Only three of the 16 state morgues in the Eastern Cape passed health and safety inspections between 2023 and 2024. The three are in Mdantsane (East London), Graaff-Reinet and Makhanda.

According to a report provided to Daily Maverick by the spokesperson for the Eastern Cape Department of Health, Sizwe Kupelo, the other 13 are in a dismal state, having failed health and safety inspections for several reasons: including fridges overfilled with bodies; badly maintained fridges, in some cases with cracked floors; poor management of medical waste; a lack of pest control and rodent proofing; poor yard maintenance; and poor hygiene standards.

Health Minister Dr Joe Phaahla confirmed the findings in an answer to a parliamentary question on 2 April 2024, about the inspection of forensic pathology services (FPS) across the country.

The Eastern Cape Department of Health’s FPS investigates the cause of unnatural or sudden unexpected deaths.

Former turnaround plan

A plan implemented in June 2023 by the former head of the Eastern Cape Department of Health, Dr Rolene Wagner, before she was moved to Premier Oscar Mabuyane’s “special projects team”, had resulted in significant progress in turning around the forensic service, which was in shambles.

In October 2018, the Eastern Cape legislature’s health committee first raised the alarm that the service was in disarray after an oversight visit to morgues in the province, which found significant infrastructure problems as well as staff shortages, a lack of appropriate security, the use of inappropriate personal protective equipment and no working X-ray machines for use in autopsies.

In her turnaround plan presented in August 2023, Wagner stressed the need for strict compliance with occupational health and safety guidelines. The New Brighton and Mthatha morgue received X-ray devices, and 10 oscillating autopsy saws and rib cutters were procured for pathologists in the East London morgue.

More trolleys were obtained for the Queenstown and Mount Fletcher morgues. Wagner also secured approval for 62 computers to be distributed, and funds were set aside to buy them.

Protective clothing was supplied to morgues in all regions, and uniforms were procured for 53 forensic pathology officers.

Read more in Daily Maverick: Outrage as ‘remarkable’ top Eastern Cape health official, Dr Rolene Wagner, shifted to premier’s office

As part of Wagner’s plan, 39 forensic pathology officers were trained in occupational health and safety and some in infection prevention and control. 

New drainage systems were constructed for the morgues in Kariega (formerly Uitenhage) and New Brighton in Nelson Mandela Bay, a refrigeration unit was revamped for Butterworth and a hydraulic lifter was installed for Queenstown. The Mount Fletcher facility also received a spring clean. 

A provincial intervention team was appointed to provide operational support for burial where the accumulation of unclaimed bodies was rife. This team managed to secure the burials of 152 deceased in various municipalities by May 2022. 

As a result of these interventions, the morgues started reaching their targets for autopsies performed on time (96%) and interventions were instituted in morgues that failed to meet the target.

“All facilities are ensuring strict compliance to occupational health and safety guidelines and Komani [Queenstown] region has successfully appointed an occupational health and safety official responsible for forensic laboratories, and Covid-19 vaccine and subsequent boosters have been administered to all staff members,” Wagner said in August 2023.

She added that much-needed protective clothing was supplied to all regions, including East London, Komani, Mthatha and Port Elizabeth.

To boost employee morale, the department paid out all overtime accruals for the 2021/22 financial year, except in Mthatha, and contracts for medical officers at Mdantsane, Butterworth and Woodbrook were renewed for a year. The department also selected from all four regions registered 30 forensic pathology officers for a one-year formal certificate in forensic science. 

Wagner was removed from her post as the head of the health department in October 2023 and no turnaround plan has been implemented since then.

Only four of the facilities that failed recent inspections were visited before the implementation of Wagner’s turnaround plan. The rest were visited after she had been removed from office. DM