Fabio Cembrani, recollection of  Val di Stava events. Thirty years after the disaster, in 112 Emergencies, 6, 2015

Dr. Fabio Cembrani, specialist doctor in forensic medicine, former Director of the Operational Unit of Forensic Medicine of the Provincial Healthcare Services Agency of Trento, in charge of the identification of the victims of the Val di Stava tragedy (Trento, Italy).  Even a long time after that tragic event, his direct experience is a heartfelt testimony to the role of those who are called  to identify the victims of natural disasters – a key step to grant victims a proper burial and enable the community of survivors to mourn their own.

On the July 19, 1985, at 12:20 p.m., the collapse of the settling basins of the fluorite mine in Val di Stava (province of Trento) caused the death of 268 people, suddenly hit by 150,000 cubic meters of water and mud flowing downstream along the course of the Stava creek, up to the confluence with the Avisio creek, for several kilometers. A very high number of victims – only overcome in Italy by the Vajont tragedy, which caused nearly 2,000 deaths in 1963 – because the holiday season brought many tourists staying in the valley’s three hotels and many owners of cottages, at that time of day mostly gathering with their families for lunch.

The purpose of this testimony is to describe the organization of rescue, and namely the medical-legal intervention, in order to highlight the importance of the role of those called to identify the victims of natural disasters, as there is no place for improvisation in this field of civil defense. It remains an inescapable humanitarian duty to always give victims a name and identity, so that their families and community can accompany them on their final journey, in every part of the world.

The organization of the medical intervention

I arrived at the site of the disaster at about 5:30 p.m. on July 19, 1985, 5 hours after the wave of mud that swept away the village of Stava. Rescue operations, coordinated by the Minister of Civil Defense Giuseppe Zamberletti, were being organized in the Operations Center immediately set up in the Tesero Town Hall, 3 km from Stava. The first recovered victims of the tragedy had already been composed in the gym of the village school.

After making contact with the civil and military authorities of the Operations Center and understanding the dynamics of the tragedy, it was decided to proceed with an inspection of the disaster site to set up excavation and recovery operations. On my way there in a military vehicle, I realized the severity of the disaster and that – unfortunately – very few survivors would be found. The first sanitary problems we encountered were identifying a suitable place for reassembling victims bodies and ensuring their preservation over time to facilitate identification.

We had to identify a facility offering, on the one hand, suitable micro-climatic conditions and, on the other hand, logistical convenience to facilitate access for the relatives of the victims as well as to accommodate the victims themselves.  We ruled out, for obvious reasons of space and pietas, both the small mortuary of the Hospital and the only structure in the area equipped with cold rooms – the municipal slaughterhouse.

So we opted for the Parish Church of Cavalese, 7 km from Stava, which could guarantee on the one hand respect for the dignity of the deceased, and on the other hand sufficient space to contain the victims of the tragedy and the reception of relatives. It also guaranteed optimal micro-climatic conditions, a key concern considering the season.

This was, however, while waiting to identify a more suitable facility for identification purposes and in this regard, we worked in collaboration with the Government Commissioner (1) in Bolzano and the Judicial Authority in Egna (Bolzano), to seize a large refrigerated warehouse – used for fruit storage – located in the nearby town of Ora, about 30 km from Stava. To facilitate the preservation of the corpses, each recovered body was subjected to the usual anti-putrefactive treatments with formalin administered into the abdomen.

We set up, in cooperation with the local healthcare authorities, an initial collection center at the Cavalese Hospital. There, the bodies were washed and then transferred by Red Cross ambulances to the parish church for identification. Aided by numerous soldiers and Red Cross volunteers, we proceeded through the night to describe the corpses and the anatomical remains that the rescue teams were gradually recovering, as the genetic investigation techniques used today for identification purposes were not available then.

These operations continued throughout the following Saturday and part of Sunday. On Sunday we decided to transfer the bodies that had not yet been recognized to the refrigerated rooms of the Ora warehouse, which in the meantime had been completely cleared and equipped for the purpose. The body transfer operations took place using Army vehicles. Certainly, the organization of work at this second location turned out to be much more rational. First of all, because it was possible to split the work of identifying the remains among several medical-legal teams assisted by technical personnel. Also, and most importantly, it was possible to organize a single medical coordination capable of organically managing the large amount of relations with civil and military authorities, the judiciary and the police and those in charge of voluntary work, all of whom were engaged in solidarity with the families of the victims.

Extraordinary cooperation in this regard, as well as for the rest of the tragedy, was offered by the volunteers of the Italian Red Cross and Caritas.

The optimization of the work was also possible because, in Ora, the operation was only of a medical-legal nature, while in the course of the first few days medical workers had to set up sanitary and hygienic interventions, as well as take care of the periodic disinfection with vapor of quaternary ammonium salt in the Parish Church of Cavalese and in the ambulances used to transport bodies; of vaccine prophylaxis against tetanus and typhoid delivered through a healthcare assistant; of controlling the springs and water intake works in the area in order to immediately spot any form of chemical and/or bacteriological pollution; of the recovery and treatment, in collaboration with local veterinarians, of the numerous carcasses of large animals involved in the tragedy and affected by conspicuous early putrefactive phenomena.

Body recognition operations continued here until the July 25, with daily workload always exceeding 10-12 hours. Identified corpses were transferred to their respective places of origin. Unrecognized corpses and anatomical specimens were buried in the old cemetery. Meanwhile, the cemetery area had been greatly enlarged with earthworks that lasted for several days and nights. On July 25, the medical-legal team moved to the small anatomical room of the Cavalese Hospital where two prefabricated cold rooms had been conveniently arranged for the storage of the remains.

With a stable location and more adequate tools, it was possible to establish and activate an information system. The system permitted the input in the archives of all the names of missing people with the relevant personal and somatic data, characteristic and particular signs, useful for the possible recognition of the recovered bodies. This archive was updated with the results of medical-legal investigations and in particular with the data deduced from the odontostomatological study. It was also useful for the economic intervention established by the Provincial Council of Trento in favor of surviving family members belonging to the same family unit of the victims, or in a family relationship in direct line up to the 2nd degree. At the Cavalese Hospital we operated uninterruptedly until September 4, when the excavation and search operations for the victims of the Val di Stava tragedy ended. This was not before repeatedly using the canine units of the Swiss Red Cross and scanning, with underwater cameras, the Stramentizzo Lake for further search for victims, at least in places where visibility allowed.

Results

The recognition operations were particularly difficult for two substantial reasons: (a) at that time, the genetic typing that today allows for the identification of unrecognizable human remains of missing persons was not available; (b) the bodies showed significant traumatic phenomena as they had been dragged downstream for more than 4 km. In several cases, further trauma was caused by the mechanical means forced to dig and search for the bodies of the victims under sediments, in some places more than 8 meters high.

The results of the activity can be reconstructed through the examination of the 248 necropsy examination reports drawn up at the time of the intervention. Each of them reported some data including the deceased person’s biographical information, sex, place of origin, type of identification performed (direct and indirect). Finally, with regard to indirect recognition, the elements of an extrinsic nature (clothing, documents, personal effects) and of an intrinsic nature (description of the corpse, dental formula, description of scars, finding of malformations and any ongoing pathology, blood group) subject to medical-legal analysis were reported. On purpose, only the results of the external examinations on the body were examined, leaving out the thick documentation concerning the very numerous anatomical remains, which in any case testifies to the enormous medical-legal effort carried out during the operation.

Overall, of the 268 people who died as a result of the collapse of Prestavel mine settling basins, 201 were identified (74.9 %), 47 were unrecognized (17.4 %), and 20 (7.4 %) missing. Among the unrecognized corpses, 20 did not offer useful element for identification purposes, but 27 did. Of the 201 bodies recognized, 126 (47%) were directly recognized by family members, while 75 (27.9 %) were identified on the basis of the descriptive elements revealed through medical-legal examination. And in this regard, good results were given by the study of dental impressions systematically performed on 97 corpses, that could have been even more evident if the many doctors surveyed had kept memory/ documentary trace of the dental care given to the person during his or her lifetime.

Conclusions

In any case, this personal experience seemed useful to us to remind our country’s government, local political authorities and those who institutionally and technically have to deal with natural catastrophes of what is shared at international level: a good civil defense intervention cannot ignore the need to rescue injured people, identity the victims and psychologically support their families. All of this requires properly trained specialized teams that avoid the uncertainties, improvisations and misjudgments that happen whenever one is not prepared for catastrophic events that can always happen. Some conclusions are possible, however, in view of our experience.

  1. Intervention should be as swift as possible and put in place with specialized personnel – not only medical – adequately equipped for the purpose, trained and always ready for an emergency.
  2. In the operational phase, it is essential to organize a single healthcare coordination center, endowed with management autonomy and able to direct and supervise the work of the different teams so as to avoid any fragmentation of activity. 
  3. The rescue team should always include a core of professionals specifically dedicated to the composition of bodies, their possible storage in appropriate places, and the identification process.
  4. The identification of victims, beyond the extraordinary options offered today by genetic investigation, must still make use of the traditional techniques of descriptive morphology investigation.
  5. The dignity of human individuals does not end with their death, regardless of the cultural, political, and religious context of the catastrophic event.

Stava (Trentino, Italy), 1985. Rescue and recovery operations

 

Stava (Trentino, Italy), 1985. Hotels and other collapsed buildings