There are estimated to be 60 to 110 million landmines in the world, placed in about 70 countries. Two million people are injured or killed by landmines and unexploded ordnance every year; 30% to 40% of these are children. Approximately 80% of disabled persons live in undeveloped nations and a high proportion of loss of limbs is caused by mines and weaponry. Afghanistan is one of the countries most severely affected (Death and Injury From Landmines and Unexploded Ordnance in Afghanistan, JAMA Volume 290;5).
Unexploded Cluster Bombs Cause Civilian Death and Injury
Cluster bombs which are designed to release hundreds of bomblets at different altitudes and cover a large area, contribute to the problem of indiscriminate bombing as well as unexploded munitions that cause death and injury. Cluster bombs used by the US military continue to pose a considerable risk to civilians in Iraq and Afghanistan.
Other unexploded ordnances include military explosives such as grenades, bombs and mortar shells. Some mines are deadly traps fashioned to look like shiny objects or toys. These explosive munitions can remain for generations or indefinitely; landmines from the Soviet occupation in Afghanistan almost 30 years ago still cause death and injury to civilians.
Most victims of landmines are men and boys who farm the land or travel for work. Almost 50% of victims are younger than 16 years. Children who have a natural curiousity about their surroundings and are less cautious are more likely to be injured or killed by picking up unexploded munitions.
Injury and Death Caused By Landmines
As landmines are present in areas that have been devastated by war and suffer post-war consequences of loss of infrastructure, economic and social failure and loss of health care facilities and workers, most landmines victims do not receive adequate care. Many victims also bleed to death before receiving medical attention because landmines are usually hidden in isolated areas and victims may not be found or have conveyance to get to hospital.
International Red Cross statistics claim that less than 25% of mine victims are able to get to a hospital within six hours of being injured and approximately 15% must travel for more than three days before reaching a hospital.
Those that survive and receive medical attention likely require amputations, long hospital stays, pain management and extensive rehabilitation. Other complications to the health of injured victims include burns, dehydration, septic shock, bone infections, kidney failure and psychological trauma.
Most children do not survive blasts from landmines or munitions because of their smaller sizes, fast loss of blood and closer proximity to the explosion.
Types of Injuries Caused By Landmines and Explosives
The severe trauma and bone shattering injuries require surgery and orthopedic specialist care.
- Landmines designed to kill, such as bounding mines, explode at waist height when triggered.
- Anti-personnel mines usually cause traumatic foot of leg amputation with severe injury by shrapnel, depris and bone fragments to the rest of the body.
- Fragmentation mines are designed to cause wounds to the entire body by hot razor sharp metal shrapnel released when triggered.
- Injuries that occur when accidently detonating a mine or explosive by picking it up, usually involve the hands, face, abdomen and chest. These injuries are most common in children.
Kidney Failure After Limb and Body Trauma
Victims of landmines who survive landmines and undergo surgery often suffer kideny (renal) injury or failure due to the intense trauma to the body. Extreme blood loss causes low blood pressure and reduced oxygen flow to the kidneys.
Renal damage due to myoglobinuria in patients occurs when myoglobin and potassium from muscle cells is released into the blood circulation when the muscle is destroyed or severely injured by trauma or burns. Large quantities of myoglobin in the blood can block the renal filtration system leading to kidney cell necrosis (death) and loss of function or complete failure of the kidneys. Patients then require kidney dialysis until kidneys regain function and the care of nephrologists (kidney specialists).