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Injuries Among Afghan Refugees: Review of Evidence

Published online by Cambridge University Press:  28 June 2012

Khurram Nasir ,
Adnan A. Hyder  and
C. M. Shahbaz
Khurram Nasir
Affiliation:
Johns Hopkins Hospital, Baltimore, Maryland, USA
Adnan A. Hyder*
Affiliation:
Assistant Professor and Leon Robertson Faculty Development Chair, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
C. M. Shahbaz
Affiliation:
Medical Student, Aga Khan University, Pakistan
*
Department of International Health, Bloomberg School of Public Health, 615 N. Wolfe Street, Suite E-8132, Baltimore, Maryland 21205USA E-mail: ahyder@jhsph.edu
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Abstract

Background:

Injuries are a public health problem in developing countries resulting in major financial and productivity losses. Injuries in vulnerable populations, such as refugees, make an even greater impact on loss of life. Afghan refugees in Pakistan continue to form one of the world's largest refugee populations. This study systemically reviews the literature to estimate the magnitude and prevalence of intentional and unintentional injuries in Afghan refugees, and explores the implications of the findings for refugee healthcare policy and development of potential interventions specifically for Afghan refugees.

Methods:

Electronic databases of MEDLINE, POPLINE, Refworld, and Winspirs were searched. In addition, a web search was conducted and specific organizational websites were reviewed. The search in developing countries was limited to studies in English or with an English abstract for the years 1966–2001.

Results:

The literature review identified patients with reported war injuries who presented to hospitals. Injuries to extremities (45%) were more frequent than injuries to the head or neck (36%, p <0.001), and thorax/abdomen (14%, p <0.001) regions. A majority of the injuries were caused by explosives, which included landmines (32.5%), fragmentations, such as shrapnel (33%), and firearms (27%). The mean incidence of mortality in these studies was 11%.

Conclusions:

Despite such an extensive search, limited information was found pertinent to injuries in Afghan refugees residing in refugee camps. This dearth of literature on the prevalence of injuries, risk factors, and outcomes among this vulnerable group is a research and policy gap for public health. Specific quantitive and qualitative studies in this field are required to shape refugee healthcare policies and develop intervention programs.

Keywords

Afghansinjuriespublic healthrefugee campsrefugeesrisk factorsvulnerability
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 19 , Issue 2 , June 2004 , pp. 169 - 173
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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References

1World Health Organization: Injury: A leading cause of global burden of disease. World Health Organization. Available at http://www.who.int/violence_injury_prevention/index.html. Accessed 26 May 2002.Google Scholar
2World Health Organization: World Health Report 2001. Available at http://www.who.int/whr/2001/main/en/annex/annex3.html. Accessed 26 May 2002.Google Scholar
3United Nations High Commissioner for Refugees: Crisis on Afghanistan. Geneva:United Nations High Commission for Refugees. Available at http://www.unhcr.ch/cgi-bin/texis/vtx/afghan. Accessed 26 May 2002.Google Scholar
4United Nations High Commissioner for Refugees: Refugees by number, 2001 edition. Geneva: United Nations High Commission for Refugees. Available at http://www.unhcr.ch/cgibin/texis/vtx/afghan. Accessed 26 May 2002.Google Scholar
5Yusuf, F: Size and sociodemographic characteristics of the Afghan refugee population in Pakistan. J Biosoc Sci 1990;22(3):269–279.CrossRefGoogle ScholarPubMed
6Her Majesty's Government: Immigration and Nationality Directorate UK. Available at http://www.ind.homeoffice.gov.uk/. Accessed 26 May 2002.Google Scholar
7Boss, LP, Brink, EW, Dondero, TJ: Infant mortality and childhood nutritional status among Afghan refugees in Pakistan. Int J Epidemiol 1987;16:556–560.CrossRefGoogle ScholarPubMed
8Coupland, RM, Howell, PR: An experience of war surgery and wounds presenting after 3 days on the border of Afghanistan. Injury 1988;19:259–262.CrossRefGoogle ScholarPubMed
9Rautio, J, Paavolainen, P: Afghan war wounded: Experience with 200 cases. J Trauma 1988;28:523–525.CrossRefGoogle Scholar
10Bhatnagar, MK, Smith, GS: Trauma in the Afghan guerrilla war: Effects of lack of access to care. Surgery 1989;105:699–705.Google ScholarPubMed
11Sherif, AA: Vascular injuries: Experience during Afghanistan war. Int Surg 1992;77:114–117.Google ScholarPubMed
12Bowyer, GA: Afghan war wounded: Application of Red Cross wound classification. J Trauma 1993;38:64–67.CrossRefGoogle Scholar
13Korver, AJH: Outcome of war-injured patients treated at first aid posts of the International Committee of the Red Cross. Injury 1994;25:25–30.CrossRefGoogle ScholarPubMed
14Roostar, L: Treatment plan used for vascular injuries in the Afghanistan war. Cardiovasc Surg 1995;3:42–45.CrossRefGoogle ScholarPubMed
15Hunsun, H: Effects of early prehospital life support to war injured: The battle of Jalalabad, Afghanistan. Prehosp Disast Med 1999;14:43–48.Google Scholar
16Batinica, J: War wounds in the Sibenik area during the 1991-1992 wars against Croatia. Mil Med 1995;160:124–128.CrossRefGoogle Scholar
17Vujovic, B, Mazalagic, D: Epidemiology and surgical management of abdominal war injuries in Sarajevo: State hospital of Sarajevo experience. Prehosp Disast Med 1994;(9)2:S29. Abstract.CrossRefGoogle Scholar
18Nassoura, Z, Hajj, H, Dajani, Q: Trauma management in a war zone: The Lebanese war experience. J Trauma 1991;31:1596–1599.CrossRefGoogle Scholar
19Coupland, RM, Samnegaard, HO: Effect of type of conventional weapons on civilian injuries: Retrospective analysis of prospective data from Red Cross hospitals. BMJ 1999;319:410–412.CrossRefGoogle ScholarPubMed
20Marcikic, M, Kraus, Z, Dmitirovic, B: View of a war from a pathology department: Croatian experience. Med War 1993;9:33–37.CrossRefGoogle ScholarPubMed
21Garfield, MR, Nieget, AI: Epidemiological analysis of warfare: A historical review. JAMA 1991;266:688.CrossRefGoogle ScholarPubMed
22Kuzman, M, Tomic, B, Stenavonic, R, et al. : Fatalities in the war of Croatia, 1991 and 1992: Underlying and external causes of death. JAMA 1993;270:626–628CrossRefGoogle ScholarPubMed
23Safar, P: Disaster medicine and war torn former Yugoslavia. Prehosp Disast Med 1994;9:91–93.CrossRefGoogle Scholar
24Pelka, F: Voices from the war zone. The Humanist March/April 1995.Google Scholar
25Aboutanos, MB, Baker, SP: Wartime civilian injuries. J Trauma Injur Infect Crit Care 1997;43:719–726.CrossRefGoogle ScholarPubMed
26VanRooyen, MJ, Sloan, EP, Radavany, AE, et al. : The incidence and outcome of penetrating and blunt trauma in Central Bosnia: The Nova Bila Hospital for war wounded. J Trauma 1995;38:863–866.CrossRefGoogle ScholarPubMed