Dr Ekeroma responds to Editorial on forensic pathologists

28th March 2023



 Your editorial of the 10th March 2023 entitled “enough of the rhetoric on forensic pathologist” deserves a different perspective.

The editorial quite rightly referenced the outrage when deceased bodies were in the morgue for prolonged periods causing delayed justice and bereavement.

The delay in pathology exams was linked to the absence of a local forensic pathologist or the appointment of one. The link is tenuous. We do not have a cardiothoracic surgeon and there have been no issues with people needing heart surgery.

Upon completion of your undergraduate degree – Bachelor of Medicine & Surgery, it takes an additional four years to train a general pathologist and then another one to two years to sub-specialise in forensic pathology. To become a forensic pathologist would take at least ten years of study and training. The days when a general pathologist can do a postmortem examination are gone.

The only pathologist referenced in previous editorials who returned with a Masters degree would not have been able to do one. She was not a forensic pathologist.

Forensic pathologists, like most subspecialties in medicine, is a rare human resource in the Pacific Islands. Most Pacific Island countries do not have a general or forensic pathologist and the general pathologist we have is contracted from Fiji paid by a development partner. As mandated by law for police cases, only a forensic pathologist can carry out a post mortem.

The current arrangement for a forensic pathologist is facilitated by the Ministry of Police and the Office of the Attorney General. The economies of scale will not allow every Island to have its own airline, own shipping line, own university and own pathologist, let alone a forensic one.

There were only five forensic pathologists in New Zealand in 2016 with two in training. That is a ratio of one forensic pathologist to 940,000 people.

What needs to happen is for Pacific Island countries to share rare resources coordinated by the Pacific Forum, Pacific Community and the many regional governance frameworks and groupings. When we add New Zealand and Australia as Pacific Countries into the mix, then we will a substantial volume of specialists to draw from.

Two weeks ago, we had a group of paediatric surgeons from Australia and NZ on Island changing the lives of 17 children. And then the following week, we had plastic surgeons providing surgical care for 30 dialysis patients. This week, we have a group of orthopaedic surgeons.

An arrangement can certainly be made with all Pacific countries, including Australia and New Zealand, to provide a forensic pathogist for our forensic examinations on a monthly basis or when there is a spate of homicides. This is a discussion that can take place in the near future.

As a way forward, the Ministry has two junior doctors in pathology and we are currently looking for postgraduate opportunities.

Aiono Dr. Alec Ekeroma ONZM


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