The underreporting of landmine and explosive remnants of war injuries in Cambodia, the Lao People's Democratic Republic and Viet Nam

Durham, Jo; Hill, Peter S; Hoy, Damian

doi:10.2471/blt.12.110411

Cited by 9 publications

(11 citation statements)

References 6 publications

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“…Cluster munitions continue to be used including in Iraq, Yemen and Syria and there is an urgent need for more research of the health impacts of these weapons including epidemiologic population-based surveys in affected areas [ 16 ]. There is also a need for enhanced reporting systems that coordinate with national health systems and integrate UXO injuries with broader efforts to improve injury surveillance systems [ 6 ]. In addition, health professionals and others should continue to advocate for full implementation of the Mine Ban Treaty and the Convention on Cluster Munitions.…”

Section: Discussionmentioning

confidence: 99%

“…While the number of reported deaths in post-conflict contexts has been steadily declining, the number of survivors has increased with an estimated 226,000–358,000 survivors in countries with significant ERW contamination, many of which are civilians [ 5 ]. However, these figures are likely to be underestimated as most injuries occur in low/lower-middle-income countries where injury surveillance systems are often inadequate and incomplete [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Population trends related to injury from explosive munitions in Lao PDR (1964–2008): a retrospective analysis

et al. 2018

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BackgroundThe presence of landmines and explosive remnants of war (ERW) including unexploded ordnance (UXO) poses a serious public health risk for populations living in conflict-affected and contaminated areas. Current analysis, however, provides only a partial view of the burden. In this study, we examined the multivariable relationship between year of injury, activity at the time of the incident, case fatalities and casualty rates in order to provide decision-makers with a more fine-grained understanding of landmines and ERW injuries in the Lao PDR.MethodsUsing data from a retrospective, national household survey, frequency tables, logistic and Poisson regressions were performed using STATA 13 to predict the case fatality and population-standardized incidence rates for ERW casualties.ResultsThe findings indicated that most casualties were male (86.75%), with the majority of incidents (74.7%) occurring during the conflict period (1964–1979). The odds of death for the conflict period was 1.5 times that of the post-conflict period (1980–2008). The highest odds of death during the conflict period was associated with big bombs (OR = 1.38, 95% CI: 1.243–1.522, p < 0.01), and landmine injuries were more common during conflict compared to the post-conflict period (IRR = 1.42, 95% CI: 1.368–1.477, p < 0.01). Post conflict, cluster munitions had the highest incidence rate for death or injury (IRR = 1.07, 95%CI: 1.006–1.143, p = 0.03). Scrap collection which is often the target of mine risk education and thought to be one of the main activities at time of injury had the second lowest incidence rate of the activities related to incident during post-conflict period.ConclusionsAs the first study of this nature in Lao PDR, this research provides information essential for planning services and prevention. This study suggests more effort needs to be directed towards addressing the geographical regions and population subgroups experiencing increased casualty numbers and odds of death. Further research is required to improve the documentation and understanding of the health and socio-economic consequences of landmine and ERW injuries.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Population trends related to injury from explosive munitions in Lao PDR (1964–2008): a retrospective analysis

et al. 2018

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“…International NGOs typically used computer‐based systems for data storage, but these were not linked to other databases or shared with other stakeholders. Most information on disability was reported to be in the Mine Action sector, which is overseen by the National Regulatory Authority (NRA) and is responsible for the removal of unexploded ordnance (UXO) and other explosive remnants of the Vietnam War but not linked to the HIS (Durham et al, ).…”

Section: Health Information System Infrastructurementioning

confidence: 99%

“…It was also reported that records were frequently destroyed once they had been sent to the next level. In terms of injury, the NRA has the most comprehensive database, but this is not formatted into any regular reporting format (aside from annual reports on the number of fatal and non‐fatal injuries), nor does it record loss of functioning as a result of UXO injuries (Durham et al, ).…”

Section: Data Management and Information Productsmentioning

confidence: 99%

Health information systems and disability in the Lao PDR: a qualitative study

Durham

Sychareun

Rodney

et al. 2015

Health Planning & Management

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The Convention on the Rights of Persons with Disabilities provides an opportunity to strengthen disability-related health information. This study analysed the health information system in Lao PDR and sought evidence of interventions to improve disability-related health information. The study was based on a literature review and key informant interviews (N = 17) informed by the Health Metrics Network's Framework and Standards and the Performance of Routine Information System Management framework. The Lao health information system is in an embryonic stage with health data often incomplete, inaccurate and poorly used. Indicators related to disability or functioning are not included, and capacity to diagnose the health condition of disability is limited. No studies of health information interventions were found. As a State Party to the CRPD, the Lao PDR has a legal obligation to collect health-related information on people with disabilities. Given the nascent stage of development of the health information system in the Lao PDR and diagnostic capacity, indicators related to basic functioning and access to services should be integrated into household level surveys. As the health information system further develops, small, incremental changes in the type of disability information and rehabilitation and the way it is collected can be implemented. Copyright © 2015 John Wiley & Sons, Ltd.

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“…1 In a paper in this issue of the Bulletin, Durham et al note that in Global Burden of Disease (GBD) studies, the true number of landmine and ERW casualties has historically been underreported. 2 Their paper was written before the release in December 2012 of the GBD 2010 report, which fails to specifically discuss accidents caused by landmines and ERW and categorizes them under "collective violence". 3 In line with the Landmine Monitor's reporting on landmine and ERW casualties, the disability-adjusted life years (DALYs) attributable to collective violence have declined.…”

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confidence: 99%