Critical Incident Stress Response Team Report: SwisAir 111

 
 

Editorial Note: Mr. Johnson is a Green Cross Projects Registered Traumatologist. He was invited to write a brief report of his experiences in co-leading the Canadian Forces Critical Incident Stress Response Team. We hope that others who were involved will contribute similar reports or write well-constructed responses. Together, we hope that these essays will offer useful insights into how theory, research, and plans are applied in actual traumatic events. CR Figley

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      As a Registered Traumatologist and one of two Leaders running a Canadian Forces Critical Incident Stress Response Team at 14 Wing Greenwood in Nova Scotia, I wish to present our experience in dealing with the tragic crash of Swissair 111 and the loss of all 229 souls on board that aircraft. Dr. Jeffery Mitchell's CISM model indicates the necessity for "NEAR-scene defusing" and that is the philosophy we have used when training team-members. How quickly we had to change that view when our team was tasked to provide ON-scene defusing and walk & talks from within the temporary morgue!

    When we received the request to help the Primary military CIS response organization and provide CIS services, we were given three hours to organize and deploy our team to Canadian Forces Base Shearwater, where the temporary morgue and helicopter squadrons were located. Upon our arrival, we were advised to set up within the confines of the temporary morgue, with the mandate to provide CIS services to all morgue personnel (military and civilian), and for the helicopter squadrons given the grim job of body transportation from the Navy ships to the morgue. In the initial briefing of all morgue staff and Royal Canadian Mounted Police by the Chief Pathologist (Dr. John Butt), he introduced our CISM team to everyone and said, "Take a good look at these CIS providers. The services they offer us will become more important as time goes on, and if you don't think you'll need their services, THINK AGAIN! Their role is VITAL to your well being". I knew that with those words, we were being supported at the highest level.

    I knew there would be an ethical dilemma in working on-scene in the morgue versus near-scene, located perhaps in a building near the morgue entrance. Would we become too traumatized to be effective, or would our presence increase familiarity with the staff and encourage more interventions because of our proximity? Our decision to remain within the morgue proved successful beyond our wildest expectations. Comments such as "I would never have come to talk to you if you had been outside this building", and "When I felt overwhelmed, I would look across the hangar floor and see one of you there, and knew you would understand what I was going through" were stated on numerous occasions each day.

    This gave our team the feedback that our on-scene presence was seen as "safer" and provided greater face-validity for those who wanted to talk about their experiences with someone who could "talk the talk".

    During the first two days after the crash, we worked on a 24-hour schedule with three team members working each six-hour shift. On the third day, the morgue staff stopped working by midnight to allow personnel to rest. By day five, the body recovery had come to a standstill due to deteriorating weather and a marked decrease in surface debris. This enabled the morgue to process all the body bags (about 100) and their contents. All the human remains were in small pieces, the largest only partial torsos. This made the work of body handlers, pathologists, x-ray technicians, dental staff, and RCMP especially difficult and gut wrenching. Another group of people who could have easily fallen through the cracks was the carpenters, electricians and plumbers who worked around the clock to build proper examination rooms and x-ray sites in the morgue. Their work required constructing partitions on-site while forensic work was going on. Needless to say, the scenes of humanity that unfolded during the identification process also impacted these workers. Had we not been there to observe this group of workers, subsequent interventions with some of these people may not have occurred. After day five, the partitions were in place that removed the visual and olfactory stimuli that our team was initially exposed to.

    Although the morgue activity had come to a standstill from day five to day ten, the occasional body bag arrived and was processed immediately. Our team continued to provide support in the morgue, but additional requests from outside agencies were also addressed. These included one-on-one interventions and defusing for helicopter crews and technicians, debriefings for ship's crews involved in the body retrieval, defusing for local hospital staff, and stress-inoculation sessions for divers who were to descend into the ocean to collect body parts. One of the most profound and difficult interventions occurred when five of our peers and myself were tasked to provide support for the families of the deceased who were to arrive at the wreckage hangar and attempt to identify personal belongings of their loved ones. Over a six-hour period, 200 family members were bussed to the site and supported by our team. A defusing by other team members right after this ordeal proved to be extremely beneficial for our own well being.

    By day 12, our team was starting to hit the proverbial brick wall and we knew it was time to leave. A new CISM team was flown in from Ontario to replace us at Shearwater and a Debrief of the Debriefers was conducted for the majority of our team. Two days later, after a comprehensive turnover from our team to the replacement team, the remaining five members of our team came home.

    During the two weeks that we worked in Shearwater, our team successfully broke new ground in an on-scene situation in short order. We accomplished our goal of providing first-class CIS interventions for personnel involved in the body recovery and identification process. Countless testimonials from group directors, supervisors, and staff working in the temporary morgue have confirmed what we endeavored to show; that working on-scene could improve the face-validity and viability of CIS services. The impact of such work on our team was far less than originally feared, and could be attributed to the composition of our team, the mandatory monthly training sessions for all members, the large number of CIS interventions conducted prior to the Swissair tragedy and the high group cohesion that our CIS Response Team has enjoyed for the past five years.

    Although we always conduct our training in a "worst case scenario" fashion, nothing, absolutely NOTHING can prepare a team to respond in a disaster of such a magnitude. Of the 229 dead, to date 143 separate DNA types have been documented and yet, only 12 have been positively identified! The task is monumental. The interventions conducted by our team number in the hundreds.  I hope in our own way, our 14 Wing Greenwood CISRT has helped mitigate serious CIS reactions in those we touched. The large numbers of first responders who have been significantly impacted by this accident cannot be understated. There are many who still need help.