ARising murders put strain on State, pathologists
Senior Reporter
shane.superville@guardian.co.tt
It costs the State about $15,000 to do an autopsy.
With 384 murders as of Friday morning, the State would have paid at least $5,760,000 in autopsies up to this time.
Autopsies are mandatory and form a critical aspect of any murder investigation.
With 5,272 people murdered between 2013 and 2023, the State would have paid more than $79,080,000 for autopsies during those ten years.
In July, Guardian Media calculated that it costs the State at least $5,545 to remove a body from a crime scene, transport it, and store it before and after an autopsy. Using this estimate, a single murder, inclusive of an autopsy, together with transportation and storage fees, can cost the state at least $20,545.
Applying this cost to the 5,272 murders between 2013 and 2023, it works out to $29,233,240 spent on the transportation and storage of bodies within this period.
This amounts to $108,313,240 spent by the State on murder victims over the ten years.
Investigating the cause of death of a murder victim usually isn’t a simple exercise. Even in situations where the cause of death is obvious, extensive forensic analysis, usually requiring multiple staff, ballistic testing, and toxicology tests using sophisticated equipment and tools are part of the procedure.
These expenses, together with the cost of labour of the pathologist and mortuary attendants who assist in the post-mortem, can amount to hundreds of thousands of dollars in the most extreme cases, one forensic pathologist said.
Under Section 14 part (C) of the Coroner’s Act Chapter 6:04 the fees for an autopsy performed by a pathologist are set at $300. According to the pathologist, it is challenging to determine the actual cost of a single autopsy because factors such as utilities, the kind of equipment used, and the tests required vary based on the situation and can also impact the overall cost.
Also included in this cost, he said, are expenses for shipping samples for DNA testing abroad, photographing the body for evidence, and the costs of preparing the final post-mortem report and other documents for court cases when a suspect is eventually arrested and charged.
Speaking with Guardian Media on Thursday, Professor of Pathology at the University of the West Indies (UWI) in St Augustine, Faculty of Medical Science Dr Chalapathi Rao agreed it is difficult to calculate the cost of a single autopsy, noting that post-mortem examinations were done in tandem with other inquiries and follow-up procedures.
“There are multiple other procedures that form the basis of a single murder investigation. In the case of gunshot wounds, there are ballistic analyses that need to be performed; if someone is suspected to be poisoned, there are toxicology examinations that also have to be done to determine specifically what poison was used.”
Dr Rao, however, said the most conservative estimate of the cost of a single autopsy “may be between $15,000 and $20,000, given the different procedures required.”
Dr Rao, who has almost 30 years of experience practising pathology in T&T and eight years in India, also works as a consultant at the Eric Williams Medical Sciences Complex (EWMSC).
Number of murders
in ten years
Year No of murders
2013 407
2014 403
2015 414
2016 462
2017 496
2018 517
2019 539
2020 402
2021 451
2022 605
2023 576
Total = 5,272
Cost of autopsies likely to increase
In July, former general manager of the North-West Regional Health Authority (NWRHA), Dr Keegan Baggan, told Guardian Media that the cost of treating the victims of gunshot wounds was likely to increase over time due to the cost of shipping associated with ordering medical equipment and reagents to perform complicated procedures.
Dr Baggan said the issue of ordering medical equipment affected healthcare as a whole.
Pathologist Dr Kerri-Ann Latchmansingh, speaking with Guardian Media at her Fitt Street, Woodbrook office, said the issue of inflation has also affected the cost of autopsies.
“Sometimes a saw is dull, you need to get new saws. You need to get Personal Protective Equipment (coveralls, gloves, aprons, hairnets, goggles), all of these may be provided by private vendors who may have contracts with the different hospitals, and these private vendors incur costs because not everything is locally manufactured.
“Getting foreign exchange is also an issue; all these things the vendors have to deal with, so they may mark up their prices and make things more expensive for the hospital to acquire, and that drives up the public sector bill.”
Autopsies are mandatory for all murder investigations and are performed at the Forensic Science Centre, St James, free of charge by the State.
In some instances, the victim’s family has requested a second, private autopsy to confirm the exact circumstances of their death.
Dr Latchmansingh said a private autopsy can usually cost around $15,000.
When asked about the prevalence of private post-mortem examinations, Dr Rao said he was not convinced that a second autopsy adds much more evidence to the overall investigation.
“I don’t have a lot of confidence in these second autopsies that are sought. Most of the evidence and information on a person’s death is gathered in the initial autopsy. The second examination, in my opinion, is usually to satisfy the victim’s family.”
T&T’s high murder rate puts pathologists under pressure
Meanwhile, the pressure brought on by T&T’s high murder rate is a significant issue impacting local forensic capabilities.
The Forensic Science Centre, St James, was founded in December 1983 at a time when murder and violent crime were still relatively rare. During a media briefing last December, National Security Minister Fitzgerald Hinds reported that in 1985, 150 post-mortems were performed at the centre, compared to the 889 that were performed as of December 1, 2023.
Every murder in Trinidad has to be sent to the Forensic Science Centre for post-mortem examinations, with some Tobago cases also being sent to the centre depending on the availability of storage or staff at the Tobago Mortuary.
Dr Rao said while hospitals and Regional Health Authorities (RHAs) have sought to ease the burden on the centre by performing autopsies on the victims of suicide and accidental deaths (drownings, road fatalities), there is still a significant workload on forensic pathologists at the centre given the number of murder cases they are required to work on.
“At present, there is definitely a need for more pathologists to perform autopsies. I would say about five or six different pathologists would be required to effectively conduct the work for a (country with a) population of one million people.
“With such high numbers, it’s important to have the necessary support to ensure every assessment at every level is done competently, especially given the important legal consequences it has.”
Referring to reports that construction on a new Forensic Science Centre at Farm Road in St Joseph is underway, Rao said while this development was encouraging, he hoped it would be completed as promised, noting that some promises of new facilities in the public health sector were not delivered, referring to the National Oncology Centre (NOC) at the EWMSC, which was promised in 2007 but eventually scrapped in 2019.
Another pathologist said the sheer volume of murders can place them under significant strain and affect their ability to accurately assess cases.
“The Government pays a fixed fee, and that fixed fee tells you that you have to do all the autopsies that come before you. Sometimes for the month, you end up doing 30 autopsies. That’s a lot of strain because when you do that many autopsies, you’re not refreshed intellectually.
“For most of the cases, you need to read and get things right, and you need to recall and have things in an orderly way so that when you go to court, it must be prepared in a way you can deal with it in order.”
According to the US Department of Justice’s National Commission on Forensic Science, caseload limits per pathologist should be 250 autopsies per year. However, former pathologist at the centre Dr Valery Alexandrov, has repeatedly raised concerns over the volume of autopsies he has performed–up to 300 autopsies per year, up until his resignation in September 2017.
The issue of staffing shortages was even highlighted by then national security minister Edmund Dillon during a sitting of the Standing Finance Committee, one month later in October 2017, where he admitted the centre was understaffed. During this sitting, he reported that an allocation of $1.8 million (TT) covers the salaries of scientific staff who are involved in the forensic, ballistic, and chemical tests.
Pathologist positions at the centre are filled by contract.
‘The job could be physically and mentally exhausting’
Dr Kerri-Ann Latchmansingh said the job of a pathologist could be physically and mentally exhausting.
She added that burnout was a major concern in the profession. “On top of actually doing the physical autopsies, we have to deal with putting the entire story together.
“You still have to do your toxicology report, you still have to get your X-rays done, and you still have to integrate crime scene information, which may not be the best depending on the staff you have working with and the integrity and preservation of the crime scene based on the people you’re working with.
“You have to write up reports and, in a lot of cases, go to court and testify. So it is a lot of work in the forensics speciality, and there is a lot of burnout.”
‘This country needs pathologists’
Dr Rao estimated there were up to 200 pathology students between year one and year three groups at the UWI. He noted, however, that clinical fields of study were more attractive to many students specialising in branches of medicine, given the financially rewarding nature of these careers.
Rao said while forensic pathology was an exciting field of medicine, it was also challenging given the demanding nature of investigations.
“It’s a career that you must have the correct attitude and aptitude to be a part of. It’s something where there are a lot of investigations, and you have to have that mindset that you are working on something that requires follow-up analysis.
“It’s something your country needs now, but you also have to be prepared for the challenge of the work.”
Rao said once a student has earned their Medicine and Bachelor of Surgery (MBBS) degree, it would take them roughly six years to specialise as a forensic pathologist. This can be earned locally, or students can receive further accreditation at institutions abroad; however, some institutions require that candidates have, in addition to their medical degree, some experience in forensic pathology as an entry requirement.
One local pathologist, who has years of experience performing post-mortems, said there was a severe shortage of qualified forensic pathologists and called on the authorities to make the field more attractive.
“The pathologists need to be compensated properly. If not, then the position and discipline aren’t going to be attractive, medical students will go to other disciplines; they will go into OB-GYN (obstetrician-gynaecology), or surgery, or something that is more high-paying than coming to this profession where you have to deal with the dead or decomposing bodies. Nobody is attracted to that.”
The individual could not say exactly how much a forensic pathologist in T&T is paid, but estimated it is less than $60,000 per month.
A 2015 Guardian Media report noted that a former pathologist at the Forensic Science Centre, Dr Valery Alexandrov, worked for a basic salary of $26,300 per month. Also included in Alexandrov’s contract were a $2,700 transport allowance, a $10,000 duty allowance for extended work hours, an incentive allowance of $10,000, a telephone allowance of $350, and a housing allowance of $5,000.
Dr Latchmansingh agreed that finding students interested could be difficult given the nature of the job.
“We have medical students who come into the mortuary as part of their rotations; some of them are fine and are very interested, but some people want to pass out; they get very queasy, so it takes a certain personality who will want to do autopsies.
“We see everything from people who were ailing, we also have people who have crushed injuries, burn injuries, and people who were found dead in a river somewhere bloated, so each patient is different.
“People like me might find it exciting on a day-to-day basis, but not everyone has the stomach for doing autopsies.”
The payment of the salaries owed to pathologists has also been an issue on at least one occasion. In March 2018, a video of forensic pathologist Dr Hubert Daisley was shared on social media, which showed him visibly disgruntled over an apparent non-payment of money owed to him outside the Tobago Mortuary.
In the video, Daisley was heard saying, “I come here religiously and do the blasted work, and what happens? Playing the fool with me.”
As of Friday morning, the murder toll was 384 compared to 364 for the same period in 2023. For August, thus far there have been 36 murders, compared to 27 last year.
With almost daily murders and multiple murders, the final figure may cross 2022’s record of 605.
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