Casualties of War
I am back at my morning ‘quiet time’ location. Sitting at an empty pool, palm tree murals on the wall to keep me company.
When is an injury a war related injury ?
Yesterday, there seemed to be a predominance of what I inadvertently termed para-war injuries. There is almost an obsession in the hospital with categorizing injuries into war or non-war related injuries. While this may seem to be a minor issue, the repucussions are large and multifactorial. If the injury is related to war, then there is a clear cause/ effect / blame scenario. And everyone knows that wars are bad with innocent victims. Implications: if a child is shot nearby, someone needs to be blamed. If one is working in a region where a child is shot. It is unsafe and the entire medical team will be withdrawn. So when the bomb-blast victims from a mortar / gun attack present a few hours later, textbook case of mass casualties, a surgical / trauma team can make a difference. The gunshot abdomen can go straight to theatre for a laparotomy at the same time as the bilateral femur gunshot for vascular exploration and grafting (repair). Followed by the blast / thermal burns to the face with a compound elbow fracture for debridement, fixation and repair of the degloving scalp injury concurrently with the blunt abdominal injury for exploration / laparotomy. All in a converted house.
Families at home see a fraction of the story, not in context and put pressure on the members of the team to do the responsible thing and return home prematurely.
Who does one blame when the nine year old child, no siblings, was shot accidentally, while his father was cleaning his gun the morning before he was due to be deployed?