In South Africa, cause-of-death data is often inaccurate or incomplete, a challenge compounded by the underreporting of deaths. This lack of reliable information undermines efforts to improve essential services like healthcare and justice. It is precisely these systemic gaps that Associate Professor Laura Heathfield, head of the Biomedical Forensic Science Unit at the University of Cape Town (UCT), is working to close.
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Heathfield’s work is towards resolving one of society’s most pressing yet overlooked challenges, the identification of deceased individuals and determining the causes of sudden and unexplained deaths. Her pioneering work has not only advanced scientific knowledge but has also brought closure to grieving families and improved forensics practices in South Africa and beyond.
“Research shows that in South Africa, unidentified bodies are buried en masse. Among them are migrants, the homeless, victims of human trafficking and abandoned babies. These individuals represent some of the most vulnerable people in society,” said Heathfield.
Since joining UCT in 2014, she has established the Molecular Forensics Research Group and built two state-of-the-art forensics laboratories, one at UCT and another for the provincial Forensic Pathology Services. Her UCT lab houses Africa’s first MiSeq FGx sequencing platform, a cutting-edge tool for forensic DNA analysis.
“Despite hundreds of studies published on DNA extraction, there appears to be no consensus on the best approach.”
Her research centres on two key areas. The first is molecular autopsies, where DNA is used to determine the cause of sudden and unexplained deaths, particularly in infants. This work has led to the identification of novel genetic markers associated with infant mortality and the development of ethical frameworks for post-mortem genetic research.
The second area is human identification, focusing on developing advanced DNA techniques to identify decomposed and skeletal remains – often the victims of drownings, fires and cold cases.
Impact beyond the lab
Heathfield’s influence extends well beyond academia. She collaborates with government agencies and forensic pathologists to address South Africa’s DNA backlog crisis and strengthen forensic capacity. She is a founding member of the South African Academy of Forensic Science (SAAFS) and actively contributes to global initiatives tackling the issue of unidentified deaths as a “silent mass disaster”.
“The training workshops I run with forensic practitioners across the continent always include the same question: ‘What DNA extraction method should be used for hard tissues, and which bone or tooth is best?’ Despite hundreds of studies published on DNA extraction, there appears to be no consensus on the best approach,” Heathfield explained.
“I want to create a custom ‘forensic exome panel’, which is essentially a specialised genetic test for unexplained deaths.”
In response, she was part of a team who conducted a large-scale systematic literature review and meta-analysis, now considered a key reference for empirical data and guidance for new forensic laboratories in Africa and beyond.
Her leadership has also shaped the next generation of forensic scientists. She has supervised over 80 postgraduate students and authored numerous papers in high-impact journals.
Looking ahead
Over the next six years, Heathfield aims to optimise the use of post-mortem DNA analysis in holistic medico-legal death investigations and forensic casework in South Africa, with the aim of intensifying the expansion of her work across the continent.
Her goal is to take her current research to the next level by upgrading from testing individual genes in compromised post-mortem samples to using technology that can examine many genes at once.
“I want to create a custom ‘forensic exome panel’, which is essentially a specialised genetic test for unexplained deaths,” she said.
This toolkit would be different from those used in hospitals, which focus mainly on genes related to diseases we live with. Instead, Heathfield’s version would focus on genes that may explain why someone – often a seemingly healthy baby or young person – died suddenly with no warning signs.
“Through my research, I hope to develop and implement a molecular autopsy service that is both accessible to families and is informative for investigating sudden unexpected deaths within the African population.”
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