Neatly laid out on steel tables in the dissection hall at the University of KwaZulu-Natal’s medical school are 20 plastic-wrapped cadavers — to be used by second-year medical students this year.
The lump in one’s throat is knotted with the room’s antiseptic sterility and memories of director George A Romero’s zombie films.
But less irrational responses to death — ranging from the cultural to the personal — are equally capable of leaving Hoosen Vawda, head of anatomy at the Nelson R Mandela medical school, anxious at the start of each academic year. He says not enough people in KwaZulu-Natal are donating their bodies to the medical school.
Says Vawda: ”When you ask whether someone wants to donate their body to ensure scientific endeavour many get flushed and evasive. Others are repulsed. This negative impression is common, no matter what religion people subscribe to or their community.
”There’s been a slight increase in cadaver donations, but our student intake has increased 100% over the past 12 years so we always have a shortage of cadavers for students to learn from,” he says.
Vawda says that the migration of donors from KwaZulu-Natal to other provinces, especially the Cape, means further potential cadavers are lost to the institution because each medical school draws from its own province. Supplementing them are bodies unclaimed from public hospitals for more than three months.
The UKZN anatomy department works with 20 cadavers a year — a ratio of 10 students to a cadaver — while the medical sciences department at the Westville campus needs a further 16 annually for courses such as physiotherapy.
”The ideal is six to eight students per cadaver,” Vawda says. ”But we can’t accept bodies which suffered infectious diseases [such as Aids], unnatural deaths or underwent major surgery in the weeks before death. We also can’t accept obese people because they don’t fit into our storage containers.
”Dissecting an actual human cadaver is vital for students’ education. They get first-hand knowÂledge, so their studies aren’t just theoretical, while they’re also practising decision-making and learning respect for patients and the dead, who have nobly donated their bodies to medicine.”
For 16 years the medical school has conducted a cadaver dedication ceremony for first-year students and donors’ family members.
At last week’s ceremony Vawda emphasised to students ”the aspect of spirituality in scientific endeavour — and respect for the human body, whether it’s dead or alive”.
A solemn occasion, the ceremony also assuages the fears of donors’ relatives and prospective donors, especially with regard to disrespect for the cadaver.
Such sensitivity does not end at the dissection hall door. When the academic year ends family members are given the option of having the donor’s body cremated or buried at the medical school’s expense. The ashes are returned at a solemn ”ashes ceremony”. This week Donovan Pillay from Durban, who could not attend the ceremony, arrived to collect his partner’s ashes. A priest said a prayer and Vawda handed over the urn with a few soft words.
Keeping the dead going for longer
A cadaver sprawls out of a metal tub in the embalming room at the University of KwaZulu-Natal’s medical school in Durban.
Tubes run into the body, the extremities of which are turning blue, as if from frostbite. The skin is mottled yellow and brown.
”Twenty-five litres of the chemical mixture [which includes formaldehyde, methanol, ethanol and aromatic perfumes] goes into the body under slow pressure and the body starts swelling up. The embalming process takes about two to three days to complete,” says Hoosen Vawda, professor of anatomy at the Nelson R Mandela Medical School.
He says once embalmed, cadavers can last for up to three years if stored properly. The over R4-million facility at the medical school has capacity to store bodies, embalm and store both organs and bones for further use.
Most of the bodies received by the medical school for dissection are bequeathed. Families of donors have the option of requesting the bodies to be cremated or buried at the end of the university year.
Those cadavers that are not returned are used for further teaching at the school, according to Vawda.
Body parts and organs — ranging from tongues to the cerebellum — are cut up and stored for further dissection.
”The flesh and bone marrow is burnt away through a maceration process, until all you are left with are the bones,” says Vawda.
”The full skeletons that you see in the films are actually impossible, because the bones are held together by DNA. Our assistants then articulate the bones into a single skeleton, or the various bones are numbered and stored away,” he continues.
Due to the sensitive nature of its contents, the school’s anatomy section is under strict security monitoring with hidden surveillance cameras and identity access control.