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Abstract A mass disaster is a catastrophic event where there is almost, always a substantial loss of life as well as damage of property and loss of crops and livestock. It invariably overwhelms the resources of the community. Egypt has been the victim of different types of disasters that have had significant, longterm consequences, particularly among a population with scarce economic resources. Death does not end human suffering, especially when death is sudden, as the result of a disaster. The families of the deceased suffer additional harm because of the inadequate way that the bodies of the dead are handled. The protocols and procedures that are used in regular death investigations or even multiple death situations are not appropriate for use in the DVI efforts in a mass-fatality event. These events require special planning and preparation designed specifically for situations with potentially thousands of deceased individuals. The ”Medico-legal Department” has a critical role in standardizing and guiding the tasks of handling dead bodies (recovery, identification, transfer, and final disposal), ensuring that legal norms are followed, and guaranteeing that the dignity of the deceased and their families is respected in accordance with their cultural values and religious beliefs. This study aimed to implement a mass disaster contingency plan, designed and directed to meet the needs of The Department of Forensic Medicine, Ministry of Justice in Egypt. This plan is concerned mainly with the proper, efficient and dignified management of dead bodies in mass disaster situations. Analysis of ten contemporary Mass Fatality Incidents was conducted, with special respect to the management and the DVI process. Analysis of the data collected revealed that a lot of difficulties and problematic issues were encountered both on the national and international scale.One of the most prominent problems that were met in open disasters was to establish an accurate manifest list of the missing people, followed by collection of appropriate and relevant ante-mortem information needed for forensic identification. Accurate and well directed response planning was defective in the management of the deceased in incidents of mass fatalities, both on the national and international levels. A lot of transcription and data entry problems were also encountered especially in national disasters, a problem that was aggravated by defective labeling and tagging systems. Commingling of the remains offered another problem that was encountered in disasters associated with excessive fragmentation and putrefaction, as in explosions, aviation accidents and structure collapse. The last problem was encountered in mega disasters and disasters where a lot of foreigners were deceased; was international team coordination, with evident discrepancy in identification methodologies and dealing with local habits and taboos. These identified problems were analyzed, and methods of proper handling and management were addressed as a mass fatality management plan. The proposed plan is a four-phase approach one comprising: mitigation, preparedness, response, and recovery. By mitigation, it is meant the application of measures through which disaster is prevented or its impacts are diminished. “preparedness” refers to the activities whereby the Medico-legal Department is sensitized to positively respond to a call for help when disaster strikes; “response” as the application of resources and emergency procedures to manage the dead bodies of victims of disasters; and “recovery” involves the measures that are taken, in the long run, to return to normal the normal functioning state after the immediate impacts of the disaster have passed, in addition to the lessons learnt from the disasters and methods to employ them in preparedness for the next disaster. This research has resulted in key recommendations in a number of areas for relatively low-cost but practical actions to improve the capacity of the Medico-legal Department of Medicine to deal with a mass-fatality situation and to be better prepared to identify victims of a given disaster and return those individuals to their families as quickly and accurately as possible. |