AFRICA
The sourcing of bodies of the deceased for medical education and training remains a critical challenge for West African universities.
A recent study shows that 63% of all unclaimed and unidentified bodies from mostly health facilities are used for training healthcare professionals in anatomy education, research and clinical skills. This highlights the need for developing body donation programmes and establishing ethical guidelines.
The study, entitled, ‘Sourcing and utilisation of bodies of the deceased for medical education and research: An Examination of West African Universities’, was published in Anatomical Sciences Education in May this year.
It investigated the sources, utilisation, and ethical oversight of bodies of the deceased in West African universities. It reveals the limited information available about the provenance of human bodies, their acquisition and utilisation, imaging, and the accompanying ethical approval and supervision.
“This study presents the first attempt to capture a comprehensive set of data on body procurement in anatomy from several nations in West Africa,” said the authors, Oheneba Boadum of the University of Mississippi in the United States, John Ahenkorah of the University of Ghana, and Joy Balta of the University of California, also in the US.
Key findings
The authors investigated the different sources of bodies of the deceased and their use in education at 57 institutions in 15 West African countries. It showed similar practices across several West African higher education institutions regarding the sourcing and utilisation of bodies of the deceased in education, research, and clinical skills training.
Of the 57 education institutions that were approached to participate, 27 in 11 countries responded (48% response rate): Benin, Burkina Faso, Cape Verde, The Gambia, Ghana, Ivory Coast, Mali, Mauritania, Niger, Nigeria, and Senegal.
The study highlights the diverse origins of unclaimed and unidentified bodies, primarily from health facilities, indicating that many of these bodies may have been abandoned. It showed that 63% of bodies used in education were from unclaimed and unidentified sources, while 69% of unclaimed bodies were from health facilities.
Out of 25 institutions, 21 had individuals or committees that provide ethical approval and supervision of work with bodies.
A total of 10 institutions allowed faculty and staff to take photographs or videos of bodies for educational purposes. Most of the institutions indicated that they used a local register or record book to track the bodies, either manually or electronically.
The bodies of executed persons were used for anatomical study purposes only in Nigeria. Only two higher education institutions in Ghana had body donation programmes.
Tracking and confirming
Given the reliance on unclaimed and unidentified bodies, the study supports the development of body donation programmes and improved tracking of individual bodies.
As done in Senegal, the study found that “implementing legislation that allows the use of unclaimed bodies – after extensive tracking has been done with no responses and expiration of a stipulated time – may be helpful”.
Considering the socio-cultural and religious landscape, the study called upon anatomy departments to involve community leaders in body donation awareness campaigns to help change perceptions and foster a more supportive environment for body donation.
“While efforts continue to reduce the use of unclaimed and unidentified bodies, good practices must be maintained and strengthened in their acquisition, transport and utilisation for education, research, and clinical skills training to ensure that the use of bodies is conducted ethically and respectfully,” the study noted.
It also suggests that victims of road traffic accidents, or persons accidentally discovered dead, should not be automatically sent to anatomy departments for education as observed in the study. Instead, institutions that receive these bodies should confirm they are truly unclaimed by doing extensive tracking.
“While striving to minimise their use, institutions that accept bodies of victims of shooting with bullet wounds or strangulation marks should be mindful of the psychological distress this may have on students.
“Such institutions could consider alternative options, including adequate pre-briefing and psychological preparation for students who must use any of these bodies, while continuous efforts to minimise their use are upheld.”
Anatomists on the African continent face numerous social, religious and cultural challenges, and any lack of transparency in acquiring and utilising the bodies of the deceased, especially regarding informed consent and imaging, could hinder inclusiveness for all population groups that could contribute to future donation programmes, the study found, and concludes by saying: “Upholding the integrity of the discipline and respecting bodies of the deceased are essential for improving anatomy education within the continent.”
The Anatomage Table
Dr Ifeanyi McWilliams Nsofor, the director of the Vaccination Initiative Targeting Adolescent Lives (VITAL) Project in Nigeria, told University World News the study is timely and critical as it puts forward measures to face longstanding challenges in anatomy education in Africa.
“Transitioning from cadaver-based training to digital technologies could improve access, safety and learning consistency across institutions,” said Nsofor, who is also the former director of Policy and Advocacy at Nigeria Health Watch.
“Virtual tools like the Anatomage Table offer a scalable, ethical, and interactive alternative that can complement or even replace cadaver labs in many settings,” he added.
Such technologies can reduce dependence on limited cadaver availability, address cultural and ethical concerns, and support repeated, detailed anatomical learning, which is especially useful for resource-limited institutions, Nsofor said.
“For African countries, investing in such digital solutions must go hand in hand with faculty training and infrastructure support to ensure effective integration.
“These innovations can democratise access to quality health education, especially in under-served locations,” Nsofor concluded.
Morad Ahmed Morad, professor of medicine at Egypt’s Tanta University, told University World News that the Anatomage Table, which offers a life-size digital representation of the human body and allows visualisation, manipulation and virtual dissection, is increasingly being adopted in African medical schools as a valuable tool to augment traditional cadaver-based learning.
North African medical schools that are already using the Anatomage Table include Algeria’s University Mohamed Boudiaf of M’sila, and Libya’s Derna University and the Libyan International University, according to Morad.
Compared with the traditional cadaveric dissections, the Anatomage Table is less problematic regarding cultural acceptability and health-and-safety-related concerns. However, the Anatomage Table could only be a complementary teaching tool, since it cannot totally replace the use of cadavers, Morad said.
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