ICRC gives training on treatment of war wounds

Being well-prepared and capable of fast and effective triage (the sorting and treatment of patients based on the degree of their injuries) are the key to caring for war-wounded.

That is the core guidance given by the International Committee of the Red Cross (ICRC) in war surgery seminars it has been conducting in Sri Lanka, Morven Murchison, the ICRC health coordinator in that war-torn country, told IRIN.

Treating those injured in battle requires specialised training and knowledge of traumatic injuries caused by bullets and explosives, she said. “It is different to what you would get under ordinary circumstances… War surgery is not something that you would learn in-depth at medical college.”

The ICRC has been conducting - in Sri Lanka since 2001 - a series of war surgery seminars for medical personnel who work with victims of conflict. In July 2008, it concluded the sixth such series for personnel working in the conflict-affected northern areas. The seminars were conducted by two experienced war surgeons from the ICRC's headquarters in Geneva.

“This year the programme targeted personnel working in hospitals in the conflict zone like Jaffna, Padaviya, Mannar and Vavuniya,” Murchison told IRIN. “The participants include doctors and others like nurses and physiotherapists involved with treating the wounded.”

Two seminars were held in 2008 - one in Anuradhapura, a north central town, and the other in Jaffna in the north. A total of some 50 participants attended the two training sessions.

Murchison said the aim of the seminars was to give medical personnel the latest knowledge on treatment and management of the war-wounded in the field.

Photo: Amantha Perera/IRIN

Triage and prior preparation are core issues emphasised at war surgery seminars conducted for medical personnel in Sri Lanka by the ICRC

Awareness of wounds

Medical staff needed to be aware of the damage that could be caused by a ballistic wound and how best to treat it.

“You have to know what a bullet will do when it hits the body, or a fragmentation mine or a landmine… And when the wounded start coming in [in large numbers] triage is very vital… you classify cases based on the [extent] of the injuries,” she said.

Newer techniques in triage and managing the wounded were two vital issues examined at the seminars, according Champika Abeyakoon, medical officer at the government hospital in Padaviya town in the northeast, who was a participant.

“We got a chance to compare our management methods with those from other situations in the world,” Abeyakoon told IRIN. “There was a lot of emphasis on newer techniques in triage and treating trauma.”

Since 2006, on several occasions his hospital has had to deal with civilians injured by fragmentation mines, some of which had targeted public transport buses.

Need for practical training

Abeyakoon said that in future seminars he would like to see practical training sessions and the inclusion of more surgeons working in the field. “That will help us to gain greater knowledge of the wounds and what needs to be done.”

ICRC’s Murchison told IRIN such suggestions would be considered.

“The next seminars in 2009 will have a component in which we will have practical sessions involving the use of dummies for training,” she said. “We try to structure the seminars according to the needs and feedback of the participants.”

Sri Lanka’s health infrastructure was in a better position to deal with the war-wounded compared to other countries where the ICRC works. “It is not like in Darfur where there is hardly any equipment and facilities,” she said. “Here the hospital network is pretty good but what we need is more training.”

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