By Mike Harbert
Whenever anyone mentions homeland security funding, the first topics that come up involve interoperability issues, radios, and mobile command centers. While the need to ensure that first responders from different jurisdictions can work together is essential, there are other items that are not as exciting and do not receive the same attention, but are every bit as necessary.
This morning I attended a panel at American Military University’s “Homeland Security: The Ripple Effect” symposium that addressed an area that we never hear about in the news or from the politicians. That is, Mass Fatality Management. We frequently hear about “Mass Casualty” exercises, or how hospitals and first responders will handle hundreds of sick and injured, but no one wants to address the aftermath.
Dealing with dead bodies is not something people want to think about. Politicians would rather deal with hope and recovery than with death and disposal. Most table top disaster exercises end before anyone has to deal with anything more than designating a collection point for fatalities. Maybe someone will think far enough ahead to state that refrigerated trucks will be used, but few will think to figure out where the trucks will come from or how many will be needed.
Here are a few thoughts:
- How will a community handle 500 dead over a period of a week? How about 5,000? Or 50,000?
- If the disaster is WMD related, how and when do we decontaminate the remains? Politicians ensure that first responders are issued PPE and trained, but how about mortuary professionals?
- How does a community identify 5,000 or 50,000 casualties? Are systems in place to handle that amount Ante-Mortem and Post-Mortem data collection? How many phone calls will come into the operations center about missing persons when 50,000 are killed? Can we issue death certificates and process estates without doing the appropriate identification of remains?
- Can local mortuary services handle those numbers? How many bodies can fit in local refrigerated storage? How many bodies can fit in a 48-foot refrigerated trailer?
- Where will they get 5,000 or 50,000 caskets or embalming supplies for that many? Cremation? Consider that a modern crematorium needs 4 to 6 hours to cremate one body. Will religious and cultural issues be considered in final disposition of remains?
- What about funerals? If the disaster is a pandemic, will the population be able to gather, or will the risk of transmission be too great?
- Over $100 million has been spent identifying and processing the 2749 victims of the World Trade Center attacks. Has your community considered the cost associated with handling ten times that number of dead?
These are just some of the issues that were addressed at this session of the symposium, and they barely scratched the surface. There is some debate as to whether this is a medical issue or a logistical issue. From my viewpoint, it’s a leadership issue.
It’s time for our politicians and leadership to begin addressing these issues. It’s time that the table top exercises continue beyond first response and relief operations and address these unpopular but necessary issues.
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