Surgery and Healing in the Developing World - Dartmouth-Hitchcock

CHAPTER 1
CHAPTER 22
The Prevention and Treatment
of Landmine Injuries in the Developing
World
James C. Cobey
The Size of the Problem
Recognizing that the world is polluted with landmines, especially in, but not
limited to developing countries, is essential if one wants to assist in teaching surgical
skills in the developing world. Large tracts of land have been rendered unusable
from the presence, or just as limiting, the perceived fear of landmines. According to
data of from Physicians for Human Rights (PHR) and the International Committee
of the Red Cross (ICRC), close to 70 countries are contaminated with mines with
close to 500 injuries a week or 24,000 a year. Peasants foraging for wood and food or
tilling their fields are particularly at risk. Children herding livestock are vulnerable
since they often traverse many fields looking for pastures. There are an estimated
250,000 mine victim amputees worldwide. Most of these have not gotten a prosthesis.
Almost half of these injuries kill the patient while the other cause massive pain
and crippling.
The landmine problem is not just in developing countries. Active mines from
World War II are discovered in Europe every year. Egypt is trying to develop land
west of the Nile, but is limited until mines left by the English and Germans are
cleared. Farmers in South America and throughout the world use mines to protect
their crops. Russian has dropped mines in Georgia on the Chechnya border. Most
of the newly independent countries of the Caucusus are afraid to live without mines
on their borders stating that if the United States still feels that landmines are useful,
they do to. In fact a conference in Tiblisi, Georgia in December 1999, a Ukrainian
ex-military engineer felt his country needed “intellectual mines” that would kill
humans but not livestock. He even recommended increasing the explosive charge to
reliably kill the victim so as not to leave amputees who are a strain on the rehabilitation
systems in many countries!
History
The concept of mines as explosive below ground goes back to at least the 15th
century when attackers would dig tunnels (mines) under a city wall to plant explosives
below the city. Mines really became a major weapon in the 20th century to stop
tanks, which had been invented to breach the trench warfare of the First World War.
Antipersonnel mines were designed initially to prevent the removal of antitank mines.
Soon after their development antipersonnel mines started to be used on national
borders as on the Finnish-Russian or Thai-Cambodian borders. These “hidden kill-
Surgery and Healing in the Developing World, edited by Glenn Geelhoed.