Forensic exhumations and autopsies in Zambia, Africa

To our knowledge, this is the largest case series of forensic exhumation and autopsy cases in Africa to date. This paper fills a critical knowledge gap in Africa by profiling the cases, describing the challenges of accessing burial sites, conducting forensic autopsies at burial sites, and the approach to forensic exhumations and autopsies. An analysis of forensic exhumations and autopsies we had performed (January 2016 to December 2020) throughout Zambia was conducted using Microsoft Excel 2010. Of the 168 cases, 128 (76.2%) were male. The age ranged from 1 to 86, with a median age of 35.0 and a standard deviation of 21.4. The commonest age range was 31–45. The top five (5) circumstances of death were assault (17.9%), family violence (17.9%), body recovered in a water body (11.3%), body found in the bush (11.3%), alleged witchcraft (7.7%), alcohol abuse (6.5%) and mob violence (6.0%). The duration of burial ranged from < 1–30 months. The commonest duration was 1–5 months (56%). The total distance that the pathologists traveled was 261,250 km. The cause of death was determined in 112 (66.7%). The top 5 causes of death were blunt impact trauma to the head (29.8%), homicidal violence (10.1%), hanging (4.8%), fire (4.2%), and gunshot to the head (3.6%). This paper shows that forensic exhumations and autopsies address forensic questions critical to law enforcement and justice.