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Journal Article

Citation

Burkle FM. Disaster Med. Public Health Prep. 2019; ePub(ePub): 1-5.

Affiliation

Professor (Ret.); Senior Fellow & Scientist, Harvard Humanitarian Initiative, Harvard University and Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts; Senior International Public Policy Scholar, Woodrow Wilson International Center for Scholars, Washington, DC; Elected member, Institute of Medicine, National Academy of Sciences, Washington, DC; Captain, MC, USNR (Ret.).

Copyright

(Copyright © 2019, Society for Disaster Medicine and Public Health, Publisher Cambridge University Press)

DOI

10.1017/dmp.2019.77

PMID

31397655

Abstract

The toll of civilian deaths in current wars and conflicts has been building for decades. Civilian populations, particularly since WWII, have suffered most of the consequences of armed violence and today represent the most at-risk population. This is attributed to the rise of religious and ethnic hatreds, the collapse of State structures, the battle for control of natural resources, the vast availability of weapons, the proliferation of acts of terrorism, and the spread of so-called asymmetric conflicts. Protections provided to innocent civilians under International Humanitarian Law and the Geneva Conventions have been ignored. This commentary captures the experience of the immediate care and transportation provided to military casualties of the Battle of Solferino in 1859 with civilian casualties recently documented in a Stanford-led study during the "golden hour" after injury in 13 conflicts from 1990 to 2017. Despite many advances in triage and management of war injuries over the intervening decades, the common thread of these 2 scenarios is that transport times and early resuscitation capacity and capabilities, first recognized in the 19th century wars and now accepted as global norms and markers for survival from trauma, are as unavailable today to civilians caught up in war and conflict as they were to soldiers in the 19th century.


Language: en

Keywords

Geneva Convention; civilian casualties; international humanitarian law; trauma; war and conflict

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