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The document discusses the role of naturopathic doctors in mass disasters. It defines a mass disaster as an event resulting in 12 or more deaths, or exceeding local emergency services' capacity. Causes can be natural or man-made. The document outlines the protocol for victim identification, including establishing identity through morphology, anatomy, DNA profiling. It emphasizes the importance of proper remains preservation and reconstruction to aid identification and determine the cause of the disaster. Naturopathic doctors can help by collecting evidence from remains to support investigations.
The document discusses the role of naturopathic doctors in mass disasters. It defines a mass disaster as an event resulting in 12 or more deaths, or exceeding local emergency services' capacity. Causes can be natural or man-made. The document outlines the protocol for victim identification, including establishing identity through morphology, anatomy, DNA profiling. It emphasizes the importance of proper remains preservation and reconstruction to aid identification and determine the cause of the disaster. Naturopathic doctors can help by collecting evidence from remains to support investigations.
The document discusses the role of naturopathic doctors in mass disasters. It defines a mass disaster as an event resulting in 12 or more deaths, or exceeding local emergency services' capacity. Causes can be natural or man-made. The document outlines the protocol for victim identification, including establishing identity through morphology, anatomy, DNA profiling. It emphasizes the importance of proper remains preservation and reconstruction to aid identification and determine the cause of the disaster. Naturopathic doctors can help by collecting evidence from remains to support investigations.
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