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Seen but Not Heard: Injuries and Deaths from Landmines and Unexploded Ordnance in Chechnya, 1994–2005

Published online by Cambridge University Press:  28 June 2012

Oleg O. Bilukha*
Affiliation:
International Emergency and Refugee Health Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Muireann Brennan
Affiliation:
International Emergency and Refugee Health Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Mark Anderson
Affiliation:
International Emergency and Refugee Health Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Zaur Tsitsaev
Affiliation:
United Nations Children's Fund, Office for North Caucasus, Nazran, Republic of Ingushetia, Russian Federation
Eliza Murtazaeva
Affiliation:
United Nations Children's Fund, Office for North Caucasus, Nazran, Republic of Ingushetia, Russian Federation
Ramzan Ibragimov
Affiliation:
Voice of the Mountains, Grozny, Republic of Chechnya, Russian Federation
*
Oleg Bilukha, MD, PhD National Center for Environmental Health Centers for Disease Control and Prevention 1600 Clifton Rd, Mailstop E-97 Atlanta, GA 30333 USA E-mail: [email protected]

Abstract

Introduction:

Due to more than a decade of armed conflict and civil unrest, Chechnya is among the regions most affected by landmines and unexploded ordnance worldwide.

Hypothesis:

The study was performed to assess the magnitude of injuries and deaths due to landmines and unexploded ordnance in Chechnya between 1994 and 2005 and to describe epidemiologic patterns and risk factors for these events.

Methods:

Surveillance data that included 3,021 civilian non-combatants injured by landmines and unexploded ordnance in Chechnya during 1994–2005 were analyzed. Local non-governmental organizations in collaboration with the United Nations Children's Fund conducted victim data collection using trained staff to interview victims or their families. Surveillance data were used to describe injury trends, victim demographics, injury types, risk behaviors, and types of explosives related to landmine and unexploded ordnance events.

Results:

The largest number of injuries occurred in 2000 (716, injury rate 6.6 per 10,000) and 2001 (640, injury rate 5.9 per 10,000). One-quarter of all victims were younger than 18 years, and 19% were females. The case-fatality rate was 23%. Approximately 40% of victims were injured by landmines, 30% by unexploded ordnance, and 7% by booby traps. A large proportion of children and adults were injured while traveling or performing activities of economic necessity; 29% of children were injured while tampering with explosives or playing in a contaminated area. The proportion of victims with lower limb amputations was similar among children and adults (14% and 17%, respectively), whereas the proportion of victims with upper limb amputations was three times higher in children than in adults (12% and 4%, respectively). Most accidents that occurred while the victim was traveling or performing activities of economic necessity were caused by landmines, while most accidents that occurred while the victim was playing near an explosive device or tampering with it were caused by unexploded ordnance.

Conclusions:

Civilians in Chechnya experienced the highest rates of injury from landmines and unexploded ordnance ever documented, 10 times higher than injury rates reported from such highly affected countries as Afghanistan, Angola, or Cambodia. Urgent efforts to identify, mark, and clear mined areas and/or areas contaminated with unexploded ordnance are needed to prevent further civilian injuries and deaths.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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