Time for a ban on landminesBMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7053.366b (Published 10 August 1996) Cite this as: BMJ 1996;313:366
Workload resulting from landmine injuries is huge burden on hospitals
EDITOR,—One aspect of the epidemic of antipersonnel landmines1 that is often overlooked is the implication for the indigenous surgical services of the constant flow of injuries caused by the mines.2 The countries affected are the ones least able to help themselves, with surgical provisions already stretched to the limit. Few figures exist on the epidemiology of landmine injuries and the workload these impose on local services, as most of the data have been gleaned from Red Cross hospitals dealing solely with war injuries.3
Last year, while working in Angola, I conducted an audit of the surgical admissions to Kuito General Hospital. Of 795 admissions over 10 months, 211 were due to war-type injuries inflicted on civilians. Landmine injuries accounted for 82 of these. Most of the rest were gunshot wounds. War injuries, whether caused by landmines or high velocity rounds, use a disproportionately large amount of surgical time and resources in comparison with civilian-type trauma.4 Each injury frequently requires two or three operations. The patients with war injuries who were admitted accounted for 42% of the general and orthopaedic operations carried out during the study period (268/643). The consequences of such an influx of patients for a British hospital are almost unthinkable.
Such a large burden of work detracts from the ability of local surgeons to care for patients with non-traumatic conditions. In addition, the resulting large population of young people with amputated limbs becomes an economic burden on the society as a whole: a one legged man cannot feed his family, and a one legged woman cannot look after her children. In Kuito an average of six people a month lose their legs because of landmine injuries. Such an incidence would tax the resources of a district general hospital in Britain; the effect on Kuito is disastrous.