Doctors should learn how to care for victims of new military wars
- The Conflict Medicine Congress in Beirut has brought together hundreds of doctors, nurses, health officials and experts from NGOs in the Middle East. Objective: to adapt the medical and emergency structures, plans and techniques of professionals and volunteers to the health damage caused by the new weapons and war strategies. The vast expanses of the world live in perpetual war, and the wounds they inflict on people cannot be heeded without understanding the ecology of war.
He had to be in Lebanon. If you know somewhere what modern military disasters look like, it's in Beirut. The School of Medicine and Hospital of the American University (AUBMC) has worked hard to repair the damage caused by the last hundred years of conflict in the Middle East. When the 1982 civil war and the invasion of the Israeli Army caused 250,000 deaths and one million injuries in sixteen years in Lebanon, “we treated victims from all parts of the conflict, thus developing great experience in managing the wounds caused by the war,” the leaders of the organization say.
With the invasion of Iraq and the destruction of the entire health system in 2003, thousands of Iraqis, sick and wounded by the war, headed for AUBMC. In the recent outbreak of the disaster in Syria, many of the victims of the Israeli bombing have also arrived at the hospital in Beirut.
Going to listen to the conferences in Beirut made it with a hardened heart, as the serious titles suggest. Acute and chronic effects of chemical warfare. Disaster response: differences between wars. Blasting wound workshop. Mass casualty care in emergency services. The control of hemorrhages in the war, which we have learned in Iraq and Afghanistan. Conflict volunteers: when should they say no. Conflict medicine and war ecology...
Two of the prestigious doctors who participated in the congress, the Palestinian surgeon Ghassan Abu-Sittah and the Lebanese epidemiologist Omar Dewachi, under the patronage of MSF Doctors Without Borders, shared the Conflict-Medicine manifesto in 2015: “With the manifesto we want to emphasize the need to better understand the dynamics of wounds and wounds, within the ecology of war instead.”
In Iraq, Syria, Libya, Yemen, etc., it has been seen that wars are increasingly taking place in cities, which means the proliferation of victims, such as warriors among civilians. The distinction between gudaris and civilians is essentially blurred and the injuries sustained are becoming more and more similar. Therefore, the aid provided to the wounded is limited and inadequate, because health infrastructures have been damaged by the war, often expressly planned.
Injuries have changed with the change of war, but the capacity of doctors who want to treat them has also been reduced. In addition, refugee crises and mass transfers further complicate work, as the health systems of neighbouring countries must take care of the high rates of refugee population.
As for the care of the wounds of the new weapons, the military, creators and rehearsals of them, have developed the advances in the treatment of them in the hospitals of their campaign, while the majority of those injured in the new wars are civilians, these techniques have not reached the civilian hospitals, which face with very little experience wounds with increasingly complex bio-psycho-social components.
But that's not all. “War changes the biosphere, that is, the physical infrastructure and the biological and social environment in which people live. The destruction and change of war is often irreparable and has long-term consequences for people and society.” War creates its ecology and within it viruses and bacteria will not act in the same way.
Every war their ecology
Surgeon Ghassan Abu-Sittah has explained in an interview the importance of understanding the ecology of war. Because today's wars have nothing to do with those of the past. In the times of Napoleon, in the 19th century, two armies collided, mostly on the front, were settled, shot and killed. Most of the injured were combatants and were treated in military hospitals, according to police reports. Then war medicine was created.
On the contrary, the wars we see today in the Middle East are not the ones that begin and end up as the classic wars, with their fronts, intensities and durations. Those of today are long enough to change the ecology of the environment in which people live. They create war ecology.
This peculiar ecology will persist even after the guns have been silenced, changing the environment of people. The physical, psychological and social wounds suffered by people in military attacks are further worsened in these transformed environments.
We have an example of drug-resistant microbes. If there are problems in the operating rooms of hospitals around the world, think of an environment destroyed by war. According to Dr. Abu-Sittah, 85% of those injured in the Iraq war have drug-resistant bacteria and 70% of those injured in Syria.
“This ecosystem of war, the biosphere that generates conflict, also causes changes in bacteria at the DNA level. We work around several theories. (...) So, your biosphere, that green bubble in which you live in conflict, is constantly changing. And it won't go away either the day bombs shut down. (...) Everything changes: bacteria, water, water cycles, toxic waste, reactions of people's bodies... In the families of many Iraqi patients I have seen there are many wounded relatives.”
Poverty is also part of this ecology. If a body injured in an attack tries to heal the nurses in a war-degraded place, the bodies are wounded for the second and third time. In the case of Syria, it also happens far from the battlefields, as in the refugee camps, where the concentration of people in the shelters causes astonishing burns among children.
The destruction of the majority of health infrastructures means that controllable diseases are left untreated: What cancer treatment or dialysis can patients with severe diabetes or cancer follow in Syria, Libya, or Yemen? Are they not victims of war, for not having been wounded with a gun? Attention to mental illness also needs to be reorganized in these persistent crises, the psychological consequences of war and trauma do not work as in the manuals in areas where conflicts have been chronified from generation to generation.
Because of the new wars, many places in the world are in eternal war. Perpetual war. “It’s not over. It lasts all the time. It is not a question of crisis, we are against that word. Here there is no referee announcing the end of a crisis with the Txistu. When the cameras leave, the media first and then the world decide that a crisis is finite.”
On November 25, International Day against Male Violence, the Steilas Feminist Union Feminist Secretariat has published a poster: Our body is a battlefield, and all the schools in Hego Euskal Herria have received it. We wish to denounce the violence suffered by women and children... [+]
“The time has come for courageous, comprehensive and noble proposals (…) for Euskal Herria to re-enter the world’s revolts,” said friend Hartu López Arana in her opinion article “For an effective aggression” published in ARGIA magazine in July 2018. Six years have... [+]
Japan, 6 and 9 August 1945, the United States launched an atomic bomb causing tens of thousands of deaths in Hiroshima and Nagasaki; although there are no precise figures, the most cautious estimates indicate that at least 210,000 people died at the end of that year. But in... [+]
The nuclear winter theory Paul J. It was the result of an investigation published in 1982 by Crutzen and John Birks. According to this study, "nuclear explosions and subsequent fires would release large amounts of soot, dust and ash into the atmosphere, causing a notable... [+]
On this rainy Sunday, we are responsible for the fate of people living in disquiet at the various conflicts that exist in the world. By far, it seems that we cannot be freed from the hands of many rulers acting towards power. Many human beings live in the world with the... [+]
The following infographic is based on the report number 55 of the Delàs Peace Research Center of Catalonia, published in October 2022. In the report, Xavier Bohigas, Pere Brunet, Teresa de Fortuny, Anna Montull García and Pere Ortega analysed in depth the links between... [+]
When I was a kid, it was customary at home to park what we were doing at eight o'clock in the afternoon, assemble the TV and watch the ETB1 news. At first, I was very irritated by those unjust changes in the night chain, and I was asking my parents how it was possible that, being... [+]
In the fall of 1415 the battle of Agrincourt erupted between England and France, one of the most decisive wars of the Hundred Years War. To this end, when Henry V, king of England and lord of Ireland, decided to send his army to France that summer, the soldiers landed on the... [+]
In the 1980s, the young Basques sang “si vis pacem, para bellum”. If you want peace, get ready for war, we screamed in Latin, without understanding very well the meaning of the phrase.
At that time, the Basque conflict was in the vortex and the world lived in the last years... [+]
Genocide is unfortunately a fashionable word. According to Rafael Lemkin’s definition in 1946, genocide is defined as “actions aimed at the total or partial destruction of a national, ethnic, racial or religious group.” These actions may include “killing the members of... [+]