BMJ 1999;319:412-415 ( 14 August )

Papers

Circumstances around weapon injury in Cambodia after departure of a peacekeeping force: prospective cohort study

Editorial by Smith

David R Meddings, epidemiologist, ^a Stephanie M O'Connor, head nurse. ^b

^a Unit of the Chief Medical Officer, International Committee of the Red Cross, 19 avenue de la Paix, 1202 Geneva, Switzerland , ^b Health Operations Division, International Committee of the Red Cross, 19 avenue de la Paix, 1202 Geneva

Correspondence to: Dr Meddings dmeddings{at}icrc.org

Objective: To examine the circumstances surrounding weapon injury and combatant status of those injured by weapons.
Design: Prospective cohort study.
Setting: Northwestern Cambodia after departure of United Nations peacekeeping force.
Subjects: 863 people admitted to hospital for weapon injuries over 12 months.
Main outcome measures: Annual incidence of weapon injury by time period; proportions of injuries inflicted as a result of interfactional combat (combat injuries) and outside such combat (non-combat injuries) by combatant status and weapon type.
Results: The annual incidence of weapon injuries was higher than the rate observed before the peacekeeping operation. 30% of weapon injuries occurred in contexts other than interfactional combat. Most commonly these were firearm injuries inflicted intentionally on civilians. Civilians accounted for 71% of those with non-combat injuries, 42% of those with combat related injuries, and 51% of those with weapon injuries of either type.
Conclusions: The incidence of weapon injuries remained high when the disarmament component of a peacekeeping operation achieved only limited success. Furthermore, injuries occurring outside the context of interfactional combat accounted for a substantial proportion of all weapon injuries, were experienced disproportionately by civilians, and were most likely to entail the intentional use of a firearm against a civilian.

Key messages The study took place in Cambodia after a United Nations peacekeeping operation that achieved only limited success in disarmament A substantial proportion of weapon injuries was inflicted in contexts unrelated to interfactional combat These injuries were most commonly firearm injuries inflicted intentionally on civilians Widespread availability of weapons can facilitate social violence

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© BMJ 1999
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