BENGALURU: A tragedy of the scale of Air India’s Boeing 787-8 crash in Ahmedabad on Thursday is unfathomable and massive. Handling the aftermath of such accidents is an extremely tough job that requires trained, responsible and sensitive expertise. Fortunately, we do have the expertise in India.
On the one hand is the shock and scale of the tragedy, on the other is the need to have immediate boots and hands on the ground. It begins with cordoning off the areas by the police, dousing the fire by expert fire personnel, searching for survivors and rushing them to the nearest hospital, pulling out the dead bodies from inside the debris and sending them to the nearby mortuaries.
This is a humongous exercise which calls for immediate and seamless coordination of multiple agencies; from the airport authorities (in an incident like the AI171) to the local police, civic authorities, medics and paramedics, ambulance services, disaster response task force and young volunteers among others who serve as the first responders.
The most daunting task is the identification of bodies, which may have got charred or disfigured beyond recognition because of the impact of the crash and the ensuing explosion. The pressure is on forensic doctors to identify and hand over the bodies to the relatives on an urgent basis, but this kind of pressure may be counterproductive. Also, the handing of the victims over to the next of kin requires sensitivity. Sometimes, only a part of the body is available and not the whole body. There are strict guidelines for disaster management and relief, which have to be adhered to.
"DNA profiling for disaster victim identification (DVI) is considered to be one of the most reliable and efficient means to identify bodies charred with dismembered body parts," said Dr Vina Vaswani, professor, Forensic Medicine & Toxicology, and Director of the Centre for Ethics at Yenepoya (deemed to be University), Mangaluru.
According to the DVI Interpol guidelines, "In disasters, identification is established by taking a post mortem DNA sample, which is matched with their first-degree biological relative. From the relative, antemortem (information before death) information about the victim regarding dental treatment or past history of fracture surgery (including prosthetic implants) is also elicited. For instance, parents may inform them that their son or daughter had dentures or a front tooth missing," she said.
Vaswani said this kind of information "backed up with treating dentists' records often helps in DVI". The forensic expert and ethicist said, "In many instances, superficial body art like a tattoo or old surgical scar has helped in identifying bodies or a piece of jewellery on the person that is identified by their relative which is unique. This by itself cannot be used as the sole criteria for identification. DNA sampling, and antemortem interviews with relatives take time depending on the magnitude of the disaster. It could take more than a week or 10 days." She added, "We have to be sensitive in handling the emotions of the families while being cautious in avoiding any rush in handing over bodies without confirming identity."
Vaswani recounted the experience of the 2010 Mangaluru Air India Express crash victims. "There were 10 to 12 bodies that remained unidentified towards the end. The state performed their last rites," she said. DNA can be collected from hair follicles, nails, teeth, tissue and bone marrow. This can be a challenge due to charring.
Grief counsellors also play a very important role in tragedies of this scale, to soothe and calm the families as they await news of their loved ones in the hospital or are called for DNA samples. "Unfortunately, we do not have the concept of grief counsellors, so nurses, medical attendants, staff and often the police come forward to help families deal with their grief. It requires empathy and a lot of patience," added Vaswani.
Yenepoya (deemed to be University) has been providing DVI training for the last 10 years and many forensic doctors, dentists and forensic scientists have benefited from this hands-on training where disaster sites are simulated and the trainees get a real-world feel of DVI. The programme envisages training many more professionals so that disaster-preparedness in the country reaches global standards.
