September 11

The National Disaster Medical System (DMORT)

On September 11, in response to the attacks on the World Trade Center and the Pentagon, and the crash of United Airlines flight 93 in Pennsylvania, U.S. Secretary of Health and Human Services Tommy G. Thompson activated the National Disaster Medical System. It was the first time this federally coordinated response system - comprised of voluntary medical, forensic and mortuary professionals - had been activated on a full nationwide basis. A vital component of the NDMS is the Disaster Mortuary Operational Teams (DMORTs) program. In mass casualty situations, DMORTs help local authorities identify the victims and prepare them for burial. Following the attacks, four DMORTs were dispatched to New York City, three to Washington, D.C. and one to Somerset County, Pennsylvania. The following is a brief overview of the DMORT system and the services its members provide to communities in times of need:

How did the DMORT program originate?

DMORT began in the early 1980's as an idea of the National Funeral Directors Association (NFDA). Concerned at a lack of standards of practice for mass casualty crisis situations, the NFDA formed a committee to look into the issue. It quickly became apparent that the services of forensic professionals -- such as medical examiners like Dr. Baden and forensic anthropologists like Kathy Reichs - would be necessary in addition to those of mortuary personnel. The NFDA formed a non-profit organization of these specialists and purchased the first portable morgue unit, called a Disaster Portable Morgue Unit (DPMU), in the country. In 1996, at the urging of individuals who had lost loved ones in airline disasters, Congress passed the Family Assistance Act, which requires all airlines operating in the U.S. to have plans to assist the bereaved in the event of a crash. DMORTs have become a major component of those plans.

How are DMORTs organized?

As stated above, DMORTs are part of the National Disaster Medical System, which determines when they are called to duty. For organizational purposes, the country is divided into ten regions, each with a Regional Coordinator. For the duration of their service, DMORT members work under the local authorities of the disaster site and their professional licenses are recognized by all states. DMORT service is voluntary and, while members can be compensated for their time as temporary federal employees, most take unpaid leaves of absence or vacation time from their jobs in order to provide their services.

How do DMORTs identify the victims?

It's basically a two-part process that utilizes a sophisticated computer program for matching physical characteristics. The families of the deceased provide as much information about them as possible: dental records, x-rays, photos or descriptions of tattoos, clothing and jewelry; blood type information and objects that may contain the deceased's DNA, such as hair or a toothbrush. The information gathered, called antemortem, or "before death" information, is entered into a computer program called WIN-VIP, which is capable of assimilating 800 different item categories, including graphics, photos and x-rays. As forensic scientists (pathologists, anthropologists, odontologists) examine the recovered remains, they enter their findings - called postmortem data -- into WIN-VIP. Depending on the availability of data, the WIN-VIP system enables scientists to match the remains to their identity.

Who works on DMORTs?

In addition to forensic pathologists, anthropologists and odontologists, DMORT activities require the efforts of funeral directors, fingerprint experts, X-ray technicians, medical records transcribers, family assistance personnel (to conduct interviews with family of the deceased), and information technology specialists, as well as the administrative and security personnel always required for such an extensive operation.