Mass disaster.pdf

MASS DISASTER VICTIM IDENTIFICATION BY ANGELIE OROPILLA, MD

Disaster • occurrence of widespread severe damage injury or loss of life or property, with which a community cannot cope and during which the affected society undergoes severe disruption

MASS DISASTER VICTIM IDENTIFICATION • Procedures to properly, accurately and scientifically identify the deceased victims of a multiple fatality incident for medico-legal purposes.

OBJECTIVES •

• •

•

Identify disaster victims using reliable scientific methods. Determine the cause, manner and mechanism of death Recover and document clothes and personal effects of the deceased Recover and document possible evidence of criminal activity from the body of the victim that will aid in the investigation of incidents, whether civil or criminal in nature, in which the Government/ public may be interested.

LEGAL BASIS • MEMORANDUM OF AGREEMENT (2001) • DOH A. O. # 2007-0018 • MANAGEMENT OF THE DEAD & MISSING

• NDRRMC ACT OF 2010 • MEMORANDUM OF AGREEMENT (2011) • NBI / PNP LAWS • PD 856

Management of the Dead, the Missing, and the Bereaved Families

DOH

Assistance to Search and Recovery

DND – AFP/ PNP BFP-SRU PCG DILG PNRC LGU Leagues

Identification of the Dead

Final Arrangement

Handling the Missing

NBI/ PNP-CL Forensic Experts Academes LGU Leagues

DILG LGU Leagues Mortuary Cemetery Religious Organizations

DSWD DILG PNRC NBI PNP LGU Leagues

Bereaved Families

DSWD DOH, PNRC DILG Insurance Companies/ Commission Social Security Groups LGU Leagues

Search andRecovery DND – AFP/ PNP BFP-SRU PCG DILG PNRC LGU Leagues

Identificationof the Dead NBI = Natural Disaster PNP-CL= Man-made Disaster Forensic Experts Academes LGU Leagues

Final Arrangement

DILG LGU Leagues Mortuary Cemetery Religious Organizations

Handling the Missing

DSWD DILG PNRC NBI PNP LGU Leagues

Assistance to Bereaved Families

DSWD DOH, PNRC DILG InsuranceCompanies/ Commission Social Security Groups LGU Leagues

ANTEMORTEM DATA

BODY RECOVERY

POSITIVEVISUAL ID

BODY RECEPTION/STORAGE

BODY EXAMINATION UNIT

FINGERPRINT

PHOTOGRAPHY

PATHOLOGY

COMPUTER DATA ENTRY / DATA COMPARISON

MATCH

IDENTIFICATION BOARD

BODY RELEASE

DENTISTRY

DNA

DISASTER VICTIM ID PHASES • PRE-OPERATIONAL PHASE • RECOVERY PHASE • POSTMORTEM PHASE • ANTEMORTEM PHASE • RECONCILIATION PHASE

RECOVERY • BODY BAGS • Plastic sheets, shrouds, bed sheets

• Body parts are treated as individuals • 2 groups • One to collect • One to transport to storage area

• Ambulances should not be used to transport. Use flatbed trucks or tractor trailers

RECOVERY • Personal belongings, jewelry & documents should not be separated from the corresponding remains during recovery

BODY STORAGE •

Endorsements from Recovery team

•

Tag body with unique number (location + recovery unit/indiv + body#)

•

keep a record of each cadaver in a logbook.

BODY STORAGE •

maintain a record of cadavers examined in a logbook

•

Periodic inventory of examined and unexamined cadavers shall be reported to the site commander

BODY STORAGE •

cryofreeze at –20C and thawed at +4C so that they become soft enough for examination.

•

dry ice • • • •

For short term storage Should not be placed on bodies Build low wall of dry ice around groups of 20 bodies and cover with a plastic sheet, tent Produce CO2, use in areas with good ventilation

BODY STORAGE •

ICE- Avoid where possible because: • • •

•

Melts quickly and large amounts needed Melts to large quantities and may cause concern about diarrheal disease May damage bodies and personal belongings

LIME – “apog” •

Should not be used as a preservative

BODY STORAGE •

TEMPORARY BURIAL • •

• • •

use individual burial for a small number of bodies and trench burial for larger numbers burial should be 1.5 meters deep and at least 200 meters from the water source leave 0.4 meters between bodies Lay bodies in one layer only (not on top of each other) Clearly mark each body and their positions above ground.

IDENTIFICATION PHASE • PRE-OPERATIONAL PHASE • POST-MORTEM PHASE • ANTE-MORTEM PHASE • RECONCILIATION PHASE

PRE-OPERATIONAL PHASE • ACTIVATION

• Request (verbal or written)

• COORDINATION WITH NBI REGIONAL OFFICE • COORDINATION WITH OTHER AGENCIES AFP PNP

DOH PNRC

ICRC

• COORDINATION WITH LGU • Governor • Mayor • Municipal Engineer • Municipal Health Officers

• ESTABLISHMENT OF AN OPERATIONS BASE

OPERATIONS BASE

INCIDENT COMMANDER

SCIENTIFIC COMMITTEE

MORTUARY SITE COMMANDER

LOGISTICS OFFICER

SUPPLIES OFFICER DRIVER DIETICIAN

TEAM LEADER, BODY EXAM UNIT

MORTUARY SERVICE PROVIDERS FINGERPRINTERS PHOTOGRAPHERS MEDICO-LEGAL OFFICERS DENTISTS PROPERTY TECHNICIANS MORGUE TECHNICIAN

RECOVERY UNIT COMMANDER

TEAM LEADER, IDENTIFICATION CENTER

FINGERPRINTERS PHOTOGRAPHERS MEDICO-LEGAL OFFICERS DENTISTS PROPERTY TECHNICIANS ADMINISTRATIVE OFFICERS DATA ENCODERS FORENSIC CHEMISTS

VISUAL IDENTIFICATION •

classified according to sex, age and race.

•

assigned and tagged with a unique cadaver number

•

No clothing or any personal effects shall be removed from the body.

VISUAL IDENTIFICATION •

Clothing and personal effects shall be documented.

•

The cadaver may be inspected for identifying marks or any identification cards but such identification cards must be placed back with the body.

VISUAL IDENTIFICATION •

All cadavers shall be photographed with its assigned number. The following views should be taken: • • • • •

•

Front, head, at 90% angle lateral left, head lateral right, head Front, full body shot Distinguishing features

Fingerprint the cadavers

VISUAL IDENTIFICATION •

suitable holding area for public viewing of cadavers.

•

exposed to the public for visual identification within 24 hours only

VISUAL IDENTIFICATION •

suitable holding area for public viewing of cadavers.

•

exposed to the public for visual identification within 24 hours only

VISUAL IDENTIFICATION •

positively identified visually by a friend or relative will be subjected to fingerprint and dental examination prior to death certification and body release

POST MORTEM PHASE • Establish a mortuary site • Criteria for selection • • • •

Space Electricity Water Availability of decontamination / disposal area for biohazard materials

Thailand Tsunami Victim Idenification Effort Site 2 at Phuket, Thailand

Philippine dvi set up

THE TEAM

ST BERNARD, LEYTE LANDSLIDE

SENDONG CAGAYAN DE ORO

LEGASPI MAYON LANDSLIDE

GUINOBATAN, ALBAY MAYON LANDSLIDE

YOLANDA TACLOBAN

YOLANDA TACLOBAN

YOLANDA TACLOBAN

MORTUARY SERVICE

MORTUARY SERVICE

Proposed Organization of Examinations at Site 2

FROM CONTAINERS

Fingerprint Supplies

Intake

Intake

Fingerprint

Fingerprint

Fingerprint

W ash Fingerprint Basin

Each trailer has two identical tracks, one for English speaking teams and the other for European teams. The diagram on the right is an overview of the process, the diagram on the left is a detailed view of the placement of staff and equipment. The starburst pattern for some staff represents the general range of motion of a person working at that station.

FINGERPRINTS 4-6 Staff 20 - 30 minutes per case

Fingerprint Refuse

Pathologist

Pathologist Refuse

Pathologist

W ash Basin

Dental

Transit path for gurneys, safety zone

Pathology Supplies

Pathologist

PATHOLOGY 3 Staff plus property person 30-45 minutes per case

DENTAL 3 Staff 45-60 Minutes per case

Dental Supplies

Dental Dental

Dental Refuse

QC Supplies

QC 2 Staff 15 Minutes per case QC

Quality Control

Mark Humphries, New Zealand Hedwig Tromp, Netherlands Mike Hennesey, Gene Codes Forensics January 28, 2005

Each track does 7-8 cases a shift, 20-25 a day for a total of 50 cases per unit a day.

TO LONG TERM STORAGE

FINGERPRINTING

PATHOLOGY

PERSONAL PROPERTY

DNA COLLECTION

DNA COLLECTION

FORENSIC ODONTOLOGY

BURIAL • • • •

Location Site should be acceptable to the communities living near the grave There should be adequate space available Soil conditions should be considered

BURIAL • •

Graves should be at least 200m away from water sources such as streams, lakes, springs, waterfalls, beaches, and the shoreline. Burial distance from water wells are as follows: 4 or less bodies 200 meters 5- 60 bodies 250 meters 60 or more 350 meters 120 bodies or more per 100 sqm 350 meters

BURIAL • Communal graves may be unavoidable in very large disasters. • Such graves should consist of a trench holding a single row of bodies each placed parallel to one another, 0.4 meters apart.. • grave should be 1.5 – 3 meters deeps, 2 meters between the bottom of the grave and groundwater.

BURIAL

DECONTAMINATION

ANTEMORTEM PHASE

RECONCILIATION PHASE ANTEMORTEM DATA BODY RECOVERY

POSITIVEVISUAL ID

BODY RECEPTION/STORAGE

BODY EXAMINATION UNIT

FINGERPRINT

PHOTOGRAPHY

PATHOLOG Y

DATA COMPARISON

MATCH

IDENTIFICATION BOARD

BODY RELEASE

DENTISTRY

DNA

RECONCILIATION PHASE • ISSUANCE OF RESULTS • ISSUANCE OF CERTIFICATE OF IDENTIFICATION OF BODY • ISSUANCE OF DEATH CERTIFICATE (c/o Municipal Health Officer) • RELEASE OF BODY TO LEGITIMATE NEXT OF KIN

THANK YOU !