By: Valerie Feria-Isacks
Anthropology has the ability to illustrate, identify, and
keep up with the real world, which is too complex to address within the
confines of classic socio-political theories. As a bridge between science and
humanities - culture clash, death, and issues of uneven and fragmented resource
distribution are prime examples of what it can serve to address. In
addition, anthropology’s scholarly pursuits often further denationalization of
academic dialogues so as to encourage planet-wide dissemination of ideas in
order to better understand issues that plague the world writ large.
One such issue is the conflux of the forensic method and
evidence-based medicine. In 1956 Alan Moritz reflected on this issue when he
said “He [the pathologist] may be highly esteemed by the police and by
prosecuting counsel because he is an emphatic and impressive witness. His
prestige, together with exclusive access to original evidence, places him in an
exceedingly powerful position in the courtroom… the stakes are too high to play
hunches in forensic pathology.” and this still holds as basically true. (Moritz,
1956)
Recently though concerns have been raised in several
countries about forensic sciences effectiveness, efficiency, cost and whether
it is being used in pursuit of a larger socio-political agenda not based on
impartial and/or scientific evidence. Thus auditing forensic and medical
evidence is an important task as it serves a ‘checks and balances’ role in
terms of determining efficacy of police procedure, the importance of proper
diagnosis, epidemiological and criminological trends, and subjects them to
quality control assurances. Indeed this application is particularly important
in my adoptive homeland by marriage - South Africa.
Per the United Nations, South Africa has the most per capita
sexual assaults in the world, and such violence has striking long and
short-term effects on the victim’s health. In some surveys over 25% of men have
admitted to having raped a female. The World Health Organization (WHO) states
“Health services for victims of rape have two important roles: to assist the
victim and to gather evidence for the police and courts.” Additionally the
murder rate is 4.5 times the global average, and drunk driving kills just shy
of the murder rate. Couple this with an epidemiologically significant amount of
people with HIV, and other potentially fatal illnesses – as well as a diaspora
level of emigration – it is surprising that anyone is left in the country at
all! (Jewkes R, Christofides N, Vetten L; et. al. 2009)
In an attempt to try and combat these scourges the South
African Police Service (or SAPS) in 2006 created the world’s first robotic
Genetic Sample Processing System (GSPS) in its Forensic Science Laboratory in
Pretoria. The GSPS occupies 47 meters and can effectively process 800 samples
per day – four times the previous maximum of 200 per day. As in other British
Commonwealth countries initial rape kit evidence is collected either in
hospitals, police stations, or in “care centres” – places where trained
forensic nurses, therapists, childcare providers and police work together in
one location. However in some regions of South Africa only the police station
option is available, where unfortunately they are often told not to bother with
charges because it might shame their family. Worst yet because of rampant
corruption in local law enforcement there is a euphemism called “lost files”
for when a police officer or staff working in the station requests a bribe from
the victim in order to “find” the files. (Du Mont, J; White, D WHO 2007)
Next, provided the kit actually gets to the lab - per SAPS
“all exhibits from criminal cases and crime scenes which may contain DNA are
delivered to the Forensic Science Laboratory, registered as a case and
allocated with a number. Some are processed but many are archived as suspects
have not as yet been arrested or there are no samples with which to make a
comparison.” Once there is an identified suspect the prosecutor (but in rare
instances the victim) will request that the sample be “activated” and then DNA
cross-referencing and analysis begins. When the prosecutor and/or the police
investigator give the lab the court date, then the evidence is re-prioritized
in a manner so everything is completed by the start of proceedings. This whole
process is roughly 90 days from DNA extraction (not collection) to the time the
final report is finished, thought it can be expedited when needed urgently. (De
Beer, 2006) Unfortunately the entire system seems to be colossally
underutilized. Currently the vast majority of samples are merely archived
because the prosecutor often doesn’t bother requesting the report. Mainly
because of these two factors SA is one of the few countries in the world
without a DNA “backlog” but this is not a positive indicator!
In the spirit of understanding these issues the World Health
Organization (WHO) and the South African Medical Research Council (SAMRC) -
separately and in concert with each other and/or others, have done several
studies on what measures are effective - particularly in relation to
gender-based violence, murder, and HIV/Aids. Studies have utilized the analysis
of rape kit collection procedures across multiple venues, morgue/autopsy
reports, court proceedings documents, biological samples, drug tests, and
epidemiological surveys.
My first report read is a dispiriting look at femicide by
analysis of forensic measures in relation to case progression and conviction
outcomes where the court dockets and all forensic records were meticulously
analyzed. The study did show an improvement of DNA process speed post-GSPS implementation.
However it also pointed out that doing full autopsy is a mentally exhausting as
well as time intensive procedure, which cannot be automated. Furthermore that
study indicated that in “21.5% of cases the perpetrator was convicted the
[major] factors associated with a conviction for the female murders included
having a history of intimate partner violence, weapon recovery [including
ballistics] and a detective visiting the crime scenes…None of the forensic
medical activities increased the likelihood of a conviction.” Later this same
study showed finger scrapings had a slight but statistically significant
correlation with conviction – all of which has been corroborated in some of the
other later studies I read. (Abrahams N, Jewkes R, et.al. 2011)
The most stupefying thing discovered though was
that laboratory quality control measures don’t improve the efficacy of forensic
techniques impact on the court-room. In this and other reports from 2007-2011
there was a bit of a failure to take a page out of socio-cultural anthropology
and ask larger questions such as – What do the family/friends (and in South
Africa one must frequently ask Tribe) feel about the forensic processes in
terms of giving them closure? This is particularly weird in light of the fact
that the Netherlands, UK, and US studies that inspired the South African ones
there is an effort to analyze not just forensic science and case outcomes – but
also more of an effort to examine the socio-cultural factors as well. (Abrahams
N, Jewkes R, et.al. 2011)
Another key study looked at 226 sexual offenses perpetrated
on children as well as adult females in the Johannesburg area from January 2002
to June 2003. It determined that 13% of the cases had no forensic report
attached to them at all, and that even in the 23% that did have a complete
forensic report there was no evidence that a single report had even been read
at a trial! (Blass 2004) Most of the others I read had similarly depressing
results.
Contrasting this is that in newspapers and other
non-scientific publications several people involved with these studies
regularly comment on such issues. In fact one of co-authors of multiple studies
- Dr. Rachel Jewkes is quoted in The Guardian as saying "The social space
for debating these gender issues is now smaller than it was a few years ago. We
need our government to show political leadership in changing attitudes. We need
South African men, from the top to the grassroots, to take
responsibility." (Smith 2009)
It is interesting to note that since the completion of the
recent scientific improvements related to the processing of DNA evidence – for
example it can now be effectively collected up to 96 hours after an incident.
In response to these changes and internal pressure from various lobbying groups
South Africa law has changed to so that there is currently no legal time limit to the collection of
physical evidence and there is no longer a need for corroboration of a woman’s
testimony in cases of sexual violence whether paired with murder or not.
Moreover any healthcare personnel who examined and/or collected evidence from a
victim may testify in court. Per WHO effective additional examinations
typically comprise actions such as “acquiring victim consent to process the
previous evidence, taking the medical and sexual assault histories, documenting
medico-legal findings, and carrying out treatment guidelines.” (Du Mont, J;
White, D WHO 2007)
Another related concern is firearm based crimes. Firearms
feature in South African masculine culture where one’s manhood has long been
tied to weapons ownership. Previous to European colonization the spear was the
weapon of choice but since then the firearm has been the de rigueur status
symbol. South Africa has the third worst rate of firearm deaths (26.8/100,000)
worldwide - in fact some years it’s the second leading manner of death and
always the leading cause of ‘violent’ deaths.
Though men are the majority of victims of firearm related
deaths, their availability also features in the correlation between femicide
and suicide. About 83% of femicides are committed with a firearm and within
seven days of murdering their loved one about 19% of wrongdoers commit suicide,
usually with the same firearm. Statistically speaking a gun in the home is less
likely to be used to protect family members than in harming them. Estimates
show that the rate of females killed by shooting to be 7.5/100,000 more than
four times the US. Indeed, the intimate femicide firearm rate of 2.7/100,000 is
higher than the overall US statistics of females killed by firearms period!
Utilizing homicide firearm data from 2001 to 2004 the
National Injury Mortality Surveillance System (NIMSS) study collected data from
mortuaries in all four major cities (Cape Town, Johannesburg, Pretoria and
Durban). Using statistical regression they tested whether any changes occurred
due to the implementation of the Firearms Control Act (FCA) of 2000. Findings
showed a decline in homicide did occur afterward - a fast decline in firearms
based homicides and a slower decline in regular homicides as well! However, the
femicide rate is still about five to seven times more than that of the US
showing that supplementary endeavors are needed in this direction.
There is some hope for other applications of forensic
anthropology/medicine such as in the fight against HIV/Aids. In fact a recent
study of autopsies which was primarily done in order to gain basic
‘cause/manner of death’ statistics noticed an interesting comorbidity
correlation between HIV and tuberculosis – leading to further more specific
epidemiological studies showing that TB is the leading cause of death among
people infected with HIV even when on antiretroviral therapy (ARTs) as
antiretroviral don’t do much in the way of counteracting TB. (Byass P, Kahn K,
2010)
In conclusion: in South Africa only two forensics procedures
seem to have discernible positive outcomes in relation to sexual violence
and/or murder (ballistics and finger scrapings) so the application of forensic
anthropology/medicine there has had a mixed bag of results. It does seem that
on the social aspects that as the general public awareness of such activities
plays somewhat in decreases in firearm crime. As well there is a non-profit
organization simply called “The DNA Project” currently lobbying to pass a “DNA
Bill” which would make is compulsory for all those convicted or arrested to
have their DNA profile entered onto the Pretoria database so as to compare
crime scenes trace and rape kits – which should lead to more frequent matching
and more effective use of the GSPS. The bill also calls for the creation of a
second laboratory in the Cape Town where sexual assault and drug crimes are
most heavily concentrated. Additionally the analysis of mortuary data has at
least accidentally found out that co-morbidity of HIV with Tuberculosis is
basically a death sentence, thus enabling the medical establishment to do
something that it might be able to improve conditions. In the end it seems that
despite relatively forward thinking laws and modern scientific equipment
unresolved social issues – such as sexism, racism, poverty and law enforcement
corruption – as well as a need to train more healthcare personnel in forensic
procedure are to blame for the lack of efficacy.
Ideas for further research:
What are the perspectives of the police investigators and/or prosecutors
toward forensic science? What’s preventing prosecutors from asking/using
forensic reports? How does one improve the sensitivity of law enforcement
personnel? Clarification of the socio-cultural reasons that affect the
adherence to proper collection procedure on initial examination? What is the
value and meaning of the post sexual assault examination for victims and/or
their community? Under what circumstances are which forensic tools most valuable
(case adjudication, psychological, etc.)? How to prioritize resource allocation
given budget constraints? What kind of training would best serve those in the
healthcare community become more efficient in collecting evidence for crimes
such as rape, assault, muggings, etc.? Could the marketing of ‘consensual sex
culture’ as more masculine and pleasurable than ‘rape’ help to change cultural
attitudes that permeate current society? Who is prone to committing femicide
and thus shouldn’t be allowed gun ownership?
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