South Asian Perspectives  of Management of Dead in Mass Disasters: Thoughts in Action Clifford Perera Christopher Briggs
Two key phrases <ul><li>Mass Disasters </li></ul><ul><li>Management of Dead </li></ul>
Mass Disaster – Definition <ul><li>Many definitions exist </li></ul><ul><li>Many SAARC countries now have legal definition...
Recent mega disasters in SA Country Disaster Deaths People affected Bangladesh Cyclone 1970 300,000 20 million Bangladesh ...
India Thailand Recovery of Dead Sri Lanka
Transportation of Dead Bangladesh, 2007 Velankanni, India 2004
Identification   of Dead
Cyclone Sidr 2007 Disposal of Dead through community participation
Mass Burial -Velipalayam India   Mass burial in Kolachal Tamil Nadu Single layered burial – proper burial: Thailand
Performing post Tsunami mass burials at night in Cuddalore district  Tamil Nadu India Change of practice is needed !
Challenging issues:  Changing Disposal methods in Mass Disasters Velankanni Nagapattinam Cremation of Tsunami deceased - I...
Indian Ocean Earthquake & Tsunami Emergency Update  January 31, 2005  Source:·  http://www.coe-dmha.org/
Objectives of Management of Dead <ul><li>Respect the  dignity of the dead  </li></ul><ul><li>Respect the bereaved, includi...
Disaster management in South Asia <ul><li>Major feature of all mass disasters – heavy human toll </li></ul><ul><li>Managem...
First Responders: Who are they ? Why are they needed ?
First Responders <ul><li>Definition = individuals/volunteers who arrive at the    disaster scene/site during the immediate...
Tsunami Train tragedy  in Peraliya Sri Lanka 2004
Challenges of First responders <ul><li>Initial scene chaotic </li></ul><ul><li>No one to advice </li></ul><ul><li>Not awar...
Role of First Responders <ul><li>Recovery of Dead </li></ul><ul><li>Transportation of dead </li></ul><ul><li>Storage of de...
WHO has formulated instructions for disposing dead in Disasters   in   2002
Dealing with First Responders <ul><li>Recognition of them as Essential service providers </li></ul><ul><ul><li>Indispensab...
Target groups <ul><li>Local Red Cross Society volunteers </li></ul><ul><li>Local NGOO operating at community level </li></...
ICRC has explored the potential role of  First  responders on managing dead in disasters
Current Developments in South Asia <ul><li>ICRC India delegation commenced a RFL project on drafting guidelines for first ...
Thoughts in Action <ul><li>Identification of dead  is of prime importance in all major disasters however difficult the cir...
Thank you! [email_address] [email_address]
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South Asian perspectives of Management of Dead in Mass disasters – thoughts in action

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South Asian perspectives of Management of Dead in Mass disasters – thoughts in action

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  1. 1. South Asian Perspectives of Management of Dead in Mass Disasters: Thoughts in Action Clifford Perera Christopher Briggs
  2. 2. Two key phrases <ul><li>Mass Disasters </li></ul><ul><li>Management of Dead </li></ul>
  3. 3. Mass Disaster – Definition <ul><li>Many definitions exist </li></ul><ul><li>Many SAARC countries now have legal definitions on a “Disaster” </li></ul><ul><li>eg. DM Act 2005 India </li></ul><ul><li>It is important to define a mass disaster from the pathologist’s point of view as they have a definite role to play </li></ul><ul><li>a disaster is an episode in which the number of fatalities is in excess of that which cannot be dealt with using the normal mortuary facilities . </li></ul><ul><ul><li>The Royal College of Pathologists, United Kingdom </li></ul></ul><ul><ul><li>(Busuttil et al., 2000) </li></ul></ul><ul><li>A major disaster is any situation in which there are more human bodies to be recovered and examined than can be handled by the usual local resources. </li></ul><ul><ul><li>The National Association of Medical Examiners, USA (2005) </li></ul></ul>
  4. 4. Recent mega disasters in SA Country Disaster Deaths People affected Bangladesh Cyclone 1970 300,000 20 million Bangladesh Cyclone 1991 138,000 15 million India Earthquake 1993 9475 1 million India Cyclone 1999 10086 15 million India Earthquake 2001 13805 1.8 million India Tsunami 2004 12405 3.5 million Pakistan Earthquake 2005 83,000 5 million Afghanistan Drought 2000 712 2.5 million Sri Lanka Tsunami 2004 35,399 1 million Bangladesh Cyclone Sidr 2007 3060 6.8 million
  5. 5. India Thailand Recovery of Dead Sri Lanka
  6. 6. Transportation of Dead Bangladesh, 2007 Velankanni, India 2004
  7. 7. Identification of Dead
  8. 8. Cyclone Sidr 2007 Disposal of Dead through community participation
  9. 9. Mass Burial -Velipalayam India Mass burial in Kolachal Tamil Nadu Single layered burial – proper burial: Thailand
  10. 10. Performing post Tsunami mass burials at night in Cuddalore district Tamil Nadu India Change of practice is needed !
  11. 11. Challenging issues: Changing Disposal methods in Mass Disasters Velankanni Nagapattinam Cremation of Tsunami deceased - India
  12. 12.
  13. 13. Indian Ocean Earthquake & Tsunami Emergency Update January 31, 2005 Source:· http://www.coe-dmha.org/
  14. 14. Objectives of Management of Dead <ul><li>Respect the dignity of the dead </li></ul><ul><li>Respect the bereaved, including their right to know the fate and whereabouts of their missing loved ones </li></ul><ul><li>Positive Identification of all deceased </li></ul><ul><li>Ascertain Cause of Death of Deceased </li></ul><ul><li>Dignified disposal and mourn the remains of dead in accordance to religious and cultural needs of the affected community </li></ul><ul><li>To resolve other medico-legal issues pertaining to the disaster eg. cause of the disaster esp. in man made disasters </li></ul>
  15. 15. Disaster management in South Asia <ul><li>Major feature of all mass disasters – heavy human toll </li></ul><ul><li>Management of mass disasters essential </li></ul><ul><ul><li>To minimize the damage </li></ul></ul><ul><ul><li>To accelerate the recovery and rebuilding process </li></ul></ul><ul><li>Most countries did not have proper Disaster management mechanism and infrastructure until 2005 </li></ul><ul><li>First responders play a lead role at the initial stages of disaster management </li></ul><ul><li>Recent Developments </li></ul><ul><li>Establishment of Central Disaster management legislation and mechanism in India Sri Lanka Bangladesh eg. NDMA DMC NDMC etc </li></ul>
  16. 16.
  17. 17. First Responders: Who are they ? Why are they needed ?
  18. 18. First Responders <ul><li>Definition = individuals/volunteers who arrive at the disaster scene/site during the immediate aftermath of a disaster and respond actively in managing victims </li></ul><ul><li>Mostly from the affected or neighboring community </li></ul><ul><ul><li>“ Primed” individuals </li></ul></ul><ul><ul><li>Non-skilled/semi-skilled volunteers of local NGOO/Red Cross Societies </li></ul></ul><ul><li>Ideally : First Responders should be skilled professionals; such as emergency medical personnel, trained police and fire services, forensic pathologists etc.. </li></ul><ul><li>However it is an exception than a rule in South Asia !! </li></ul>
  19. 19. Tsunami Train tragedy in Peraliya Sri Lanka 2004
  20. 20. Challenges of First responders <ul><li>Initial scene chaotic </li></ul><ul><li>No one to advice </li></ul><ul><li>Not aware of any impending dangers </li></ul><ul><ul><li>Experience in WTC explosion 2001 </li></ul></ul><ul><ul><li>Experience in Earth quake China May 2008 </li></ul></ul><ul><li>Guided by “common sense” </li></ul><ul><li>Whom to be given priority ? </li></ul><ul><li>Emotional about the destruction </li></ul><ul><li>Less/No attention on health issues </li></ul>
  21. 21. Role of First Responders <ul><li>Recovery of Dead </li></ul><ul><li>Transportation of dead </li></ul><ul><li>Storage of dead – temporary burial </li></ul><ul><li>Identification of dead – as secondary service providers </li></ul><ul><li>Disposal of dead – burial </li></ul><ul><li>Providing accurate information of dead to surviving families </li></ul><ul><li>Dispelling myths associated with disposal of dead </li></ul>
  22. 22. WHO has formulated instructions for disposing dead in Disasters in 2002
  23. 23. Dealing with First Responders <ul><li>Recognition of them as Essential service providers </li></ul><ul><ul><li>Indispensable </li></ul></ul><ul><ul><li>Always at the disaster scene before skilled professionals </li></ul></ul><ul><li>Readily available; minimal barriers </li></ul><ul><li>Rapidly deployable force </li></ul><ul><li>Their action need to be guided </li></ul><ul><li>India has taken the lead role in formulating guidelines </li></ul>
  24. 24. Target groups <ul><li>Local Red Cross Society volunteers </li></ul><ul><li>Local NGOO operating at community level </li></ul><ul><li>Community Religious/Faith groups </li></ul><ul><li>DM units in armed forces </li></ul>
  25. 25. ICRC has explored the potential role of First responders on managing dead in disasters
  26. 26. Current Developments in South Asia <ul><li>ICRC India delegation commenced a RFL project on drafting guidelines for first responders in August 2007 </li></ul><ul><li>Completed in August 2008 </li></ul><ul><li>implementation progressing </li></ul><ul><li>Widely accepted by NDMA India </li></ul>
  27. 27. Thoughts in Action <ul><li>Identification of dead is of prime importance in all major disasters however difficult the circumstances are </li></ul><ul><li>First responders play a lead role in recovery transportation and disposal of dead </li></ul><ul><li>Forensic experts must play an active role in training first responders in management of dead to ensure formal identification </li></ul><ul><li>Local disaster management mechanisms should be strengthened with knowledgeable participation of first responders: state and community based </li></ul>
  28. 28. Thank you! [email_address] [email_address]

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