In the Philippines, a Doctor Unearths a Drug War’s True Toll

Raquel Fortun, one of only two forensic pathologists in the Philippines, is using her skills to show how other doctors falsely claimed some victims of the country’s drug war had died natural deaths.

QUEZON CITY, Philippines — Standing in a university classroom surrounded by six skeletons lying on wooden tables, Raquel Fortun held up the broken skull of a man who was slain during President Rodrigo Duterte’s drug war.

She poked a finger through a hole in it.

“This looks like an entry,” said Dr. Fortun, who is one of only two forensic pathologists in the Philippines. “So an apparent gunshot wound to the head for this one.”

Since July 2021, Dr. Fortun, 60, has been quietly examining these bones at the behest of a Catholic priest, the Rev. Flaviano Villanueva, and the families of the victims.

What Dr. Fortun discovered made headlines in the country.

Out of 46 remains that she had examined, there were seven cases in which the death certificates had stated that the cause of death was natural, though her investigations showed them clearly to be homicides. The findings, disclosed at a news conference in April, raised questions about whether medical authorities were complicit in a cover-up.

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Dr. Fortun’s discovery also suggests that the true extent of the drug war could be far bigger than what the government has disclosed. Rights activists have long argued that the number of people killed — up to an estimated 30,000 since 2016 — is far higher than the official figure. The Philippine National Police puts the number at over 6,200.

Before Dr. Fortun, there had been no independent inquiry into the drug war, including its many casualties. The International Criminal Court said last year that it would open an investigation, but the Duterte administration said it would block investigators from entering the country.

In response to Dr. Fortun’s findings, the Philippine National Police said it would conduct its own investigation into falsified death certificates, though any conviction is unlikely. Since the drug war began, only three police officers have been imprisoned — for the murder of a 17-year-old boy.

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In a country where the justice system is weak, where extrajudicial killings are common, and where forensic pathology is almost nonexistent, Dr. Fortun has a kind of celebrity status. Family members of homicide victims either ring her up at the University of Philippines College of Medicine, where she chairs the pathology department, or track her down on social media.

She is skeptical of the police narrative that many suspects in the drug war were killed because they tried to fight back. She has been critical about the lack of a proper death investigation system in the Philippines that allows the police to handle the evidence, the witnesses and the bodies of victims killed in police shootouts.

“That’s how you get away with murder. Easily,” she said in an interview in her office. “And here I am in my ivory tower, saying: ‘No though, you’re wrong. You’ve missed this, you’ve missed that.’ How do you think they feel about me?”

“They hate me,” she said, chuckling.

Dr. Fortun grew up in Quezon City in a family of lawyers and doctors. As a child, she loved disassembling items, wanting to find out what was wrong with a broken doorknob or car part. She said she gravitated toward pathology, seeing it as “the backbone of medicine.”

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Dr. Fortun graduated from medical school in the Philippines in 1987 and started her residency training in anatomic and clinical pathology in 1989 at the University of Philippines’ College of Medicine.

But it was a one-year training course in the King County Medical Examiner’s Office in Seattle in 1994 that led her to focus on forensic pathology. Dr. Fortun left her 4-year-old daughter, Lisa, behind with her in-laws. “That was the most difficult thing ever,” she said.

In a telephone interview, Dr. Richard Harruff, the chief medical examiner at King County and Dr. Fortun’s former boss, said he enjoyed being her mentor because “she wasn’t afraid of anything.”

“She was just as good as any pathologist that I’ve ever trained over the years,” he said. “She just basically absorbed everything, and decomposed bodies and skeletal remains were not a factor at all. She just did the work.”

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Over the years, Dr. Harruff said he “always wondered how she managed not to get killed or assassinated.”

It’s a question Dr. Fortun has given a lot of thought to herself.

“Am I at risk? Should I consider moving elsewhere?” Dr. Fortun wondered aloud. “There’s a certain effect on your psyche. You’re not safe. Knowing that in the Philippines, assassins can simply come near you, start shooting and get away with it.”

Whatever the dangers, Dr. Fortun makes no effort to mince her words.

She is voluble on Twitter, where she tweets under the account @Doc4Dead. In 2016, she angered Mr. Duterte’s daughter, Sara Duterte, after she questioned whether Ms. Duterte’s announcement of being pregnant with triplets was part of a public-relations campaign for her father. Ms. Duterte, who is set to become the vice president on June 30, called Dr. Fortun a “bitter melon” and urged her to “turn off her Twitter.”

Dr. Fortun’s work has taken her to Cyprus, The Hague and East Timor. She would make more money if she practiced medicine abroad full time, but said she felt “there was always this guilt that I’m not in the Philippines where I’m needed.”

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Most mornings, Dr. Fortun arrives at her makeshift lab in the University of the Philippines’ College of Medicine that she hastily put together with tables sourced from a junkyard. She works alone, sifting, piecing and gluing the bones together. In the past month, those mornings were interrupted by a radiotherapy program to treat early-stage breast cancer, after which she would head to the lab.

“When I’m there in the room with all of these skeletons, I feel that I’m giving them what was denied to them before,” she said. “They were not given a proper investigation, no proper examination. So I’m trying to see what was missed.”

Several things have stood out to Dr. Fortun: the victims were nearly all men, the majority had head wounds, and they were the “poorest of the poor.”

She held up a jawbone without teeth. “They’ve probably never seen a dentist in their life,” she said.

Dr. Fortun is working for free — she charges Father Villanueva about $96 per body to cover only the costs of materials. With more and more bodies that need to be exhumed, she said she “is on a treadmill.”

Ezra Acayan for The New York Times

Dr. Fortun said she hopes to get help from the international forensic community but acknowledged it was unlikely even when Mr. Duterte leaves office. Ferdinand Marcos Jr., elected president in May, has indicated he would not help pursue the I.C.C.’s case and would only allow investigators to enter the Philippines as tourists.

What troubles Dr. Fortun the most, she said, are the unidentified. “What happens to the unnamed, unclaimed bodies?” she asked. “Where are they?”

Dr. Fortun saves hair and finger nails to remind herself that these “were all part of somebody.” Halfway through the interview, she rummaged in a shelf behind her desk and brandished a clear plastic bag of kneecaps she is keeping for possible DNA analysis. (“I love the patella!” she cried.)

“You never lose sight of the fact that you’re dealing with a person,” she said. “Especially when you meet the relatives.”

Ezra Acayan for The New York Times

In presenting his case to the families to have their loved ones’ remains assessed, Father Villanueva, known as “Flavie,” said he told them “we have bones that could speak.”

“In Tagalog, we call it bones of truth,” said Father Villanueva, the founder of the AJ Kalinga Foundation, a nonprofit that is helping victims’ relatives. “Because the bones cannot lie.”

After finishing her examination, Dr. Fortun explains her findings to the families. Father Villanueva said he has seen many of the relatives embrace the urns with their loved ones’ ashes, while listening to her.

Father Villanueva said he knew there was only one person he could turn to to examine the bones. He had never doubted Dr. Fortun as far as her “sense of justice is concerned,” he said, and recalled her excitement when he told her about his plan.

“She’s been demanding, craving, and on a minimum, asking, that we bring bodies to her,” he said.

Five years away from retiring, Dr. Fortun said she sees this project as a culmination of her life’s work.

“When Father Flavie started referring them, I felt the sense of satisfaction, that, OK I’m going to make use of what I know,” she said. “Finally, I wouldn’t feel so useless. I shouldn’t have those regrets anymore of staying.”

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