Annals of Anatomy 253 (2024) 152212

Available online 18 January 2024
0940-9602/© 2024 Elsevier GmbH. All rights reserved.

Acquisition of cadavers for anatomy education and research in Malawi

Arthur Tsalani Manjatika a,b,*,1, Joshua Gabriel Davimes b,2, Anthony Mwakikunga a

a School of Life Sciences and Allied Health Professions, Department of Biomedical Sciences, Anatomy Division, Kamuzu University of Health Sciences, Blantyre, Malawi
b School of Anatomical Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa

A R T I C L E I N F O

Keywords:
Anatomy education
Indigenous Malawian
Body donation program
Cadaver sources
Human Anatomy
Unclaimed body

A B S T R A C T

Background: The use of human cadaveric dissection forms an essential part of teaching anatomy to health sciences
students in Malawi. Despite worldwide struggles in acquiring sufficient human cadavers for anatomy education,
the current recommendations on the best anatomy practices require the use of cadavers exclusively from the
body donation programs. The current study aims to describe the sources of cadaveric bodies used for anatomy
education in the Malawian context and reflect on the feasibility of using cadavers from the body donation
program only.
Methods: A retrospective audit of the cadaveric records for the 2006–2022 academic years at the Kamuzu Uni-
versity of Health Sciences was done. The perceived challenges when sourcing the cadavers were identified and
described based on the authors experiences in Malawi.
Results: The majority (97.3%) of the cadavers used between 2006 and 2022 were unclaimed bodies. The mean
age of the cadavers was 45 years. Most (95.6%) of the unclaimed bodies were males. All the unclaimed bodies
were sourced from hospitals. The body donation program in Malawi was patronized by populations of European
descent only. Strongly held sociocultural and religious beliefs as well as economic reasons were perceived as
significant barriers to acquiring cadavers of the indigenous Malawians through the body donation program.
Conclusion: Cadavers for anatomy education in Malawi are mainly from unclaimed bodies, similar to other Af-
rican countries. The authors support the transition from using “mostly unclaimed bodies (and, less often, body
donation)” to using “mostly body donation (and, less often, unclaimed bodies)” through awareness campaigns
that are targeted to address the prevailing challenges.

1. Introduction

Human anatomy is known to form the basis of teaching and learning
in clinical practice, specifically for healthcare professionals who handle
patients (Estai and Bunt, 2016). Despite numerous criticisms (Nandi
et al., 2000; Pawlina and Lachman, 2004; McMenamin et al., 2018;
Emanuel, 2020), the use of cadaveric dissection is still considered a gold
standard method for teaching and learning anatomy (Patel and Mox-
ham, 2006; Kerby et al., 2011; Davis et al., 2014). Preferences for this
method of teaching are well acknowledged for over the last 400 years
(Azer and Eizenberg, 2007). The advantages of cadaveric dissection
include enhancement of active and deep learning, improvements of
manual skills in preparation for clinical practice, preparation for en-
counters with death and understanding of patient-physician

relationships (Azer and Eizenberg, 2007; Fruhstorfer et al., 2011).
Globally, most health sciences institutions have registered a decline in
the cadaveric-based teaching method over the years mainly due to the
challenges in acquiring cadavers and due to the adoption of modular and
more clinically oriented curricula (Estai and Bunt, 2016; Gürses et al.,
2018).

Historically, human cadavers for anatomy education have been ac-
quired through a variety of ways that include grave robbing, bodies of
executed criminals, unclaimed bodies from hospitals and prisons, and
most recently through well-established body donation programs
(Gangata et al., 2010). The International Federation of Associations of
Anatomists (IFAA), a body that advises global anatomy practices, rec-
ommends the use of donated bodies as the only way of acquiring ca-
davers for anatomy education in modern times based on ethical reasons

* Correspondence to: Anatomy Division, Department of Biomedical Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health
Sciences, Private Bag 360, Chichiri, Blantyre, Malawi.

E-mail address: arthurmanjatika@gmail.com (A.T. Manjatika).
1 ORCID:ATM: 0000-0003-0867-7123
2 ORCID:JGD: 0000-0001-9808-5249

Contents lists available at ScienceDirect

Annals of Anatomy

journal homepage: www.elsevier.com/locate/aanat

https://doi.org/10.1016/j.aanat.2024.152212
Received 20 July 2023; Received in revised form 27 November 2023; Accepted 16 January 2024

mailto:arthurmanjatika@gmail.com
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Annals of Anatomy 253 (2024) 152212

(IFAA, 2012). Globally, the modes of acquiring cadavers have been
classified into five categories: (1) exclusively body donation, (2) mostly
body donation (and, less often, unclaimed bodies), (3) mostly unclaimed
bodies (and, less often, body donation), (4) exclusively unclaimed
bodies, and (5) other sources (e.g., import of cadavers from abroad),
either exclusively or in addition to another category (Habicht et al.,
2018). While most Western European and North American health sci-
ences institutions are believed to run successful body donation programs
and have stopped the use of unclaimed bodies, most African health
sciences institutions on the other hand, thrive through the use of un-
claimed bodies (Gangata et al., 2010; Ihunwo, 2014; Mazyala et al.,
2014; Riederer and Bueno-López, 2014; Mwachaka et al., 2016; Habicht
et al., 2018). Notably, most health sciences institutions relying exclu-
sively on cadavers from body donations are from developed countries
(Gangata et al., 2010; Jones and Whitaker, 2012; Habicht et al., 2018;
Štrkalj et al., 2020). Gangata et al. (2010) reported that body donation
programs in African countries relied on donors of European descent,
rather than the indigenous African population. Besides facing compa-
rable challenges in obtaining cadavers from indigenous Africans, health
science institutions in Africa have encountered difficulties in establish-
ing effective body donation programs. The underlying sociocultural,
economic and political reasons leading to limited success in running
body donation programs utilizing indigenous African populations in
developing countries like Malawi are unclear (Štrkalj et al., 2020).
Recommendations may best be adopted and implemented if the specific
environmental context is first understood.

Malawi is a sub-Saharan developing country located in the south-
eastern part of Africa. Malawi has an estimated 19.8 million people,
mainly (97%) constituted by indigenous African populations that are
subdivided into ethnic groups, a small proportion of people of European
descent (0.04%) and people of mixed ancestry (2.5%) (Statistics, 2018).
The Malawian ethnic groups have distinct cultural and religious prac-
tices, though most of them overlap. The religious practices include
Christianity (77.3%), Islam (13.8%), Ancestral worship and others
(6.7%), with some (2.1%) who do not identify with any religion (Sta-
tistics, 2018; Demographics.. 2023).

In Malawi, human anatomy is taught in many public and private
health science colleges and training institutions, but Kamuzu University
of Health Sciences (KUHeS) is the only institution in Malawi that uses
cadaveric dissection in the teaching of anatomy. Three other public and
private health science institutions that require the use of cadaveric and
skeletal materials make use of the anatomy department of the KUHeS. At
KUHeS alone, human anatomy is taught to around 1000 students each
year across multiple courses, including Bachelor of Medicine Bachelor of
Surgery, Bachelor of Dental Surgery, Bachelor of Biomedical Sciences,
Allied Health Sciences (such as physiotherapy, pharmacy, and medical
laboratory sciences), Bachelor of Nursing and Midwifery, and post-
graduate biomedical sciences. To enhance their learning experience,
medical, dental surgery, and biomedical sciences students are given the
opportunity to perform in-depth full-body cadaveric dissections using a
regional approach with approximately 12–15 students per dissection
table. On the other hand, allied health profession teaching uses pro-
section, skeletal material, and plastic models.

KUHeS, formally known as the College of Medicine-University of
Malawi, was opened in 1991 as the first medical school and became an
independent university in 2021. At KUHeS, the (cadaveric) body
donation program was implemented in 2006. Remarkably, considering
over 17 years of existence of the body donation program, only a single
study has investigated and reflected on their impact and mode of
sourcing (Gangata et al., 2010). The current study aims to describe the
sources of cadaveric bodies for anatomy education and research in the
Malawian context, and critically reflect on the feasibility of imple-
menting the IFAA recommendations.

2. Material and methods

To determine the sources of cadavers for anatomy education, a
retrospective audit of the KUHeS Anatomy Department cadaveric re-
cords from 2006 (implementation of body donation program) to 2022
was done. This retrospective audit complies with the Anatomy Act 14 of
1990 of the Malawi Government (Act, 1990). The study ethical clear-
ance was waived by the University of Malawi’s College of Medicine
Research Ethics Committee (P/02/10/872). In addition, permissions
were obtained from the custodians of the cadaveric records. Information
retrieved included the total number of cadavers used per academic year,
the age and sex distribution of the cadavers, the sources of the cadavers
(body donor program or unclaimed body), geographical sites/location
from where the cadavers were sourced, and how the cadaveric remains
were disposed of after completion of the dissections per academic year.
For the donated cadavers, their sex and population affinity were also
recorded. The ‘2018 Malawi Population and Housing Census’ main
report (Statistics, 2018) was used to ascertain the proportions of the
Malawian population composition to determine their representations in
the dissection halls. Additional details regarding the perceived chal-
lenges to sourcing cadavers and their possible solutions are described by
the authors (A.T.M and A.M) in the results section, based on their ex-
periences in handling (collecting/receiving cadavers from their respec-
tive sources, prosection, maceration and/ or cremation) cadavers in
Malawi. These descriptions and perceptions were supplemented further
by informal discussions with three other anatomy staff members (tech-
nical) of KUHeS. The authors describe and rank the perceived challenges
from a list of common challenge themes found in the literature, such as
‘sociocultural’, ‘political’, ‘economic’, ‘religious’, and ‘legislative’, as
described by Štrkalj et al. (2020).

2.1. Data analysis

The retrospective audit record data were managed in GraphPad
Prism version 8.4.2. All the descriptive data were presented as fre-
quencies and percentages. The perceived challenge themes (for
example, "sociocultural" or "religious") were described based on the
authors ranking. No statistical analysis was conducted based on the
limited sample size.

3. Results

3.1. Sources of cadaveric bodies for anatomy education in Malawi

Between the 2006 – 2022 academic years, a total of 188 cadavers
were used for dissections (Fig. 1), representing an average of 11 ca-
davers per academic year, and an approximation of 12–15 students per

Fig. 1. A graph showing sex and source of cadaver distribution for the 2006 –
2022 period.

A.T. Manjatika et al.

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Annals of Anatomy 253 (2024) 152212

dissection table. Cadavers from the unclaimed bodies represented 97.3%
while the cadavers from the body donation program represented 2.7%
(5/188). The age at death ranged from 25 to 85 years (mean 45 years).
The cadavers were predominantly males (95.2%) with very few females
(4.8%). The unclaimed bodies were sourced from four main referral
(central) hospitals: Mzuzu central hospital in the northern region (about
700 km away from the university), Kamuzu central hospital in the
central region (about 400 km away), Zomba central hospital (about
70 km away) and Queen Elizabeth central hospital (about 0.5 km away)
in the southern regions of Malawi (Fig. 2). The majority (90.2%) of the
cadavers were from Zomba central hospital while few cadavers (1.0%)
were sourced directly from district hospitals in the southern region
(Table 1). The body donation program was implemented in Malawi in
2006 with the first cadaver being donated in 2008. One (1/5) of the
donated cadavers was a female of European origin. Of the remaining
male donated bodies, three were of European origin and one was a South
African of European descent. Following completion of the dissections,
the cadaveric remains of three (3/5) of the donated bodies were
cremated, one (1/5) was returned to their family for burial (typical
coffin burial) and one (1/5) was returned indefinitely to the Anatomy
Department Skeletal repository. KUHeS provided the burial and
cremation-related costs. The skeletal remains from all the unclaimed
bodies were retained indefinitely in the skeletal repository for teaching
and potential research purposes.

3.2. Perceived challenges of body donation in Malawi and possible
solutions

The perceived challenges during the sourcing of cadavers from the
body donation program in Malawi, were ranked as follows: (1) socio-
cultural, (2) religious, (3) unsubstantiated beliefs and (4) economical.

(1) Socioculturally, most indigenous Malawians practice unique
burial ceremonies that vary in the length of time before the
burial. Nearly all the burials occur within seven days after death
and this depends on where death happened (for example in the
home village, workplace in another district, or abroad/overseas)
and the intended burial site. In cases where a Malawian national
has died abroad or overseas, repatriation of the deceased is al-
ways facilitated to conform to cultural burial practices, for
instance, paying their ‘last respect’. As such, Malawian tradi-
tional societies consider it inappropriate and unacceptable as per

their customs to donate a body that may be retained after an
academic year for burial. Possibly, the use of prominent tradi-
tional leaders as an initial point of contact to support body
donation awareness campaigns may likely counter this challenge
and lead to increased patronage of the body donation program by
indigenous Malawians.

(2) Religion: most religious practices (Christianity and Islam) in
Malawi subscribe to the belief in life after death, and as such, a
deceased body is not expected to be dissected in any way. In a few
instances, the typical mortuary embalming, and post-mortem
examination practices also raise religious concerns. The ratio-
nale behind these beliefs is rarely studied and, hence, poorly
understood. Engaging with religious leaders in body donation
awareness campaigns may subsequently eliminate or reduce this
obstacle. This action, however, will best be implemented once the
support from the traditional leaders has been obtained, as tradi-
tional leaders are more influential than religious leaders in the
Malawian context.

(3) Unsubstantiated beliefs regarding the use of deceased human
body parts for ritual purposes were also perceived as a challenge
that had contributed to the lack of patronization of the body
donor program by indigenous Malawians. Numerous verbal and
written claims in Malawian local newspapers have been made
against mortuary attendants, suspecting them of removing some
body parts during routine embalming and post-mortems. Another
recent drawback to the body donation awareness campaigns
came in around the 2014 and 2019 Malawi general elections
period where claims of mass grave robberies were made nation-
wide. One possible way to overcome this challenge will be to
engage the current and past students who have dissected previ-
ously to explain to the communities how the cadavers and human
body parts are/were used as part of their training. This form of
public outreach will likely improve the current view on body
donation within local communities and families and in turn, in-
crease public support of body donation.

(4) Budgetary constraints also affect the mode of acquiring cadavers
for anatomy education in Malawi. With ever-increasing costs of
transportation due to the recurrent devaluation of the Malawian
currency, it has been challenging to acquire cadavers from do-
nors/unclaimed bodies residing outside the southern region of
Malawi. A dedicated budget, for example, a grant for this pur-
pose, may increase the number of cadaveric bodies available per
year. Malawian anatomists will have to explore education-related
grants to counter the financial challenges.

There were no perceived legal/legislative challenges as the Gov-
ernment of Malawi’s Anatomy Act 14 of 1990 (Act, 1990) allows the use
of both donated and unclaimed bodies for anatomy education and
research purposes. In addition to the legal provisions on the use of un-
claimed bodies, hospitals regulate the maximum period before the burial
of unclaimed bodies depending on the hospital’s storage capacity.
Hospitals store unclaimed bodies for a maximum of 30 days. If the

Fig. 2. A map of Africa showing the location of Malawi highlighted in grey. An
inset detailed map of regional Malawi further shows the location of the main
sources of unclaimed bodies and the location of the Kamuzu University of
Health Sciences. K=Kamuzu central hospital, M=Mzuzu central hospital,
Q=Queen Elizabeth central hospital, Z=Zomba central hospital.

Table 1
Cadaver source location for anatomy education over the past 17 years
(2006–2022).

Location Number of cadavers

Frequency (n) Percentage of total(%)

Mzuzu central hospital 1 0.5
Kamuzu central hospital 5 2.8
Zomba central hospital* 165 90.2
Queen Elizabeth central hospital* 10 5.5
Mangochi district hospital* 1 0.5
Thyolo district hospital* 1 0.5
Total 183 100

* represents hospitals in the southern region of Malawi.

A.T. Manjatika et al.

Annals of Anatomy 253 (2024) 152212

bodies remain unclaimed after this time, they are referred to the medical
schools for possible teaching and research purposes, or to the District or
City Assemblies for disposal in mass graves at government cemeteries.
The Malawi Police is involved in this process.

4. Discussion

This study aimed to describe the state of acquisition of cadavers for
anatomy education in the Malawian context. The results show that the
average number of eleven (11) cadavers per year is small as demon-
strated by the high student-to-cadaver ratio (12–15 students per
cadaver). With ever-increasing student enrolments, it may be recom-
mended to increase the number of cadavers per year to achieve high
levels of quality education and safety during dissections as per recom-
mendations of the Basic Medical Education (BME) and Occupational
Safety Health Administration (OSHA), (OSHA. 2005; BME, 2020). The
current findings show that the mode of acquiring cadavers in Malawi is
“mostly unclaimed bodies (and, less often, body donation)”, and this
supports previous reports (Habicht et al., 2018). Similar to some other
African countries, the concept of body donation is yet to be accepted by
indigenous Malawians (Akinola, 2011). Despite legal provisions on the
use of unclaimed bodies, the predominance of unclaimed bodies raises
major ethical and moral concerns including loss of dignity of the
deceased as no consent was sought, exploitation and social injustice as
unclaimed bodies are often from low-income individuals (IFAA, 2012;
Kramer and Hutchinson, 2015).

In the current study, most of the unclaimed bodies were younger
adults, similar to the cadaveric profile of unclaimed bodies from other
studies (Kramer and Hutchinson, 2015). The use of younger adults for
dissections may be advantageous as most of the body organs are well
preserved. Body donation programs may likely have more elderly people
(Cornwall et al., 2012) and most of the structures may be affected by
age-related changes. For a good representation of the young and elderly
populations, the use of both unclaimed and donated bodies for anatomy
education may be recommended. While most of the body donors may be
from nursing homes/institutions for the elderly, there are limited
nursing homes and elderly clinics in Malawi (Cornwall et al., 2012;
Nyasa et al., 2019). This may be because living in extended families is a
common practice in Malawi and most elderly people live together with
their families. Possibly, this may be based on socioeconomic reasons
considering the high cost of living associated with being at a nursing
home.

Fewer female cadavers were utilized in our context. This is similar to
the cadaveric composition of many countries where female cadavers
form a minority percentage of both donated and unclaimed bodies
(Labuschagne and Mathey, 2000; Hunt and Albanese, 2005; Techata-
weewan et al., 2018; Popoola et al., 2020). The sex of the cadaver be-
comes important when teaching reproductive and urinary systems
(Hurren, 2004; Osuagwu et al., 2004). Difficulties may be experienced in
demonstrating the female reproductive and urinary systems based on
current cadaveric availability. It is believed that females are less likely to
find themselves in situations that may result in an ‘unclaimed’ status of
their bodies as they are mostly at home and do not travel extensively in
many African settings. Males, on the other hand, are considered
breadwinners and they may travel a lot to make ends meet for their
families and may find themselves in unfamiliar environments (for
example migrant workers), making it difficult to be traced by their rel-
atives when they are deceased (Gugler, 1989).

The findings show that Zomba central hospital is the main source of
unclaimed cadaveric bodies in Malawi. This may be because the
maximum-security prison in the country is located in the Zomba district,
just adjacent to the Zomba central hospital. Prisons are well-known
sources of many unclaimed bodies in the literature (Gangata et al.,
2010; Ghosh, 2015). The findings also show that the cadavers are
sourced mostly from the southern region hospitals which share prox-
imity and logistical advantage with the KUHeS. This study supports the

proposition that most of the cadavers may be easily sourced from areas
in proximity to the university as this lessens the burden of transportation
costs (Alblas et al., 2018). The unclaimed bodies may require specialized
storage and preservation before they are transported to the health sci-
ences institutions (Štrkalj et al., 2020). As such, most hospitals, espe-
cially those far from the university (over 300 km) may prefer the burial
of the unclaimed bodies which is more cost-effective on their side. The
advances in mass communication, for example, the use of social media,
will lead to a decrease in the availability of unclaimed bodies. With
better communication means, there will be fewer missing persons and
therefore fewer unclaimed bodies. With logistical issues and fewer un-
claimed bodies, a massive strain will ensue for anatomical education and
body donor programs will be relied upon more heavily. This situation is
a wake-up call for the Malawian anatomists to explore new ways to
promote the body donation program beyond its current level.

Importantly, the body donor program in Malawi has been patronized
only by people of European descent. The limited patronage by the
indigenous African Malawians to donate their bodies to date may imply
that the implementation of IFAA recommendations to use cadavers
‘exclusively from body donation’ is still far from being a reality (IFAA,
2012). With one body donation every 3–4 years, the number of cadavers
from the body donation program alone is insufficient to meet the anat-
omy education needs per academic year (De Gama et al., 2020).
Notably, some American and United Kingdom institutions that relied
only on body donors as the sole source of cadavers following the
introduction of the Human Tissue Act of 2004 (Human Tissue Act.
2004), had registered a significant decline in the number of cadavers
available for dissection, and this potentially affected the quality of
anatomy education (Buchanan, 1997; Renstrom, 1997; McLachlan,
2004; Stott, 2008). However, intense promotion of the existing body
donation program in Malawi may make the transition from the use of
‘mostly unclaimed bodies (and, less often, body donation)’ to ‘mostly
body donations (and, less often, unclaimed bodies)’ feasible (Štrkalj
et al., 2020). From the educational point of view, it is important that
students have access to high-quality education (OSHA. 2005; BME,
2020) through the availability of sufficient cadavers, acquired either
through unclaimed bodies or body donation programs or both. Thus, a
move towards the use of ‘mostly body donations (and, less often, un-
claimed bodies)’ will ensure the availability of sufficient cadavers for
teaching and learning purposes.

The procedure of acquiring cadavers through the body donation
program in Malawi follows suit with that practiced by other countries
(Kramer and Hutchinson, 2015; Techataweewan et al., 2018). During
the early years of the implementation of the body donation program,
Malawian anatomists faced challenges that led to decreased efforts in
awareness campaigns to the general public (indigenous Malawians), and
hence, an increased reliance on unclaimed bodies. As such, all the
donated bodies used so far were purely by self/family initiative. There is
a paucity of literature on African countries that run successful body
donation programs involving indigenous African populations, with the
exception of South Africa. Some institutions in South Africa have been
successful in running body donation programs with donors of European
descent (Kramer and Hutchinson, 2015). It is important to note that
South Africa is a further developed country and has a different
socio-economic status compared to Malawi.

The Malawian sociocultural context is similar to that of other African
countries which have limited success with body donations programs
utilizing indigenous African populations (Monteiro-Ferreira, 2005;
Akinola, 2011; Ngubane, 2012). Notably, other South African cultures
which also strongly opposed the use of the human body for dissections
previously are now appreciating this as a way of advancing medical
practice and education (Bhengu and Uys, 2004). While religion plays a
significant role in the success of body donation programs in other
countries outside Africa (Roach, 2004; Garment et al., 2007; Techata-
weewan et al., 2018), it acts as a barrier in the Malawian context, similar
to other African countries (Akinola, 2011; Anyanwu et al., 2011; De

A.T. Manjatika et al.

Annals of Anatomy 253 (2024) 152212

Gama et al., 2020). As opposed to the early years of cadaveric dissections
globally where most religions opposed human dissection (Ghosh, 2015),
there have been positive developments, for example, in Thailand, where
mainstream religions are now accepting the use of human bodies for
dissections and organ donations (Techataweewan et al., 2018). The
support of religious leaders also played a significant role in promoting
body donation programs in some American and United Kingdom in-
stitutions (Roach, 2004; Garment et al., 2007).

The request for body donors is mainly based on altruism and ethical
reasons (Gunderman, 2008; Bolt et al., 2011; Techataweewan et al.,
2018; Smith et al., 2022), however, such requests in the current Mala-
wian political environment may likely raise more suspicions and solidify
the existing unsubstantiated beliefs. Economical/budgetary constraints
are well known to affect the mode of acquiring cadavers in many
developing countries (Štrkalj et al., 2020). Relying on cadavers from an
‘exclusively body donation program’ requires dedicated funds for
specialized transportation of the bodies, storage and maintenance,
disposal and end-of-year commemoration services (Wingfield, 2018).
Additional funds are also needed for the staff members involved in body
donation awareness campaigns (Štrkalj et al., 2020). As such, most
developing African countries rely on the relatively cost-effective means
of sourcing cadavers (using unclaimed bodies) for anatomy education.

The small number of total cadavers sourced in Malawi appears to
have affected cadaveric research output and explains the limited num-
ber of cadaveric studies done in the Malawian populations, with most
studies instead focusing on osteology (Mwakikunga et al., 2016, 2021;
Matundu et al., 2021; Nyasa et al., 2021a, 2021b; Kaledzera et al.,
2022). The use of unclaimed bodies for research poses potential biases
when interpreting the findings as some demographic data like popula-
tion affinity, age, and associated data like occupational, medical and
genetic history may not be available. Additionally, unclaimed bodies are
not an accurate representation of the general population as factors like
socioeconomic status, sex, age or cause of death may contribute to who
becomes an ‘unclaimed body’, as such, the research findings from un-
claimed bodies may not be generalizable to the general population.
Limited population-specific literature may pose challenges in clinical
and forensic anatomy as many anatomical variations are considered
population-specific, and population-specific studies are recommended
to substantiate the emerging new variation patterns.

5. Conclusion

Cadavers for anatomy education in Malawi are mainly sourced from
unclaimed bodies, similar to other African countries. A combination of
factors amongst indigenous Malawians including unwillingness to
donate based on beliefs, misinterpretations, and limited public aware-
ness are current challenges in strengthening the body donation program
within Malawi. In addition, limited resources, logistical difficulties, and
insufficient funding add to the challenge and require a different
approach and effort. As student numbers increase, the most effective and
feasible anatomical teaching methods will need to be adapted accord-
ingly. Further promotion of the body donation program may lead to a
more equitable balance between donated and unclaimed bodies and
therefore not only improve anatomy education and research but may
also ensure legally and ethically acceptable practices of anatomy edu-
cation are maintained in the future.

Funding

None.

Ethical statement

This retrospective audit was conducted in compliance with the
Anatomy Act 14 of 1990 of the Malawi Government. The study was
waived by the University of Malawi’s College of Medicine Research

Ethics Committee (P/02/10/872).

CRediT authorship contribution statement

Manjatika Arthur Tsalani: Conceptualization, Data curation,
Formal analysis, Methodology, Writing – original draft, Writing – review
& editing. Davimes Joshua Gabriel: Writing – review & editing.
Mwakikunga Anthony: Methodology, Writing – review & editing.

Declaration of Competing Interest

The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.

Acknowledgements

The authors are grateful to Mr B. Matundu and Mr B. Ndoma for their
help with access to the data. The authors also thank Dr B. Billings and
Prof G. Strkalj whose advice improved the quality of this work. We are
also grateful to those whose bodies (donated or unclaimed) are being
used for anatomy education.

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Acquisition of cadavers for anatomy education and research in Malawi
1 Introduction
2 Material and methods
2.1 Data analysis

3 Results
3.1 Sources of cadaveric bodies for anatomy education in Malawi
3.2 Perceived challenges of body donation in Malawi and possible solutions

4 Discussion
5 Conclusion
Funding
Ethical statement
CRediT authorship contribution statement
Declaration of Competing Interest
Acknowledgements
References

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P259 Lion cheetah orexin
Orexinergic neurons in the hypothalami of an Asiatic lion, an African lion, and a Southeast African cheetah
Abstract
1 | INTRODUCTION
2 | MATERIALS AND METHODS
2.1 | Specimens
2.2 | Sectioning and immunohistochemical staining
2.3 | Anatomical reconstruction and photomicrography
2.4 | Stereological analysis

AUTHOR CONTRIBUTIONS
ACKNOWLEDGMENT
CONFLICT OF INTEREST
DATA AVAILABILITY STATEMENT

ORCID
PEER REVIEW

REFERENCES

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