British Columbia Forensic Odontology Response Team (BC-FORT)

www.bc-fort.org

Incidents

BC-FORT with other Canadian Dentists Respond After Thailand Tsunami

Canadian forensic odontologists responded to Thailand to assist the Interpol-directed disaster victim identification (DVI) efforts there. More than 5,500 souls perished in Thailand. The Royal Thailand Police Force with the assistance of Interpol and the Australian Federal Police brought together forensic experts from 37 countries to attempt to recover and identify the victims of this catastrophe.

Dr. Sweet and the BOLD Laboratory (www.boldlab.ubc.ca) were contacted to respond with a team of forensic dentists as part of the Canadian DVI effort. This effort commenced on January 4, 2005 and continued for 239 days until August 30, 2005.

Background
In Canada there are approximately 30 dentists that work part-time to identify deceased persons for medico-legal agencies, such as police, coroners and medical examiners. The majority of these dentists are private practitioners; three are university professors. In 1992, forensic dentists and allied dental personnel in the western provinces began to assemble a disaster response team under the aegis of the Chief Coroner of British Columbia. Since then this group has grown to a well-trained response team of 81 members. More recently, the Chief Coroner of Ontario also commenced development of a comprehensive response plan and assembled a core group of dental personnel. The dentists that responded in Thailand are members of these two teams.

The Need for a Dental Response
Comparison of antemortem dental records to postmortem dental characteristics is a proven identification method. This method can be used alone if sufficient dental data are present or in combination with other established identification methods, such as fingerprint or DNA comparisons. A RCM Police team was deployed to Thailand soon after the tsunami to assess the damage and support the disaster recovery effort. This 10-member police team comprised forensic specialists; five of whom were selected because of their current experience in searching for missing persons in Canada's largest criminal investigation in Coquitlam, B.C. As part of this large investigation, local forensic odontology experts are using dental methods to assist the police specialists. It was believed that dental methods would also be needed in Thailand if victims' bodies could be recovered. Subsequently, a RCMP Task Force was established in B.C. to spearhead the Canadian response to the tsunami.

Dr. Sweet requested BC-FORT members and forensic dentists from elsewhere in Canada to assist the Task Force to a) recover as much dental data as possible for the Canadians reported missing after the tsunami, and b) assemble a team of experienced forensic dentists to respond to the site to identify the victims.

Missing Canadians
With the assistance of provincial dental organizations and Task Force members who contacted next-of-kin, antemortem dental records were recovered for each of Canada's missing. These records were digitized at ultra-high resolution as insurance against loss in transit. Then they were dispatched via courier to the Interpol DVI Centre in Phuket. Early in the response when courier shipments were unreliable, certain dental records were delivered to the site in person by team members when they were deployed.

Subsequently, it became necessary to increase the speed and efficiency of the transfer of antemortem data to the site. To accomplish this, with the assistance of IT experts at the UBC Faculty of Dentistry, a secure, encrypted aspect of this website was set up. This allowed identification specialists in Thailand to display records for missing Canadians. The method was very effective. Due to the success of this web-based protocol, the Task Force expanded the scope of the data transferred using this method to include fingerprint records, medical records and photographic images of clothing, jewelry, etc. DVI teams from other countries adopted this technique to transmit their missing persons' data. Use of this technology was seen as a significant contribution to the overall effort by the Canadian forensic odontology team.

Deployments
Fifteen dentists were dispatched to Thailand to work in the DVI response. Although the work was very demanding and exhausting, each dentist asked to return to the IMC to continue the identification effort there if this was required. Team members are:

British Columbia
Dr. Kathy HORWOOD, Coquitlam;
Dr. Dave HODGES, Prince George;
Dr. Bill INKSTER, Delta;
Dr. Glenn KERYLUK, Coquitlam;
Dr. John KING, Courtenay;
Dr. Tom ROUTLEDGE, Coquitlam;
Dr. Jim SEVERS, North Vancouver;
Dr. David SWEET, Vancouver;
Dr. Dirk VAN DER MEER, Armstrong

Ontario
Dr. Ross BARLOW, Hamilton;
Dr. Stan KOGON, London;
Dr. Bob WOOD, Burlington

Alberta
Dr. Ron HAINES, Spruce Grove;
Dr. Glen ZENITH, Edmonton

Yukon
Dr. Ron PEARSON, Whitehorse


Initially each odontologist was deployed alone for a two-week tour of duty. With travel added, each deployment was 19-20 days. Not long after the start of the response, it was decided to send teams of two dentists because there was an acute need for odontology expertise during this phase of the DVI effort. Additionally, it was decided to increase the dentists' time in theatre to 25-26 days, which allowed them to be more productive since it increased the productivity to training ratio.

Duties
At the DVI Centre, Canadian odontologists participated with an international team in all aspects of the dental DVI response. General duties included recovery, analysis and comparison of dental records from the home countries to dental records recovered from the found human remains. Additionally, the Canadian team members were involved in analyzing and interpreting records that contained very limited data. They attempted to extract as much meaningful information as possible from both antemortem and postmortem sources. Working with Australian commanders, team members were placed in leadership roles due to their high level of forensic expertise and exemplary work ethic.

The Canadians were requested on several occasions to test new versions of the computer software used by Interpol when these improved versions were brought online. Significantly, team members were involved in troubleshooting problems with certain protocols encountered by the on-site commanders. At times they were involved in refining specific quality control measures to improve the way dental information was managed.

Team members performed dental autopsies and recovered dental data from deceased victims at the Site 2 mortuary at Mai Khao, Phuket. Also at Site 2, they consolidated victims' records, verified identifications prior to release of bodies, and assisted DNA experts to catalogue and export postmortem forensic samples for analysis. Once a Canadian victim was identified, in some cases the dentists were present along with other Canadian team members to witness the solemn ceremonies at a Buddhist temple. This was very beneficial for the dentists since it provided an opportunity for them to see the full spectrum of the identification response from antemortem record collection to laying the victim to rest.

Impact
Canadian forensic odontologists contributed much more than expected through their very hard work and seemingly limitless enthusiasm. The team leader's briefing notes record many outstanding contributions that were made by each member during each deployment. Various site commanders from Interpol and other team leaders from Australia, Belgium and Britain, contacted the team leader several times throughout the response with news of excellent work by the Canadian dentists. In many cases, Canadians successfully resolved refractory cases that were unable to be identified by others.

The Canadian forensic odontology team made two donations at the end of their time in Phuket. First, on behalf of the people of Canada, the team donated a modern x-ray film processor that can be used without a darkroom to develop x-ray films. This was given to the Dental Department of the Phang-Nga General Hospital to improve the quality of oral care for the needy patients there. Second, the forensic dentists arranged and paid for the dental treatment of two staff members that worked in the Canadian Consular Office at the Sheraton Grand Laguna Resort. These staff members had supported the dental team from the satellite Consular Office at the resort throughout the response.

Acknowledgements
As the dental response team leader, I wish to extend a sincere thank you and my appreciation to the dedicated forensic dentists, as well as RCMP fingerprint specialists and liaison officers, and Embassy officials, that unselfishly contributed their expertise in Phuket. These individuals left their own families and livelihood for extended periods of time to work in extreme tropical conditions to provide victims' families with answers that could not have been provided otherwise.

Dr. David Sweet
September 20, 2005