The center should be close enough to the incident site to allow officials and volunteers who are involved in the recovery and the center efforts to easily travel between sites. There will be private
areas within the FAC for interviews, private rooms for official death notifications, areas for medical care that may be needed, and mental health and spiritual care.
DISASTER MORTUARY OPERATION RESPONSE TEAMS (DMORTS)
of the nature and extent of injuries; identification of victims by scientific means; and certification of cause and manner of death. The citizens who comprise these teams are experts in their respective fields as funeral directors, medical examiners, pathologists, forensic anthropologists, fingerprint specialists, forensic odontologists, dental assistants, administrative specialists, and security specialists. When they are activated and deployed in the wake of an MFI, they strive to quickly and accurately identify victims while supporting local mortuary services. There are several areas in which DMORTs can provide technical assistance and/or consult on fatality management and mortuary affairs. The teams can establish temporary morgue facilities in which many of their duties and functions may be performed. In these temporary morgues, the teams can track and document human remains and personal effects; assist with determining cause and manner of death; perform postmortem data collection; perform forensic dental pathology; and utilize forensic anthropology methods. The teams are further able to provide resources to aid in collecting antemortem data; documenting field retrieval and morgue operations; and processing and reinterring disinterred remains. To quickly and accurately identify the deceased victims, the teams collect the medical records, dental records, and/or DNA of victims from the next of kin. The U.S. Department of Health and Human Services supports the DMORT program through its office of Emergency Preparedness (OEP/NDMS). A warehouse is maintained, which houses a disaster portable morgue unit (DPMU). The DPMU is used as a depository for equipment and supplies that can be deployed to sites in the event of MFIs. The DPMU is a complete, mobile morgue with a designated workstation for each process element and with prepackaged equipment and supplies (Federal Emergency Management Agency, 2019).
In the 1980s, the National Funeral Directors Association (NFDA) recognized a need for an organized and trained group to be called upon to assist and lead the efforts in MFIs. The NFDA formed a committee to address disaster situations, specifically incidents that resulted in simultaneous multiple deaths. The committee formed the Disaster Mortuary Operation Response Team (DMORT), a multifaceted nonprofit organization to support the concept of a national-level response protocol for all related professions. DMORT was incorporated into the federal disaster response system with the National Disaster Medical System. This incorporation resulted in the formation of federal regions throughout the country. Eventually, two specialty teams formed: The Weapons of Mass Destruction Team (WMD) and the Family Assistance Core Team (FAC-T) (LaDue & Herrmann, 2009). Today, DMORT is divided into 10 federal regions and is tasked through the federal government’s Emergency Support Function #8 (Public Health Emergency, 2012). The teams are composed of private citizens, each with a particular field of expertise. The team members deploy when there is an MFI that requires their resources and services. The federal government compensates the members of the teams as temporary federal employees under the National Disaster Medical System (NDMS) and the U.S. Department of Health and Human Service (HHS). The NDMS works in conjunction with a regional coordinator to direct the teams (Blakeney, 2002). The teams are now capable of properly and accurately documenting the scenes. In addition to the recovery of victims and personal effects, they are trained in evidence-recovery procedures. Certain incidents may require decontamination of remains and personal effects, which the teams are prepared and qualified to do. Overall, DMORTs can provide transportation, storage, documentation, and recovery of forensic evidence; recovery of physical evidence; determination
RECOVERY EFFORTS
The mass number of cremations quickly exhausted the available supply of wood and left many survivors without adequate fuel for cooking and heating (Pan American Health Organization/ World Health Organization [PAHO/WHO], 2004). Expediting final disposition in manners such as this will often result in failure to properly identify and document the recovered bodies. Resources needed to care for the living must be maintained and accounted for in the plans by officials. The ways in which the victims’ bodies are handled must be considered, including the social, cultural, legal, and psychological characteristics of the community. This can have a significant impact on the families’ mental health. The safety of the teams working in the recovery effort is likewise critical. First responders and rescue personnel will often risk harm to their own safety to save a victim’s life. The same level of risk is not warranted in the recovery of a confirmed deceased individual. Proper planning and following protocols must be observed to ensure the safety of the team members’ recovery efforts. There is also potential risk to those working in the aftermath efforts, as well as the general public, when biological or radiological factors are present.
Two of the most enduring American values are the respect for the deceased and compassion for the bereaved (Merrill et al., 2015). For families to begin to cope with the loss and start the healing process, many necessary steps must take place. The first is recovery and identification of the victims from the scene of the MFI. This is, and should be, the stated primary mission for the teams involved in the recovery efforts. Though this is the primary mission in victim recovery, the rescue of survivors should always be the most urgent concern. The recovery of the deceased must be done in a manner that ensures safety for the teams involved, as well as accuracy. There are potential factors that may delay the recovery efforts due to safety issues. Mass fatalities present many valid concerns related to the health and safety of the teams involved, as well as to the general public. Many myths also exist, including the belief that bodies must be buried or incinerated as quickly as possible to avoid a supposed contamination risk. Beliefs such as this have created issues not previously considered, such as during the earthquakes of 2001 in India. The number of fatalities neared 100,000, with the recovered bodies quickly being cremated.
PANDEMIC EFFECTS
hypothetical high fatality pandemic event. The respondents generally indicated their preparedness level as “suboptimal.” Greater than 80% of the respondents indicated they would be willing to report to work during an event such as a pandemic. The study also indicated a high prevalence of those in the death care sector whose ability and/or willingness would be hindered by secondary obligations (Gershon, 2011).
COVID-19, which fully affected life and death in 2020, tested all funeral home preparations for a biological disaster. Cultural and political differences influenced how localities responded and are still responding to perceived changes in health and safety requirements. A 2011 study gauged the preparedness of the death care sector’s ability and willingness to report to duty for a
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