Unseating the Myths Surrounding the Management of Cadavers

Mon, 29 Dec 2003 10:20:14 -0800

To Whom it May Concern:

I listened with interest to Weekend Edition on Sunday, December 28, to Liane Hansen's interview with Martin Zak of the International Federation of Red Cross and Red Crescent Societies concerning efforts following the devastating earthquake in Bam, Iran last week. She mentioned the often cited need to rapidly conduct mass burials of those killed in the earthquake to avoid the spread of disease. As far as public health professionals have been able to determine, this concern has never been substantiated. Please see the following quotation from the Pan American Health Organization (the Word Health Organization's arm in the Americas) in the October, 2003 issue of "Disasters: Preparedness and Mitigation in the Americas."

"Unseating the Myths Surrounding the Management of Cadavers

In the aftermath of a major natural disaster, authorities must prioritize many urgent tasks, including: (1) rescuing the survivors and providing the care they need, (2) restoring or maintaining basic services and (3) managing a potentially large number of cadavers. The latter deserves special attention. The most pressing issue is preserving the identity of those who have lost their lives. Under no circumstances are burials in common graves or cremations justified or warranted.

Many myths survive to this day regarding the health hazards posed by a large number of cadavers at the scene of a disaster. Dead bodies are seen as highly contagious, a source of epidemics that can raise the death toll. Often such convictions have led the public to demand that authorities rush to bury or cremate victims, even before the dead could be identified, and frequently in disregard of the customs and beliefs of loved ones left behind.

The history of large-scale disasters is full of examples of this kind. Soon after Hurricane Mitch hit Central America, the fear of infection led to mass cremations. After an earthquake struck another country in the Region, authorities and local residents demanded that common graves be dug, without first identifying the intended occupants. And yet no scientific evidence to date has suggested that the bodies of victims of disaster increase the risk of epidemic breakouts. In fact, the cadavers of the victims pose less risk of contagion than an infected living person."

I have included the URL for the publication for your further reading: http://www.disaster-info.net/newsletter/93/cadaveres.htm

What we do know is that there are several factors that can mitigate the impact of natural hazards on human populations. These include: a thoughtful analysis of the likely hazards that can occur in the region; how those hazards will directly impact the population and health care institutions on which people depend; the stability of the community's water, power and sanitation, transportation, and communication infrastructure; the overall, baseline status of the community's public health programs; optimal construction standards for the types of hazards likely to be encountered; and well conceived interagency disaster management that involves all of the major public health and safety agencies present in the community. Perhaps these factors help to explain why similar disaster hazards can be so destructive for one community while causing significantly less morbidity, mortality and property losses in another.

Yours truly,

Steven Rottman, MD, FACEP Director UCLA Center for Public Health and Disasters Professor UCLA School of Public Health and David Geffen School of Medicine (310) 794-0864

Kimberley Shoaf, Dr.P.H. Adjunct Assistant Professor Community Health Sciences UCLA School of Public Health 1145 Gayley Avenue, Ste. 304 Los Angeles, CA 90024 ph. 310) 794-0840 fax 310) 794-0889