAU, Multan and other competent authorities concerned may take legal action against the delinquent officers/officials responsible for this lapse a5 Per law/rules. IL. Theunclaimed / unidentified dead bodies not required by the medical teaching institutions in the Public sector for teaching purposes may be provided to the private medical teaching institutions on the terms and conditions as may be prescribed by the Government. Mi. Tae Police authorities should not hand over all unidentified / unclaimed dead bodies to Anatomy departments of medical colleges in the province as a matter of routine, The dead bodies may be provided to the medical colleges on need basis. IV. Separate graveyards for burial of unclaimed / unidentified dead bodies may be established in the cities where medical colleges’ have been established by the government. Such dead bodies may be buried in the specified graveyards from where bony skeleton may be retrieved for teaching purposes once required. For the purpose land measuring 2-4 Kanal may be allotated by the Deputy Commissioners In the“tongemed districts for immediate burial of such dead bodies / their remains Instead of placing these bodies in the rooms. This will ‘ensure the dignity of human dead body aa per religious injunctions. \eV. The unclaim ; ed d i . tourer. isd bodies stil lying in the purpose- bullt rooms of Anatomy ’ ae Not required for medical cducation purposes may be burled n observing all codal formalities by the SHO. maemo may be constituted in cach medical Inatitution headed by HOD, 3 Partment comprising of Representatives of LO&CD department, Police department and Philanthropist nominated by DC of the district for implementation of the SOPs notified by Home Department dated 04-03-2014, The proposed committee may hold meetings on monthly basis to streamline burial of such bodies. Vil, To streamline the process further, Mortuary may be place under the control of Forensic Medicine and Toxicology Department. “SVM. The SoPs issued by the Home Department may be implementsd by all the medical institutions in truc letter and spirit. * % . nr > tg-le * wes i Prof Hasoo -ur- Rauf Heraj pr. Shffig:Uilah Chaudhry fessor of Surgery, Assistant Professor of Anatomy, Nishtar Medical University, Multan Nishtar Medical University, Multan, (Member) (Member) . wes Sye d Nabi Rana jaa Ras 1) >) DSP/SDPO Gulgasht Additiénal Deputy Co! Wsdte ®, Multan. (Member) nail, Sete RQ Muhammad Muzammil Bashir f Additional Secretary (G), Nishtar Hospital, Multan. SH&MED, South Punjab (Member) (Convener) -