Identity Crisis

The efforts of Argentinian grandmothers transformed forensic science and how it identifies the dead. In India, however, the official approach is still catching up. At no time is this more evident than during natural disasters.

Identity Crisis by Deepa Padmanabhan; Illustration by Akshaya Zachariah for FiftyTwo.in

Every Christmas, the coastal town of Velankanni in Tamil Nadu’s Nagapattinam district attracts thousands of pilgrims to its Basilica of Our Lady of Good Health. On 25 December 2004, the gathering on the beach thought the sea looked different. The dark and gloomy waters were beginning to swell in unusually huge waves. “Kadal pongi varadu,” they cried out, as the water rose. The sea is boiling. Within minutes, gigantic waves smashed into the land, sweeping away boats, trawlers, houses and people.

The Indian Ocean tsunami proved to be one of the deadliest natural disasters of all time. It claimed 230,000 lives and recorded 43,000 missing across multiple countries including India, Sri Lanka, Indonesia, Thailand and the Maldives. Of the 16,000 dead in India, it was estimated that 3000 to 6000 were from Nagapattinam district.

When the tsunami came, a local fisherman named Anthony Raj took refuge in the town of Thanjavur, which wasn’t engulfed. When he returned to Velankanni beach the following day, the waves had receded, and the land was dotted with bodies. Some had been dismembered by fallen power lines and metal rods. Others hung, bat-like, from trees, their clothes and hair entangled in the branches.

For nearly two days the bodies that weren’t claimed by the incoming tide lay untouched. Then, volunteers from local NGOs showed up, and the townspeople, too, got down to work. “We carried the bodies with our own hands and put them onto trucks, cars, tractors,” Anthony told me. They recognised some of their neighbours from their clothes, and handed over the bodies to the families. Other bodies, in various stages of decomposition, could not be accurately identified. The tourists could not be identified at all.

By the time the chief minister of Tamil Nadu made an appearance on the 28th, there were close to 3000 unidentified bodies in the canal behind the Nagapattinam government hospital—“poured” in there, as a cleaner at the hospital described it. The church donated a piece of land for their burial. “There were no rituals conducted,” said S. Rajendran, chief coordinator at SNEHA, an NGO in Nagapattinam. “They were not treated with the respect that is the norm in our culture.”

Keeping A Record

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n a checklist of responses to a large-scale disaster, victim identification comes low down the pecking order. First responders are on the lookout for survivors, and often have to move past the dead. But human remains decompose rapidly, and as time passes, it becomes increasingly challenging to identify bodies.

Prioritising the living over the dead is a given. But the dead have an afterlife, particularly for their families, and ignoring them has terrible consequences, both in the matter of emotional closure, and other, material ones. In the absence of a positive identification and death certificate, families can only report their loved ones as “missing.” Their lives can, quite literally, be put on hold.

As a life-threatening pandemic lingers beyond the world’s short-term calculations and precautions, this concern has acquired new dimensions. In India, mass pyres and burials gave many survivors a strong inkling that the disaster had expanded beyond its cautious recording in government accounts. India’s historically porous processes to record deaths appeared more threadbare and inadequate than ever. Graveyard workers, ambulance drivers, and conservancy staff became as important to counting and revering the victims of Covid as doctors and nurses.

“There were no rituals conducted. The bodies were not treated with the respect that is the norm in our culture.”

S. Rajendran

It might seem demoralising to acknowledge that people will die irrespective of how much we improve existing processes and plan for the future. But this is precisely what we need as we brace for more mass-scale natural disasters to affect our ever-warming planet. Managing the identities of the dead, and conducting farewell rituals according to their way of life, will become more important than ever.

This is at the heart of the humanitarian approach to forensics, a shift from the more traditional approach that deals with criminal investigations, law and order, and evidence. For survivors, humanitarian forensics helps provide closure, and a chance to face the future with a measure of peace. For state agencies and record keepers, it offers a chance to plan for and protect the fragile future of all humans.

“The whole world is starting to realise that we will not be able to manage the increasing frequency of natural disasters just by making it up on the run,” Stephen Cordner, professor emeritus in forensic medicine at Monash University, said. “And part of that is managing the dead honourably. I think a lot of people forget that.”

A Glacial Outburst

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he 2004 tsunami set alarming bells ringing in many corridors. An Interpol evaluation suggested that “forensic identification is in urgent need of revision.” In 2006, the World Health Organisation and the International Committee of the Red Cross came together to develop the first-ever field manual for first responders after natural disasters.

The tsunami laid bare India’s own lack of forensic infrastructure. Compounding the gap was what appeared to be a lack of political and administrative will to put in place victim identification processes. It took almost six years from the tsunami for the National Disaster Management Authority to bring out guidelines for the Management of the Dead in the Aftermath of Natural Disasters. “The 2004 Indian Ocean Tsunami has given us an insight into our capacities and preparedness regarding management of the dead,” it said, “and also the lack of support and compassionate care to the relatives of the dead.”

Three years after the publication of the guidelines, another catastrophic event rocked India. Around midday on 16 June 2013, heavy rainfall came upon Kedarnath, site of a famous temple in the state of Uttarakhand. The confining wall of the nearby Chorabari glacier came crashing down when its lake filled beyond capacity. The resulting flood and landslides stranded 73,000 pilgrims headed to the Kedarnath temple. Around 6000 people died.

Ten days afterwards, Dr. Ishwer Tayal, professor of forensic medicine at Punjab’s GGS Medical College and Hospital, was dispatched by the Uttarakhand government with seven other experts. They were to take samples for post-mortem and DNA profiling of the victims of the Uttarakhand floods. “We travelled by road from Nainital,” he told me. “The roads were damaged, landslides had blocked the roads. It was raining daily, making the roads even more slippery.”

Three team members dropped out of the mission, unnerved by the precarious conditions. (The first rule for responders is ‘me first,’ Derek Congram, a forensic specialist currently working with the Red Cross in Delhi, told me. “You shouldn’t increase the possibility of having two casualties rather than one.”) It took the remaining members three days to reach the site. The passage of ten days had made it extremely challenging to procure DNA samples. “The bodies were buried in the debris that was scattered all around,” Tayal said, “Some were hanging on the trees.”

A majority of the responders dispatched to the scene were involved in airlifting the survivors, approximately 100,000. A few police officials and mountaineers aided Tayal’s team with retrieving as many mud-sunken bodies as possible. The work was painstaking. Using a scalpel and forceps, Tayal and his team had to incise the skin of victims carefully, to pluck pieces of ribs, bones and teeth. After that, they placed the samples in clean plastic boxes, which they labelled and handed over to the police. The police would then send the samples to forensic laboratories for DNA profiling.

But the site was just too large. Before all the bodies could be recovered, the operation had to be shut down due to adverse weather conditions. The bodies from which the team had been able to gather samples were cremated on-site.

The Uttarakhand government did not release data on how many people were identified by their DNA samples. In fact, even official figures differ quite wildly from the estimates of people who visited the sites. Govind Singh Kunjwal, the Uttarakhand assembly speaker who surveyed the Garhwal region after the disaster, reckoned that the dead could number well over 10,000. The National Institute of Disaster Management (NIDM) put the figure at 4,021.

“It’s public data,” Tayal said. “There’s nothing to hide.”

In 2014, Pooja Puri, assistant professor in forensic sciences at Amity University, conducted a study of victim identification status. Of the individuals officially reported as missing or dead by the NIDM, the Centre for DNA Fingerprinting and Diagnostics in Hyderabad had completed the DNA profiling of 550 victims. The identity of only 20 had been conclusively established, she found.

“There were a lot of challenges because of the terrain, and they had deputed very few staff,” Puri explained. “In India, we are mainly focusing on rescue operations and very little is done for victim identification. We have to look beyond knee-jerk reactions.”

Missing A Beat

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ne of these knee-jerk reactions is to hastily dispose of the bodies. There’s a widely held belief that exposed dead bodies, following a disaster, can cause an epidemic. “That is, generally speaking, false news,” Cordner says. “The only exception is if there is an epidemic like Ebola.”

This contention about dead bodies made matters worse in Nagapattinam, says Aswin Subanthore. In June 2005, Subanthore, then a geography researcher at the Oklahoma State University, travelled to Nagapattinam to study efforts at body recovery and identification after the tsunami. The sense of urgency to dispose of bodies was “ill-informed,” he told me.

Individuals who handle the dead could be exposed to blood, body fluids or faeces that carry chronic infections such as Hepatitis B and C, HIV, tuberculosis, and gastrointestinal pathogens. But Derek Congram says that these pathogens don’t survive beyond 48 hours after death, and can be managed with sufficient protective equipment including gloves.

Disposing bodies without making efforts at positive identification can be traumatic for a victim’s family. “Not knowing the fate of the family member has a corrosive effect on the integrity of that family, their mental health and social well-being,” Cordner told me.

To compound distress, next of kin are often left running pillar-to-post for a death certificate. Until this is issued, the lost person is officially considered “missing:” in India, a death certificate for an unidentified or a missing person, is issued only after seven years. The family is expected to file a missing person complaint and issue advertisements. It must provide extensive proof to a court on the missing person’s background, the circumstances of their disappearance, and search efforts. Spouses of missing persons cannot remarry in most cases. Property matters and access to social welfare become a bureaucratic nightmare.

“You need to have two things running in parallel,” Cordner said. “The handling of the dead bodies, and the handling of families who think they might be missing a family member who might be dead.”

“The question that one should be asking is: what would success look like two or three weeks after the disaster that improves the chances of their future identification,” Cordner said. “We haven’t really made any inroads on this when there’s hundreds or thousands of fatalities.”

Arriving On The Scene

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he first people to arrive at a disaster scene are emergency responders: the police, fire force and ambulances, among others. When the disaster is a large-scale one, personnel from the armed forces may be deployed along with specialists from organisations like the Red Cross and Red Crescent societies. Their first task is to secure the scene and draw barricades: this prevents locals and media personnel from straying onto what might be dangerous ground, or contamination.

“There’s only one chance to visit the scene,” Puri told me. “We can’t go back later because it will be altered. So, recording is very important.” The police are responsible for taking photographs of the site and drawing rough sketches. Their examination of the scene must note the coordinates and measurements of the area with reference to a fixed point, like a river or tree.

A team is then dispatched to begin search-and-rescue for survivors, Aparna Suresh explained. Aparna is a postgraduate diploma holder from the International Centre for Humanitarian Forensics, preparing for a career in the field. This team might include personnel from the National Disaster Response Force (NDRF) and the local State Disaster Response Force. If the disaster has occurred in hilly terrain, mountaineers and forest guards get involved.

The forensic team only gets involved in the second phase of operations, which is focussed on collecting and recording human remains and personal belongings. These become important markers for both criminal cases, if any, and aid victim identification. The team usually includes a medical officer for DNA sampling and veterinary officers. They are joined by assistants who manage cremation arrangements.

“There’s only one chance to visit the scene. We can’t go back later because it will be altered.”

Dr. Pooja Puri

P. Vairavanatham, former assistant commandant in the NDRF, gave me a glimpse of how arduous this process can get. He was sent to help out with rescue operations in the aftermath of the Nepal earthquake in 2015. For the first 10 days, he told me, rescuers crawled through the debris looking for survivors.

They started looking for dead bodies only when the chances of locating the living had become very low. By this time, the bodies had started decomposing and smelling. Once the decomposition sets in, the chances of visual identification are almost impossible, and it becomes necessary to use methods of forensic analysis.

The unidentified bodies, along with possessions such as mobile phones and wallets, are photographed at this stage. Descriptions of clothes and jewellery are noted. The bodies are put into bags, numbered, labelled with geographic coordinates and handed over to the police or the district administration.

There’s a variant of this process in flood situations. Vairavanatham told me that 48 hours after the disaster, bodies are often found 10 to 15kms downstream. Rescue boats go out, and divers assist in bringing up drowned bodies. Sometimes, the body may be caught in between rocks or weeds, making it challenging to retrieve from the water. “We use a forklift, or we try to create a whirlpool by spinning the boat around very fast. This helps to dislodge the body.”

If the families are present at a retrieval, they can visually identify the dead on the spot. If unidentified, bodies are transferred to a mortuary or temporary holding place, until forensic investigation can begin under controlled conditions.

When the number of casualties is manageable, the bodies are placed in freezers at the mortuary. If the mortuaries are overflowing, Puri said, administrators find it key to take steps to slow down decomposition. This can be done by burying bodies in temporary, shallow graves or through embalming. Both have their disadvantages: the former requires space, and the latter is time-consuming.

Then, there is the autopsy. Apart from identifying ailments that victims may have been living with, autopsies also reveal surgical implants and medical devices. These have a unique identification number that can direct to the hospital where the devices were inserted: a big clue towards establishing identity. Although Interpol recommends both external and internal examinations in autopsies, internal examination is rarely conducted in mass disaster situations in India and other developing countries due to a lack of resources at hand.

But all these are secondary pieces of evidence, Aparna said. For a reliable confirmation of identity, you need lab-based forensic analysis.

Blood And Bones

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he use of forensic techniques to establish victim identity was actually pioneered by a movement from Argentina. The circumstance there was not a natural disaster but the abduction of hundreds of pregnant women by the country’s military junta between 1976 and 1983. The women’s unborn children were meant to be adopted by families running the regime or sympathetic to it, so that a new generation of Argentinians wouldn’t inconvenience the dictatorship. Some of the children were even killed.

In 1977, the mothers of the abducted pregnant women got together under the banner of the Grandmothers of the Plaza de Mayo to search, recover and identify their missing daughters and grandchildren.

As a result of their campaigning, large-scale exhumations were conducted to reveal the remains of children and women. The grandmothers, housewives with little understanding of laboratory science, approached geneticists with a question: could the scientists help identify their children through their blood and bones?

The years that followed led to the creation of the world’s first forensic genetic data bank. This bank was recognised by national law in 1987 and later led to the formation of the Argentine Forensic Anthropology Team (EAAF). The EAAF became a model for other nations who were in or recovering from armed conflicts.

The world took note of the melding of two disciplines: forensic science and humanitarian action. In 1996, the International Commission on Missing Persons was established to help the search for missing people through large-scale DNA analyses and forensics.

“It took a while for the realisation to surface that the huge amount of effort going into this was not answering a crucial question: who are these people who died?” Stephen Cordner told me. “A country’s legal system is mainly concerned with convicting a criminal. But it leaves a glaring hole for the family of that person who may not even know that they’re dead, let alone how they died.”

In 2005, the ICRC started a small forensic lab. “Now, that unit has grown from one person to 100 forensic experts all over the world,” Cordner said. “But people would be totally surprised, shocked really, about how badly we are doing, particularly when it comes to natural disasters.”

Meeting A Match

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he main reason for doing badly on forensic identification is the lack of success with matching ante-mortem and post-mortem data. In resource-strapped countries like India, the problem is more acute. Incomplete data, information asymmetry and logistical bottlenecks mean that even if, against all odds, workers do manage to collect samples from disaster sites, there is nothing to compare them with.

One of the most convenient forensic identification techniques is fingerprinting analysis. Fingerprints can be collected digitally or on specialised fingerprint paper, at the site of the disaster or in the mortuary. The post-mortem fingerprint data can then be compared with the information available on a national identity database like Aadhaar. But fingerprinting can be ineffective when the body has decomposed, or burned. That rules out its use in many mass disaster scenarios.

Forensic odontology is a more reliable method because teeth are a lot more resistant to post-mortem decomposition. Pooja Puri took me through the procedure. She first examines the teeth for fillings, decayed or missing teeth and any peculiarities. She then takes an X-ray of the entire jaw to identify signs of aging (blunter edges, more plaque deposit, loose gums) and growth (crown formation, root growth, eruption of teeth).

To determine gender, she measures the canines, which are smaller and more slender in women. In certain cases, she explained, even the occupation of a person may be reliably surmised. For instance, electricians and carpenters hold wires or nails in their teeth and these leave certain impressions.

But the big obstacle with this method is the lack of ante-mortem dental records. Unlike Aadhar, there is no database for dental records. The method may be useful to identify well-heeled victims from urban areas, given their information may be available with the family or a dental clinic. But it can be quite ineffectual when the victims are rural-based or from marginalised communities that don’t have good access to dental care.

Odontology is a part of standard forensic analysis in the US, UK and Australia. It also proved successful to identify tsunami victims in Thailand. But there aren’t enough trained experts in India, Puri said. Additionally, due to lack of awareness, government agencies do not involve forensic odontologists in mass disaster operations.

“The government has to inform the relatives that if you want to claim, there is this place you can go and give your DNA.”

Dr. R. Harinarayanan

The most common identification technique in India is DNA profiling. To understand how it works, I spoke to Dr. R. Harinarayanan from the Centre of DNA Fingerprinting and Diagnostics, Hyderabad. When a forensic lab receives a sample of bone, teeth or nails, a DNA examiner first grinds it into a fine powder. After using an enzyme to break open the cells in the powder, the DNA is separated from the cell mix and chemically treated.

For identification, fragments of the DNA called Short Tandem Repeats (STRs) are compared. “In one location of the DNA, the number of repeat units can vary from, say, 10 in one individual to 25 in another,” Harinarayanan said. “If you pick up another individual quite randomly and look for the repeat number in, say, 20 locations, you will never find two individuals who are matching exactly for all the 20 locations—except for identical twins.”

STRs are inherited: one half from each parent. When the STR pattern of a victim is compared with that of a close relative, there should be a 50 percent match.

But here again, a reference sample from a known relative is necessary for identification to work. Many times, this is not possible because the places of residence and family provenance of victims remain unknown. Several victims in the Uttarakhand flood could not be identified for this reason.

Harianarayan told me that those unmatched samples are still lying in the premises of the Centre for DNA Fingerprinting. “The idea is that at some point people may come looking to identify their relatives who died,” he said. “The government has to inform the relatives that if you want to claim, there is this place you can go and give your DNA. But if people are not informed, they will not approach us.”

The Road to Closure

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fter the disaster in Uttarakhand, things in India have been advancing, slowly but surely. The International Centre for Human Forensics (ICHF) in Gandhinagar, a joint venture of the ICRC and the Gujarat Forensic Sciences University, is helping the National Disaster Management Authority update its 12-year-old guidelines.

It is likely that the updated guidelines will reflect the recommendations shared by forensics experts. These include: the formation of a rapid response team, applying suitable body preservation methods, the need for documenting the process and socialising local communities. Many experts have suggested including forensic medicine specialists as part of the disaster management team.

The ICHF is also planning to facilitate training programs on victim management, primarily for the first responders who deal with mass disasters. Dr. Anand Mugadlimath, forensic medicine expert with the ICRC, shared an example of the kind of knowledge that needs to become common among on-field personnel. “If the body is submerged in water,” he said, “the skin becomes detached from underlying tissues, but the fingerprints can still be intact.” In such cases, the body needs to be handled carefully so that the skin with the intact fingerprint can be unpeeled and put in formalin for preservation.

Derek Congram shared another tip. “We discourage sampling on the scene because it’s not in a controlled environment,” he said. “It increases the possibility of contamination. But there are exceptions when the ambient temperatures are high, there are a lot of bodies, and not enough resources to manage them.”

Beyond the science, communication and soft skills are integral to the management of victims’ families post-disaster. “You need a communications team that’s directly engaging with the community providing information to help them understand that the processes for identification can be complex and need time,” Congram said, “The team needs to manage expectations on both sides—the communities and the agencies involved in response and recovery efforts.”

When everything in the forensic testing chain does go right, the cold certainty of the results can go a long way in helping victims’ families achieve some sort of closure. In a bus accident in Aurangabad in 2007, for instance, some passengers were charred beyond recognition. Even their bones were burnt, and it was difficult to take DNA samples. But the molar teeth were intact. The on-site forensic team took samples and sent them to a laboratory. The pulp of the teeth was then used to extract DNA and identify victims.

All of this work can take weeks and months. “Dealing with dead bodies can be emotionally draining,” Puri said. “But even if one person can get closure, it gives us the motivation to carry on.”

Deepa Padmanaban is an independent journalist based in Bengaluru writing on environment, climate change, science, and wildlife conservation.

Acknowledgements: 

I would like to thank the people of Nagapattinam and Velankanni who graciously spoke to me about one of the most difficult periods in their life: the 2004 tsunami. The story would not have been possible without the help and patience of all of my sources, particularly Anthony Raj, Aswin Subanthore, Dr. Stephen Cordner, Dr. Pooja Puri, Derek Congram, Darshana Sharma, and Dr. Anand Mugadlimath.

For details on the two major natural hazards, and to understand the history and concept of humanitarian forensics, I referred to over 30 research papers, media articles and white papers.