Missing in action: Afghan civilian victims of traumatic brain injury - the signature wound of the war in Afghanistan. Richard Tanter Nautilus Institute for Security and Sustainability [email protected]
Nautilus Institute for Security and Sustainability
The First International Conference on Law Enforcement and Public Health - Melbourne, Australia. 11-14 November, 2012
See: Source: Monitoring Trends in Global Combat: A New Dataset of Battle Deaths, Bethany Ann Lacina and Nils Petter Gleditsch, European Journal of Population (2005) 21: 145–166.
“There is no such thing as a nice war wound. Even the simplest weapon has devastating consequences.
But the biggest danger is for Afghans travelling any distance to get here [Boost Hospital in Helmand Province].
The biggest problem is them arriving late in terms of their disease.
So a two-hour journey could take two or three days as they go around the checkpoints, with the result that the disease has progressed much more seriously to life threatening in some cases.”
Michiel Hoffman, Medecins Sans Frontiers (2010)
Source: Neta C. Crawford, Civilian Death and Injury in Afghanistan, 2011-2007, Costs of War, Eisenhower Study Group, (September 2011), p.14, at http://costsofwar.org/article/afghan-civilians
“The fact is that asymmetric warfare is inherently horrible, causes numerous civilian casualties, leads to inevitable abuses on both sides, and presents constant dilemmas in dealing with local allies that are not subject to US command and discipline.”
Anthony Cordesman, CSIS 2011
National ISAF participating states mandates derive from UNSC 1386 (2001) and annual successor motions, and bilateral requests for assistance from the Government of the Islamic Republic of Afghanistan.
Source: Defense Contractors in Afghanistan, Overseas Civilian Contractors, December 21, 2009. http://civiliancontractors.wordpress.com/2009/12/22/defense-contractors-in-afghanistan/
Source: Blast injuries, Stephen J Wolf et al, Lancet 2009; 374: 405-15.
Exposure to blast wave and high-velocity wind behind shock front of blast wave.
Hurricane: 200 km/h, over-pressure of 1.72 kPa (0.25 psi)
Lethal blast-induced shock wave: 2,414 km/h; over-pressure 690 kPa (100 psi)
Source: Traumatic brain injury: an overview of pathobiology with emphasis on military populations, Ibolja Cernak and Linda J Noble-Haeusslein,
Journal of Cerebral Blood Flow & Metabolism (2010) 30, 255-266
Source: Traumatic brain injury: an overview of pathobiology with emphasis on military populations, Ibolja Cernak and Linda J Noble-Haeusslein, Journal of Cerebral Blood Flow & Metabolism (2010) 30, 255-266.
Source: Ralph De Palma et al, Blast Injuries, New England Journal of Medicine, 352:13 (31 March 2005)
Source: J.L. Duckworth, et al., Pathophysiology of battlefield associated traumatic brain injury, Pathophysiology (2012)
Source: Department of Defense data, in U.S. Escalates Air War Over Afghanistan, Noah Shachtman, Wired (30 August 2010), at http://www.wired.com/dangerroom/2010/08/u-s-afghan-air-war/; http://www.wired.com/images_blogs/dangerroom/2010/08/Drilldown-2010.pdf
“The new warfare” and “Damage limitation” frames
= focus attention on weapon performance parameters and targeting protocols as putative casualty indicators
“Casualty agnosticism” frame
= empirical evidence unreliable; sets unattainable data standards
- ignores empirically-based estimates qualified by uncertainty ranges
“Casualty irrelevance” frame
Source: Carl Conetta, Disappearing the Dead.Project on Defense Alternatives Research Monograph #9 (18 February 2004), http://www.comw.org/pda/0402rm9exsum.html
Small number of studies and reporting of “mental health problems”
(Source: ‘Over 60pc Afghans suffer from mental health problems’, Zarghona Salehi, Pahjwok Afghan News (10 October 2010), at http://www.pajhwok.com/en/2010/10/10/over-60pc-afghans-suffer-mental-health-problems
Health care professionals, Uruzgan (total/female)
“The problem with these CHWs is the discrepancies between the expectations residents have of them and the services they are capable of providing. Residents treat them as qualified doctors when in reality they are more a referral service for health care facilities, with the ability to provide a cure for simple colds or the flu at most. Moreover, the CHWs are all volunteers. They are overwhelmed with requests while they have their own daily occupations to attend to as well.
Source: The Dutch Engagement in Uruzgan: 2006 to 2010, A TLO socio-political assessment, The Liaison Office, August 2010.
[Source: Atul Gerwande, “Casualties of War: Military Care for the Wounded from Iraq and Afghanistan”, New England Journal of Medicine 351:224 (9 December 2004])