Effects of Land Mines and Unexploded Ordnance on the Pediatric Population and Comparison with Adults in Rural Cambodia

This paper was designed to evaluate and compare the impact of explosive war remnants on children versus adults in rural Cambodia. A prospective review of trauma database from November 2003 to January 2006 of the Civilian War Victims Surgical Centre in Battambang, Cambodia, run by an Italian NGO called "EMERGENCY" was performed. Age, female ratio, time of evacuation, type of ordnance, pattern of injury, number of operations, transfused patients, hospitalization, mortality, and residual disability were registered and compared. A total of 356 patients acutely wounded by antipersonnel land mines, antitank land mines, or unexploded ordnances (UXO) were admitted. Among these, 94 (26.4%) were children (younger than aged 16 years). Females were more common among children than adults (31.9% vs. 11.8%); 61.7% of children were injured by UXO, whereas 72.1% of adults were victims of antipersonnel land mines. Antitank mines victims were uncommon in both groups. The majority of adults (49.2%) were injured to lower limbs, whereas 50% of children were injured to upper limbs, face, and torso. Random wounds, typical of an explosion in vicinity, were observed in 32.9% of children and 18.7% of adults. All differences were statistically significant (P < 0.005). Time of evacuation, number of operations, and hospitalization did not statistically differ among groups. Number of transfused patients (23% vs. 7.2%), mortality (6.3% vs. 1.5%), incidence of blindness (21.2% vs. 9.5%), and maimed upper limbs (23.3% vs. 8.8%) were significantly higher in children compared with adults (P < 0.05). Long after ceasefire, antitank mines, antipersonnel land mines, and UXO continue to injure and kill civilians. Children are commonly injured and sustain more severe injuries.