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The Honolulu Advertiser
Posted on: Monday, April 3, 2006

Morgue too small for growing Maui

By Christie Wilson
Advertiser Neighbor Island Editor

Forensic pathologist Dr. Anthony Manoukian, left, and assistant medical examiner Burt Freeland say the Maui Memorial Medical Center morgue is too small to properly process about 400 bodies a year.

CHRISTIE WILSON | The Honolulu Advertiser

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WAILUKU, Maui — Steady growth on Maui has meant more development, more traffic, more visitors and more dead people — about 845 of them last year.

Roughly half pass through the Maui Memorial Medical Center morgue, whose walk-in refrigerator can "comfortably" hold six bodies at a time, said forensic pathologist Dr. Anthony Manoukian.

But the bodies don't show up at a consistent rate, Manoukian said, and crowding can be a problem, particularly when there are unclaimed corpses that can remain in storage for weeks or months. Bagged bodies sometimes have to be laid on top of one another, and decomposing corpses are stored in the same small space as the newly dead.

"At times when we have been overloaded, we've tried to talk to families about getting their family members to a funeral home as quickly as possible," Manoukian said. "In a pinch we have an auxiliary chilled unit" similar to a shipping container.

But making space for bodies isn't as big a problem at the Maui morgue as providing a dignified viewing area for the next of kin and ample working space for Manoukian, police evidence technicians and others who process the dead and their personal effects.

At the request of the Maui Police Department, Mayor Alan Arakawa included $4 million in his proposed budget for fiscal year 2007 to acquire or build a county morgue that could also house the police crime lab. Police Chief Tom Phillips said a larger space would provide more room for collecting and storing evidence "in a more professional manner."

"Like anything else, we've outgrown the morgue. The number of death cases has been growing and it's inadequate," Phillips said.

The chief also wants to provide families with a quiet place where they could see their loved ones and meet with police chaplains if necessary.

"A lot of times when someone dies in an accident or it's a sudden death, the family wants to come and pay last respects, and it's important for them to be able to do that as part of the grieving process. But we're not always able to do that because of the number of bodies," Phillips said.

Honolulu, where about 70 percent of the state's population resides, has a Department of the Medical Examiner with its own free-standing morgue that conducted more than 750 autopsies in fiscal year 2005.

On the Neighbor Islands, police chiefs serve as county coroners, and morgues occupy space within state hospitals.

Manoukian, who works for Clinical Laboratories of Hawai'i, is a coroner's physician, performing approximately 200 autopsies annually on Maui and traveling to other islands for the same purpose.

The Maui morgue, with an estimated 1,000 square feet of working space, includes an examination room with a single table. The walk-in refrigerator also stores amputated limbs and other body parts from medical procedures at the hospital, and separate refrigerators hold tissue samples that are stored for three years in case further examination is needed.

Because of limited counter space, sheets are spread on the floor in the morgue's cramped central hallway to sort belongings. The hallway is also used for X-raying bodies.

A small room that formerly served as a viewing area is now an office, and bodies are displayed for identification by family members in the central hallway, with curtains drawn to cover the storage and examination areas where other bodies may be waiting.

"It would be nice to have dedicated space for that type of function where we could leave the family with the body for as long as they need, but we're conducting business in there all day long," Manoukian said.

Burt Freeland has been handling bodies for the county for 30 years and assists the pathologist at the morgue. He remembers the days before Manoukian arrived in 1993 when overflow bodies were placed in trays on the examination room floor and covered with ice to await the arrival of a Honolulu medical examiner. If it was the weekend, Freeland had to make several trips to pour fresh ice over the corpses.

He said modern forensics requires more sophisticated morgue facilities for evidence gathering and identification.

Maui Memorial Chief Executive Officer Wesley Lo said the 200-bed hospital is dealing with its own space issues and could use the morgue area for storage and central supply. Although there isn't an urgent need to move the facility, Lo said, "it would be better if it was not there." One reason is that the morgue is across the hall from the hospital cafeteria, which will be open soon to the public.

Freeland said that without a separate ventilation system, the morgue's decomposing bodies have caused odor problems. But even when the morgue isn't to blame, Lo said, there's a perception that the facility is responsible for occasional unpleasantness.

Over the years there have been informal talks between police and Clinical Laboratories about moving into a free-standing morgue, but Dr. Barry Shitamoto, one of the company's medical directors, said he was surprised that it had gone as far as the mayor's budget proposal.

He said one option is for the county to purchase Clinical Laboratories' 7,000-square-foot facility in The Millyard in Wailuku. There has been no appraisal or formal negotiations for a sale, he said.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.