Australian forensic dentists have played a major role in the identification of victims of the October Bali bombings, identifying 70% of the people killed in the terrorist attack using dental evidence.
"It was a very stressful few weeks," explains A/Prof. Chris Griffiths, Head of the Identification Section at the Department of Forensic Medicine, NSW Health and Westmead Hospital staff specialist who was a member of the team involved in the identification process in Indonesia. "The morgue was filled with victims who had suffered blast injuries and the effects of the subsequent fire. There was great pressure from the families of the victims to identify people quickly. We worked very long hours, seven days a week to try and get the ID process completed.
"The families of missing people wanted the remains released immediately so they could be taken home and put to rest. When the families were informed that this wasn't possible, there was a mixture of understandable anger and grief.
"We explained that the identification process is complex. Sixteen of the families stated that they had recognised their family members from either a photograph (of the victim) or from directly looking into a body bag at the scene. But when the victims were formally identified using dental records, half of these visual recognitions were found to be incorrect.
"We could have released eight bodies to families, these remains could have subsequently been cremated and then when we found the correct family member, how would we know who the eight victims who had been cremated were? It is important to release the deceased as quickly as possible, but equally, so is correct identification.
A/Prof. Griffiths operated as part of the Australian Federal Police team which comprised police officers, pathologists and forensic odontologists (dentists).
"We, in turn, were part of a greater multinational contingent that made its services available to the Indonesian government," he said. "At the peak of the identification effort, 12 forensic dentists from Australia together with two each from Hong Kong, Japan, Taiwan and one from Sweden worked as the dental team. Many Indonesian dentists and students from the dental school in Denpasar were also involved.
"The entire victim identification process was run very professionally by Indonesia. The Indonesian Disaster Victim Identification Team (DVI) were most accommodating and flexible, fostering outstanding cooperation. It was obviously a very sensitive situation but they welcomed our participation."
A/Prof. Griffiths said that given the nature of the disaster, with the detonation of a high explosive device in a crowded, confined space, he expected the identification process would be difficult at best.
"We knew we may have some problems, but we didn't realise how bad it was going to be until we arrived. When we realised the extent of the situation, we immediately called in more forensic dentists.
"It was a total team approach with all the forensic dentists working long hours under gruelling conditions," he said. "I particularly take my hat off to the private practitioners amongst our group who put their businesses on hold to help Australia through this national tragedy."
Internationally recognised conventions were employed that stipulate fingerprints, dental evidence or molecular biological evidence (DNA) can standalone as a means of identifying the deceased.
"If we have any one of these three, we can confirm the person's identity," he said. "If none of these are available, we then look for any two lesser identifiers, such as scars and tattoos or a persons property, jewellery or clothing.
"Dental records are generally the quickest to access because the majority of dentists are meticulous with their record keeping."
A/Prof. Griffiths, who finished a 3-year term in May as Scientific Vice Chairman of the Interpol Disaster Victim Identification Standing Committee, in Lyon, France, said that where identification was achieved using dental evidence, they had, in fact, compared dental radiographic evidence between the ante mortem and post mortem radiographs.
He stressed how vital good patient records and radiographs were in situations such as this and was grateful that so many dentists were able to provide detailed information quickly that expedited the identification process.
"The work done in Australia by the Police Missing Persons branch in each state was also outstanding. The Police had to contact dentists that each family had nominated to obtain a person's dental records. Each branch also has forensic dental officers that helped collate the ante mortem information which was then sent to Indonesia to help identify the victims. I must thank the NSW team, Dr Bill Saunderson, Dr Russell Lain and Dr Barry King for their work in this area, together with the other forensic dentists who worked with Police Missing Persons Units in the other states.
According to A/Prof. Griffiths, in the post mortem dental examination of the victims, dental charting, photographs and radiographs were taken. The victims' files were then divided into the Interpol sub-groupings, male, female, Caucasian and non-Caucasian. The same groupings were then applied to the ante mortem files which were sent from all over the world.
Then the pain-staking process of attempting to find a match commenced.
"Once a match is found, the evidence is presented to the Indonesian Reconciliation Board which is comprised of a police officer, a pathologist and an odontologist (forensic dentist). They review the evidence, which may be dental, or DNA or fingerprints or other evidence, and the three members must agree that the correct identification has been made.
"After that, the information is presented to the DVI Commander for Indonesia for final sign off. Once this has occurred, a death certificate can be issued and the body released to the next of kin."
The majority of the forensic dentists returned home to Australia after three weeks in Bali. At this time, over 70% of the victims of all nationalities had been identified using dental evidence.
One forensic dentist is currently stationed in Bali, on a rotating basis, to help with the final process of identifying the remaining victims using DNA techniques.
Australian forensic dentists who worked in Bali included:
- LCdr Mattew Blenkin (ADF)
- Dr Sue Cole
- Dr Pamela Craig
- SqnLdr Alex Forrest (RAAF Reserve)
- Dr Pamela Gower
- A/Prof. Chris Griffiths
- Dr David Griffiths
- Dr Tony Hill
- Dr Stephen Knott
- Dr Russell Lain
- Dr Veronica Lambert
- SqnLdr Alain Middleton (RAAF Reserve)
- Lt. Col. Geoffrey Stacey (ADF)
- Dr Linda Steinberg
- Dr Jane Taylor
- Dr Paul Taylor
- Dr Marie Wilson