CITATION: Schwar, T.G. 1977. Aircraft fatality investigation as a function of a comprehensive health service. S Afr Med J, 51(7):153.The original publication is available at http://www.samj.org.za[No abstract available]Publisher’s versio

Schwar, T. G.

Stellenbosch University SUNScholar Repository

20 J ulie 1977 SA MEDIESE TVDSKRIF 153Aircraft FataJity Investigation as a Function of a Comprehensive Health ServiceT. G. SCHWAR. M.D., D.P.H., F.e.PATH., Chief Governmenr Path%oisl, Cape Town, and Professor of ForensicMedicine, University of Stellenbosch, Parowval/ei, CPHistorical Background of Public Health InvolvementThe teaching and practice of forensic pathology andpublic health on an integrated basis or as one in whichthese disciplines are closely associated dates back to theturn of the century, as exemplified by the publicationin 1902 of John Glaister's Textbook of Medical Juris-prudence, Toxicology and Public Health. In the metamor-phosis of medical training and medical practice, however,current circumstances were exploited by well-meaningidealists to bring about changes, but often with lackof foresight. The proverbial 'wind of change' is nowstarting to blow and once again the 'holistic' approachto medicine is gradually emerging.In contrast with trends in the academic sphere, theDepartment of Health has practised this ideal since thepassing of the Public Health Act, 1919, or even before.This practice is greatly facilitated by a medicolegal sys-tem which lends itself ideally to the practice of forensicmedicine and forensic pathology beyond the requirementsof the country's judicature.Statutorv Obligations regarding the Investigationof FatalitiesAircraft fatality investigations are governed, as is thecase with all non-natural deaths, by the provisions of theInquest Act, 1959 (Act 58 of 1959), administered by theDepartment of Justice. Rules regarding the reportingof aircraft accidents in general and matters incidentalthereto are prescribed by the provisions of the AviationAct, 1962 (Act 74 of 1962), promulgated by the Depart-ment of Transport. The Department of Police providesmortuary facilities.The function of the State Health Department is de-fined in broad terms of the Public Health Act, 1919(Act 36 of 1919) and is now more clearly spelt out inthe Draft Health Bill (Government Gazette, 14 July 1976).In the State Health Department the Health LaboratoryServices are responsible for, inter alia, the developmentand running of comprehensive pathology laboratory andchemicophysical services respectively, and at the sametime are charged with the rendering of medicolegalservices. The laboratory facilities are readily availableat all times to the forensic pathologist responsible forthe medical aspects of aircraft fatality investigation, andare free of restrictions, as the service is rendered by thedepartment of which he is a member.Identification of the ProblemThe medical investigator of aircraft fatalities is facedwith intriguing problems and must be in the positionto identify pre-existing, predi po ing, precipitating, con-tributing and obscure factors. many of which are sub-ject to continuous evaluation, a for example coronarartery di ease, while others have received little or nomention in recent literature, a inter alia passenger deathsoccurring during flight' and deaths due to causes otherthan pure accident. A facet not sufficiently stressed andappreciated in the investigation of non-natural deaths isthe identification of a possible murder or suicide. Abrief reference to the latter was recently made,' whereasa 'murder in the air' other than sabotage has as yetnot been proved but remains a distinct possibility.The Interim SolutionSome 4 - 5 years ago a consultative medicolegal servicewas created by the State Health Department 'for allmedicolegal cases requiring expert attention as well as forall fatal aircraft accidents'. This service was designedto ensure optimal use of existing expertise and effectivecommunication by regionalization. For this purpose theRepublic of South Africa, which covers approximately1,22 million km'. is divided into 5 geographical area.The consultants are forensic pathologists - usually theprofessors of forensic medicine in the area. They areappointed by virtue of their experience in the investi-gation of unexpected death and the broad spectrum ofnon-natural deaths, and by virtue of their experience incourt at murder and culpable homicide trials and at in-quest proceedings, where cases of fatal accidents a~dsuicides are generally presented. They are therefore Inthe best position to sense any abnormal circumstances orconditions which may lead to the correct identificationof cases in which the obvious and expected did nothappen.The FutureTo meet the increasing challenges of the expandinghorizons of the future, development must be aimed atthe effective co-ordination, on a national plane, of thefull spectrum of services, the training of professionaltechnical personnel, and of research in relation to ne~dsand resources and must continue to be based on the pnn-ciple of a service as a function of a comprehensive healthservice.REFERENCEI. leading Article (1976): Brit. med. l., I, 29-.2. leading Article (1976): Ibid .. I. 168.

Aircraft fatality investigation as a function of a comprehensive health service

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Aircraft fatality investigation as a function of a comprehensive health service

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