PRACTICE OF FORENSIC MEDICINE – THEN AND NOW

L.B.L. De ALWIS Retired Chief Consultant Judicial Medical Officer, , Sri Lanka Founder President of the College of Forensic Pathologists of Sri Lanka.

This article titled “Practice of Forensic Colombo-Kurunegala main road close to Medicine - Then and now” covers a period Alawwa. There was a bloated decomposed of 33 years commencing from the year body of a male lying on a ‘Messa”, a make- 1974 to the year 2007. The year 1974 refers shift autopsy table in village style. At that to the year that I carried out my first post- time police constables wore shorts. One mortem examination as the acting District such constable was carrying a shot gun Medical Officer of Alawwa in the possibly to prevent the body from being Kurunagala health division. The year 2007 attacked by several ‘Kabaragoyas’ who refers to the year of my retirement when I were roaming about the ‘Messa’. I was carried out my last of over 11,000 post- also in mortal fear that the Kabaragoyas mortem examinations. During a carrier of would attack me as well, during the post- over 35 years as a government medical mortem examination or there may be a officer of which 32 years were as a full misfire hitting me as the police constable time Judicial Medical Officer (JMO), the carrying the gun appeared to be drunk and last 15 years as the Chief Consultant JMO unsteady. However, I carried out the post- Colombo. mortem examination and arrived at the cause of death as due to blunt cranio- In the year 1974, I was a preliminary grade cerebral trauma. medical officer with 12 months of service in the government. As the Medical Officer But today such a post-mortem examination in charge of the peripheral unit Talampitiya would not be carried out even by a senior in the Kurunegala health division, I was District Medical Officer but referred to the very often called upon by the health Provincial Judicial Medical Officer or even authorities to cover up the medico legal to the chief JMO Colombo when the work at the District hospitals Polgahawela provincial JMO is not available causing and Alawwa. On the day that I carried out much inconvenience to the relatives and the my first post-mortem examination, District police officers. Medical Officer at Polgahawela and Alwwa had reported ‘sick’. This was the I assumed duties as the Judicial Medical system in those days whenever a murder Officer of General Hospital in case was reported in the district. So 1975. The situation was the same as in the naturally I was served with the post- year 1974. No Medical Officer in the entire mortem order at which time I was engaged Gampaha heath division was willing to on a “shramadana campaign” in the carry out post-mortem examinations on hospital compound with my hospital staff. cases of murder. Once I visited a scene I could not “report sick” for obvious where a body was hanging from a tree. The reasons even though I would have very relatives and the villages were of the belief much liked to have done so. that it was murder and post-mortem suspension. After the post-mortem I went with the police to the “scene of examination when I expressed an initial murder” which was on the banks of the opinion that it was a case of suicide, the Ma-oya at Walakumbura bordering the people turned ‘hostile’ and they even

Sri Lanka Journal of Forensic Medicine, Science & Law 2010 Vol.1 No.1 4 destroyed the ‘edanda’ along, which I came until the arrival of the senior police to the scene. I was carried over the stream investigators, the magistrate, the medical by police officers on my return. officer (DMO / JMO) and the forensic scientist. I assumed duties as an Assistant Judicial Medical Officer, Colombo in 1980. Prior to the enactment of the administration Considering my experience in field post- of judicial law (AJL) in 1972 medical mortem examinations in the past, I was of officers had to appear in person to give the firm belief that no post-mortem evidence in magistrate’s court and even in examinations should ever be conducted in coroners court, on oath. But since 1972, the field on a ‘Messa’. medico-legal reports, post-mortem examination reports, and other reports Today medical officers are adviced that submitted by medical officer to courts of they should not carry out post-mortem law are accepted. However even up to the examinations in the field. The scene of present day the medical officer must attend crime where a dead body is lying is today high courts to give evidence in cases of visited by a medical officer not to carry out murder, attempted murder, sexual offences the post-mortem examination but to and similar crimes. observe the scene, make notes, take photographs and also to carry out basic The AJL of 1972 also resulted in the medico-legal investigations that would help abolition of non summary trials in cases of to establish the cause of death, manner of murder, attempted murder, sexual offices death, time of death and to collect trace and other grave crimes. The accused in the material. above mentioned cases were indicted directly in the high court. This only short This new concept of visiting a ‘scene of circuited trials but did not bring justice to death’ has also received support from the the accused. As a result of which the code Judiciary, Attorney General’s department, of Criminal Procedure Act of 1979 department of the Government Analyst and reintroduced non-summary inquiries in the Police department. Dead bodies lying respect of the crimes mentioned above. at scenes of death are today never disturbed until the arrival of the Magistrate. Dead When I first began to attend high courts, all bodies are never removed from a scene trials were jury trials. Such jury trials were until the medical officer (DMO / JMO) most interesting. It was interesting to see as makes his observations. Further, in most to how the seven jurors were empanelled at cases of deaths due to explosions and times with objections from the defence firearms where bodies are lying at the counsel and the prosecuting counsel. The scene, the Government Analyst visits the presiding judge’s initial address to the jury scene to make his observations. In the year on the concepts of law such as ‘You are the 2005-2006 the Government of Sri Lanka in sole judges of facts”, “Proof beyond collaboration with the Swedish police, reasonable doubt”, “Innocent until proven trained doctors, state prosecutors, forensic guilty by your verdict”, “You are however scientists and police crime investigations duty bound to adhere to the legal directions with regards to the importance of a scene of given by me in analyzing evidence and crime in crime investigation. coming to a verdict”, still ring in my ears even after my retirement. This was Today the first personnel to arrive at a followed by the opening address of the state scene of crime where a dead body is lying prosecutor. Such jury trials continued from are such specially trained police officers day to day. The trial concludes with the referred to as Scene Of Crime Officers final addresses to the jury by the (SOCO). They will preserve the scene, prosecuting counsel, defence counsel and conduct the relevant initial investigation finally by the presiding judge. The

Sri Lanka Journal of Forensic Medicine, Science & Law 2010 Vol.1 No.1 5 crowning moment of a jury trial was the suspicious deaths, deaths in police custody, verdict given by the foreman of the jury as prisons and mental hospitals etc. must to whether the accused was guilty or not necessarily be inquired into by a guilty. Wild scenes follow after the verdict Magistrate. of “guilty”. In 1975, the year I took forensic medicine Today we hardly hear of any jury trials. I as a career, most of the medico-legal work wonder whether lawyers defending accused in the country was carried out by district in criminal cases have ever explained to medical officers. They had no special them the legal standards required to prove training and knowledge in the field. But their guilt. Such non jury trials take months yet their evidence was sufficient to sentence or even years to be conducted by which an accused to death. Even in the year 1992 time most often the principle witnesses are when I assumed duties as the chief JMO, dead or the accused persons are dead. To Colombo there were only four consultants avoid such long delays in the conclusion of in the ‘health department’. However I am trials which often leads to a miscarriage of proud to state that when I retired as the justice, the Attorney Generals department Chief JMO, Colombo in the year 2007, in consultation with the judiciary there were nearly 50 consultants in the field introduced the concept of “Trial-at-Bar” in of forensic medicine. cases of grave crime which includes murder. Such trials are held before their In the year 1980 when I assumed duties as judges of the high court on a day to day an assistant JMO, Colombo, I had with me basis and a verdict given without delay. only the 1949 edition of the text book of The first of such trails in which I gave forensic medicine authored by Sir Sydney evidence was the case of torture and murder Smith. But since then several text books of Attorney-at-Law Wijedasa are available. These includes texts by Keith Liyanarachchi in the year 1986 while in Simpson, Bernard Knight, Keith Mant, police custody. This was followed by the Eckert, DiMaio & Diamio, Adelson, case of rape and murder of school girl Gradwhol, Polson, Gee, Mason, Mclay etc. Krishanthi Kumaraswami and the murder almost all of whom were professors and of her mother, brother and neighbour all by world renowed figures in forensic “strangulation” in the year 1996 at the medicine. The earliest text book in forensic hands of army personel at a check point in medicine in Sri Lanka was published by Jaffna. The last of my such cases where I Prof. N. Saravanapavanandan in the year gave evidence at a “trial-at-bar- was the 1982 titled “Medico-legal aspects of murder of the high court Judge, Mr. Sarath injuries”. This was followed by text books Ambepitiya in the year 2004 by drug by Prof. Niriellage Chandrasiri (Ruhuna) agents. In the latter two trials all accused and Prof. C.J. Babapulle (Peradeniya). The were found guilty and sentenced to death. writer (Dr. L.B.L. de Alwis) has already published two texts titled “Medico-legal Up to the year 1979, inquest into deaths aspects of injuries” (Vol. I) and “Forensic such as suicides, fatal road traffic accidents, Pathology and Science” (Vol. II). Two all other forms of accidental deaths, more texts by the writer titled “Forensic homicides, deaths in police custody, prisons Toxicology” (Vol. III) and “Medical ethics and mental hospitals were conducted by and Forensic Psychiatry” (Vol. IV) will be inquirers into sudden deaths, most of whom published soon. were political appointees even without basic education. Yet they held ‘inquests’ In the year 1995 the University of Colombo even into the most complicated murder commenced a course in forensic medicine cases and even gave verdicts. Thanks to for lawyers leading to the Diploma in the enactment of the Code of Criminal Forensic Medicine and Science. It is Procedure Act of 1979, all cases of murder, conducted even today. The number of

Sri Lanka Journal of Forensic Medicine, Science & Law 2010 Vol.1 No.1 6 diplomates are around 112. In the year evolution of the type of terrorist bombs. 2009, the University of Peradeniya Hand carts, pedal cycles, motorcycles, cars, commenced a similar course for lawyers vans, tractors and lorries were used much and judges. Such courses in forensic later. Finally was the human bomb referred medicine have been very useful to judges, to as the ‘suicide bomber’ was developed state prosecutors and criminal lawyers to where females predominate over males. understand medical reports and medical However this was not the end, for last of evidence. This has indirectly resulted in an the terrorist bombs was the use of a ‘home- awareness among medical officers to made aircraft’ loaded with explosives upgrade their medico legal knowledge. manned by a suicide cadre. This crashed into the Inland Revenue department Most of the murders up to the year 1985 building in early 2009 missing its target, were by the use of blunt weapons such as which was the Air-force headquarters clubs / iron rods or cutting weapons such as situated across the road. swords / knives. Firearms used were invariably shot guns or ‘galkattas’. The The gun-culture was limited to shot guns bombs used were locally made hand bombs and ‘galkattas’ (sawed off shot guns) with referred to as ‘duppies’. In the year 1986, the occasional use of pistols and revolvers. the first ‘terrorist bomb’ exploded outside But in years 1988-1989, southern the north and east in a plane about to take insurgents were using T-56 rifled weapons off to Male from the Airport to gun down and kill in broad day light killing amongst others, 14 tourists. politicians, their supporters, public servants, Thereafter ‘terrorist bombs’ exploded all academics, businessmen and innocent over but mainly in and around Colombo civilians who opposed their political killing tens and hundreds of innocent ideology. The government of the day civilians. In 1987, the Pettah Central bus retaliated even more strongly using similar stand explosion killed over 115 civilians, weapons to crush the southern insurgency. the largest number of civilians killed in a At the height of the southern and northern single blast. In January 1996, a blast insurgencies, several charred human occurred at the Central Bank, Colombo remains were found almost everywhere. killing over 90 civilians which included Almost all such “burnt / charred” bodies several bank employees and customers. were referred to me as the Chief JMO, Colombo. Post-mortem examinations In 1993, the President of Sri Lanka was conducted by me revealed that almost all of killed in a blast, while in 1994, a them had been shot dead on the head and presidential candidate along with several the bodies burned thereafter. top politicians of the party he represented were killed by a suicide blast. Over the Sri Lanka has also had a fair share of major years such suicide bombers have killed mass-disasters due to aircraft accidents. several politicians, including cabinet The first notable crash occurred in ministers and security personnel outside the December 1974, when a Martin Air DC 8 war-zone. In the war-zone, several aircraft chartered by Garuda Indonesian thousands have been killed on both sides. Airways carrying 182 Haj pilgrims crashed This massacre of ‘Innocents’ continued till into the 5th Mountain in the seven virgins May 2009 when the “terrorist” organization mountain range at Maskeliya killing all responsible for such murders was passengers and crew. Again, in the year decimated by the Sri Lankan security 1979 Caledonian Airways carrying nearly forces. 200 Haj pilgrims crashed at Kimbulapitiya amidst a coconut estate when trying to land The initial “terrorist” bombs were parcel at the Colombo International Airport killing bombs like the Air Lanka, CTO blasts etc. all passengers and crew. In these two Over the years there was a progressive major disasters none of the dead were

Sri Lanka Journal of Forensic Medicine, Science & Law 2010 Vol.1 No.1 7 identified. The causes for their deaths were examination. The opposition wanted an never established and even the cause for the ‘observer’ to be present at the post-mortem disaster was not scientifically identified examination. The ‘observer’ named was according to the International Civil the same person who appeared as the Aviation Organization (ICAO 1970). It ‘observer’ in the 1986 death in custody of was the Tsunami disaster in December the Attorney-at-law. I rejected the request 2004 killing 30-40,000 Sri Lankans and for the presence of an ‘observer’ and many tourists that paved the way for the carried out the post-mortem examination establishment of a Disaster Victim with the additional JMO, Colombo and Identification (DVI) programme for Sri gave a conclusive report that there were no Lanka with assistance, mainly from the evidence of torture or death by physical European Union and Great Britain. This violence and that the death was due to DVI programme has been in operation in ‘drowning’. Sri Lanka since then in the identification of armed forces and innocent civilians who A unique situation arose in December 2003 have been victims of terrorist bombs / when a highly respected Sri Lankan attacks since then. Buddhist priest died during a visit to Russia to be conferred a ‘degree’. It was alleged From time immemorial, post mortem that the death was due to a ‘Christian examinations were conducted by a single conspiracy’. The body was brought to Sri medical officer. His reports and evidence Lanka and the post-mortem examination were the only evidence before a court trial. was conducted in the presence of the four However the presence of a 2nd medical most senior forensic pathologists in the officer as an ‘observer’ during a post- country along with a consultant mortem examination first arose in the year cardiologist. The report given by the panel 1986 when the Bar Association of Sri on the same day concluded positively that Lanka requested the Magistrate who held the death was due to ‘Ischaemic Heart the inquest into the death of Wijedasa Disease’. This helped to diffuse what Liyanarachchi, an Attorey-at-law who died would have been otherwise an “explosive in police custody. This post-mortem situation’ possibly leading to ‘religious examination was infact conducted by me as riots’. the Deputy consultant JMO, Colombo. All what the ‘observer’ did was to get a copy of In the past almost all forensic science my full report and submit it to the investigations pertaining to post-mortem authorities who appointed him as the examinations were carried out by the ‘observer’ as if it were his own report. This Department of the Government Analyst in was the first and the last time that I allowed Colombo. This has resulted in very long an ‘observer’ to be present at a post- delays in obtaining reports from the mortem examination conducted by me or Government Analyst. Today however any of my assistants at the mortuary of the there are provincial sub-units of the JMO, Colombo. At the beginning of my Government Analyst department somewhat article I referred to my last port-mortem minimizing delays in obtaining reports. examination during 2007, the year of my Furthermore, many forensic science retirement. The body was that of a investigations are carried out by the Maldivian national, a dissident of the then medico-legal laboratory of the JMO Office, Maldivian president, whose dead body was Colombo. These include basic toxicology, found floating in the sea after arrest by alcohol estimations, serology, biochemistry Maldivian police. So naturally the and diatom studies to name a few. opposition to the Maldivian president alleged torture and murder and disposal at Histopathological studies were little heard sea. The body was referred to me as the of in the past. But since the year 2000 all Chief JMO, Colombo for the post-mortem consultant JMOs carry out their own

Sri Lanka Journal of Forensic Medicine, Science & Law 2010 Vol.1 No.1 8 histopathological studies in determining the who conducted the post-mortem causes of death and express opinions examinations. relating to the death. As a result of which, our forensic pathological services are The instalment of mortuary coolers is again almost on par, with the rest of the countries something good for the future. The first in the region. time that I ever saw a mortuary cooler was in the year 1980 when I assumed duties as The most singular forensic science AJMO/Colombo. But since then several investigation of the present time is the other teaching hospitals, general hospitals, DNA studies. Such DNA technology has and many other district hospitals and even helped in the conviction of murderers in the other hospitals carrying out medico-legal Hokandara murders where five persons of work are provided with mortuary coolers. the same family were killed and all young But sadly, most of these coolers females sexually abused. DNA technology ‘malfunction’ as they are not ‘maintained’ was also useful in identification of the by the health authorities. assailant of High Court Judge Mr. Sarath Ambepitiya. But sadly there is no forensic What I have mentioned above are some of DNA laboratory in Sri Lanka. Studies are the major advances and achievements in carried out by a private laboratory forensic medicine over the past 3 decades. (Genetec) and the Department of Molecular But there are also areas of decline over the biology of the University. same period. I remember the early period of my career as a JMO, when I appeared in Until recently medical officers hardly took court to give evidence. At that time there any photographs at scenes of crime, during were special seats for medical officers in autopsies or clinical examinations. Often a the well of the court to the left and close to police photographer would take a few the judge’s rostrum. Today there are no ‘shots’ at the scene. But today most such seats. Even as the Chief consultant medical officers carrying out medico-legal JMO, Colombo I often stood at the entrance work have their own digital cameras which door of the court for want of a chair, for are used at scenes of crime, during post- several hours waiting for my case to be mortem examinations and clinical medico- called and walk away disappointed when legal examinations. In addition, the police the case is postponed. In the good old days department also uses video recording of the moment the judge spots a doctor in the scenes of murders and various stages of the well of the court, his/her case is called and post-mortem examinations. This has evidence recorded without delay or resulted a new concept of photographic postponed promptly if either prosecutor or evidence. the defence was not ready for trial.

X-ray investigations in the past were only All what I have written above as the retired for the living. But in the year 1990, X-ray Chief Consultant JMO, Colombo are in the facilities were made available to the best interest of the medical profession, legal mortuary of the office of the JMO, profession, the judiciary and all other Colombo. Today such X-ray facilities are institutions responsible for the proper available indirectly to all mortuaries of administration of justice in Sri Lanka. This Teaching hospitals and provincial general was infact my ‘Dream goal’ during my hospitals. These X-ray facilities have been career as a Judicial Medical Officer for very useful in cases of fatal child abuse, over 3 decades. firearm victims, charred bodies etc. Infact, such X-ray evidence has been more useful than the oral evidence of medical officers

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