Cadavers of Hawaii residents are being studied by hundreds of foreign doctors from Asia and the Pacific, many of whom don’t have access to donated bodies in their own countries because of cultural constraints.

An estimated 600 surgeons — half of whom are from China, Korea, Japan, Thailand, Australia, New Zealand and other Pacific Islands — are using local cadavers donated to the University of Hawaii John A. Burns School of Medicine.

“Throughout the Pacific and Asia there’s a shortage of cadavers so they’re very restricted as to who can have access. A lot of it has to do with different religions,” said Steven Labrash, who runs the medical school’s Willed Body Program, which aims to advance science in Hawaii and the Pacific region. “The doctors themselves are incredibly appreciative. They do a prayer even before they start anything with a donor body. They’re giving thanks.”

The foreign surgeons use the cadavers on weekends when students aren’t in school to learn new techniques and train on the latest equipment in their field. That’s in addition to the more than 100 medical students using the bodies to study anatomy each year. The school receives an average of 150 cadavers annually, up from the roughly 30 it collected more than a decade ago.

Over the past fiscal year, the school trained 460 surgeons or residents and another 288 participants in anatomy courses in addition to more than 1,000 college and high school students and 120 emergency personnel.

“We don’t market it. We don’t do any advertising. It’s essentially word of mouth,” Labrash said. “The human body is such a personal thing. We haven’t found a comfortable way for us to advertise. (The program has) grown a little bit every year. We have more requests for educational opportunities than we have donors that can fit those opportunities.”

Natthamon Kongkasuriyachai, 42, a Ph.D. student from Thailand studying forensic osteology at Chiang Mai University, is researching the differences in skulls of varying ethnic groups at JABSOM.

“It’s a great opportunity to come here because I cannot get white skulls or black skulls or other Asian skulls in my country,” said Kongkasuriyachai, an anthropology researcher on scholarship funded by the Thai government. “It’s a very great chance for me to develop my knowledge.”

JABSOM has curated about 120 skulls from known identities in the islands — more than 70 Caucasian, about 25 Asian and another 25 are a racial mix. The collection is unique in that many are of mixed ancestry not found in other schools around the globe, said Dr. Robert Mann, a forensic anthropologist and professor in anatomy and pathology, who formerly worked at the Smithsonian Institution.

“We know who they are — their ancestry, sex, age, some of their medical history — so we’re able to take measurements and look at the skulls to see the differences between (ethnic groups),” he said. “These skeletons help us better understand how people age, how bones age differently, how different diseases affect different population groups.”

At least one Japanese orthopedic surgeon from the Funabashi Group Hospital has attended half a dozen trainings each year for the past decade, Labrash said. Physicians are typically required to update skills and complete continuing education courses annually to maintain their medical licenses.

Training other medical providers helps to offset some of the operational costs of running the medical school, which collected continuing medical education fees totaling $97,473 from June 2016 to July, up from $78,600 the previous year.

“We’re a nonprofit, so we can’t generate money on any of this. But there is a cost associated with all of this,” Dr. Scott Lozanoff, professor and chairman of the Department of Anatomy, Biochemistry and Physiology. “There’s a certain fee to actually utilize our facility that goes back to the university. We’re here as an educational institution, and that’s our primary goal.”

A potential donor must apply to be accepted into the program. The school has a 72-hour window after a donor dies to bring the body to the university for blood testing to ensure it is free of contagious diseases like hepatitis and HIV.

Bodies are later cremated and returned to their families or remains are scattered after an annual memorial service each April. Next year, more than 150 donors will be honored at the ceremony, typically attended by hundreds of family members and friends.

The school tries to match a cadaver with educational courses based on medical history, surgeries and physical body traits. UH spends about $1,000 for every donated body for mortuary transportation service, blood testing, cremation and other expenses.

“With all those foreign doctors, we’re being recognized really as one of the top medical schools in the nation because of our global reach,” said former TV journalist Emme Tomimbang, who donated the body of her husband, James Seishiro “Jim” Burns, to the program. “I am so proud.”