FORENSIC MEDICINE

MASS DISASTERS AND THE

ROLE OF THE NATUROPATH

DFM 2217
UNIT A9
LEARNING OBJECTIVES

 What is a Mass Disaster?

 What role can a Naturopathic doctor play
under these circumstances?
Definition

 A Mass Disaster is defined as the death of

more than 12 victims in a single event.

 It can also be a lesser number, if the deaths

and injured persons exceed the capacity of
the local emergency services and governing
bodies to handle.
Causes

NATURAL MAN MADE

For example Vehicular accidents for
earthquakes, floods, example train and
famine, tornadoes, airplane crashes, ship
storms, avalanches and sinking, war, terrorist
mudslides, natural forest acts, genocide, house
fires , tsunami, fires, building collapse
epidemics and others and others.
 Experience from recent tragedies;
 Airplane crash
 Transportation accident
 Building collapse (fire, explosion)
 Industrial accidents
 Epidemics
 Environmental conditions (earthquake, cyclone,
flood)
 Civil riots for example have shown the need of a
multidisciplinary approach for the management
team
 Frequent tragic disasters and its management have drawn
attention and scrutiny of the public and government, leading
to formulation of Mass Disaster Plans in many places,
covering many aspects includes search and rescue service,
health care, rehabilitation, reconstruction, preventive
measures etc.
 However, the role of Forensic Pathologist is often ignored.
 Many are unaware of the importance of preservation and
examination of the dead and still continue to have the age-
old casual attitude, oblivious of the tremendous development
and advancement in this field of science.
 The consequences will not only cause misery to the
bereaved families but also seriously jeopardize the
investigation.
Role of Forensics
 Three primary roles of the C/ME are:

 Examination of samples of tissues and

bones to determine if they are human
remains
 Positive identification of such human
remains
 Determination of the cause and manner
of death
 Three important secondary functions:

 To provide data and evidence collected

from the scene and victims to local, state
and federal investigative agencies.
 To provide epidemiological summary of
the victims of the disasters.
 To develop information to prevent or
diminish future fatalities.
The Protocol for Identification
in Mass Disasters and Natural
Events
 Mass disasters, natural events, accidents, terrorism
are all considered as threats to the life and health of
human beings.
 Forensic physicians are one of the most important
groups usually facing with mass disasters.
 An international protocol has been developed in
order to achieve the most effective as well as
practical confrontation with such events in case of
identification in mass disasters and natural events.
 The protocol strongly emphasizes that:

 On time and appropriate identification of the

victims after their death in the mass disasters is
regarded as primary and legal rights of every
human being.
 The mass disasters’ victims do not cause the
putrefaction to be spread at all and therefore
these corpses must not be left unidentified or
buried in mass graves.
 The Member Countries
accept that:
 At least one permanent Identification Commission, whose
members are decision makers and familiar enough with
identification issues, must be organized in each country.
 This commission will be liable and responsible for
identification of the victims of mass disasters and natural
events.
 The Identification Commissions of mass disasters must make
use of the standard forms and processes of the
organization that will subsequently be represented and try
their best in putting them into the action.
 The commission will be responsible for preplanning
and facing with mass disasters inside the country
and is obliged to form and construct the necessary
and appropriate human resources for the
country’s needs and requirements in order to
represent proper and on time services in
identification of the victims.

 The commission must give enough training to the

groups that will be organized to handle the mass
disasters or have an occupation relation with one of
the aspects regarding the victims’ identification.
 The commission will do its best to estimate and prepare
every hardware and software facilities needed to
confront the mass disasters (in accordance with the forms
and processes) and will make them in available for
immediate use in any probable mass disaster.

 In case of any mass disaster or natural event, the

commission is obliged to estimate the death toll, extent
and severity of the occurred event as soon as possible.

 They must proceed to make use of their predicted

facilities and equipment to handle the disaster, identify
the victims and deliver them in an appropriate condition
to their family or relatives promptly.
 In case that the extent and severity of the occurred
event or the death toll is much more than the ability
and facilities of the commission and its organization
to be handled, they must ask for help from the
member countries and the member country or
countries who are asked for help will be liable to
cooperate and assist.

 In each country the Identification Commission must

hold at least one meeting annually during which
their performance, situation, software and hardware
facilities and human resources will be evaluated.
 The commission must make a comprehensive
report on performance and the operative
experiences of the group during the accidents and
the natural events every four years and let the other
members know about that in detail.

 The secretariat is obliged to collect the members’

view points and benefit them for representing new
suggestions and policy to other members.
 Identification
1. Establishment of
Identity of the Victim
 Identification gives cognizance of the fundamental human
right to have an identify both in life and death.
 In a more pragmatic context, the identification of the dead is
essential for life of others to proceed and return to normalcy.
 In almost every disaster, there is an urgent and pressing need
to identify the victims.
 Most people will little difficulty to establish the identity from
the morphological manifestation of an intact body.
 This seemingly simple process becomes much more
complex and difficult to recapture the living
appearance of an individual from mutilated, charred
or skeletal remains that mey be partial or
intermingled which are usually encountered in mass
disasters.

 In such cases, forensic pathologist can help in

establishing the identity of the victims from the
morphology, anatomy, individual peculiarity,
fungerprinting, DNA profiling etc.
The Importance DNA
Necessity of Establishment
of Identity
Humanitarian reason
 It is not uncommon despite having learned about the involvement of
loved ones in the tragedies, emotionally traumatized bereaved
family members often fail to identify their loved ones.
 This may be due to disfigurement and mutilation of the body,
putrefaction charges after death etc.
 One can imagine how much anxiey and suffering the next of kin
would face in such situations.
 There is a strong desire on the part of people that their loved ones
be identified and fulfil the rightful funeral rituals as per religious and
cultural practice rather than to be interred in a mass grave.
 Sometimes the relief following identification can be short-lived
if another bereaved family also claims the same body.
 Involvement of Forensic Pathologist in the mass disaster
management can help ascertain the identity and thus
prevent occurance of these painful states.
 The settlement of the following mundane but pressingly
practical issues such as:
 Inheritence of property
 Access to bank accounts
 Pensions and insurance
Depends on the formal identification of the deceased,
recorded in a form and of a certificate of death.
 Civil court action and litigation relating to issues of
liability for example on the part of an airline
contributing to a disaster, needs the identity of the
deceased to be formally corroborated.

 Similarly, if the incident happened at the workplace,

litigation relating to health and safety concerns in the
work-place can be initiated with the formal
identification of the deceased.
2. Proper preservation and handling of the
remains
 By skilled personnel will prevent loss of crucial
evidences, check introduction of artefacts and
prevent further putrefaction and also reduce health
hazards.

3. Reconstruction of the mutilated remains

for a decent presentation
 The Coroner and his assistants are often involved
in this task as well especially if the remains are
partial.
4. To determine the cause of the disaster by collecting
evidence such as:
 Bomb or detonator fragments that may be embedded in the
bodies.
 Toxicological evidence for any evidence of intoxication of
the key victims
 Pathological evidence to see any disease conditions in the
key victims that could have contributed to the disaster.
 In case of impending epidemic as well as in tragedies
resulting from biological or chemical sabotage, the Forensic
Pathologist can help in the detection and diagnosis of the
causative agent, which in turn enable the concerned
authorities to take necessary preventive measures.
 Trace evidence to find any physical evidence that could help
solve the investigation of the tragedy.
5. To assist in reconstructing the cause of the
disaster
This can be achieve by:

 Establishing the cause of death particularly the key

victims such as pilots, driver, human bombs etc.
 Studying the nature and pattern of injuries sustained by
the victims to see whether the injuries take the pattern that
conforms to other similar incidence.
 Studying the position of the remains in relation to the
wreckage at the site of the tragedy.
6. Establishment of the period of survival of
the victims

 By studying the time since death.

 This is required in case of presumption of
survivorship after the disaster.
 Also it can be helpful to determine whether there
was any lapse in the search and rescue operation
and accordingly from the findings necessary
corrective measures can be incorporated in the
plan.
7. Preventive medicine

 Evaluation and analysis of the data during the

course of medico-legal investigation can be
utilized as a toll for development and
improvement of safety measures in the
workplace for example seat belts, airbags, head
rests, helmet, leg guards, laminated windshield
etc.
 All of these safeguards are developed and
improved over the years by studying such date
and may of these safety measures have been
made mandatory in many countries.
8. Counter disaster plans

 These should be simple, comprehensive and up to

date and should be understood by all.
 A disaster plan should not be something ‘done a
few years ago’ gathering dust on the shelf.
 There is a need for constantly revising the
plans to see how good they have been when
implemented.
 This process of review, rehearsal and training
should be continuous so that the oral tradition is
every bit as strong as the written manual.
 ‘If you think safety is expensive,
try having an accident.’

 Such costs are not mere financial

considerations.
 It challenges us all to avoid and control
accidents and loss of life by the use of
good design, workplace practice and
counter disaster planning.
Conclusion
 It is difficult to get most people to consider the unthinkable yet
unimaginable disasters will always occur.
 This inevitability of disasters should not give rise to fatalistic
attitude for that removes the need to plan and prepare.
 Today, mass disaster management itself is considered as
a discipline.
 It requires the cooperation and coordination of various
professions such as administration, police, medical, forensic
experts, fire service, civil defence, public work services (water
and power supply, transport and telecommunication etc) and
seismologists, hydrologists, geologists, NGOs etc.
 All these disciplines and professions are essential
at different levels in the course of management.

 A Forensic Pathologist plays an integral role in the

menagement of mass disaster. He is a key
member in both Disaster Victim Identification as
well as Disaster Investigation teams.
Role of Naturopath

 A Naturopath can only play a

humanitarian role in disaster
management.

 He should not participate in any activity

with medico-legal consequences.
Key Points
 Mass disasters can happen anywhere and at
anytime.
 Each city and area should have a Disaster Plan to
deal with such a situation.
 The role of a forensic examiner is to help in the
identification of bodies, the cause of death and
recording of evidence to enable safety measures to
be put in place in the vent of another such disaster.
THANK YOU