CADAVERS! WHERE DO THEY COME FROM?

The free online dictionary defines a cadaver as "A dead body, especially one intended for dissection." From first year through the second year at the Makerere University College of Health Sciences, medical students study anatomy. They have to use cadavers as specimen for their practical study.  They start these anatomy practical sessions as soon as their first semester at the college begins. However, these cadavers were living people at one time. So, who are they and where do they come from?

“Dissecting cadavers is an evolving tradition” ¹ and cadavers have been used in training of medical students for over 200 years. ² Executed criminals were the first ever to be used as cadavers but “As the number of criminals being executed decreased, it became commonplace to steal bodies from graves…” ² and at the time, anatomists were seen as nothing short of executioners. ² Family members also contributed to anatomy as the anatomists would even dissect them too as “William Harvey, the man famous for discovering the circulatory system” ² did. He “... was so dedicated that he dissected his father and sister.”²

By the 20^th century however, body snatching was no more, ² and with an improved education system in medical schools, “The medical profession received new esteem by diagnosing and healing more people.” ² This respect brought forth “a larger supply of cadavers” ²from “people like you and me who decide to donate their whole body for medical research when they die.” ² “Today, medical institutions cannot buy a body”² and “persons donating their body receive no financial compensation; this is truly their ultimate gift.” ³ A gift that has facilitated the training of medical students, the world over and almost all doctors that we see walking the corridors of hospitals today.

REFERENCES

1. How med students learn from cadavers. A rare peek at how doctors-to-be learn from bodies donated to science. [Online]. 2009 Nov 30 [Cited 2011 Nov 11]; Available from: URL:http://www.msnbc.msn.com/id/34173673/ns/health-health_care/t/how-med-students-learn-cadavers/
2. Cadavers: Where do they come from? [Online]. 2007 [Cited 2011 Nov 11]; Available from: URL:http://diesmart.com/funerals/cadavers-where-do-they-come-from/
3. Use of the cadaver lab at Cornell College. [Online]. [Cited 2011 Nov 11]; Available from: URL:http://people.cornellcollege.edu/bchristie-pope/CadaverLab/CadaverLab_Rules.html

A day's trip to Rakai Health Sciences Program- a high end grade research facility

The name 'Rakai Health Sciences Program (RHSP)' did not sound any bit familiar as a colleague called me up on phone to inform me of the upcoming club trip slated for the 19th of December. The only thing I could have told you about Rakai before the trip was of something that I had heard that "that's where the first cases of HIV were first recorded in Uganda." Feeling adventurous, I told Kenneth to sign me up for the trip. I was yet to find out that there is a lot of ground breaking research that has been done by the RHSP.

Members of the Research and Writer's Club and staff at the entrance to the Rakai Health Sciences Program Research Facility

As part of a couple of 16 students, all members of the Research and Writer's Club we made way to Rakai in our college van on a such a sunny Monday morning. I never cease to appreciate the splendid greenery Uganda boasts of as one journeys through it's highways away from the capital city and even this time, it was ever so wonderful.

In our College Van

To get to Rakai from Kampala one travels to the West, through the districts: Wakiso, Mpigi then through Masaka taking a more southerly direction this time and soon you are in Rakai. Google maps places the travel distance between Kampala and Rakai at around 191.48 km to 208.12 km. With no stops made during our journey, the trip took us averagely two and a half hours to reach the facility. Not such a bumpy ride as I had expected since the road was in a fairly good condition. Only a few final touches and the Kampala-Masaka highway will be much better than before- not world standard, just better than before.

Entrance to the facility

Parked outside across the road from the enclosed facility, as we exited our van I could not help but notice the sign planted high on one of the buildings that was just opposite were we had parked. The sign read: "Rakai Health Sciences Program. Founded in 1988 as the Rakai Project. Improved health sciences through research." We then made way through the gate to the sentry booth just at the entrance.

The Sentry booth

Standing in line before the sentry booth as we awaited to be registered before being given visitors' tags I appreciated the splendor of structural organization and hygiene that lay before us. Right after the sentry booth as one headed away from the gate, were two fairly large grass-thatched structures nicely decorated with art made with a fine African style. We were led to one of the structures which was well furnished like an outdoor meeting place. Such a nice site it was, particularly to enjoy an evening off after a tough day, just lay back and relax. One of the scenes of the art pieces hanged up within the structure depicted health professionals sensitizing and most of all carrying out circumcision community outreaches. The whole reception so far combined with the surrounding art full of science and the community would give you a feeling of being in a scientific facility that does care for the community.

Mr. Mugamba, Mr. Balikuddembe and Ismael Kawooya

The happy welcome by our hosts would have made anyone feel special. They introduced themselves to us as Mr. Balikuddembe Ambrose (Transport Coordinator), Ms Nakawesa Goretti (Administrative Secretary) and Mr. Mugamba Steven (Supervisor; commuity mobilization aka Health Education).

We were introduced to some of the history of the Program by Mr. Mugamba. He said that it was originally known as Rakai Project before being later renamed: The Rakai Health Sciences Program. It was initially started to respond to the AIDS epidemic of which the 1st recorded cases where in a place called Kansensero. With effect, two doctors were sent to Rakai to investigate one of which included Professor Nelson Ssewankambo.

Mr. Mugamba went on to say that the facility is both research and service (towards the community) oriented. One of the recent research done was that circumcision give safety percentage of 60% against contracting HIV prompting circumcision to be put among the top preventive measures against HIV contraction. He said that among the so many things they do in the community include health education, condom promotion where they give out condoms freely to those that require them and have even stationed salespeople throughout the community to sell them at subsidized prices e.g below 500 shillings.

The Shang Ring

Demonstration of Shang Ring with a dummy penis

Next speaker was Dr. Rajab Kakaire who is in charge of the circumcision study at the facility. He told us a lot about the circumcision program but interesting of all was the Shang Ring study. The Shang Ring is one of the modalities for conducting circumcision invented by a chinese called Jianzhong Shang and Dr. Kakaire said that the device has been in use in China for about 6 year now. It's feasibility, safety and efficiency for use among Ugandans are currently being investigated at the facility. He said that among it's advantages as compared to the conventional surgical methods of circumcision includes: it takes much less time, does not require suturing and it can be perfomed by less experienced personnel.