Managing mass disasters linked to the sinking of illegal migrant boats: experiences of the Sfax forensic medicine service.

Background: The sinking of illegal migrant boats has been unpredictable. It has resulted in mass disasters that cause deaths and attracts huge media attention, thus making it a medico-social emergency. Aims: This paper reports activities of the forensic medicine service in Sfax, Tunisia and describes the forensic management of mass disasters related to the sinking of illegal migrant boats as well as the main challenges. Methods: This is a retrospective, descriptive study that includes all cases of drowning deaths examined at the forensic department of Habib Bourguiba Hospital, Sfax, following the sinking of illegal migrant boats over a four-year period (October 2017 to September 2021). Results: During the study period, we received 539 corpses following the sinking of illegal migrant boats. The median number of deaths was 93 per year. There was a significant decrease in the number of victims in 2019 (13 victims), followed by a significant increase in 2020 (115) and 2021 (271). We noted two frequency peak periods in June and July, 31.4% and 20.8%, respectively. The victims were mostly male (67.5%) with a sex ratio of 2.08. Minors aged under 18 years were 5.8% and pregnant women were 2.4%. The majority (63.1%) of the victims were of sub-Saharan origin and there has been an increase in the number of victims from this region over the past two years. Samples were systematically collected for genetic investigation and 146 (27.1%) victims were identified. Conclusion: There have been significant advances in the identification of the victims of migrant boat sinking around the Tunisian coast, however, there are several challenges in providing information rapidly to the families of the victims to clarify the uncertainty about the fate of their missing loved ones.

[Medico-legal issues of the practice of ritual circumcision by nurses in Tunisia]. / Enjeux médico-légaux de la pratique de la circoncision rituelle par les infirmiers en Tunisie.

Circumcision is the most performed surgical procedure in the world. This removal of the foreskin answers most often to an obligatory ritual practice in the Jewish and Muslim religions. In Tunisia, this act, formerly practiced by customary circumcisers, is mainly performed by nurses. In case of complications, the responsibility of the latter remains unclear, in the absence of regulations specific to this ancestral practice, with the exception of two ministerial circulars.

Criminal medical liability in the context of Covid-19 pandemic.

The COVID-19 infection causes to medical community many difficulties worldwide. In addition to its therapeutic problems, it can generate situations with high medico-legal risk to doctor who can see his criminal medical liability engaged. In fact, in Tunisia, this new infection imposes many specific legal obligations. Some of these obligations have recently been introduced, therefore still little or not known by doctors, despite the need for them to comply with. In this paper, we propose to analyse the circumstances of medical practice in Covid-19 pandemic period , which risk to engage the doctor's criminal medical liability, and to set out the sanctions incurred, in order to protect health professionals against the specific legal risk of this emerging disease.