We are sitting in her brand-new office at the Observatory Forensic Pathology Institute (OFPI). This completed building, with its modern medical equipment, laboratories, 405 body spaces, teaching auditorium, bereavement centre and more, was her brainchild. It is not just a forensic pathology morgue; it is a place of learning for students.

It was Martin who had the idea for this institute when she became the first female head in the country of forensic medicine at the University of Cape Town in 2004. In 2012 she started in earnest with the task of building the OPFI. 

This is her legacy.

After graduating as a medical doctor from Wits University, her first job was as a district surgeon in Hillbrow. The year 1996 was life changing. She got a job as a registrar in forensic pathology where she he worked mainly at the Diepkloof mortuary.

“I did 849 cases. I still have my book with all their names and causes of death,” she says slowly and takes a breath.

Many of those people were women who died due to gender-based violence.

We sat and tried to put them together. All the bits, smaller and larger ones. It was horrendous.

But, “life interfered and in the middle of 1997 I came to Cape Town, for a woman,” she laughs. “Some of the very first cases in Cape Town were the bombs. I have a book of all the incidents [bombing] which were not reported in the news. There were hundreds and quite a lot of people died. I was part of a team on this…” She hesitates to say more.

“It was exciting and I was young. I wanted to do all these things and my boss [Professor Deon Knobel] allowed me. There were few of us working at the Salt River Mortuary, so we had to get on with it.”

During this time she had to cope with her worst case to date. It stands out from the estimated 10,000 bodies she examined during her career. Making direct eye contact with her intense blue eyes, she slowly starts to tell what happened. 

“Two children were going down water slides. The gates to the pump station were left open. The force was so great they were sucked inside the system. They were mangled. Churned up. And then went back down the slide into the pool.

“The forensic pathology team had to collect all the pieces in the pool with nets. I was called to the morgue where two body bags were delivered. We sat and tried to put them together. All the bits, smaller and larger ones.

“It was horrendous.”

Evil

Martin was born in 1965 in the small town of Jarrow, Northumbria in England. As a child she lived with her parents and sister in Zambia, Malawi, Benoni and Boksburg, but always went to Catholic schools. A strict conservative upbringing.

Walking in the darkest places of humanity, she has much to say about it.

“My reality is that people are just fucking evil. We need to somehow bring back the empathy and sympathy. The kindness. Especially in South Africa, life is not worth much. The incompetence of the last 30 years has made it even worse.

“We now medicalise certain things. When actually it is not a pathology: You are just an evil shit. When I was a district surgeon I used to ask: Why did you rape? No one had a reason. The reason is because they could. Why do you kill? Because you can. It is like filters have been taken off,” she says with conviction.

Read more in Daily Maverick: Women in health – ‘No one taught me how to treat a sick system’, says leading young prof

This reminds me again of Martin’s inaugural lecture as professor in 2011. The title was “No Woman No Cry – a journey into forensic pathology services and violence against women”. A lecture I never forgot. She spoke about the war on women. But then, with prior warning, she showed those in attendance pictures of the bodies (hiding the faces) of women who had been raped and murdered.

And that is what all South Africans should see. This I have intrinsically believed ever since her powerful lecture. We should physically witness what is done to women during gender-based violence. See the evidence to pluck us out of our comfort zones and ignorance.

Maybe then all the victim blaming, the baseless comments and the stereotypes will fall away.

Sizzlers massacre

She speaks about the Sizzlers mass murders of January 2003. Nine men were murdered and one was severely injured in an ordeal that lasted at least three hours. The victims were bound, tortured, had petrol poured over them and shot in the head, execution style.

The murderers were Adam Woest and Trevor Theys who claimed the motive was robbery, but many believe the act was a hate crime against the gay massage parlour. 

“Sizzlers was one of those cases… I suppose it was almost a defining moment for me.” As a lesbian woman she identified closely with the victims.

Martin went to the scene to see the evidence. “There was blood everywhere. They were tortured. It was the identification and dealing with the families that took a lot of time.

“I remember a mother who came in with a friend to identify her son. She said: ‘That is not my son.’ The friend of the victim said it was definitely him. She was in complete denial. Even when she was shown a birthmark, she denied it was her son.

Read more in Daily Maverick: The good doctor – Mark Blaylock on finding meaning back at Manguzi Hospital

“Eventually I found another mother. She told me: ‘You can have him. Do whatever you like with him.’ She did not want her son’s body.” 

Martin becomes silent. This work is not impersonal. It cannot be.

She attended one of the church services for a Sizzlers victim in Cape Town. “It is crazy, but that is what I did. Ja, I had to do certain things, it made me feel better. I needed to have something, you know? The ritual of the church.

“And then there are many, many other cases. There are things, once you have seen them, you can never, ever forget it.”

Don’t expect Martin to use euphemisms like ‘passed on’ or ‘demised’… ‘You are dead, you died, or you have been murdered.’

How does she manage not to internalise everything, or to distance herself from the trauma? “I think I have internalised it. I went to therapy on and off for a very, very long time. Pretty much everything is in a box and I keep the box there [pointing to a faraway place] for as long as I can. I never unpack the box, but people want to know.

“But my wife [Elaine] hears things. I get phoned at night; she hears me shouting on the phone. I can hear her telling people that she never knew what my work entails. Maybe that is a good thing?

“I don’t know where all it goes? Introspection maybe. We talk about it at work, which is maybe our saving grace.”

Talking about death is easy for Martin. She is comfortable with her own mortality, but knows that most people are not. “It is one of my party tricks to talk about death, to make people uncomfortable. I am not ready to die yet, but I am not scared.”

She helps people to talk about death, especially those who struggle with it. But don’t expect Martin to use euphemisms – which she hates – like “passed on” or “demised”. “You are dead, you died, or you have been murdered.”

The need to know

Yes, one gets used to a lot of things, and forensic pathologists choose this career because they want to know things. “But one does not get used to everything and you learn as you get older. How to respond and what to say. Often doing nothing is the best. I do talk but often I am very blunt in a nice way. If I can, I do spare families some of the details. The fact that a family can talk to the pathologist who dealt with their loved one, has so much meaning. It can also be just a phone call, because it is someone tangible, because people want to know what we do.”

In this building they have beautiful state-of-the-art identification rooms. One cannot touch the body before the examination has been done, only afterwards when it is released.

To get any result, including from an autopsy, does not take half an hour. It is not CSI. Since 2021 the cases they have dealt with – all unnatural and sudden unexplained deaths – have increased. These include homicides, suicides, vehicle and other accidents, medical errors, alcohol intoxications, drownings and drug overdoses.

The area under her is the Southern and Western Metropole of Cape Town as far as Atlantis and they perform 15 to 25 autopsies per day, with a turnaround of three to six days.

Is she a cynical person? ‘Ag, you know what? Yes. I have every right to be.’

In 2022/23 the facility performed 4,263 post-mortem examinations. In the 2023/24 financial year they have already received 4,534 cases, with about 4,800 projected. For the next year more than 5,000  cases are expected at both Tygerberg and the OFPI.

“The days where we were able to clean out are gone.

“What we do is medical-legal post mortem examinations. That is from the scene until the end of the court case [if there is one]. We can decide to open the body or not, that is a post-mortem examination, which includes a lot of evidence, more than an autopsy. More often than not, an autopsy is done during a post-mortem examination. By law we can do whatever we like, as long as we determine the cause of death.”

If it is part of the evidence, by law they can keep anything, without consent. Even when those in power try to threaten them. 

Read more in Daily Maverick: One year after leaving Zithulele Hospital, Doctor Ben Gaunt reflects on his journey in public healthcare

Is she a cynical person? “Ag, you know what? Yes. I have every right to be, for many reasons and not because I am a forensic pathologist. For being white in South Africa, growing up as a lesbian, with conservative parents during apartheid.”

What Martin hates most in life is incompetence. “So, am I angry every day at work? Yes! Just get it done, not with my staff but the system of governance. I must write a book to get something. Red tape and bureaucracy.

“I am in a privileged position and that is not white privilege. Now, 30 years later, I deserve to be in this position. When you get to a certain stage in your life, where you command the respect and the gravitas of the people who are asking you things. 

“I am comfortable where I am now, and before I was not. It has taken me ages to feel this way, with a lot of introspection.

“In 2019 I was off for six months with my depression. I was diagnosed in 1996. It was an accumulation of many things and our caseload going up. That did me very well actually. I worked through myself.”

Indeed. DM