No bones wanted: The legacy of the bone trade and Medical School

Warning: The subject matter of this article may be distressing to some due to discussions about children, death, and handling of dead bodies.

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At Skepticon 2021 (our combined conference with the Australian Skeptics), guest speakers Dr. Judy Melinek and TJ Mitchell spoke about the importance of organ donation and donating one's body to science (Discussion starts at the 51:14 mark). One of Dr. Melinek's own postmortem plans was to have their body made into a meal for flesh-eating beetles, and then have the skeleton rearticulated for display at UCLA. The rationale, as Mitchell explained, was due to the current rarity of human skeletons available as a teaching aide.

And boy, I did not expect the flashback I had with that comment.

Nearly two decades ago, as a 20 year-old having a crisis of faith about university studies, I took a semester of art courses which included two of the more popular offerings from the Anthropology department: the late Elliot Leyton's War and Aggression course, as well as Forensic Anthropology. As you do, I made a friend who attended the same classes and joked that it was funny that in a course about forensic anthropology, there were very few opportunities to handle bones. In turn, my acquaintance claimed that while the University had a large collection of skeletons, a lot of them had to stay in storage because of unknown provenance, cultural sensitivity with regards to indigenous specimens, or because they were from India - which introduced further ethical considerations, including the exploitation of the Dalits, one of the most marginalised groups in India (in particular the Doms, which are the lowest ranks of the Dalits and earn their livelihood through death work).

The latter statement surprised me but, as it turned out, was far more troubling than my friend let on. Trade in human skeletons from India went as far back as the 1830s with the East India Trading Company, where the handling of human remains was seen as a low caste activity and thus an opportunity to earn an income. As decomposing bodies would not last the journey back to Western medical schools, India became best known for high-quality, articulated skeletons. One of the leading exporters was Reknas, which operated out of Kolkata (modern-day Calcutta) and was exposed in a 1943 edition of Life magazine as sourcing its skeletons from famine victims and the killing fields of Bengal. By 1985, around the time the Government of India issued its ban on the export of human remains, Reknas retired owner Sanker Narayan Sen had changed his tune, revealing some trade secrets during his campaign against his former livelihood.

In an India Today article, it's stated that deforestation meant that wood required for cremation was difficult to come by. Thus, bodies were either abandoned or handed over to members of the Dom caste to remove. While the Police had to give clearance and certify that any skeletons for export came from riversides and not from burial sites or funeral pyres, this certification was easily forged. The problem with riverside skeletons was that they were often incomplete, and Sen claimed that Doms would work in hospitals and remove coccyx bones from different cadavers in order to complete their specimens. Other exporters were accused of sourcing their stock from burial or cremation grounds, or even from the murder of children. In 1985, 1,500 human bones suspected of being those of kidnapped and murdered children were found in a container during a customs inspection in India, which finally brought about the ban; at that time, India was exporting 60,000 skulls and skeletons worldwide per year. Medical schools in the US and Europe were unsuccessful in their attempts to have the ban repealed.

In the shadow of the initial market collapse, western countries initially turned to China (which banned exports of human remains in 2008) and Eastern Europe, but found their output wanting. But as it turns out, the market never really died in India, nor did it go underground. If anything the ban has made the business more profitable than ever, with skeletons fetching thousands of dollars in Western countries, while those who do the dangerous labour of sourcing and prepping the bones are paid less than $2.00 USD/day for their efforts.

Despite the existing market, universities don't always have deep pockets or questionable morals. Processing a skeleton is a painstaking and unpleasant business, and high demand for fresh cadavers for their medical students takes up most of the supply of cadavers donated to science. Over the course of a degree and other forms of scientific research, a skeleton cannot be preserved as it is sawed apart and damaged by students, and, as per programme policies, destined for cremation. Many universities have embraced the mantra of reduce, reuse, recycle, and hence keep an inventory of skeletons that are only replaced on an as-needed basis; Stanford Medical School even cleaves a skeleton in half with each student receiving half, like a bad TV sitcom. This is a workable solution for established institutions, but new or expanding schools are still paying for new specimens.

On the other hand, some universities are reconsidering the need for, and value of, an authentic human skeleton. A representative for one New Zealand body donation programme advised me that they often take donations of specimens from schools and other teaching institutions where holding human tissue has become an issue. Plastic replicas are common but controversial, with differing opinions about their fidelity and their usability in fields like dentistry. There are aspects of human skeletal growth and the impact of disease which are not captured by a singular adult mould. Children's bones, such as the ones which finally instigated the ban in India, were valuable because they were rare, and illustrated transitional states in osteological development.

The lack of skeletons was more obvious to me when I started my Midwifery studies a decade later. Most of the pelvises we practised mechanisms of labour with were plastic, and the supposedly real skeleton in the polytechnic's collection that was brought out to us had the hallmarks of a male pelvis. Of course, I now had the additional context of New Zealand's multicultural setting, including Tikanga Māori and Pasifika perspectives on human tissue and remains, to explain the dearth of authentic skeletal specimens in my education.

While the academic market is in a lull compared to the halcyon days pre-1980, social media seems to be spurring the growth of private ownership. Doctors (or their descendents or new home buyers who have the misfortune of finding a forgotten piece of “property”) who bought boxes of bones for their students are having to face the legacy or redundancy of their purchase. In Australia, attempts to donate the remains to universities have reportedly been met with rejection and the police, understandably, have responded with a coronial inquest at least once. Concurrent efforts by museums and countries to repatriate bones and fragments to their countries of origin, restricting the addition of new pieces of human remains, and ongoing reflection and reevaluation of colonisation, are also cited as drivers of growth in this sector. In New Zealand, kōiwi tangata Māori (Māori human skeletal remains) are not displayed in NZ museums nor used for teaching.

Some bones go to an enterprising medical student, and others are misguidedly sold as halloween decorations, but it is not uncommon for these sets to find a home with private distributors and sellers. One such entrepreneur is former Aucklander Ben Lovatt, who operates his business, The Prehistoria Natural History Centre and Skullstore Oddity Shop, in Toronto, Canada. While eBay and Trade Me ban the sale of human remains on their platforms, trade on Instagram and TikTok is booming, with some influencers taking extreme liberties in altering the skulls in a manner that is culturally inappropriate and offensive.

So, it seems, if you are in New Zealand and your end-of-life request is to become an articulated skeleton, you are out of luck both here and possibly abroad. Unless, say, you want to try your luck in Alberta or with Skulls Unlimited in Oklahoma, where some people have had success with having amputated limbs cleaned and articulated.