Management of Dead Bodies in Disaster Situations

0,78
MB

194
stron

3665
ID World Health Organization

2004
rok

Foreword .ix

Preface .xi

Acknowledgements . .xiii

Chapter 1. Preparedness for mass deaths

Introduction .1

Coordinating institutions .2

Duties .3

Preparation of the plan . .4

Technical programs .5

Body identification .5

Epidemiologic surveillance and disease control . .5

Training . .6

Simulations .7

Relations with the community . .8

Relations with the media . .8

Questions commonly asked after a disaster . .9

Guidelines for the official spokesperson . .9

Proactive approach to media relations for the official spokesperson . .9

Conclusions . .10

Bibliography . .11

Chapter 2. Medicolegal work in major disasters

Introduction . .13

Organization of necessary personnel . .14

Organization and preparation of the team . .14

Formation of the group and the warning plan .15

Risk and vulnerability studies .15

Technical preparation of the team . .16

Cooperation agreements . .16

Exercises and simulations . .17

Material needs .18

Transport . .19

Communications . .20

Protective clothing and equipment . .21

Instruments and equipment .23

Body preservation measures .24

Temporary work cams or sites .25

Water and food .26

Medical care .27

Participants . .27

Disaster professionals . .27

Other participants in disaster response .31

Operations coordination . .32

Search for information .33

The place, the event, and the hazards .33

Presumed victims .34

Removal of dead bodies . .36

Procedures at the disaster site .37

Transfer of human remains .41

Holding and examination site . .41

Holding area .41

Viewing area .43

Examination area .43

Methods for identifying human remains .44

Identification using visual recognition .44

Identification using anthropological studies . .45

Other methods of identification . .47

DNA identification .47

Historic background .47

DNA identification process .49

Accepting cases, managing evidence, and maintaining

chain of custody in DNA typing .51

Final disposal of corpses . .58

Low temperatures .59

Chemical processes .59

Embalming . .60

Burial . .65

Bibliography .66

Special bibliography on DNA . .68

Chapter 3. Health considerations in cases of mass fatalities

Introduction . .71

Myths .72

Epidemiological risk of dead bodies in areas with endemic diseases . .73

Scientific basis of the absence of epidemiological risk in non-endemic areas .76

Animal corpses . .78

Conclusions . .81

Bibliography . .83

Chapter 4. Sociocultural aspects

Introduction . .85

The funeral rite .86

Changes in funeral rites through history .88

Influence of culture, religion, and history on funeral .89

The symbolic value of the corpse and burial .95

Mourning and rituals in disaster situations . .97

Unresolved grief . .98

Arguments for the rapid disposal of corpses . .100

Disaster management experiences .101

Conclusions .104

Bibliography .106

Chapter 5. Psychological aspects

Introduction .109

Specific vulnerabilities . .110

Grief . .111

The process of unresolved grief .113

Psychiatirc disorders among survivors .116

Notification of disappearance or death, and visual recognition of corpses .119

Psychosocial care for survivors .121

Psychosocial care for first response teams . .123

The importance of truthful, approriate, and timely information . .125

Role of the authorities .126

Conclusions .126

Bibliography .128

Chapter 6. Legal aspects

Introduction .129

General regulations on managing corpses . .129

Unidentified bodies . .130

Missing persons .131

Identification of numerous corpses . .134

Consequences of failure to identify corpses .135

Provisions of national law .135

Provisions of international law . .138

Conclusions .146

Model law for management of dead bodies in disaster situations . .148

Bibliography .151

Chapter 7. Case studies

The Peruvian experience in managing dead bodies in disaster situations: The Mesa Redonda fire,

2001 . .153

Introduction . .153

Actions of the Public Prosecutor’s Office .154

Actions of the Legal Medicine Institute of Peru . .155

Activities of the Public Ministry . .155

Public Ministry staff involved . .158

Achievements .159

Problems .160

Repercussions of the event .161

Conclusions and recommendations . .162

Management of dead bodies following the avalanche of the Casitas volcano in Nicaragua: Chronicle

of a disaster within a disaster . .163

Summary .163

Introduction . .163

Materials and methods . .164

Results . .164

The scene of the disaster . .165

Institutional response .166

Management of dead bodies . .166

Discussion . .168

Bibliography . .170

Final recommendations .171

Myths and realities of management of dead bodies in disasters .172

Glossary . .173