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Bilukha and Brennan provide a useful analysis of relative frequency
of injuries
due to abandoned landmines and unexploded ordnance (UXO) in Afghanistan
(BMJ 2005;330:127-8), but by excluding deaths the study risks seriously
underestimating the impact of UXO.
Accidental detonation of UXO is commonly fatal, and in practice may
kill more
than one person if the initiator is not alone. Antipersonnel landmines
(APL)
are, in general, designed to seriously injure and not to kill, though in
countries like Afghanistan death may ensue due to a lack of immediate
access
to emergency care. Death or serious injury to more than one person is
relatively uncommon for APLs.
Nonetheless, there is a growing recognition that UXO causes more
death and
injury than mines, except perhaps during a large movement of refugees or
Internally Displaced Persons, and this article at last presents some
epidemiological evidence for this view.
As the authors state, UXO disproportionally affects children. Mine
Risk
Education which aims to change behavior may be the most appropriate
response to quickly reduce casualties. However, the dismantling of UXO,
using only such tools as a hammer and chisel, in order to sell the scrap
metal
is another significant cause of death and injury in some areas. This
extraordinarily dangerous activity is generally due to a lack of other
ways to
generate family income and not just a failure to appreciate the risk
involved.
By comparison, professional humanitarian demining and explosive
ordnance
disposal (bomb disposal) are not extremely dangerous activities despite
the
obvious risks and the popular image - deminers in most countries are much
less likely to be killed while working than truck drivers and in most
years
more deminers die on the way to work in road traffic accidents than die at
work due to accidental detonation.
Where the authors are on less safe ground is the bold assertion that
"landmines pose a considerable public health threat [...]". Compared to
road
traffic accidents, HIV-AIDS, malaria and diarrhea, the world-wide death
and
serious injury rate of between 10,000 and 15,000 people per year from all
explosive remnants of war is minor, albeit tragic. The difference is that
once
mines and UXO are removed the threat is eliminated for ever and society
can
move on, the other health problems are much more difficult to address in
the
long term.
Russell Gasser, Mine Action Technology Consultant, RG@trellick.net
Injury data underestimates the impact of UXO
Bilukha and Brennan provide a useful analysis of relative frequency
of injuries
due to abandoned landmines and unexploded ordnance (UXO) in Afghanistan
(BMJ 2005;330:127-8), but by excluding deaths the study risks seriously
underestimating the impact of UXO.
Accidental detonation of UXO is commonly fatal, and in practice may
kill more
than one person if the initiator is not alone. Antipersonnel landmines
(APL)
are, in general, designed to seriously injure and not to kill, though in
countries like Afghanistan death may ensue due to a lack of immediate
access
to emergency care. Death or serious injury to more than one person is
relatively uncommon for APLs.
Nonetheless, there is a growing recognition that UXO causes more
death and
injury than mines, except perhaps during a large movement of refugees or
Internally Displaced Persons, and this article at last presents some
epidemiological evidence for this view.
As the authors state, UXO disproportionally affects children. Mine
Risk
Education which aims to change behavior may be the most appropriate
response to quickly reduce casualties. However, the dismantling of UXO,
using only such tools as a hammer and chisel, in order to sell the scrap
metal
is another significant cause of death and injury in some areas. This
extraordinarily dangerous activity is generally due to a lack of other
ways to
generate family income and not just a failure to appreciate the risk
involved.
By comparison, professional humanitarian demining and explosive
ordnance
disposal (bomb disposal) are not extremely dangerous activities despite
the
obvious risks and the popular image - deminers in most countries are much
less likely to be killed while working than truck drivers and in most
years
more deminers die on the way to work in road traffic accidents than die at
work due to accidental detonation.
Where the authors are on less safe ground is the bold assertion that
"landmines pose a considerable public health threat [...]". Compared to
road
traffic accidents, HIV-AIDS, malaria and diarrhea, the world-wide death
and
serious injury rate of between 10,000 and 15,000 people per year from all
explosive remnants of war is minor, albeit tragic. The difference is that
once
mines and UXO are removed the threat is eliminated for ever and society
can
move on, the other health problems are much more difficult to address in
the
long term.
Russell Gasser, Mine Action Technology Consultant,
RG@trellick.net
Competing interests:
None declared
Competing interests: No competing interests