Every year, thousands of unidentified people pass through South Africa's forensic pathology system, leaving families without answers and many victims unnamed. A University of Cape Town (UCT) PhD study by Kate Reid has found that while Cape Town's forensic identification outcomes are better than previously believed, fragmented record-keeping, poor communication between stakeholders and inconsistent tracking systems continue to delay justice for many families.
The study used multiple data collection methods, including a retrospective review of more than 30 000 medico-legal case files spanning an eight-year period, prospective surveys of key stakeholders and relevant professionals, and a comprehensive review of the published literature.
Reid will graduate with a PhD in Forensic Medicine on Wednesday, 9 September. Her thesis, titled "Forensic human identification: what works and where can improvements be made? Meta-data analysis of identification procedures at a forensic mortuary in Cape Town, South Africa", was supervised by Associate Professor Laura Heathfield and Emerita Professor Lorna Martin.
"During my MSc (Med) research at UCT, I became increasingly aware of how little was understood about the unidentified persons at the Observatory Forensic Pathology Institute (OFPI), despite the considerable burden these cases placed on the forensic facility," Reid said.
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"Every unidentified individual deserves to be treated with dignity, respect and compassion."
"This realisation sparked a deep commitment to investigate the factors contributing to this burden. Equally important was a strong belief that every unidentified individual deserves to be treated with dignity, respect and compassion. Beyond the operational challenges, I recognised the profound human and societal impact of prolonged non-identification."
A first-of-its-kind study
Reid's study provides the first detailed empirical account of unidentified persons at OFPI. Of the 30 535 eligible decedents examined, nearly 82% were visually identified by their next of kin within seven days of admission. Scientific methods including DNA analysis, fingerprint analysis and forensic odontology were used to identify many of the remaining complex cases, leaving only 3.8% of the overall caseload unidentified. This figure is substantially lower than the 8-10% reported in previous South African studies.
According to Reid, the improved outcome reflects both the detailed review of individual case files and the changes already implemented at OFPI to strengthen identification procedures since the first publication in 2020.
"Many procedures continue to follow historical practices rather than being adapted to modern forensic capabilities."
The study also uncovered one of the system's most significant weaknesses. In cases where scientific identification methods were implemented, 42% had at least one missing or misplaced outcome report. The findings, she said, highlight that forensic record-keeping in South Africa is hindered by fragmented systems and limited integration between government departments, resulting in duplicated, incomplete and sometimes poorly tracked records.
"Many procedures continue to follow historical practices rather than being adapted to modern forensic capabilities, while high caseloads and limited resources leave professionals with little time to follow up on outstanding analyses or unresolved cases. The result is a system where committed professionals are working within structural constraints that ultimately affect the efficiency of the identification process."
The consequences extend far beyond forensic facilities. Without identification, families may be unable to register a death, settle estates, claim insurance or pension benefits, remarry or resolve legal and financial matters. In many communities, they are also unable to perform essential cultural and religious funeral rites, prolonging uncertainty and grief.
Further findings
The study's systematic review further found that forensic facilities in low- and middle-income countries have almost twice the rate of unidentified bodies compared with high-income countries, reflecting the impact of resource constraints, fragmented record systems and limited access to forensic services.
Rather than creating an entirely new system, Reid recommends integrating the existing databases and record systems used by different departments into a secure, centralised case-tracking platform. By linking the mortuary decedent number to all relevant South African Police Service case numbers and private analysis request reference numbers, authorised stakeholders could monitor the progress of an unidentified person from admission through identification without replacing the systems they already use.
"Identifying the deceased is not just a forensic responsibility; it is a humanitarian obligation."
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"This research is not about assigning blame, but about identifying opportunities to strengthen a system that is under significant pressure," Reid said. "Identifying the deceased is not just a forensic responsibility; it is a humanitarian obligation."
She believes the single most important improvement would be stronger collaboration between all stakeholders involved in the identification process. "No single agency, scientific method or technological advancement can solve this challenge in isolation. Identifying the deceased is a shared responsibility, and creating dedicated opportunities for open, transparent dialogue, with a commitment to turning discussions into action, would have a significant impact."
Importantly, the study has already led to changes in forensic practice at OFPI. Preliminary findings were shared throughout the study, enabling missing analysis results to be traced, communication among stakeholders to improve, and DNA profiles of unidentified individuals to be uploaded to the National Forensic DNA Database's Missing Persons and Unidentified Human Remains Index.
"These are important steps towards improving opportunities for identification," Reid said.
