Mass killing during terror attack at the Israel-Gaza border and the role of the Ministry of Health in identification of human remains and their release.

More than 1200 civilians and military were killed in cities and villages by the Hamas attack on October 7th, 2023. The bodies and body-parts had to be identified and released for burial. This report outlines the challenges and mode of operation of the massive disaster victim identification (DVI) efforts. Bodies were delivered to a central mortuary. Each body was coded and undressed for external inspection and documentation of physical elements. Digital fingerprints were recorded and blood or toenails sampled for DNA. Odontology exams were performed by dentists describing dentition, aided by computerized tomography (CT). Whole-body CT was performed in cases the bodies were disfigured or burned from the second week. Simultaneously, families of missing civilians provided physical elements to the police to extract the DNA for antemortem documentation. The police took the responsibility over the reconciliation, which was based on comparison of the ante-mortem and post-mortem fingerprints, aided by DNA profile matching, odontology examination, clinical and/or radiological findings performed by forensic practitioners. Secondary identification elements were used assure the families regarding the identification. Precise scientific identification a was a priority, even if it slowed the rate of bodies release. Families were allowed to view their relative either at the mortuary or before burial. The DVI process required cooperation between several governmental agencies and police. To maximize the effectiveness, a synchronized approach should be adopted, specifying communication channels between the partners and dividing the responsibilities. The DVI should be led by a single, experienced authority to ensure interdisciplinary teamwork. This catastrophe required personal resilience of the teams for rapid and efficient functioning and communication between the partners.