A descriptive medico-legal study of female deaths in cairo governorate, Egypt

Abstract

Background: Mortality is conditioned by biological, political and social factors, as well as by culturally defined behaviors and attitudes that historically characterize the stage of development of a country or a region. Women are often in great danger, where they should be safest. Violence against women is the most pervasive yet the least recognized human rights violation in the world. It is a profound health problem and femicide, is often the tragic end-point of violence. Females represent more than half of the Egyptian population, however, they remain vulnerable.

Aim of the study: To describe and analyze data obtained from Zeinhom Morgue records in Cairo, regarding female deaths, throughout two years. To evaluate female deaths regarding age, cause, manner of death, location, perpetrator and motive. To describe the incidence of female homicides and their related injury patterns. To identify the risk factors and nature of violence from victimologic point of view. Finally, to describe the manner of death whether natural, homicidal, suicidal or accidental aiming for early identification of vulnerable females so that actions can be taken to prevent further mortality.

Subjects and methods: This is a national two year retrospective descriptive mortuary based study. The study population comprised of all adult females, aged 18 years and older, whose death was suspicious and medico-legal examination was ordered. Each investigation included a detailed case history, investigation, gross examination, histo-pathological and toxicological examinations. Data was collected from autopsy reports, hospital records and police records. From the available data the victim profile was made.

Results: All female deaths aged 18 years and older were retrospectively reviewed for 2 years at Zeinhom morgue of Medico-legal Authority from a total of 1858 autopsy cases. The most common manner of death was homicide. The commonest cause of death in homicides was due to sharp traumatic injuries. Natural death was the least common manner of death and ischemic heart disease constituted the commonest cause. Falling from height was the most common method of suicidal related deaths. Regarding poisoned cases, insecticides and carbon monoxide were the most common detected poisons. According to the cause of death (trauma), blunt trauma injuries were the most common. Falling from height constituted the largest percent of cases under this group.

Conclusion and recommendations: Females in the third decade of life with blunt injuries to the head and neck were the majority of adult female autopsies. Homicide was the most common manner of female death using sharp instruments after domestic arguments mainly by a spouse or relative. Accidental death came second mainly due to post-operative complications. In cases of suicide, falling from height was the commonest cause followed by poisoning. These findings could be useful for forensic pathologists and healthcare promoters in predicting and preventing female deaths. Moreover, this emphasizes the need for raising public awareness about the scale of female violence problem in our society. The results of this study indicates that, by not only a strong legal support network, but also by opportunities for economic independency, essential education and awareness, alternative accommodation and a change in attitude and mindset of society, judiciary, legislature, executive, men and most importantly women themselves can lower or even prevent such deaths specially suicidal.

Keywords: Egypt; Female death; Homicide; Trauma; Violence.