Approach To Saving Lives Eastern Mediterranean Region - WHO

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New response to rising trauma injuries in the Eastern Mediterranean Region - WHO

The number of conflict-related deaths between 2020 and 2021 increased worldwide by 46 per cent, amid increasing violence in Afghanistan, Yemen and Ethiopia, the World Health Organization (WHO) said on Wednesday.

To respond to this rise in trauma injuries, the WHO launched a new approach to saving lives and reducing disability, by ensuring that effective trauma care services are available during humanitarian emergencies.

“Up to 80 per cent of trauma deaths are occurring before people reach the hospital,” said Dr. Sara Halimah, Trauma Care Specialist for the WHO Eastern Mediterranean Region. “That’s a major area of concern that tells you that the civilians - the regular family in Somalia living in Mogadishu or in Afghanistan, or Sudan or wherever it may be - they are struggling to reach hospitals. They are dying on the way.” 

One in four conflict-related deaths could be avoided, simply by knowing how to stem bleeding and by making sure that communities have access to proper health materials.

But such measures are often impossible to find in fragile and conflict-affected settings where health systems have been weakened and are unable to respond to emergencies, the UN health agency stressed.

According to WHO data, injury and death rates in the Eastern Mediterranean are nearly three times higher in the region’s low-and middle-income countries than in its high-income counterparts.

One of the main problems that WHO identified in the Eastern Mediterranean is the use of increasingly sophisticated military weaponry which causes “very complex gunshot wounds, far more complex than what healthcare professionals were accustomed to treat”, Dr Halimah explained.

These injuries “will require multiple surgeries, rehabilitation for years to come, and will be a burden on a healthcare system that is already struggling”, the WHO officer continued 

Advances in improvised explosive devices have also caused extensive injuries, in addition to the loss of a limb.

“The underlying factor is that all of these advancements in military tactics and weaponry are resulting in far more deaths from conflict among civilian settings in fragile, conflict-affected States, more than ever before,” said Dr. Halimah.

Far more people are also dying because of the “double-blast” tactic used widely by non-state actors, including in Mogadishu on 29 October last year.

“It’s a simple tactic: a blast goes off in a very populated, civilian setting, the bystanders rush in to save lives and that’s when they trigger the second blast and the intent is to kill far more,” Dr. Halimah explained. 

Another major obstacle to emergency health care in fragile conflict-affected States is the lack of training for health professionals, along with a lack of basic medical supplies.

A full 98 per cent of health care standards come from developed countries that cannot be put into practice in Sudan, Yemen, Syria, Iraq or the occupied Palestinian Territories, said WHO, which warned that those most in need of trauma care are the least able to access it.

“There is often a misconception, that those who are injured are combatants and it’s not civilians, or it’s men of a certain age-range,” said WHO’s Dr. Halimah “Our research at WHO has shown that actually 40 per cent of civilians that are injured are children below the age of 15.”

With very few paediatricians working in countries including Somalia and Yemen, it is very unclear what is going to happen to those children, WHO warned. “Many of them die (or) are left with lifelong disabilities; they become economically and socially a burden to their families and the society at large, they don’t have a future,” said Dr. Halimah.

Speaking about his own personal experience as a trauma surgeon working in emergency settings, Dr Rick Brennan, Regional Emergency Director of the WHO Eastern Mediterranean Region, said that “there is nothing more unsettling than hearing the shells land, hearing the ambulances heading towards your hospital, hearing the commotion at the front of the hospital as patients are transferred to trollies and wheelchairs or carried in, and then waiting at the emergency department, wondering what you are going to see, wondering about the number of injuries, the dramatic types of injuries: penetrating head wounds, open chest wounds, amputations, severe burns.” 

Within 18 months of its launch, the WHO Regional Trauma Initiative has reached approximately 800,000 injured patients across fragile and conflict-affected countries, and responded to over 200 mass casualty incidents. Central to the initiative is support for national and local trauma care services.

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