A few lessons about drugs and gun crimeBMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39392.421701.FA (Published 22 November 2007) Cite this as: BMJ 2007;335:1097
- Ademola Odunfa, pathologist, British Virgin Islands
I arrived in Jamaica in April 1990 after landing a job at the Ministry of National Security in Kingston. I was there to boost the ministry's pathology staff because of the country's high murder rate. Jamaica has been variously described as the most violent or dangerous place on earth, although it also has one of the highest numbers of churches per square mile.
With our young family of five my wife and I were received warmly by staff. Most of my medical training had taken place in Nigeria, but we quickly settled into our new surroundings, and the work began in earnest.
Kingston is a highly volatile city of about one million inhabitants. The notorious downtown area is a place you don't visit after 6 pm unless you are armed, ready to battle for your life, or both. Murder here was seen as just one of those things, and nobody really batted an eyelid. The only thing the relatives asked you after a postmortem examination was how many shots did he get. It was just another murder. People in Kingston were murdered in the most bizarre ways. I once conducted an autopsy on a man with only parts of his body available for examination. Another time there was just the lower half of a man—the upper part had been destroyed to make identification difficult. DNA analysis was not readily available in Jamaica in 1990. It wasn't until a year or so later that a seminar entitled “DNA fingerprinting” was arranged for government pathologists—and many more years before the analysis actually became available.
Gang warfare and control of drug distribution in particular areas are said to be responsible for most of the crime, which was concentrated in downtown Kingston. Murders uptown usually resulted from robberies, especially of residents returning from overseas, who were believed to have brought back huge sums of money; political killings; or accidental discharge of weapons. But these pale in comparison with what happened downtown. In the early 1990s it was very dangerous to walk downtown in Kingston; I had a police escort if I had to do a postmortem examination at the Kingston Public Hospital morgue, and even then it was still risky. You would hear sporadic gunshots as you drove through town. There the usual weapon of choice among men was a handgun or automatic rifle. Among women, especially local women, it was a knife—sophisticated women also used handguns. Suicide was common. I remember the case of two young university lecturers, both doctors, who ended their lives because they were suspected of infidelity.
At the end of my three year contract I was seconded to the Ministry of Health and posted to Montego Bay. I later learnt that my boss back in Kingston had thought that I was getting too popular with the police because I responded to their calls at any time of the day or night.
In Montego Bay I had to double as hospital pathologist and police pathologist. At the same time I was regularly called back to Kingston to attend court, usually with a police or army escort. I used to find that the crown counsels liked to play God. They would call you up at very short notice and without any apology. You couldn't even complain to the judges, who usually took the side of the attorneys. The judge at the Gun Court, which deals exclusively with firearms cases, usually took pains to explain to the accused that the pathologist is not an eyewitness but that he is just going to relate his findings from the postmortem examination. This is important as Jamaica's witness protection programme does not work properly, and many eyewitnesses are easily eliminated by cronies of the accused, usually as a result of tips from the security forces.
In 1996 I was posted back to Kingston and stationed at the Public Health Laboratory. At this time there was an outcry about the high number of extrajudicial killings by the armed forces and especially by the police. Local human rights groups were scouting for pathologists who were willing to risk their necks and testify against the armed forces. I accepted the challenge. Of course, this put me in the authorities' black books, and I received death threats on more that one occasion. I attended about 100 postmortem examinations on behalf of the human rights groups and went to courts about 10 times for similar cases. However, no convictions were made against the police in any of the cases.
In all, in my 16 years of pathology practice in Jamaica I conducted about 1000 postmortem examinations, more than half of which were murders. Of these, 80% were gun crimes. The rest were stabbings, bludgeonings, suffocation, and strangulation.
I had a police escort if I had to do a postmortem examination at the Kingston Public Hospital morgue, and even then it was still risky