‘Integrated management needed to reduce bomb blast casualties’


KARACHI – Pakistan, with no less than 2,000 deaths and 3,650 injured during series of bomb blasts, since 2000 to early 2011, needs an “integrated medical management system” to reduce the intensity of loss inflicted upon human lives, experts said on Monday.
Experts and researchers also drew attention towards change in the nature of blasts witnessed during past four years reflected through diversity of injuries caused to the people.
“The nature of blasts has markedly changed,” said Prof. Saeed Minhas, a researcher and an expert in trauma medicine as well as a senior orthopaedic surgeon.
Minhas said improvised explosive devices are being used to cause injury.
“Previously, letters and parcels or cycles fitted with bombs were in vogue, followed by suicide bombers with back-packs and jackets soon supplemented with improved, home made explosives, causing more severe nature of harm,” he elaborated.
Prof. Minhas said that explosives that are concoctions of nitroglycerine, dynamite, plastic, ammonium nitrate, fuel oil and other hazardous chemicals have turned these to be extremely fatal.
“Unfortunately we have yet to develop a system under which our medical personnel may be trained to identify and handle hidden pattern of injuries,” he added.
He also regretted rampant indifference towards organised “rescue services” that otherwise could prevent many of the avoidable deaths and reduce intensity of injuries.
In reply to a question, he said the situation is little different even in Karachi comprising 10 percent of the total population of the country and 30 percent of urban area.
“The city, in a span of past four years, experienced 24 different incidents of bomb blasts causing 358 deaths and leaving 1,128 injured,” he said.
Cases of explosion are not new to the city, with the first of the major disaster registered in 1987 at Bohri Bazaar in Saddar area of Karachi that left 200 dead and 350 injured. Till 2004, there were no less than 97 attacks in the city with 325 deaths and 1260 injured.
“The Major difference during the two periods is the change in the nature of blasts.” Prof Minhas, who is associated with the Jinnah Postgraduate Medical Centre, said that the unfolding situation enhances urgency to develop coordination among law enforcing agencies, medical community as well volunteers and ambulance service handlers.
He said the top priority is to train people in general and volunteers associated with ambulance services to handle victims with care.
“They must be trained enough to identify the dead and also distinguish between nature of injuries so as to immediately shift those in less serious conditions to the nearest hospital or facility, he said.
He also referred to the missing concept of “decontamination” of chemicals used in explosives strapped by suicide bombers around them.
“This is equally relevant in any emergency condition, be it natural or man made and ought to be coupled with proper and round the clock blood bank facilities, training of the lower staff, easy accessibility of doctors to hospitals under emergency conditions and provision for morgue at adequate distance,” he said, adding, “All those brought dead with black cards placed on them must be directly shifted to the mortuary so that injured are immediately attended without any bottlenecks.”
Moreover, each and every hospital ought to have a “flow chart” in their emergency sections with due attention towards anticipation, backup, communication setup, dangers and equipment.
“We have to revamp our emergency medical care as lack of training and poor physical structure have merged as a leading cause of death of young individuals in the country,” the expert said.
Senior psychiatrist, Prof Mussarat Hussain said those at helm of affairs need to understand the psyche of terrorists and suicide bombers.
“The injuries they cause are not only physical but also hold deep-rooted implications on the people in general with direct impact on socio-economic conditions,” he added.