Mass Fatality Management following the South Asian Tsunami Disaster: Case Studies in Thailand, Indonesia, and Sri Lanka

Abstract

BackgroundFollowing natural disasters, mismanagement of the dead has consequences for the psychological well-being of survivors. However, no technical guidelines currently exist for managing mass fatalities following large natural disasters. Existing methods of mass fatality management are not directly transferable as they are designed for transport accidents and acts of terrorism. Furthermore, no information is currently available about post-disaster management of the dead following previous large natural disasters.Methods and FindingsAfter the tsunami disaster on 26 December 2004, we conducted three descriptive case studies to systematically document how the dead were managed in Thailand, Indonesia, and Sri Lanka. We considered the following parameters: body recovery and storage, identification, disposal of human remains, and health risks from dead bodies. We used participant observations as members of post-tsunami response teams, conducted semi-structured interviews with key informants, and collected information from published and unpublished documents.Refrigeration for preserving human remains was not available soon enough after the disaster, necessitating the use of other methods such as dry ice or temporary burial. No country had sufficient forensic capacity to identify thousands of victims. Rapid decomposition made visual identification almost impossible after 24–48 h. In Thailand, most forensic identification was made using dental and fingerprint data. Few victims were identified from DNA. Lack of national or local mass fatality plans further limited the quality and timeliness of response, a problem which was exacerbated by the absence of practical field guidelines or an international agency providing technical support.ConclusionsEmergency response should not add to the distress of affected communities by inappropriately disposing of the victims. The rights of survivors to see their dead treated with dignity and respect requires practical guidelines and technical support. Mass fatality management following natural disasters needs to be informed by further field research and supported by a network of regional and international forensic institutes and agencies.

Prehistoric Coastal Mass Burials: Did Death Come in Waves?

“…In the immediate aftermath of an event, there are usually attempts to bury individuals in culturally appropriate manners, but mass burial soon becomes the norm (Phillips et al 2008). Until recently, when mechanical diggers became available, mass burials were usually dug manually as shallow trenches or pits (< 1.0 m deep), or beneath mounds of stones or debris (Morgan et al 2006).…”

“…While some communities have used existing cemeteries for siting mass graves, they are predominantly situated in convenient coastal locations closest to the largest number of bodies (Morgan et al 2006). Mass burials generally have two types of body arrangement, either with bodies in layers or in an unstructured manner (Phillips et al 2008).…”

“…Mass burials generally have two types of body arrangement, either with bodies in layers or in an unstructured manner (Phillips et al 2008). Both types of arrangements can lead to the comingling of bodies and, subsequently, skeletal remains (Morgan et al 2006). In the case of the 2004 IOT, there were 14 mass graves in Banda Aceh alone, with the largest containing 60,000-70,000 bodies (Morgan et al 2006).…”

“…Both types of arrangements can lead to the comingling of bodies and, subsequently, skeletal remains (Morgan et al 2006). In the case of the 2004 IOT, there were 14 mass graves in Banda Aceh alone, with the largest containing 60,000-70,000 bodies (Morgan et al 2006). Death rates in coastal communities can be high-the 1896 AD Sanriku tsunami killed up to 83% of the population of some villages (Smits 2011).…”

Use of DNA Technology in Forensic Dentistry

“…This fact could be demonstrated after the South Asian tsunami disaster on December 26th 2004, when the most varied techniques were applied for identification of thousands of victims, such as forensic pathology, forensic dentistry, DNA profiling and fingerprinting. Even though, 99% of the bodies were identified using dental records or fingerprints and only 1% of forensic identification was made by DNA profiling [14,15].…”