One of the areas of disaster planning that seems to get very little attention is the handling of mass fatalities. I was reminded of this by a thoughtful presentation by my colleague James King at yesterday's Emergency Management Summit in San Francisco sponsored by EM Magazine.
What makes this problem so difficult is that no one really wants to talk about it and everyone assumes it's someone else's job. This is particularly true in the collection of remains where we assume that the coroner/medical examiner, local funeral homes or Disaster Mortuary Operations Teams (DMORTs) will handle collection. However, DMORTs support the processing of remains, not the collection, local morticians will be overwhelmed, and coroner/medical examiner offices lack the resources to collect, store, and process the large number of remains associated with mass fatality events.
Adding to this complexity is the need for cultural sensitivity. Various faiths have different beliefs and rituals regarding the deceased. For example, Islamic law requires burial as soon as possible and specifies a ritual cleansing, shrouding and prayers. Hindu custom calls for cremation of the dead, normally within 24 hours. Ignoring funeral customs in the interest of expediency can cause considerable pain to the victim's family and may have an impact on mortuary operations. In his paper Identifying the Dead in Thailand and Sri Lanka: Multi-national Emergency Organizations researcher Joseph Scanlon describes how a charge of not treating the dead with sufficient respect led to one country being ordered to stop processing bodies. There is even a bill, HR 6566 the Mass Fatality and Religious Considerations Act, currently in committee, which would require FEMA to provide guidance and coordination on mass fatalities in consultation with, among others, religious organizations.
Another common problem is the myth that bodies must be disposed of quickly to prevent the spread of disease. This has led in the past to mass burials without proper identification of the deceased and greatly added to the grief of survivors. While there are indeed risks where the deaths are the result of disease, there is no evidence that disaster victims who are the victim of trauma pose any greater risk of epidemic. Handling remains may be unpleasant but there is time to do things right.
One of the few books on this subject of which I am aware is Robert A. Jensen's Mass Fatality and Casualty Incidents: A Field Guide which offers a tactical level overview of mass fatality response. There are also a number of plans and guides available on the Internet. Don't wait for an incident before you check them out.