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Current challenges in cause of death data in South Africa 17/21

In South Africa, injury deaths are legally required to undergo a post mortem investigation and some also require an inquest to establish the cause of death and/or culpability.  The Inquests Act states that anyone who pre-empts the finding of an inquest can be subject to a fine or imprisonment.  For this reason many forensic pathologists do not state the manner of death - homicide, suicide, accident or natural - on the death notification form, even though they may have this information. 

The ICD-10 coding rules for assigning the manner of death caused by injury, defaults to “accidental”, if no manner is listed.  Therefore, if you have a case with a gunshot wound to the chest, without the manner of death indicated, it would be coded as an “accidental gunshot wound”. 

The South African Medical Research Council undertook an injury mortality survey at a national sample of forensic mortuaries in 2009 and compared the injury mortality profile obtained through the survey. See the pie graph on the left, with the national injury mortality statistics on the right.  It is clear that the official injury statistics are very inaccurate.