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Challenges in implementing best practice DVI guidelines in low resource settings: lessons learnt from the
Sameera A Gunawardena1, Ravindra Samaranayake2, Vianney Dias2
1Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. sameera@fortox.cmb.ac.lk.
Forensic Science, Medicine, and Pathology
|October 12, 2018
Summary
Mass fatality management in Sri Lanka highlighted challenges in Disaster Victim Identification (DVI). Adaptations were crucial due to resource limits and public expectations, emphasizing multidisciplinary collaboration for effective DVI.
Area of Science:
- Forensic Science
- Disaster Management
- Public Health
Background:
- The Meethotamulla garbage dump collapse in Sri Lanka caused 32 fatalities, necessitating a large-scale Disaster Victim Identification (DVI) response.
- The incident exposed significant challenges in applying international best practice DVI guidelines within a low-resource setting with unique socio-cultural and legal contexts.
Purpose of the Study:
- To analyze the practical challenges encountered during the DVI process following the Meethotamulla disaster.
- To identify necessary adaptations and alternative strategies for effective DVI in resource-limited environments.
- To underscore the importance of multidisciplinary collaboration and public engagement in mass fatality management.
Main Methods:
- Review of the DVI process implemented during the Meethotamulla disaster.
- Analysis of the effectiveness of primary (odontology, DNA) and secondary identification markers.
- Assessment of the impact of legal processes, public expectations, and resource constraints on DVI.
Main Results:
- Delays in legal proceedings and initial body recovery without medical teams led to procedural shortcomings and public dissatisfaction.
- Primary identification methods like odontology and DNA faced limitations due to lack of antemortem data and resource constraints.
- Identification was successfully achieved using a combination of secondary markers (clothing, jewelry, scars, tattoos, morphology, circumstantial evidence), with odontology providing supplementary confirmation in two cases.
Conclusions:
- Effective mass fatality management requires robust public awareness and strong multidisciplinary commitment.
- Implementing best practice DVI guidelines in low-resource settings necessitates significant adaptations to address legal, socio-cultural, and resource challenges.
- Future DVI efforts should prioritize flexible strategies integrating various identification methods and stakeholder engagement.
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