gms | German Medical Science

Since the implementation of the UN Iraq-Kuwait Observation Mission (Unikom) after the Gulf war in 1990 a medical Team was set up in 1991 to support the UN Troops in their difficult tasks in the DMZ (= demilitarisised zone) a remote desert area between Kuwait and Iraq to take care of the medical treatment für the UNIKOM members and the nomadic paople living in the DMZ as point out in the UN reports S/2001/287 and S/2001/913 of the Secretary-General on the official UN - webside.

During the first years the medical duties in this international enviroment of troops from 33 nations was carried out by an Austrian and later a Norwegian Medical Team (Normed). In october 1995 this role fell over to Germany and since then 13 German Medical Teams (Germed I to 13) were responsible providing the EMS Service in the dessert of the DMZ between Kuwait and Iraq.

Beside the usual day to day OPD visits for the military and local stuff personel, dehydrations, scorpion bites, infectious deseases, road traffic accidents and mine-injuries were the challenging tasks for our GM 12 team. This report shall give an overview of the EMS - experiences in the 6- month period based on the notifications of 3 precursor missions from January 2000 to June 2000.

The rescue area includes 3800 sqkm of the DMZ and the remote desert surroundings. 5 ambulances from rescue stations with 7 paramedics with rescue equipment provide an 24-hours duty for the 1200 UN personal and the nearby nomadic population. There were about 4000 regular OPD visits and about 50 calls for CASEVACS served in 2001.

The number of patients casualities and mine-injuries treated during 6 month period was 2000 / 25 / 10 Treatment guidelines, ICRC classification of the mine injured patients were discussed and compared with the regional mine-injury epidemiology of previous missions within the medical team and accompanied by weekly concurrent medical education based on the advices of R. Coupland from ICRC as well as M.King & P. Bewes in their handbook PRIMARY SURGERY www.meb.uni-bonn.de/dtc/primsurg or www.tropenchirurgie.de and trainings for special situations as well as some research about possible telemedical support for medical treatment in this remote area during the changing political situation arround the 11th of September 2001.

The medical challenges in a remote area require the strict cooperation of a medical team with representatives of different disciplines within the a mulitinational UN-peacekeeeping military environment. An acompanying continous medical education as well as telemedical support in spaecial situations proofed to be helpful. The lessons learned will be used to establish the WADEM Land Mine Taskforce to formulate an update of WADEMs 1997 declaration on the MINE HAZARD situation of the world at the beginning of the new millenium (preliminary URL: www.dismedmaster.de) A further report on the situation from 1996 to 2002 is in preparation for publication in the Journal of Mine Action from JMU URL: www.maic.jmu.edu

1) United Nations Iraq-Kuwait Observation Mission; Chapter 33, in : The Blue Helmets, A rewview of United Nations Peace-Keeping; ISBN 92-1-100611-2, New York 1966

2) Web-Site: www.un.org/depts/dpko/missions/unikom/index.html

3) Piehlsticker; Germed in Unikom; History and Activities; Unikom News No 1 2001:

4) R. Karasek, Rettungsdienst in Kuwait ; Mit Grünlicht durch die Wüste; Rettungsdienst 24. Jhg. 2001 p 65

5) A..Y. Al-Ghunaim; Landmines and the Destruction of the Environment of Kuwait,

Report of the official Commission of Kuwait1999 ISBN: 99906-32-20-0

6) R. M. Coupland : Amputation For War Wounds 1992 , ICRC Publication

7) R. M. Coupland The SIRUS Project 1998; ICRC Publication

8) B.M. Schneider et al: Medical Challanges during an UN-Mission to the Middle East in 2001, Turkish Journal of Trauma & emergency Surgery Vol 8 Supp 10/2002 p 212

9) B.M. Schneider, et al: Basic Telemedicine during an UN-Mission to the Middle East in the DMZ: TELEMED 2002 p 158-162 ISBN 3-9808-6530-4

10) H. Husum, G. Strata: Measuring Injury severity: ISSvs NISS for Penetrating Injuries ; Prehospital and Disaster Medicine Vol 17 No 1 /2002

11) H.R. Jahunlu, H. Husum, t. Wisborg: Mortality in Land-mine accidents in Iran; Prehospital and Disaster Medicine Vol 17; No 2 p 107-109

12) Web-Site: www.un.org/pubs/cyberSchoolBus/landmines/index1.html

13) UN Mine Action Summary: www.mineaction.org with actual PORTFOLIO of Mine Action Projects