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Cluster munitions: public health and international humanitarian law perspectives
Abstract
As a result of civilian deaths in Vietnam, Cambodia, Laos, Chechnya, Kosovo, Afghanistan, Iraq and Lebanon, cluster munitions have been recognised to pose a grave threat to civilian populations because of their limited precision and problematically high rate of initial failure to explode. Efforts are intensifying to ban cluster munitions and to mandate those who have discharged them to defuse them effectively so as to reduce the risks to civilians. This editorial reviews these efforts and identifies a need for them to be actively supported by both the legal and medical communities.
... C luster bombs are standard munitions for many nations. [1][2][3][4][5][6][7][8][9][10] Cluster bombs are produced by 34 countries and have been used by 23 countries. Cluster bombs have been used by the United States (US) in Laos in 1973, by Russia in 1995 during the First Chechen War, by NATO in Yugoslavia in 1999, and by the US in Afghanistan in 2001. ...
To present the visual outcomes and ocular sequelae of victims of cluster bombs.
This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006). Data were gathered from the reports to the Information Management System for Mine Action.
There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308) of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67%) with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes), corneal foreign bodies (9 eyes), corneal decompensation (2 eyes), ruptured cataract (6 eyes), and intravitreal foreign bodies (10 eyes). The corneas of one patient had extreme attenuation of the endothelium.
Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs.
Over the course of 2009, dozens of nations signed a new convention on cluster munitions, and several nations ratified the convention. To determine how public health professionals can participate in preventing death and injury from cluster munitions, we review the history of these weapons, their effects on individuals and communities, the history of efforts to limit their use, the Convention on Cluster Munitions, and ways that health professionals can support efforts to ban their use. Cluster munitions are a threat to civilians in conflict and post-conflict settings. They render homes, farms and businesses dangerous and inaccessible, and delay resettlement after the end of a conflict. Health professionals have led efforts to limit the use and proliferation of other weapons, and global collaboration to support the Convention on Cluster Munitions would be a step towards protecting the public's health.
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