Identifying bomb victims proves to be difficult, Belgian investigators say

Editor’s Note: Dr. Sanjay Gupta is CNN’s chief medical correspondent, a practicing neurosurgeon and a member of the American College of Forensic Examiners.

It took days before victims of the attacks in Brussels began to be identified. While many of the victims were likely carrying identification, as they were preparing to board flights and trains, it hasn’t made the task at hand any easier.

With explosions like the ones we witnessed on Tuesday, the situation is very different than an airplane crash, where you more or less know the number of victims and their identities. The goal in that situation is to find and confirm the identities of the remains.

With explosions, there are many pieces of the puzzle that have to be pieced together, including the number of people in the vicinity of the explosions, their current whereabouts and whether they potentially match the deceased.

As things stand now, families are being told it could take up to three weeks before we hear more conclusive information about identification. To complicate matters further, while the cause of death will likely be attributed to the explosions, investigators still need to provide a more precise manner of death, such as blunt organ injury, shrapnel or smoke inhalation.

Three waves of injury in a bombing

Part of the difficulty is that when a bomb explodes, there are three waves of injury.

First, there is a primary blast – a concussive wave, really – that compresses everything around it. The most common fatal injury is called a blast lung, because the lungs, which are essentially large air sacs, are so rapidly compressed by this primary blast that the result is sudden death.

Second comes the debris – shrapnel and bomb fragments – causing devastating penetrating injuries.

Third are the bodies themselves, which are catapulted through the air and into or on top of other victims.

Identification is proving especially difficult because many of the bodies are not intact, Red Cross Belgium spokeswoman An Luyten told CNN.

Those individual parts need to be identified and then “reassociated” with the rest of the body, according to Victor Weedn, chairman of the Department of Forensic Sciences at Columbian College of Arts and Sciences. Authorities may not release the bodies to the families until all of the remains have been positively identified, he said.

The types of injuries on the Brussels bombings are rarely seen outside of combat. Belgian Health Minister Maggie De Block has described the scene as a war zone.

“All our patients are now in 25 different hospitals because they have such severe injuries and surgeons tell me that they are like war injuries,” De Block told CNN’s Christiane Amanpour on Tuesday, listing serious burns and amputations among the injuries.

Back in October 2005, Brussels Airport opened a “full-service” morgue to facilitate transportation of the deceased. At the time, it was only the second of its kind in Europe. Now, it’s serving on a scale no one anticipated. A disaster victim identification team, which is a division of the police, has been brought in and are working to identify the bodies at the airport, the Red Cross’ Luyten told CNN.

‘What color were their eyes?’

The Red Cross provides psychological support during the process while police ask basic questions to the family such as, “What was your loved one wearing?” and “What color were their eyes?” Luyten told CNN. Authorities also ask for dental records as part of the process of identifying the deceased after large explosions.

“It’s a terrible scene to work, but … mass disasters happen – plane crashes, terrorist activities – and we have highly specialized, trained individuals,” CNN contributor Larry Kobilinsky told CNN’s Ashleigh Banfield on “Legal View” on Thursday.

“They’re part of mortuary teams, and they are primarily pathologists, with other kinds of scientists, DNA experts, odontologists (dentists). And the idea is to collect every part.

“You’ve got to document everything, sketch it, photograph it, but certainly collect every single body part. If the body is more or less intact, you could try to identify by height, weight, gender, hair color, eye color, dental records, fingerprints.”

“On top of this, you need to create a DNA database of close relatives or samples that we know come from these individuals,” said Kobilinsky, a forensic scientist and professor at John Jay College of Criminal Justice. “Ultimately, next of kin is going to want to bury their loved ones. So we need to get everything together, kind of like a puzzle, putting the pieces together, so that … these people can be laid to rest.”

And sometimes the puzzle remains incomplete. Eight years after the Oklahoma city bombing, a woman was discovered to have been buried with another victim’s leg.

Just 60% of those who died in the World Trade Center on 9/11 were ever officially identified. More than a decade after Hurricane Katrina hit, the city of New Orleans still has 31 unidentified remains.

While we don’t yet know all the identities of the deceased, we do know they are composed of at least 40 nationalities. The responsibility to notify next of kin typically falls to the ministries of foreign affairs or embassies of victims’ respective countries.

The painstaking process of identifying the victims will continue for weeks and months, with little rest for investigators.

None of it, of course, will bring back the dead or provide more solace for the living. The goal for these experts is to provide some measure of closure to the victims’ families.

CNN’s Frederik Pleitgen, Atika Shubert, Salma Abdelaziz and Nadia Kounang contributed to this report.