Swissair Flight 111 Disaster Response Impacts: Lessons Learned From the Voices of Disaster Volunteers
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Swissair Flight 111 Disaster Response Impacts:
Lessons Learned From the Voices of Disaster
Volunteers
Terry L. Mitchell, PhD, CPsych
William Walters, MSW
Sherry Stewart, PhD
This qualitative research study provides insight into the specific experiences, trauma, and
needs of disaster volunteers as an understudied and marginalized sector of response and
recovery personnel. Based on a qualitative analysis of in-depth interviews, the authors
present the tasks, exposures, impacts, and search for meaning of the Swissair Flight 111
disaster volunteers who were exposed to human remains during response and recovery
efforts. The article is structured to amplify the voices of volunteers to reveal the specificity of
disaster fieldwork and resultant multilevel impacts critical to understanding and
responding to contemporary disasters. The article concludes with a discussion of the need
for clinical and operational policies and protocols that acknowledge the risk and impact of
volunteer exposure to human remains and serve to protect the well-being of future
volunteer disaster response and recovery workers. [Brief Treatment and Crisis Intervention
6:154–170 (2006)]
KEY WORDS: disaster, volunteers, human remains, PTSD, qualitative research, Swissair Flight
111, Nova Scotia.
Exposure to disasters is known to have both about their adverse impacts, inadequate atten-
short- and long-term cognitive, emotional, tion has been given to the experience and well-
physiological, and behavioral consequences being of disaster rescue workers and volunteer
(Chu, 1998; Fullerton & Ursano, 1997; Schnurr responders. Response workers often experience
& Green, 2004). Despite a growing body of lit- trauma in relation to the cognitive and sensory
erature about the traumatic nature of events assaults of disaster response work, while at-
such as disasters and increased knowledge tempting to process and integrate what they are
seeing, hearing, touching, and smelling around
From the Department of Psychology, Wilfrid Laurier them (Fullerton & Ursano, 1997). The range and
University (Mitchell), the Canadian Red Cross, Indonesia magnitude of stress responses vary significantly
(Walters), and the Departments of Psychiatry and
among those involved in disaster response oper-
Psychology, Dalhousie University (Stewart).
Contact author: Terry L. Mitchell, Assistant Professor, ations chiefly in relation to the individual’s role
Faculty of Science, Department of Psychology, Rm. 2018, in the response efforts. There is, however, a well-
Wilfrid Laurier University, Waterloo, Ontario N2L 3C5,
Canada. E-mail: tmitchel@wlu.ca. established link between human remains ex-
doi:10.1093/brief-treatment/mhj011 posure and the development of posttraumatic
Advance Access publication April 7, 2006 stress disorder (PTSD) (Leffler & Dembert,
ª The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
journals.permissions@oxfordjournals.org.
154Swissair Flight 111 Disaster Response Impacts
1998; Ursano, 1990). Despite the known risks of disaster response workers—individuals who
disaster exposure, in particular human remains have endured human remains exposure in their
exposure, there is a dearth of research role as disaster response and recovery volun-
investigating the experiences of and impact of teers. As very little is known about this group
this type of exposure on volunteer disaster of disaster workers, we seek to contribute to
workers. On reexamining the voices of the Swis- increased understanding and insight into the
sair Flight 111 (SA111) disaster volunteers who experiences and needs of disaster volunteers
were exposed to human remains, we learn impor- by listening to first-hand field accounts and
tant details about volunteer experiences and by amplifying the voices of the volunteers
impacts and begin to address a critical gap in themselves. Drawing upon in-depth qualitative
the literature that describes the phenomeno- interviews, we analyze qualitative data to de-
logical nature of experience and exposure, as scribe the field experiences, impacts, and cop-
well as short- and long-term impacts on vol- ing strategies of volunteer recovery workers
unteer disaster workers. involved in the SA111 disaster who were ex-
This article extends from and further explains posed to human remains. Despite the small num-
the initial findings of a larger mixed-method ber of interview participants in this subsample
study in which the initial analyses of volunteer of recovery volunteers, we are able to provide
responses (n ¼ 13) to standardized question- otherwise rare accounts of recovery volunteer
naires indicated that 71% of the volunteers experiences with reflections on their specific
that were exposed to human remains were suf- tasks, exposures, and impacts. Working with
fering from likely PTSD according to scores very rich data (Denzin, 1989) and detailed
on a self-report measure (Mitchell, Stewart, first-person accounts, we represent the voices
Griffin, & Loba, 2004). The first analysis of of disaster response workers whose role was
the community-level health utilization data to recover human remains. Given the known
from this study (three years prior as compared mental and physical health impacts of human
with 3 years postdisaster) also identified com- remains exposure and the long-term social, re-
munity residents as potential secondary victims lational, occupational, and health impacts of
with the report of certain disease categories sig- posttraumatic stress, we portray the specific
nificantly increasing in this region following experiences and responses of volunteer disaster
the disaster, that is, respiratory, neurological, recovery workers. We conclude the article with
Cardiovascular Disease, mental health, gastroin- a call for further research on volunteer impact,
testinal, and endocrinological/immunological treatment models, and protocols to inform vol-
diseases (Weerasinghe, Stewart, Mitchell, & unteer involvement in disaster response and
Russell, 2003). Also, our earlier work on recovery efforts.
coping-related drinking (Stewart, Mitchell,
Wright, & Loba, 2004) demonstrates the nega- Methods
tive impact of volunteer exposure. The present
article involves further analysis of interview In 1999, an interdisciplinary research team,
transcripts of the seven response volunteers working in partnership with a community
from the original sample who were involved advisory group, studied volunteer- and
in the recovery of human remains in the after- community-level impacts of the SA111 dis-
math of the Swissair disaster. In this secondary aster. The Community Advisory Group in-
analysis, we consider the response and recovery volved 12 community members from various
experiences of a much understudied group of disciplines included three clergy, three mental
Brief Treatment and Crisis Intervention / 6:2 May 2006 155MITCHELL ET AL.
health professionals, a community fire chief, a debris and human remains. For the purpose
community volunteer, an Emergency Measures of this article, we selected the recovery
Coordinator, a Ground Search and Rescue volunteer transcripts as an intensity sample
Captain, and two elected civic leaders from (‘‘Information-rich cases that manifest the
the impacted communities. Utilizing an ecolog- phenomenon of interest intensely but not ex-
ical perspective (Bronfenbrenner, 1979) and tremely’’) of volunteers (Patton, 1990, p. 171).
a mixed-method methodology (Tashakkori & The disaster response volunteer data selected
Teddlie, 1998), the team of researchers studied for this article (n ¼ 7) were collected over a pe-
trauma exposure, stress responses, and resil- riod of 9 months between July 2001 and April
ience in the aftermath of the disaster. 2002, approximately 3 years after the SA111 di-
The research team received ethical approval saster. Volunteer interviews were open-ended,
from a university research ethics board to con- semistructured, and lasted for approximately
duct a research study to determine both individ- 1.5–2 hr. The interview guide invited partic-
ual- and community-level impacts of the crash ipants to tell their stories in relation to their
of SA111. All interview participants were pro- personal experiences the night of the crash,
vided with a letter of information, and all signed their role in response and recovery efforts,
a consent form that indicated the voluntary na- and the impacts of such work on themselves.
ture of the interview process. All participants Interviews were audiotape recorded and tran-
were also given a resource sheet with informa- scribed, and the transcripts were checked
tion about possible negative health responses against the original tapes. All identifying data
that can be associated with exposure to disasters were removed to ensure participant anonymity.
with contact information for counseling and (All names used in the representation of find-
support services in their area of residence. ings in this article are assigned pseudonyms.)
Utilizing a naturalistic paradigm (Hammersley Each of the seven volunteers (two women and
& Atkinson, 1983) and a participatory action five men) included in this article participated in
research methodology (Green et al., 1995), the the collection and cataloging of human remains,
team of researchers studied the nature and me- personal effects, and airplane debris. Partici-
chanics of exposure, trauma, stress responses, pants worked in the field between 7 and 35
and resilience during and in the aftermath of days. Further participant demographic infor-
the disaster. Such an approach allowed for a mation is not reported due to the small sample
wholistic evaluation of the subjective realities size, in order to better protect the confidential-
of people who experienced the response efforts ity of research participants.
and the aftermath of the SA111 disaster.
The data for this article are derived from Data Analysis
a subset of the qualitative data (7 of 13 volun-
teer interviews). The initial study involved In February 2004, the disaster recovery volun-
volunteer respondents who were categorized teer transcripts were reanalyzed using the
as instrumental and recovery volunteers. In- coding procedure of Strauss and Corbin (1998).
strumental volunteers were individuals who Transcripts were coded using a three-phase
provided logistical support such as food, cloth- process of open, axial, and selective coding
ing, and transportation to response and recov- derived from a grounded theory approach to
ery workers both professional and volunteer. data analysis (Strauss & Corbin, 1998). In the
The recovery volunteers were those who were initial phase of the data analysis process, a se-
actively involved in the recovery of airplane ries of broad categories with subthemes were
156 Brief Treatment and Crisis Intervention / 6:2 May 2006Swissair Flight 111 Disaster Response Impacts
developed: impacts and processing experience attention to. In establishing trustworthiness,
(meaning, hope, respect, and honor), commit- Lincoln and Guba outline several key issues
ment and determination (positive and negative to be attended to while carrying out research:
coping), impacts (social, relational, occupa- credibility, dependability, confirmability, and
tional, PTSD symptoms: physical, behavioral, transferability.
cognitive, and emotional), communication (co- In the execution of this research initiative,
worker, family, community, and confidential- several strategies were employed to ensure that
ity), positive implications of involvement, the findings were trustworthy. To establish cre-
traumatic incidents (direct and secondary), dibility, four key techniques were employed:
work environment (recognition, information prolonged engagement, persistent observation,
sharing, role, changes in the nature of role over constant comparison, and member checks. De-
time, coordination, policy/protocol, duration, pendability and confirmability were assured
intensity: emotional and physical), interven- via an extensive audit trail that outlines the
tions and supports (in field and external), and chronology of community and research events
coping (positive-active coping, negative). as well as details of each stage of the data anal-
Based on the open-coding process and the ysis process. The first two authors indepen-
preliminary placement of codes into purposeful dently coded and analyzed the volunteer data
groupings, subsequent categories were derived and conferred on interpretation before axial
and existing categories refined, leading to the coding and checked back with the original
process of axial coding. During the axial-coding transcripts during the writing up of the article
process, the relationship between all previous to confirm and to seek negative cases of emer-
codes and coding categories was explored and gent interpretations/representations of the data.
the connections between all data were further Transferability speaks to the degree to which
considered and collapsed to reach a data synthe- the findings apply to other similar situations
sis revealing a narrative of key constructs: the as determined by the reader of the article. In or-
task, the exposure, the impact, and the mean- der for such a determination to be made, there
ing. This analysis of a largely underinvestiga- needs to be ‘‘thick data’’ (Denzin, 1989). In the
ted phenomenon intentionally privileges the context of this study, transcribed interviews
voice of the disaster recovery volunteers versus provided a wealth of ‘‘thick data’’ detailing very
the interpretive voice of the researchers. How- consistent accounts of the recovery workers
ever, the narrative constructed from volunteer experiences. While working with a small sample
voices in this article has consciously been (n ¼ 7), we believe that the information yielded
employed by the authors to share insights, to from the voices of these individuals, especially
increase understanding, and to inform policy in relation to being exposed to human remains,
recommendations for future involvement of is highly transferable and applicable on a much
volunteers in disaster response efforts. broader level, beyond the confines of this study.
Rigor
Findings
Lincoln and Guba (1985) describe ‘‘trustworthi-
ness’’ as having collected data that are to be
The Task
found credible. They argue that the basic issue
in relation to trustworthiness is to demonstrate To give specific contextual information to the
that the findings of an inquiry are worth paying reader and to highlight the profound nature
Brief Treatment and Crisis Intervention / 6:2 May 2006 157MITCHELL ET AL.
of the volunteers’ experiences, we provide an gets emotional] That’s why I’m doing it. I’ll
extended quote derived from the transcript do it for them because they can’t [pause]
of one of the recovery volunteers as a for- nor should they be expected to [pause] do
ward to the findings on the volunteers’ field what I’m doing. Ah, so I’ll do my best and
experiences. I’ll make sure that my guys have the oppor-
tunity to do the best and we’ll get everything
I’ll Do It For Them Because They Can’t that we can.
About the fifth day, by that time getting
worn down [pause] I was starting to wonder, When SA111 crashed into the Atlantic on Sep-
I needed some, some attainable goal. Some tember 2, 1998, at 10:31 p.m., many residents
reason for what I’m doing. Why am I doing of the surrounding area were already at home
this to myself? I needed something to keep in bed. Fishers and volunteer firefighters re-
going. To try and dig that strength out. Be- sponded as they always had to marine disasters
cause I was starting to tire down, I was start- and readily went to the shore, launching their
ing to get tired out. And ah, near a point that I boats to assist. Individuals initially presumed
hadn’t been before. So I was in kind of an un- that they went out to sea to rescue survivors
tested territory with myself as far as my resil- of the crash. In reality, however, response
ience was concerned. And I wasn’t sure and rescue workers were faced with the pro-
where my mind or where my body was going found realization that all 229 passengers and
to go from here if I kept going. And even then board personnel had perished in the disaster.
I (was) suspecting that you’re okay now but if Responders were confronted with an extraordi-
even if you stop at this point, is there going nary and horrific watery debris field.
be a . . . a period of time where the effects are
still accumulative or whatever when, when it . . . the confusion and the eeriness of the
stops physically, is it going to continue emo- night, um was sort of like a messed up paint-
tionally or whatever? The toll. And I needed ing when on acid. It was black. It was rainy,
something to cling to because usually, when miserable. The waves were pretty high. The
you’re out on a search, you have the energy sea was coming over the bow. The Hercules
to keep going no matter how tired you dropping para-flares which wouldn’t make it
are because you think, if I just keep going, thought the clouds completely and it would
you might find the person alive and if you give this weird glow to the whole area.
don’t at least, ah know you, work hard be- It was just a surreal night . . . it was sort of
cause you want to be able to find them even like one of Dante’s levels of hell.
if they are dead, to say that the families have Bert who was with me was starting to get
somebody and they’re not laying out there in very panicky because of what we heard on
the woods somewhere for two or three years the radio. There was a lot of fishermen losing
for some hunter to come across or, or not get control on the radio and the final straw was
them back at all and I can understand that when he heard one fisherman talking about
being very important. And that’s what hit how he had found a pair of legs because he
me. Coming back in transport one day, we thought it was hose and he was pulling it
were coming back in the camp and there were up and these female legs floated to the surface
some family members out by the water and it and he lost it. And then when Bert heard that,
just struck me then. You know, there it is he said, George we’ve got to go. I can’t deal
right there. [pause] That’s . . . [long pause, with this.
158 Brief Treatment and Crisis Intervention / 6:2 May 2006Swissair Flight 111 Disaster Response Impacts
It was beyond my experience to see humans wouldn’t know. You know, it could have
in that condition. Ah, I think what struck me been jellyfish . . . So I mean we were aware
apart from the gruesome and the grotesque- that we might be dealing with tissue from
ness of it was the fragility of the human body a person, okay?, but we didn’t know. So
that ah, something that can walk and talk and we did what we were supposed to do and
do things can be reduced to this in a flash and we came back in
there’s nothing you can do about it. It is that . . . you made sure that (you covered) the area
fragile. It can be extinguished that quickly that was cast for you to do that there was no
and torn asunder that easily. rush job. You had to do a very thorough job
that you were set out to do. Your task had to
Despite the surreal and grotesque nature of the be very efficient or else.
debris field left by the tragedy and the emo- . . . we’d stop around noon and take half an
tional and physical demands of the rescue hour and because, at least the way I felt, that
efforts, on the first night an untold number an half an hour was enough because we were
of community volunteers stayed out in the searching and we didn’t know what we could
darkness searching for people to save. find or what we would come in contact with.
Maybe a person was still alive or something,
. . . I felt that it was necessary to stay out so we didn’t want to take an hour.
there as long as possible just in case.
You know, your logic dictates everyone was The task shifted from rescue to recovery with
dead and there wasn’t a chance of survival. the daunting role for both workers and volun-
We didn’t know that that night. teers of salvaging parts of the devastated air-
craft, recovery of human remains, and
After the first night, as ground search and cataloging of personal effects. The daily events
rescue teams started to be organized and of volunteers involved long hours, in extreme
deployed in an organized manner, volunteers settings. Groups of three were taken by boat or
were asked to follow a strict protocol for col- helicopter to one of over 300 small islands
lecting, bagging, and tagging human remains, within St. Margaret’s Bay and Mahone Bay,
personal effects, and airplane debris. All items Nova Scotia.
needed to be securely wrapped and identified.
The volunteers took their roles seriously and Within a few hours actually we knew that
worked with a high degree of respect, profes- there was gonna be no survivors. When
sionalism, and care as illustrated in the follow- the reports were coming back in on what
ing quotes from three volunteer response was being found, there was absolutely no
workers. way that anybody survived it. So we knew
that. So there was a real general sadness over
Well, [pause] we ‘‘bagged and tagged it’’ as the support camp we’d set up, but everyone
they say, it got picked up and brought back was still very dedicated. ‘‘Well okay then,
[pause]. There was a routine for plane stuff. It here’s what we have to do. We have to go
went into one bag and [pause] body parts, or out and we have to bring these things back.’’
alleged body parts, went into another. We But it was . . . it was hard.
would have just been talking about tissue
here eh. Something that is so undefined that Volunteers worked in remote areas under all
you know, unless I was a doctor or something types of weather conditions. While individuals
Brief Treatment and Crisis Intervention / 6:2 May 2006 159MITCHELL ET AL.
worked together in teams, they were asked not Disorders lists only three symptom categories,
to speak with one another about what they our finding of four symptom clusters has been
were finding. The task was physically demand- corroborated by earlier work by Stewart, Con-
ing with individuals working long hours, some- rod, Pihl, & Dongier [1999].) The profound na-
times weeks on end without rest. ture of the multiple exposures and the related
physiological, cognitive, behavioral, and emo-
One recovery volunteer spent 34 days in the tional impacts are revealed in the following
field and some volunteers, particularly in the vivid quote from one recovery volunteer. This
first two weeks, were working from six in the quote indicates the profound intersection of
morning to midnight. exposures and impacts and contextualizes the
When I left, when I left (for) the crash site, it volunteer’s experience as a preface to the struc-
was dark. When I arrived on shore it was tured presentation of findings.
light and when I went home it was light, it
was a new day. It was totally, it was like The Experience Was So Intense
a bad dream or a nightmare and when I went The experience was so intense. The sensory
to sleep, I kind of, it wasn’t that I forgot about input was so high, the emotional level so high
it, but I left it behind me. It wasn’t a, [pause] that when it started to wane, when it started
it was very surreal. to decline, Ah, you found yourself missing
that adrenaline I guess. The sensory excite-
Although it was evident for most response ment. The whole intensity of it. It was ah, a re-
workers very early in the operation that the al depressing feeling came over you that this
probability of finding survivors following the isn’t like it was the first couple of days now,
total devastation of the aircraft was remote, vol- you know, the smell of the jet fuel is starting
unteers worked conscientiously and continued to disappear. The pieces of the plane are be-
to be motivated by the hope that there might be ing battered and worn and becoming soggy.
someone to rescue. The human remains are beginning to decay
and ah, that’s what I was getting mad at. I
It’s not a job, it’s a task that you’re asked to
was angry. I wanted fresh debris. I wanted
do and you volunteer to do it and ah, there’s
it to be like it was the first couple of days.
always the hope, the hope is, the hope is re-
I wanted a fresh crash, damn it. [laughs]
ally what keeps you going. It’s not something
was the sort of mindset that I had. I want
that you can give up on, the hope. Because if
a new crash. I want it back the way it was . . .
you give up on hope, you really have noth-
Why was it? Um, it was easier then. It was
ing, you know. There’s nothing to work with
more, if you could possibly fathom that it
or nothing to accomplish so hope is a wonder-
was more. Um, it was cleaner. It was newer.
ful thing to keep you, you know, striding
Um, to deal with ah, fresh human remains in
ahead.
my mind is much more preferable to deal with
than decaying remains . . . . It’s, it’s a much
different experience to, um, collect parts of
Exposure and Impact
a person that have been very recently torn
In this section, we present the impact findings apart, than it is to pick through, um, stuff
in the subcategories of behavioral, emotional, that’s ah, that smells offensive, that looks,
cognitive, and physiological impact. (Although ah, I would compare um, the first human re-
the Diagnostic and Statistical Manual of Mental mains would be ah, grotesques and unsettling
160 Brief Treatment and Crisis Intervention / 6:2 May 2006Swissair Flight 111 Disaster Response Impacts
where as later on, they became offensive . . . teers to assist in the unfamiliar role of
Um, it smelled bad. It looked, rotten. It was recovering human remains rather than rescuing
rotten. It was getting old. And that’s what survivors.
was bothering me. The same with the plane
parts and everything else. The freshness of It was hard because you know we’re used
it was going away and it was just, it was to, like I said, we go out and we hope to find
something peculiar that I just, I noticed, and the person alive and well maybe hypother-
it struck me. I actually laughed after when mic, or whatever right, and we bring them
I realized, hey buddy, you know you’re tell- home. And even when we do find someone
ing off debris here. [laughs] . . . This isn’t re- who’s deceased we bring the body back to
ally going to change anything. It just struck the family.
me as kind of funny that I was actually doing I don’t think it was so much the bodies but
that. That, that had happened . . . . And ah, the fact that we went out there to do a job,
using a few expletives then I realized you’re to provide first aid, to provide medical ser-
angry at the debris is what I was angry at and vice to help people and how can you help
I was actually angry at the debris. It was, I body parts? You can’t. And I think that, that
was ah, talking to myself but complaining was the hardest part for them.
to the debris, animating it. That ah, I wasn’t Because really our team, I mean, we’re
happy. I was ah, telling the debris off. In a a search and rescue team and what we were
way. Like you’d talk to yourself if you were doing was search and recovery. So . . . Um, I
going to anticipate a confrontation with some- never realized what a big world of difference
body or if you had an issue with a person and there was in the two until then.
you were sort of rehearsing ah, how you
would ah, address that confrontation. Going The volunteers were also exposed to sleep
through various scenarios. Ah, you know, im- deprivation and physical and emotional ex-
provising kind of. And I, I was telling the de- haustion over extended periods of time from
bris off. I was angry at the debris and I when I 1 week to over 1 month. Recovery volunteers
realized what I was doing, I ah, oop, hee were exposed to massive loss of life, grieving
ho . . . Pull over to the side and put a pink family members, repeated exposure, and threat
flag out the window. Help needed here. . . . of exposure to dismembered human remains,
personal effects, as well as intense international
Due to the nature, intensity, context, and du- media coverage.
ration of the volunteers’ fieldwork, volunteers
had multiple types of exposure and various I didn’t sleep really the first five or six days.
levels of impact. The biggest challenge for Maybe an hour or so but I’d wake up and it
many volunteers was to come to terms with the would be two or three in the morning and I
distinction between their original expectations figure I might as well go back down and get
and their actual role in the disaster response ready to go out back in the field. After . . .
efforts. Most, if not all, individuals volunteered [pause] After about the fifth day, um then
to rescue survivors of the crash. That is the it started getting [pause] I started wearing
traditional role of coastal people and the from fatigue and a, as well as, the nature of
designated role of ground search and rescue the operation. Ah, there was . . . there were
volunteers. The SA111 response efforts chal- a lot of factors involved. Part of it was fatigue.
lenged this expectation and called upon volun- Just the physical demands traveling that
Brief Treatment and Crisis Intervention / 6:2 May 2006 161MITCHELL ET AL.
much shoreline and being up that much com- up the next day. Some of them would go
pounded by the, the ah the nature of the ma- home and some of them would stay there.
terial being recovered and as well ah, one of They wouldn’t go home at all.
the more difficult aspects would be the ah . . .
seeing the families. Volunteers reported various behavioral out-
And we all sat together and we cried, oh we comes, which included excessive washing, iso-
cried. Because when they handed out the pam- lating themselves, and not talking with anyone
phlets and it had all the names on it. It was when about the recovery experience or responses to
you looked at it, you realized, that there were the experience. For three volunteers, these be-
whole families. You know, there would be six, havioral responses contributed to marital prob-
seven names all the same. It was like, ‘‘Oh my lems, and for some, their behavioral responses
god, that was that whole family, gone.’’ also contributed to difficulties at their place of
Yeah.Ithinkthat’swhatreallybroughtithome. employment.
Even more than the day we saw the human
remains, was seeing the families come. That, I washed my clothes five times now and I can
those were people. They’re not just pieces of still smell people on them.
people that you put into a bag. They were peo- I stayed in the woods . . . I just built a little
ple. They had lives, they had families. . . . lean-to you know and got under there and if
I lived, I won’t say I slept but I ate and lived it rained, I would sleep under one of the
Swiss Air all the time I was down there. So in buses. I had a sleeping bag. I go in the woods
the evening when I did come home, I’d turn and sleep all the time anyway. Sometimes I
on the news and just find out. It just went go for four or five days in the woods and
along with it. I just saturated myself in it. wouldn’t come out . . . . I want to be alone
It might have been a good thing or a bad all the time. I don’t want nobody around with
thing. It’s just the way . . . It felt like what me. . . . I want to be alone and I’m by myself, I
I wanted so that’s what I did. can cope with things better that way.
Roy actually sold the boat that I was out in
Due to the nature of the volunteer response
that night.
workers’ task and multiple levels of exposure
It slowed me down and it made me frus-
while in the field, volunteers experienced a
trated and it made me angry. And my work
variety of impacts. The trauma effects were im-
suffered.
mediate for some behaviorally, emotionally,
cognitively, and/or physiologically.
Silence was a common behavioral response, a re-
Behavioral: ‘‘I washed my clothes five sponse that was promoted in the field but
times.’’ Volunteer respondents reflected on which was carried back to the volunteers’
and discussed the various ways in which they homes and communities further isolating and
had modified or changed their lives during putting volunteers at risk.
and following the disaster efforts. Volunteers
responded in various ways that resulted in indi- Nobody ever indicated that they had found
viduals being in the field for various periods of anything [pause] like body parts. And they
time and exposure. probably did. Some did. Some had to have.
But nobody talked about it.
So, they realized that there was something I never talked with anyone who was out
wrong. That the members were not showing there.
162 Brief Treatment and Crisis Intervention / 6:2 May 2006Swissair Flight 111 Disaster Response Impacts
Emotional: ‘‘I reached a point of satura- were felt, individuals struggled to understand
tion.’’ The emotional impacts were very signif- their experiences and their responses.
icant for the recovery volunteers with clear
reports of cognitive posttraumatic symptoms, You know it’s like a tunnel. You went into it
intrusive thoughts, flooding, and dissociation. and you came out the other end. [pause] and
The exposure to human remains in particular while you were in there, it was dark.
required a type of emotional disengagement
that resulted variously in intense emotional Volunteers were confronted with exposures
release or conversely emotional numbing. and responses that were both equally foreign
to them. Realizing that they were being affected
Ah, there was, there was a point that I reached on multiple levels, volunteers began to ques-
which was an interesting experience. That I tion their personal emotional, physiological,
reached a point of saturation. Where if so- and cognitive responses wondering what was
meone had slaughtered ten children in front happening to them.
of me, it wouldn’t have, it wouldn’t have
raised my heart rate. I would simply look at You just kept thinking, ‘‘What is wrong with
it and I, I couldn’t go any further than I me?’’ I’d get up in the morning and I’d be
had gone emotionally. There was no more. like, ‘‘Oh, why am I so fuzzy, why can’t I,
There wasn’t another level. I had reached what’s wrong with me?’’ That’s what I con-
the limit that I could endure and I think it stantly thought.
was just psychologically protective. That it But it was hard to feel that tired all the time. It
was to me, the analogy I would use is like really was. And kind of a shock. Because you
a sponge. And I didn’t know how much more constantly thought, ‘‘what the hell is wrong
I could take and then I reached a point where with me?’’
the sponge was full and the rest just washes I mean there was a long period of time. You
off. For me, other people might break or what- know, the crash is always in your head and
ever. Um, luckily, I didn’t. I don’t think I did. you thought about it constantly . . . .
. . . young recruits that were down on the
shore and actually picking up body parts
Physiological: ‘‘The body tells you.’’ The
and some of them got into trouble. You know,
volunteers also spoke of tremendous exhaus-
reality just suffocated them I think.
tion, of various physical responses, early signs
I felt kind of stifled over the whole time and
of somatization significant enough to require
it, and I didn’t really understand it because I
time off work.
hadn’t been anything, through anything
quite on that scale. The body tells you . . . You may be silent,
even your brain may be silent but your body
will not be silent for long. I’ve found that out.
Cognitive: ‘‘What the hell is wrong with It’s a different kind of tired. [laughs]. You feel
me?’’ The thoughts of volunteers were also af- like you’ve been sucked dry.
fected as they attempted to cognitively and
emotionally process the mass casualty and the
challenging and grotesque nature of the recov- Delayed Responses: ‘‘The first year after-
ery work. As the physical and emotional im- wards, I, I took a bit of a decline.’’ The
pacts of exhaustion, sadness, fear, and anger volunteers reflected on how the SA111
Brief Treatment and Crisis Intervention / 6:2 May 2006 163MITCHELL ET AL.
response and recovery involvement had af- strength from various sources, including their
fected them over time. Volunteers identified interaction with grieving family members.
sleep problems, for some increased smoking
and/or drinking, as well as relational, employ- I Didn’t Feel Like I Failed Anymore
ment, emotional, and behavioral impacts, in- At the anniversary, we talked to a lot more.
cluding a fear of flying. In particular, people And I know, they kept telling us, ‘‘We
identified an enduring exhaustion, the pres- couldn’t believe all you did for us.’’ Every
ence of depressed affect, and difficulty in relat- day that they were out there, they saw all
ing to those who were not involved in the of these people in orange combing here and
response efforts. For at least three of the partic- combing there. Going out on boats to here,
ipants, these impacts also contributed to the going out on helicopters to here. She said,
dissolution of their marriages. ‘‘Every day, there was just more of you
and more of you and more of you. She says
The fatigue’s been very slow to go. Um, prob- I couldn’t believe that all of these people
ably the worst thing of all was the over- would drop everything they were doing
whelming fatigue. Um, I just don’t have and would come help us. And you helped
the energy I used to. You know, it’s slowly us so much. We’ll never be able to thank
coming back but that was the longest effect. you.’’ I had all of the same theme kind of
And I mean the depression, you know, I thing. People telling us over and over, ‘‘I
guess that’s all just part and parcel of feeling can’t believe what you did for us.’’ I thought,
depressed. Um, what . . . post traumatic they don’t think we failed. So then, I felt a lot
stress . . . whatever right. better about it and so did some of the other
people on the team that I had talked to who
had the same feeling. They said, "Yeah, after
Finding Meaning in Disaster, Death, and
that, I didn’t feel like I failed anymore. Be-
Devastation
cause they don’t think I failed anymore.
Volunteers struggled with the massive loss of
life and their inability to rescue any survivors In light of the reality of the situation and the
from the disaster. catastrophic nature of the event, although ex-
periencing a range of adverse impacts, each
We didn’t save anybody. Why should we go individual employed various strategies to aid
there to get thanks by these people because them in finding meaning in their disaster
really at the end of the day, [we didn’t] do response efforts. Although many response
anything to help them. workers felt a sense of failure in light of their
valiant effort during the relief and recovery
Another volunteer stated—
process but their inability to rescue any crash
Hazen said to me that he felt like we failed. victims, interactions with the family members
And I’m like, I feel that way too. often helped to put their sense of disappoint-
ment and failure into perspective. Many re-
Finding meaning in such devastation caused covery volunteers were then able to see how
constant struggle with their role and their sense truly grateful these individuals were for the
of contribution or failure. Ultimately, as de- effort they had exerted. Such contact with vic-
scribed in the recovery volunteer’s quote be- tims’ family members often served to validate
low, volunteers gained significant meaning and the recovery workers’ experience and to aid
164 Brief Treatment and Crisis Intervention / 6:2 May 2006Swissair Flight 111 Disaster Response Impacts
in putting closure to their own emotional your sister you know, or a child of yours,
distress. you know. So from day to day you kind of
One key theme that readily appeared in the would go about your work and do the best
data was the abrupt realization of the fragility you could and sometimes you would get a lit-
of the human body and delicate nature of tle strength from your buddy next to you
human existence. Such realizations led many whether he was on your right or the left.
people to question their own mortality and You know. But it was always sad. There
the degree of control they have over their own was never any jokes or anything passed on
destiny and existence. and I’ve never noticed people humming
hymns more than on those searches.
I don’t think you ever really make sense of it.
It’s just um, [pause] that whole notion, it kind Weighing their experiences overall, the volun-
of made me think a little bit more. It made me teers did not seem to regret their involve-
rethink life and rethink death and um, kind ment in the recovery efforts. Nonetheless, most
of concluded that we really don’t have con- expressed the wish to move on from the disas-
trol and I guess, I guess that’s the way it’s ter, and the hope that they would not be met
supposed to be. You know, it’s just the with this type of life challenge again. Yet, some
way it happens and unfortunately, as it is, said that they would volunteer again, if needed.
that’s the way things work.
. . . it was quite an experience and I hope to
Religion, faith, and an increased understand- God that it never happens again . . . .
ing of the human spirit also became a source of
comfort for many response workers and often- Discussion
times served as a means to help the volunteers
to give meaning to the disaster and their per- As with previous sections, our discussion
sonal experiences. Turning to one’s faith aided begins with the words of a volunteer who re-
many in helping them find meaning and counts his/her experience while working in
answers to how and why such things can hap- the field. The volunteer details the careful,
pen. Many people resolved themselves to the methodical, and respectful manner in which
notion that there are no simple answers and that the response worker carried out his role.
such occurrences are beyond human control. The volunteer passionately and compassion-
ately describes his exposure to personal effects
Ah, my faith is, I won’t say very strong, it’s and shares his reflections on the profound psy-
unshakeable. I have rock solid faith. Um, I’m chological impact of such an experience.
not ah, I’m beyond the point where I would
ask the typical question, why would God al- It Was Like The Whole Universe Just
low something like this to happen?, because Closed Right In On Me
my personal belief is that ah, there is a univer- And ah, I was taking the clothing and the
sal consciousness of some kind or another. I clothing would get tangled all wrapped up
think it’s far beyond human intellect to com- in seaweed and everything so you would have
prehend the nature of that. I leave that in the pull everything apart. And, I, I thought it
realm of the unknowable, the infinite. . . . was a t-shirt that was my initial impression
The fact, you know, was that maybe it could when I was trying to get this particular, well
be your mother, your father, your brother, they’re all knotted and twisted and tangled
Brief Treatment and Crisis Intervention / 6:2 May 2006 165MITCHELL ET AL.
from rolling in it and stuff. [sighs] And I ah, I The crash of SA111 off the coastal of a rural
opened it up, I cleaned everything off and area of Nova Scotia in September 1998 pre-
folded it up to put it in the bag and ah, sented a unique disaster response experience
a lot of times, rung it out if it were saturated for local response personnel, many of whom
for, just for the weight problems. I took it out were members of the surrounding communities
and finally got it untangled and it was just ah, and served in a volunteer capacity. In such
it was just a little jumper [baby’s clothing areas, where there are limited paid emergency
item]. That might be blocked out a bit, actu- and disaster response personnel, members of
ally it’s kind of weird. I can’t really picture it the local community often serve in an auxiliary
right now. Um, but I do, I do remember that role as volunteer firefighters and members of
the . . . it was like, the whole, it was like in the ground search and rescue teams. Although
a movie or something that you see zoom in often well-versed in their respective fields and
on one spot like from outer space—‘‘vomp’’ accustomed to responding to incidents such as
[participant imitates sound]. Right in on that auto accidents and searching for missing per-
one spot on the planet. It was like the whole sons, they were ill-prepared for the magnitude
universe just closed right in on me and right of the SA111 response due the catastrophic na-
in on that. And I was holding it up and I, oh ture of the crash, the total annihilation of the
shit. It just, it just stopped me. I was just dead aircraft, and the disembodiment of all 229 pas-
in the water. And, I thought, you poor little sengers and crew. In this case, what appeared to
bastard. And that’s when it hit me. Yup. No be a routine search as local volunteers manned
sweat. If I could ah, little guy, I’d trade places their boats and headed out to sea to assist sur-
with ya. [participant emotional] vivors, turned into a salvage mission of the
most grotesque nature.
When reflecting on the voices of the response The volunteers worked for up to 34 days on
volunteers and their lived reality during their shoreline recovery work and performed a piv-
involvement with the SA111 disaster, we are otal role in the response efforts, working on
humbled by the fact that the data so eloquently a daily basis combing the beaches collecting
and succinctly reveal more than we could forensic evidence for investigative and victim
offer from an interpretive authorial voice. identification purposes. As the findings chroni-
We are committed to honoring and amplifying cled, the nature and duration of these activi-
the voices of volunteers in this text to describe ties had a vast impact on the response workers
the experiences of disaster response volunteers due to multiple, repeated, and prolonged expo-
and the interplay between their task, exposure sures to dismembered and decomposing human
in the field, and the resultant impacts they suf- remains, personal effects such as children’s
fered. Volunteer voices have clearly described clothing, fragmented components of the air-
the profound nature of their experience as re- craft—most not exceeding the surface area of
sponse workers, and they have articulated the a dinner plate—ongoing interaction with griev-
various impacts of their involvement with the ing family members, and the relentless presence
SA111 recovery efforts. Having honored this of the international media.
voice, we now transition to a discussion of these Existing research indicates that various ad-
graphic experiences in relation to contempo- verse psychological and emotional impacts
rary understandings of exposure to traumatic have been identified in disaster-affected popu-
events with an emphasis on posttraumatic lations (Bowman, 1997; Browne & Neal, 2001;
stress as a probable outcome. Coarsey-Rader, 1995; Davis, 2003; Freedman
166 Brief Treatment and Crisis Intervention / 6:2 May 2006Swissair Flight 111 Disaster Response Impacts
et al., 2002; Fullerton, McCarroll, Ursano, & training and experience in emergency re-
Wright, 1992; Herman, 1997; Litz, Gray, Bryant, sponse. The SA111 disaster was a catastrophic
& Adler, 2002; Sprang, 2002; Stephens, 1997; event beyond the range of normal emergency
Suar, Mandal, & Khuntia, 2002; Wright & response efforts. When placed in such situa-
Bartone, 1994). The fourth edition of the tions, in addition to being presented with chal-
Diagnostic and Statistical Manual of Mental lenges regarding their familiarity with their
Disorders (DSM-IV; American Psychiatric assumed role, workers may be exposed to grave
Association [APA], 1994) defines a traumatic human tragedy and hardships that may con-
event as an occurrence in which a person tribute to the psychological impact of their
has experienced, witnessed, or was confronted work (DeWolfe, 2000). In such situations, re-
with an event or events that involved actual sponse workers are often traumatized through
or threatened death, serious injury, or a threat their senses as they struggle to process and in-
to the physical integrity of self or others and tegrate what they are seeing, hearing, touching,
the person’s response involved intense fear, and smelling around them (Fullerton & Ursano,
helplessness, or horror. PTSD is an extreme 1997). In the SA111 disaster, the volunteers
response to a traumatic event characterized were exposed for an extended period of time
by specific clusters of symptoms experienced to human remains, and this exposure had a
following the event (APA, 1994, DSM-IV). variety of behavioral, cognitive, emotional, and
The PTSD symptom cluster can be formulated physiological impacts. In a study conducted
into three broad categories: reexperiencing/ by Fullerton et al. (1992), professional rescue
intrusion (nightmares, flashbacks, intrusive workers who were involved in a mass casualty
thoughts, or images), avoidance/numbing disaster suffered adverse effects. The rescue
(detachment, restricted effect, avoidance of workers complained of intrusive images and
reminder, thoughts, and activities), and hy- smells following exposure to the deaths of vic-
perarousal (hypervigilance, decreased concen- tims, and some reported difficulties in sleeping,
tration, increased startle response, insomnia, nightmares, and images of the dead during the
irritability); in order for a diagnosis of PTSD night. Fullerton et al. also identified that re-
to be made, these symptoms must last for 30 sponse workers felt helplessness and guilt at
days or more and result in significant social not being able to do more to help the victims.
or occupational distress (APA, 1994, DSM- The recovery volunteers in the present SA111
IV). However, a diagnosis of acute stress disor- study similarly suffered negative impacts from
der, while bearing many similarities to PTSD in their exposure to a mass casualty disaster com-
its symptom cluster structure, can be made as pounded by the emerging reality that there was
soon as symptoms have persisted for 2 days, complete devastation of the aircraft and no sur-
theoretically allowing for more prompt diagno- vivors. The distress was heightened by the
sis and earlier intervention (Mitchell & Everly, inconceivable devastation of the airplane and
1997). unimaginable disembodiment of humans that
Although the majority of response workers resulted in the recovery of human remains ver-
are highly trained professionals within their re- sus intact human bodies. In a study by Coarsey-
spective fields (such as paramedics, medical Rader (1995), the psychological and emotional
practitioners, members of search and rescue effects of investigating the fatal air crash of
units, police officers, and firefighters), this USAir Flight 1016, which claimed the lives of
study focused on the experiences of volunteer 38 passengers when it crashed on July 2,
response workers who had various degrees of 1994, revealed that persons who work with
Brief Treatment and Crisis Intervention / 6:2 May 2006 167MITCHELL ET AL.
affected populations and who are exposed to this study provide critical information that has
grotesque elements often become secondary not been reported previously in the literature.
victims. Due to the implosion of the SA111
aircraft and the difficulty and duration of the
response efforts, the degree of distress for Conclusion
SA111 disaster volunteers was affected by both
extremes in duration and intensity of exposure. It is evident in the findings of this qualitative
The SA111 response volunteers felt helpless at study that volunteer responders were exposed
not being able to rescue survivors or to provide to multiple tragic deaths and the shock of the
intact corpses to grieving families. We concur loss of ‘‘physical integrity’’ of the SA111 crash
with Coarsey-Rader that such exposures can victims due to the profound physical impact
produce secondary disaster victims. of the crash. We learned that the volunteers’
selfless, dedicated service resulted in varying
degrees of feelings of helplessness and horror
Limitations as they engaged in their volunteer recovery
task. Volunteer interview transcripts revealed
Although we have established the strengths of the characteristic cluster of PTSD responses
the data and the compelling importance of the of reexperiencing, avoidance, numbing, and
volunteer voice, we also acknowledge that this hyperarousal. Volunteers described immediate,
article is subject to several critical limitations. short-term, and long-term impacts with nega-
We are working with data from a small group tive personal, social, and occupational out-
of volunteers who agreed to participate in comes. Volunteer responders were grossly
the research and who may not necessarily be impacted by the nature and duration of their
characteristic of the majority of volunteers. tasks and the cumulative effect of their multiple
The research participants may be more or less exposures. The Swissair response volunteer ac-
traumatized. However, we suspect that those tivities involved multiple exposures including
who suffered the greatest long-term distress identification with victims through personal
after the disaster would not have participated clothing and effects, exposure to grotesquely
in this study given the avoidance of trauma fragmented and decomposing human remains,
reminders characteristic of those with PTSD and direct contact with hundreds of grieving
(APA, 1994, DSM-IV) and that the volunteer family members. Further, ongoing international
effects discussed here are a conservative por- media coverage of the response efforts served to
trait of PTSD impact on the SA111 recovery compound the distress of the SA111 volunteers.
volunteers. The data are all first-person It is important, however, to acknowledge that
accounts that were gathered retrospectively, some volunteers gained meaning and strength
approximately 3 years after the disaster oc- from their interaction with family members
curred. The data are therefore subject to recall and their ability to contribute at a time of need.
biases. Finally, this paper was based on a sec- The personal contact contributed greatly to the
ondary analysis of the original data completed 6 volunteers’ ability to complete their task with
years after the disaster occurred. Given this respect and dignity for human remains, honor
time lag, it is possible that the findings may for the lives of the deceased passengers, and
not accurately reflect contemporary volunteer service to their grieving families. The ability
disaster experiences. However, we believe that of volunteers to give meaning to their disaster
the in-depth first-person accounts gathered in experiences appears to have contributed to
168 Brief Treatment and Crisis Intervention / 6:2 May 2006Swissair Flight 111 Disaster Response Impacts
adaptive coping as found by Meichenbaum American Psychiatric Association. (1994).
(1994). Diagnostic and statistical manual of Mental
Further research is required to investigate disorders (4th ed.). Washington, DC: American
short- and long-term impacts, with attention Psychiatric Association.
to volunteer needs in the field for communica- Bowman, M. (1997). Individual differences in
tion, support, and debriefing. The development posttraumatic response: Problems with the
adversity-diversity connection. London: Lawrence
of treatment vehicles and modalities must also
Erlbaum Associates.
be considered for short- and long-term follow-
Browne, R., & Neal, A. (Eds.). (2001). Ordinary
up of volunteers who serve in disaster response reactions to extraordinary events. Bowling Green,
efforts. Given the profound impact of human OH: Bowling Green State University Popular
remains exposure and the long-term personal Press.
social and occupational costs of PTSD, it is rec- Bronfenbrenner, U. (1979). The ecology of human
ommended that emergency and disaster organ- development: Experiments by nature and design.
izations develop specific policies and protocols Cambridge, MA: Harvard University Press.
for volunteer involvement, support, treatment, Chu, J. (1998). Rebuilding shattered lives: the
and follow-up, in particular when responders responsible treatment of complex post-traumatic
are exposed to human remains. and dissociative disorders. New York: Wiley.
Coarsey-Rader, C. V. (1995). Effects of investigation
Acknowledgments of a fatal air crash on 13 government investigators:
Final report for grant from natural hazards research
We wish to acknowledge the interdisciplinary team and applications information center. Boulder, CO:
of researchers from the Department of Community University of Colorado.
Health and Epidemiology and the Psychology Davis, N. (2003). Problems and symptoms that
Department of Dalhousie University that a rescue worker may experience thru helping.
collaborated in this study, in particular, Rescue-Workers Online. Retrieved September 16,
coinvestigator Dr. Swarna Weerasinghe and 2005, from http://www.rescue-workers.com/
research coordinator Kara Griffin. We also recognize Denzin, N. K. (1989). Interpretative biography.
the essential role of the Community Advisory Group Newbury Park, CA: Sage Publications.
that guided all phases of the study and the DeWolfe, D. J. (2000). Field manual for mental health
important contributions of the volunteers and human service workers in major disasters.
themselves without whom this research could not (2nd ed.). Washington: Center for Mental Health
have been conducted. It is with great respect that we Services.
acknowledge the contributions of the volunteer Freedman, S., Gluck, N., Tuval-Mashiach, R.,
responders to the disaster efforts and to this study. Brandes, D., Peri, T., & Shalev, A. (2002). Gender
Without the participation of these individuals this differences in responses to traumatic events: A
article could not have been written. Finally, we prospective study. Journal of Traumatic Stress, 15,
acknowledge the generous funding of the Social 407–413.
Sciences and Humanities Research Council of Fullerton, C. S., McCarroll, J. E., Ursano, R. J., &
Canada. Conflict of Interest: None declared. Wright, K. M. (1992). Psychological responses
of rescue workers: Fire fighters and trauma.
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