By D. I. E. Aleku
Melancholic, departed souls, the bereaved public and officials here lament essential facilities. Pathologists conduct postmortems on bloody bodies without water to wash or clean up.
Typical of Ugandan town morgue, it’s awful to die in Soroti, capital of Teso sub-region and find your remains in municipal mortuary. Situated within the public cemetery on Ipuruket- Nakatunya road, authorities acknowledge the fetid conditions that compare to a makeshift abattoir for meat vendors.
“Council built that mortuary as an emergency in 2002/2003 after the then Soroti Regional Referral Hospital Director, Dr. Bernard Odu stopped municipal from using the hospital mortuary,” says the Mayor, Paul Omer. “We appropriated sh8-15m for the house with a slab but a lot remained lacking including fridges, running water, power, beds, trolleys and stretchers let alone incorrect mortuary specifications.”
Rough-and-ready, council had been reluctant to own a mortuary until the Oculoi fatal accident on Soroti-Lira road that claimed eight lives with 15 survivors critically injured. Soroti hospital administration was angered after two of its patients in the ward close to the mortuary died of shock on seeing gruesome bodies offloaded.
Self-accounting, money transfer policy then was flexible that council called for a special assembly to allocate construction funds. Incidentally, Omer who admits that there has been laxity with council on close mortuary attention was Speaker of Council then.
“We’re a regional mortuary that receives all accident victims alongside some people who die in their houses hence need for urgent fixing of lacking necessities,” says Omer. “Council doesn’t have an announcing mechanism to declare the dead yet humans decompose very fast forcing us to hastily bury some whom relatives could be tracing and that’s how dangerous it is.”
Figures in the mayor’s office show that the council annually buries close to 40 unidentified persons in the public cemetery with a monthly average of three bodies. Yet, the national coffers seem not to have a special national mortuary fund for Ugandan mortuaries to cope with the daily growing population and deaths.
Soroti municipality claims to have allocated sh15m this financial year to the mortuary renovation but it remains to be seen 15 years after construct. It comes after failed appeals to the Health Ministry for assistance and negligence to follow the health state minister, Sarah Opendi’s promised to advocate help after her fact finding tour in Soroti.
Outwardly, overhaul will be a huge task to commission. The cemetery itself where the structure stands is used up and if gazetting new burial grounds perhaps it would be prudent to build a new mortuary there.
In addition, municipal currently hires mortuary attendants from the referral hospital on activity basis due to recruitment restrictions. Catch-22 comes with rotten bodies that are buried without autopsies owing to lack of refrigerators to wait for the only one police surgeon deployed in the entire East Kyoga region.
“Unforthcoming payment of the undertakers actually is what escalates decay of bodies in the mortuary with delayed burials,” says Basil Enatu, the part-time attendant. “We’re not on payroll so for me to direct burials means make numerous trips to mayor’s office or the Chief Finance Officer (CFO) before payment is authorized.”
Scruffy-traumatized-alcoholics, these are dehumanized weak old men who long lost sense of human feeling. They hastily throw the dead in below-knee shallow graves before demanding immediate pay on dropping down spades.
It’s a hidden expense that even once pushed council to think of the radical proposal to levy charges on corpses but these in most cases, are only destitute. Synonymous with the funeral home, a mortuary is a place where bodies especially accident victims are temporarily kept to be identified and claimed.
It must have a specimen handling area, which includes body reception, preparation, temporal storage and administrative documentation work. In other words, the pre autopsy region where inquest papers are received and details entered in the register.
It’s an entry glass-paneled counter with doors leading to the doctor’s room and the cold storage apartment where up to 10 bodies with complete identities are kept before postmortem examination. Spacious, these are cold chambers with refrigerated cabinets and trolleys that Soroti municipal forensic autopsy experts only read in books.
“Honestly, I have no choice working here,” says Dr. ASP. Joseph Ongaria, the Regional Police Surgeon, East Kyoga. “I cannot say the place is substandard or not but offer a service because as police doctor people need my services.”
Forensic doctors need utility gadgets such as mobile radiography and photography to ease work and demonstrate findings. It’s important because many times postmortem findings have turned out to be of clinical or teaching interest.
But with the meagre government of Uganda expenditure on autopsy facilities and administrative apathy towards medico-legal work, mortuaries are an unavoidable liability. Budget looks at where votes are to maintain the powers that be in the reigns of which the dead are an ineligible electorate.
“Mortuary use countrywide remains irregular unless for accident victims,” says Emmanuel Banya, the town clerk, Soroti. “We would wish to have improved facilities including use of global positioning systems (GPS) to track data of the graves for historical purpose but like now, we have received a new budget structure without health.”
Cold government attitude in the public eye paints the mortuary as an eerily setting that is sad and disheartening. It’s seen as home to mystery, grief, anguish and disgust that God must not to grant circumstances leading to its visit.
Families that the dreaded reality has dawned on bear lifetime pitiful testimonies. Incidentally, with mishaps in the world advancement nowadays: road carnage, creeping lawlessness; abductions, ritual sacrifice, migration, population explosion and infrastructure development, chances of visiting the mortuary compound by the day.
Soroti municipal mortuary floor is moisture-free concrete cleanable but the worry is the developing cracks around the autopsy area. In addition, the walls though permanent are not fitted with recommended pale blue tiles to appreciate the natural colors of the dead in day light.
The natural light itself is not there given the metallic door and single window having broken glass panels. Special floodlights that would offer backup and ensure ample light over the post-mortem table or dissection bench have never been installed.
Standard, mortuary windows face east, south or west for maximum sunlight with windowsills five feet above the floor. The building must be air-conditioned with separate systems for autopsy rooms to prevent foul air saturating the rest of the area.
It takes though love and courage to reclaim a decomposing relative here due to lack of preservation. Passersby and neighbours attest to stench reeking of unclaimed bodies waiting buried.
“Suspected thieves mainly rot in there for almost two weeks polluting the entire surrounding,” says an old woman who prefers anonymity. “The lady entering the gate over there and another behind that house once suffered miscarriages due to vomit caused by stink, which galvanized angry residents to an attempted riot to demolish the mortuary.”
Small predators especially rats have preyed on bodies due to flesh remains and the broken window panes. The place inadequately sees water supply and it sickens to talk of proper waste disposal, cleanness and sanitation.
The postmortem table is not only fitted with an improvised disused water hose but non-recommended elbow-operated tap. It wouldn’t matter though had there been running hot and cold water in the sinks, wash-basins and showers that themselves have never been installed.
Testimonies further reveal that before the bush-swallowed premises were fenced-off, herdsmen had turned it into a grazing ground. From a distance it appears like an unutilized pasture paddock in a ranch without corridor provisions for trolleys.
“Fencing was prompted after the dogs exhumed the body of some woman and scattered flesh all over,” says Sarah Apio. “Undertakers have tendency of exhuming bodies when council delays to pay them only to rebury upon payment with limbs protruding out, which attracts dogs.”
Ideal mortuary ably receives bodies from outside with distinct facilities to handle decomposed and infectious ones carrying pathogens like HIV, hepatitis and Ebola. Facilities are separate from the postmortem conducting area which has a viewing gallery for authorized persons such as investigating officers, medical students and court nominees.
The bereaved in Soroti municipal mortuary though, are mismanaged and left to scatter the premises peeping through the window. Staff work environment is far below a well-furnished office area a modern mortuary boasts.
Postmortem surgeons lack an office room conducive to write reports and discuss case details with the police or the bereaved. It should have a cubical containing separate male and female bath-cum-toilets or lavatories, basins or showers with locker changing rooms where clean gowns, aprons, rubber gloves, gumboots, towels and related items are kept.
The cubical is different from the stock solutions or reagents store for viscera preservation and other packing materials. Likewise, the reagents store shouldn’t be mistaken for technicians or mortuary attendants’ viscera preparation room where they do assigned job under the doctor’s supervision.
The other important quarters that Soroti municipal mortuary lacks are the police and computer office rooms. Police are in charge of handing the body over to the bereaved or undertakers after postmortem but the corpse accompanying personnel here don’t have office room to keep guard.
Furniture to an up-to-date mortuary includes a computer room installed with scanners, printers, photographic devices and telephone facilities. But that is wishful thinking in Soroti municipal mortuary where not even a simple village chair or table exists let alone almirahs.
The abysmal facility though, only represents Uganda’s ailing autopsy services. Elsewhere in the country, the situation is worse making Soroti municipal mortuary appear among the best.
Uganda’s current national budget stands at sh29 trillion with sh1.8 trillion allocated to health. Establishing state-of-art mortuaries with such inadequate funds for a developing country Uganda would be dream come true.
Otherwise, not even Soroti regional referral hospital twin-refrigerated cabinet mortuary can currently handle mass emergency. It’s an old structure built so many decades back for a small population.
The difference is that municipal mortuary is regarded low class and for victims of sudden violent deaths while the referral hospital’s has cost sharing aspect. Families with experience claiming relatives there say a cadaver can only be handed over after a sh150, 000 cash deposit has been made.
Jittery of mass media, hospital authorities could neither deny nor confirm the allegation. Management treats journalists with utmost suspicion for alleged chronic misreporting.
“My principle is to avoid newspapers and newsmen as much as I can,” says Dr. Fred Kiirya, the Caretaker Hospital Director. “I cannot comment on a controversial issue like that and in anyway, I am not around; I am driving and it’s raining where I am.”
Nevertheless, he acknowledges spillover effects to the hospital mortuary without disclosing details. Sources however say since Dr. Odu’s directive, the hospital does not admit outside bodies except for special cases including the well-off.
Contemporary mortuary has more than one autopsy room with the first one equipped with two stainless steel mortuary tables built with arrangements having free drainage of constant flow of water from top to bottom. Furnished with a workstation, it has proper vents and duct system to let out foul gasses and allow in fresh air.
Large charts depicting weights and measurements of viscera, bones and the like for quick references hang on the walls. Likewise, it has portable x-ray machines with x-ray view boxes for seeing x-ray films while floors are made of materials like granite and walls with epoxy which facilitates easy cleaning.
The other room is an open mortuary with the net covered roof for decomposed bodies and other miscellaneous work. It’s different from the post autopsy room, which is a covered area with the central platform for handing over the body to the police and cleaning or covering by the relatives after the postmortem examination.
It’s also separate from the instrument cleaning room provided for thorough cleansing of all numbered instruments and equipment between the two autopsy rooms. Staff and doctors’ toilets cum bath with showers are just as strategic for their convenience in the building.
First recorded in 1865 in Europe, mortuary advent to Uganda is rooted to the colonial imperialism in Africa. It came along with the much more ancient term, cemetery, which is an area gazzeted for burial, graves, tombs or funeral urns and particularly not a churchyard.
Due to logistical difficulties to repatriate the bodies back to ancestral lands, the settlers gazzetted cemeteries where departed colleagues were buried. Thereafter, post-colonial governments inherited the norm that remains great source of archaeological information as in prehistory.
Cemetery Road beneath Opiyai rock in Soroti town derives its name from the colonial cemetery at the foothill. Details of its establishment are scanty but it contains remains of the 32-year old first Teso District Commissioner, Reginald Talbot Paske-Smith who died on August 18, 1914 and those of the Asian coolies who built the Uganda railways.
Overseeing cotton growing introduced 10 years earlier, Paske-Smith died before the arrival of the train to Teso to export the crop his government named “the white gold.” Construction of the railway line though started in Mombasa, Kenya on May 30, 1896 only arrived in Soroti in 1929 via Kisumu-Kampala.
But by that time, more than 2, 493 workers of mixed Gujarati, Punjabis, African and European had died of disease and accidents. The deaths claimed on average 38 workers per month or four lives every one mile of rail track with a further 6, 454 others seriously injured.
Information available indicates that Achuna area in Soroti is one of the blackspots in the railway line construction where scores of employees died towards northern Uganda. Approximately, the distance between Achuna and Soroti town is 20km hence the bodies were buried in Opiyai rock cemetery.
Such men include Cornelio Del Missier who died on June 27, 1929 and rests alongside his forerunners comprising David H. Sword of January 23, 1922. The last remains here among others is David Abercromby Rothnie, husband to Freda and father to Gillian who died on April 14, 1958, barely four years before the Uganda flag replaced the Union Jack.
The post-colonial local government gazzetted a new cemetery and mortuary at the corner-plot Moroto-Bisina roads but preserved the old one as a memorial park or garden of remembrance. Successive regimes followed in step until recent when gradually, maintenance gave way to the bush due to either negligence or budget cuts.
“It’s the late Mayor, Sylvester Papa Okurut during his tenure that preserved that cemetery through well-paid caretakers stationed there,” says Deborah Atyang, the Cell I Akisim ward area LC I Chairperson. “His successors, George Michael Egunyu tried before the practice died down with Alfred Martin Aruo who planted flowers towards the end of reign.”
Traces of the flowers are now weeds themselves with adjoined preoccupied quarrying locals wondering what came off management. None knows the municipality plans but public fear is that the place is prone to be given out as a plot to marauding private developers.
Hitherto, herdsmen have turned the place into a grazing ground with the cattle destroying most of the headstones. Moreover, the broken pieces of concrete have been carried away from the gravesites by either curious passersby or someone who could have discovered their use.
“White people perhaps relatives of the dead used to frequent the cemetery until about a decade ago and we thought the British government remits maintenance funds to municipal,” says Atyang. “When His Worship Omer was the area LCIII chairperson, Eastern division, he hotly criticized the then mayor for not preserving the place but now he’s taken the throne he’s gone the same path.”
Public desire is to clear the place of the bush, fence it up and promote to a tourist attraction garden to earn the municipality money. But none in the current municipal hierarchy knows whether the British government has ever had any kind of arrangement with the municipality or not.
The British High Commission Kampala when contact for comment promised to forward the matter to the head of communications. But it’s a week now after contact without response forthcoming despite persistent reminders on phone.
Otherwise, before Industrial Revolution in Europe and rise in infectious disease outbreaks, church exclusively controlled public graveyards. Like Islam retains the value, all the dead were buried in one place until space became limited with population explosion.
Legislation banned the practice before new burial sites were entirely established away from densely populated areas outside old towns and city centres. Majority of the new cemeteries became municipally owned or run by their establishments hence independent from churches and their churchyards.
Limited space that failed the church due to population growth remains a constant and stark predicament that weighs heavy on municipalities. The corner plot Moroto-Bisina Roads cemetery in Soroti was degazetted when it became full but suspicion remains surrounding how it was given out to the private developer.
The place contained among others significant remains those of the people killed during the turbulent days in Teso sub-region. The sitting mayor then was Egunyu who subsequently became the current district chairperson.
Though jovial as usual when contacted, he could not say much due to the long official trip across the country that has kept him busy and out of office for the second week running. Nevertheless, it’s Nchi Moto’s obligation to include Egunyu’s overall position in the next project in the pipeline that talks to this mortuary’s neighbourhood, watch this space.