Emergency Life Support for Civilians in War Zones

War surgeon Dr. Gino Strada spoke about the effects of war on civilians in worldwide conflicts and how the organization Emergency assists the victims.

Emergency is an independent, nonprofit, neutral and non-political, humanitarian organization that provides medical and surgical care to war-torn areas including: Afghanistan, Algeria, Angola, Cambodia, Eritrea, Iraq, Nicaragua, Palestine, Rwanda, Sierra Leone, Sri Lanka, and Sudan.

“The children of these countries are our children,” Strada said. In today’s conflicts 90 per cent of the victims are civilians and one-third of them are children. They are wounded, maimed and killed by weapons such as anti-personnel mines, bombs, bullets, cluster bombs, explosive devices, and landmines.

For 17 years Strada has worked in war zones and eleven years ago he founded Emergency. Through first aid posts, health clinics, hospitals, medical and surgical centres worldwide, the organization has treated over 1.5 million people.

During the 1994 Rwanda genocide, Hutu rebels armed with machetes and AK47s slaughtered one million Tutsis and Hutu moderates in 100 days. In response, Strada performed surgery on Rwandan victims with no roof over his head. For light, a youth held a lamp overhead.

“In most war-torn areas there are no transport areas or roads and when there are they are for military,” he said. Moreover, victims cannot receive medical and surgical care because the war-torn countries lack the medical facilities to help them. The health care system is usually poor and the doctors may ask the victims’ families to provide the medical supplies needed to perform the lifesaving surgeries. In most of these ravaged countries, the doctors who work there tend to leave the country. Medical schools close in most of these places. In the end, civilians pay the price of war.

Strada was introduced to the audience by three-time, Nobel Peace Prize Nominee Kathy Kelly, whose organization Voices in the Wilderness (Voices for Creative Non-violence) campaigned against the U.N. sanctions placed upon Iraq. In acts of civil disobedience, VITW delegations traveled to Iraq and brought medicine to children. Now the organization campaigns against the U.S. occupation of Iraq.

Kelly explained when organizations like Emergency go into Iraq, they not only raise awareness to the realities on the ground, but they raise money and build hospitals for war’s victims. She sees these actions as a way of “…liberating ourselves from resignation…” through “…our collective sense of caring…” so that people make a significant difference.

While examining 12,000 hospital records in Kabul, Afghanistan, Strada found that 34 per cent of war victims are children, 26 per cent are non-combatants, 17 per cent are adults, 16 per cent are female, and seven per cent are combatants participating in the hostilities. Strada analyzed casualty percentages from 1914 –” 2005. In WWI, 15 per cent of casualties were civilians and 85 per cent were combatants. During WWII, which involved the scientific elimination of part of the human race, 65 per cent of the casualties were civilians and 38 per cent combatants. In today’s conflicts, civilians are 90 per cent of the causalities. Within nine decades the ratio percentages of civilian-combatant casualties reversed, so Strada’s empirical results from Afghanistan summarized the changes in the patterns of war.

How does Strada interpret his empirical findings?

“When today someone goes to war…the correct translation of that war is slaughter of civilians nine times out of ten,” Strada said, whose organization campaigns for the ban of landmines. Wars do not end with peace treaties because landmines, which have a life span of several decades, continue maiming people years after they are planted in the ground. According to Strada there are 350 models of anti-personnel mines that are made by or were made by American, Chinese, Italian, and Russian manufacturers. When these mines are activated they “…create an army of mutilated children,” Strada explained, because the devices are designed to maim people, not kill them. As a result, the context of war has changed because wars continue into endless wars.

Strada wrote about his experiences with mine victims in his memoir “Green Parrots: A War Surgeon’s Diary.” During the lecture Strada explained that an anti-personnel mine called the green parrot, also called a butterfly or toy mine (because they fly) are the PFM1 model and were Russian-made. During the Soviet occupation of Afghanistan, thousands of these mines were scattered throughout Afghan villages. Strada has performed surgery on several hundred mine victims, who suffer mainly from blindness, burns and hand amputations.

In response to these tragedies, Emergency established three surgical centers in Afghanistan, including 23 first aid posts and health clinics. The organization constructed one maternity hospital and one pediatric department there also.

At present, Emergency’s two largest operations are in Afghanistan and Iraq. Strada showed a picture of a dry riverbed in Iraq. Embedded in-between the gray stones was a gray landmine – almost unnoticeable to the naked, human eye. It was an Italian-made, waterproof V5-50 that weighed 30-40 grams. The mine is designed not to kill but maim its victim(s). Keep in mind people who are meters away from an exploding mine can be injured severely. Strada mentioned other highly explosive mines that were manufactured such as the Russian-made PMN, which weighs 250 grams; and the Italian-made Valmara 69: a fragmentation mine that jumps as it fires into the air — 360 degrees.

“War is the biggest tragedy in public health,” Strada said. The organization not only provides war and trauma surgery, pediatric surgery and cardiac surgery, but they establish burn units, rehabilitation centres, orthopedic and physiotherapy departments. Emergency averages around three prosthetic devices per day. In Sulaimaniya, a city in NE Iraq, Emergency trains mine victims for a trade so they can provide for their families. Thus far they helped Iraqis establish 112 small business cooperatives and by the end of this year the organization anticipates the total establishment of 150 small businesses.

When Emergency concludes a program, they hand it over to local health authorities. For example, the organization turned over one department of surgery and one department of obstetrics and gynecology in Rwanda at the end of 1994. In 2004, Emergency handed over one orthopedic department and one physiotherapy department in Palestine.

Despite criticism from other agencies for Emergency’s continued construction of The Salam Centre of Cardiac Surgery in Khartoum, Sudan, expected to open in summer 2006, Strada quoted article one of The Universal Declaration of Human Rights: “All human beings are born free and equal in dignity and rights.” He explained that human rights should be everyone’s rights so that patients receive the same standard of health care and rehabilitation worldwide.

Emergency’s mission “…is to provide free-of-charge, high-standard medical and surgical care in war-torn areas, and to promote a culture of peace, solidarity and respect of human right,” and at the lecture Strada said: “War prophylaxis is building human rights for all.”

Who funds Emergency?

In 2004, the organization had a budget of $17 M euros that included $12 M euros from individuals and $5 M euros from foundations, banks and municipalities. From 1994-2004, the organization’s total budget added up to $89,655,622 US dollars, with overheard costs at 6.1 per cent.

In 2005 Strada and members of his organization began touring the U.S. for the launch of Emergency USA, which has chapters in U.S. cities including Boston, Chicago, Denver, L.A., New York, Pasadena, San Francisco, and Washington. The chapters bring public awareness to the organization’s work and its volunteers help with fund-raising. Doctors from all over the world work in Emergency’s facilities. “I hope a lot of U.S. doctors and nurses will join us,” Strada added. Emergency provides medical and non-medical personnel training. Since English is the working language in their facilities, the organization provides English language classes also.

Strada asked the audience: “What is the future for people where there is no job where infrastructure is destroyed where war is ongoing?”

Organizations, such as Emergency, demonstrate it is up to civil society to make justice, peace and equality in the world the reality.