干旱区生态环境知识资源中心

Introduction. - On the 24th July of 2014, the plane of the Air Algeria airline flight AH 5017 crashed in southern Mali with 116 passengers on board, including 54 French. The event required a prompt response of the French authorities, associated with an international mobilization. It presided at the commitment of the French military forces, which were prepositioned in Mali, in order to manage as soon as possible this disaster. Personal of French military health service, which provide medical support to forces in operations, were involved, with the reinforcement of the medical teams on the spot through a psychiatrist of military hospitals.

Method. - This work is based on the methodology of an experience feedback, by emphasizing the most salient points of the medico-psychological intervention realized on the occasion of this event.

Results. - The mission assigned to the French military forces was scalable: research for potential survivors, by providing them with the necessary help and care; identification of victims, by collecting the maximum of clues that could facilitate their recognition (identity papers, personal effects...); first judiciary and forensic findings; securing the crash zone to prevent outside intrusion on the scene. It ended with an unusual task involving the collection of human remains on the crash zone. Various experts were also essential for carrying out several surveys: an aeronautic investigation about flight safety, a criminal investigation to find the causes of an event which involved human deaths, and a forensic investigation working to identify the victims. The medico-psychological support included several prospects. The presence of a psychiatrist on the crash zone firstly allowed a psychological support for the staff early involved, and exposed to a startling scene; it anarchically combined debris of a pulverized aircraft cabin, personal passengers effects mixed with carbonized human remains in a disgusting unbreathable atmosphere. In a second time, it offered a presence for many units and personal engaged in an unexpected and testing mission. Facing an unusual situation, the main authorities involved on the area were accompanied by offering mental health advice in response to the everyday life events of a makeshift camp in the middle of the African desert. The psychiatrist’s action consisted in a work of mediation within the group by helping the flow of speech. The psychiatrist is also the privileged contact of the subject, by offering both a differentiated space, separated from the rest of the military environment, and a singular listening, allowing the welcome of a possible mental pain. The mission of collecting human remains required a special attention because of its psycho-traumatic risk. A volunteering principle was applied, as well as the identification of fragile or vulnerable subjects among volunteers, which concerned a total of a hundred soldiers. All the personal involved in this task were identified by the commandment, and then secondarily received in collective debriefing.

Conclusion. - The presence of a specialist of psychological care within a disaster shows an availability, which can lead to the possibility of a welcome, with a potentiality which already appears as a form of response and acknowledgment of a possible psychological suffering. Thus, the challenge consists in providing an assistance, which is less a gauche interventionism or an artificial forcing of an inaccurate request for care, than a careful and concerned presence for the psychological health of everyone. (C) 2015 Elsevier Masson SAS. All rights reserved.