Medico-legal encounters of 2015 Nepal earthquake – Path traversed and the road ahead

Abstract

The Gorkha Earthquake hit the region on 25th of April 2015, at 12:58, with the epicentre approximately 80 km N-NW of Kathmandu, recording 7.8 Mw on the Richter Scale. The disaster left almost 9000 individuals dead. The search and recovery as well as the subsequent Disaster Victim Identification (DVI) operations left much to be desired. The entire DVI operations consisted of examination of 365 bodies and collection of 15 blood/hair samples and 60 bone/tooth samples. This resulted in the scientific identification of eight individuals and visual recognition of 357. The scientific basis of identification of more than 8000 individuals, remains a question.The Disaster Response was hampered by miscommunication, incoordination and mismanagement on the part of all stakeholders and could have led to misidentification as well as missed identification. This demonstrates the importance of systematic management of dead bodies in mass casualty events to ensure dignity and respect of the deceased as well as family members. The helplessness felt by technical experts was compounded by the general lack of political will and the pressure on the law enforcement for quick disposal, irrespective of the available standards and protocols. Therefore, DVI operations can only be assumed to be a disaster in the making, when faced with lack of political will, lack of strict adherence to international standards as well as lack of determination from all stakeholders. Such a response from authorities is usually driven by panic following mass fatalities especially in disasters of great magnitude, like this one.The article discusses the challenges faced by the technical experts in the field and describes the advancements as well as recommendations for further improving the DVI operations in a resource-stricken country.