Poor health policy: ‘Shortage of trained MLOs compromising patient care’

Need stressed to define the legal status and range of responsibilities of MLOs .

HYDERABAD:

With the incidents of crime rapidly increasing across the country, there is a dire need to invest in the hiring and training of medico-legal officers (MLOs) to ensure proper handling and documentation of medico-legal cases.

The statistics collected from the Directorate of Health showed that Hyderabad, Benazirabad and Larkana are facing a shortfall of such professionals.

In Hyderabad, 12 officers ranging from the BPS-20 police surgeon to BPS-17 MLO are working in the medico-legal section while 17 posts are still vacant. Only one female MLO is appointed against the sanctioned strength of six MLOs. Likewise, five of the six sanctioned posts in Benazirabad’s hospitals are lying vacant, including two of the female MLOs.

“This shortage has persisted for a long time due to the reluctance of doctors in joining this field because of a lack of mechanism for their professional training,” said the health department’s director-general, Dr Ashfaq Hussain Memon. The DG also wrote a letter to secretary health last week, requesting him to fill the vacant posts by deputing the recently appointed doctors in the section.



“We are performing five to six duties a week instead of two or three, which we are expected to do,” tells Dr Waseem, an MLO at Hyderabad Civil Hospital, where only five officers are deputed and six posts are vacant. “This, without doubt, compromises the quality of work. We have to perform additional duties of attending court hearings and sitting on the medical boards besides our regular duties.”  The civil hospital also takes the workload of medico-legal cases (MLCs) from three other government hospitals in Hyderabad and from the adjoining districts, he added.

According to a senior MLO, Dr Baldev, all the MLCs reported from 7pm-8pm to early morning are referred to the civil hospital.

In Sindh, MLOs are appointed at the government hospitals of only five districts - Karachi, Hyderabad, Sukkur, Larkana and Benazirabad. In the remaining 18 districts, medical officers are often seen performing the duties of the MLOs, according to the statistics. The medical certification of a MLO is required in nearly two dozen types of criminal cases which include assault, road accidents, poisoning, alcohol intoxication, chemical injuries, burns and scalds, sexual offences, criminal abortions, attempted suicide, cases of asphyxiation, custodial or unnatural deaths, firearm injuries and drug abuse, among others.

Training and responsibility

Besides the shortage of such officers, the legal status and description of responsibilities of the MLOs and their specialised training are also issues that need to be addressed. Currently, the role of a MLO is defined in some sections of the code of criminal procedure, as no exclusive and detailed description can be found in other laws.

“There is a need to make laws which describe the role and duties of MLOs and also introduce an adequate medico-legal investigation system, where the MLOs visit the crime scene and help preserve and collect forensic evidence,” said a criminal lawyer.

“The examination of injuries and their certification requires special forensic training as an untrained physician can easily misinterpret, overlook, contaminate or even destroy valuable evidence,” says Dr Manzoor Memon, who was an MLO trainer from 1993 to 1998 in Sindh. He recalled the training was aimed at imparting knowledge about the newly introduced Qisas and Diyat laws. Dr Memon recommends that standardised training courses should be devised at the college of physicians and surgeons to prepare the MLOs.

Published in The Express Tribune, July 10^th, 2013.