A research letter in this week’s issue of THE LANCET describes the burden of injury and mortality resulting from the clearance of antipersonnel mines from seven war zones over the past decade.
Thousands of people are involved with the clearance of antipersonnel mines and unexploded ordnance in countries recovering from war—a process which usually continues long after conflict has ceased. Rick Brown from the Royal National Orthapaedic Hospital, Stanmore, UK, and colleagues prospectively recorded 92 traumatic injuries sustained by 73 mineclearers working for the HALO Trust (Hazardous Areas Life-support Organisation) in seven countries (Abkhazia, Afghanistan, Angola, Cambodia, Chechnya, Mozambique, and Nagorno Karabakh).
15% of injuries were fatal, with an incidence of 116 injuries per 100 000 workers per year. Limb injury occurred in 59% of cases, of which 30% resulted in amputation. 44% of injuries were sustained by workers handling a mine, resulting in severe upper limb and facial injuries. The incidence of facial injuries fell by around 30% after the wearing of visors was made mandatory in 1995 by the HALO Trust.
Rick Brown comments: “As recent events in Afghanistan have shown, there is a continuing need to clear antipersonnel mines and other unexploded weapons. This first prospective study details the risks of injury, which will help the planning of local trauma services and in the training of mineclearers.” (quote by e-mail; does not appear in published paper).
Contact: Mr Rick Brown, The Academic Unit, Royal National Orthopaedic Hospital, Stanmore, UK; (Mobile) +44 (0)7946 607501; E) cainebrown@aol.com.
Richard Boulter, HALO Trust, Gilchristland, Thornhill, Dumfries, DG3 5HN, UK; T) +44 (0)1848 331100; E) haloeuropedesk@halotrust.org
Note to Editors:
The HALO trust is a UK-based neutral humanitarian non-governmental organisation which trains local staff in mine clearance operations in nine countries in Europe, Africa and Asia. The organisation records details of all injuries and deaths of its workers. The HALO Trust has been working in Afghanistan for 11 years, and ceased operations for two months during the present conflict. Funding of the charity is to increase dramatically to enable the charity to play a lead role in clearing mines in Afghanistan. Local mineclearers work in small groups with trained paramedics; the training and equipping of these paramedics is supervised by a panel of doctors with trauma and tropical medicine experience.
Journal
The Lancet