Integrity of Nebanda’s samples taken abroad were questionable - Dr Onzivua

It will probably be most unfair if I do not refute some of the allegations that Mr Andrew Mubiru, a government analyst, raised in his article that ran in the Sunday Monitor of January 11.

I am disappointed that a government analyst cannot recognise a bio-hazard bag and instead calls it a school bag. Another officer from the government who came to testify in the case against me in the Buganda Road Court actually called the bio-hazard bags ‘pieces of kaveera’.

The samples of the late Cerinah Nebanda were packaged securely in bio-hazard bags. I have photographed, for the record, the type of bio-hazard bag that were used to package the samples of Nebanda. Fortunately, the police who arrested me with these samples also photographed them in these containers that were clearly labelled as bio-hazard bags.

Most analytical laboratories store samples in refrigerators prior to processing them. On the day of processing, these samples are removed from the refrigerators and allowed to attain room temperature and then analysed.

We removed the samples from Nebanda’s body on Saturday, December 15, 2012, and I immediately had them kept securely in one of the most modern scientific fridges on Mulago Hill. In the early hours of December 18, 2012, we removed these samples from the fridge and packaged them into bio-hazard bags.

I had made arrangements to have these samples analysed immediately on arrival in Pretoria, South Africa. We had estimated that by the time I reached Pretoria, the samples would have attained room temperature and therefore be ready for analysis.

Mr Mubiru states that the samples were rotting and unfit for analysis. Mr Mubiru was not present at the time of my arrest or when the samples were being searched for. Indeed, in the process of the search, the samples were mishandled by the police officers and this resulted into some spillage into the bio-hazard bags.

Even if the samples were rotting (which they were not by any stretch of imagination), would the narcotics or any other drugs in the tissues or alcohol in the blood rot? Do we not carry out toxicological examinations on decomposing bodies? Do we not carry out toxicological analysis in persons who are long dead?

The police tried to do all they could to find out where I kept the samples. I refused to disclose this to them as they already had an identical set of samples. Why did the police have particular interest in the samples I had? Some people have tried to carry a smear campaign in regard to the samples in my possession and I fear Mr Mubiru’s article may lend credence to such.

I, in person, received the request from the police to carry out the post-mortem on the body of Nebanda. The request was explicit. It stated: “I have to request you to hold a post-mortem on the body sent herewith or on the body to be found at …and to furnish me with a report thereon…”

The request did not say how we should have carried out the post-mortem nor did it state that samples we removed had to be sent to the Government Analytical Laboratory (GAL). There is no legal mandate for health workers to take samples to GAL; there is no legal mandate for GAL to handle all samples in Uganda.

GAL provides services that we may use or are free to find alternatives. Period. There is no law which states that the courts of law in Uganda will only accept forensic evidence from GAL.

On Saturday, December 15, 2012, we performed the autopsy on the body of Nebanda. In the process of the autopsy, two of the pathologists with whom we were performing the autopsy informed us that they had contacted Mr Mubiru who was ready to start working on the samples immediately.

It was for this reason that a Member of Parliament, on a Saturday, drove the Forensic Liaison officer to GAL with the samples. GAL does not usually receive samples on weekends. There was no mention then that the machines needed servicing.

A meeting was held at the Mulago hospital boardroom on Monday, December 17, 2012, in the evening with officers from GAL with respect to the samples; again there was no mention that the machines at GAL needed servicing. This reason, as advanced by Mr Mubiru now, for taking the samples to London and Israel has really taken me aback. Indeed, if a doctor had to go with these samples out of this country, it should have been Prof Henry Wabinga, whom I nominated to lead us.

Why was Prof Wabinga not invited to go with these samples? Perhaps this is the root cause of the saga we had with these investigations. Remember Christmas was around the corner then.

I have an issue with some of the toxicology results we received. The alcohol levels in the urine were nine times higher than that in the blood. This has never been observed anywhere in the scientific world.

The highest ratio from numerous scientific researches done is less than three (I have literature to this effect).

This means that either the urine sample taken was contaminated (deliberate or otherwise) or this was not Nebanda’s urine. This throws into doubt the integrity of all the samples taken to London and Israel.

The level of alcohol found in Nebanda’s blood implies that she took less than half a glass of wine. Alcohol kills by respiratory depression or reduced blood sugars in the blood. Death due to narcotic drugs has been attributed to cardiac arrthymias (abnormal heart beats) or respiratory depression.

However, to suggest that death could have occurred as a result of half a glass of wine or these very low levels of narcotics is rather strange. I am not aware of any medical literature anywhere or any precedence or any case report to the effect that these amounts of alcohol and narcotics have caused multiple organ failure or pancreatitis or death through idiosyncrasy or synergistic effects.

Body organs at the time of death undergo changes (agonal reactions) which may easily be mistaken for multiple organ failure. If an independent analysis had come up with similar results to that from London, this would suggest that death of the honourable was consistent with the cardiac effects of narcotic drugs. I am of the opinion that alcohol per se played no role in the death of Nebanda.

I am baffled that Mr Mubiru argues that the chloroquine and dextromethorphan were probably used to enhance the effects of the narcotics. Why were these drugs only found in the body of the deceased and not the remains of the drink or remains of the drugs? That these medical drugs were not found anywhere else is also puzzling. Were any remains of street drugs found in the house? Did the street drugs contain these other drugs? A thorough investigation should have sought to establish the origin of these drugs. Speculations will only do more harm than good. Scientists do not speculate.

Crime scene investigations are ideally carried out by specially trained police officers for this purpose. To the best of my knowledge, a government analyst and a scene of crime officer are two very different people. And I am of the view that experts should confine themselves to their respective areas of expertise.

A government analyst may be straying too far in expressing an opinion about the cause of death, and more so about multiple organ failure. The government analyst should stop flogging a dead horse.

The Tereo have a saying, ‘Ondrakana’a onvu zo ku’. Loosely translated, this means ‘the orphans of a man who lived a corrupt life will neither live nor thrive’. The government analyst should remember and meditate on the time he attempted to raise these issues in Buganda Road Court.

It is imperative that in death investigations, we must work as a team and avoid intrigue and backstabbing. I do hope that we shall treat this as an audit and use it to ensure that we do not mishandle our investigations in future. Let those who have ears, listen.