Mine blast injuries: ocular and social aspects

Background/aims-Landmines have long been used in conventional warfare. Thes e are antipersonnel mines which continue to injure people long after a ceas efire without differentiating between friend or foe, soldier or civilian, w omen or children. This study focuses on Afghan noncombatants engaged in min e clearing operations in Afghanistan in the aftermath of the Russo-Afghan w ar. The patterns and types of injuries seen, are described and experiences in their management, ways, and means to prevent them, and recommendations f or the rehabilitation of the affected individuals are given. Methods-It is a retrospective and analytical study of 84 patients aged 19-5 6 years who sustained mine blast injuries during mine clearing operations i n Afghanistan from November 1992 to January 1996. The study was carried out at a military hospital with tertiary care facilities. The patients were di vided into three groups on the basis of their injuries. Group 1 required on ly general surgical attention, group 2 sustained only ocular injuries, whil e group 3 had combined ocular and general injuries. Patients in groups 2 an d 3 were treated in two phases. The first phase aimed at immediate restorat ion of the anatomy, while restoration of function wherever possible was don e in subsequent surgical procedures in the second phase. Results-it was observed that 51 out of 84 patients (60.7%) had sustained oc ular trauma of a variable degree as a result of the blasts. The mean age of the victims was 29 years and they were all male. A total of 91 eyes of 51 patients (89.2%) had been damaged. Bilaterality of damage was seen in 40 (7 8.4%) patients. Most, 34 (37.3%), eyes became totally blind (NPL). Only a f ew escaped with injury mild enough not to impair vision. Foreign bodies, sm all and multiple, were found in the majority of eyes; most, however, were f ound in the anterior segment, and posterior segment injuries were proportio nally less. Conclusions-The prevalence of blindness caused by mine blast injuries is qu ite high. The resulting psychosocial trauma to the patients and their famil ies is tremendous and has not been adequately highlighted. These injuries a re a great drain on the country's resources. Enforcement of preventive meas ures and the use of protective gear and sophisticated equipment by the mine clearing personnel would prove to be far more economical in terms of human Life as well as medical and economic resources. There is also need for gre ater attention towards the establishment of support groups and rehabilitati on programmess for these individuals.