• About CIVIC

    CIVIC is a Washington-based non-profit organization that believes the civilians injured and the families of those killed should be recognized and helped by the warring parties involved.

    On this blog, you will find stories from our travels around the world as we meet with civilians and military, aid organizations and government in our quest to get war victims the help they need.

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    Sarah, Executive Director

    Marla B, Managing Director

    Kristele, Field Director

    Liz, Chief Communications Officer

    Trevor, CIVIC's fellow based in Afghanistan

    Chris, CIVIC's fellow based in Pakistan

    Jon, CIVIC's US military consultant

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GUEST BLOG: Fussing Over Numbers: Body Counts and Accountability (The Huffington Post)

Posted by Erica G from Kabul

Since the new UN estimates on civilians killed so far in 2009 were released on Friday, I’ve been getting questions on whether these numbers are helpful, or even accurate, in describing the conflict: What’s the value of the obsession with body counting?

In one sense, these numbers offer a measure of accountability for the human costs of the conflict. As I pointed out in my blog on Friday, in a month where the news has been dominated by competing press statements about attempts by both sides to the conflict to reduce civilian casualties, an estimate that 1000 people have already died so far this year is a stark reminder of how far these promises are from the past 6 month’s reality.

Nonetheless, there is a strong argument that we shouldn’t even be fussing about numbers when there is so much guesswork involved. In general, the UN has pretty accurate estimates, but it is a fair point that any estimates in Afghanistan should be treated with a wide margin of error. (The Globe & Mail published a great piece describing how access issues, local traditions, and sometimes deliberate misinformation by locals or local leaders, can make it impossible to find the “truth” in some of these investigations.)

Another critique raised by a friend of mine who is a human rights investigator is that these civilian casualty counts boil a thousand stories of loss into impersonal statistics, and obscure the real tragedy of these incidents. Once you digitize them, she would argue, no one bothers to ask about the names and faces behind those numbers.

A recent op-ed by Tom Hayden put a sharp point on this issue for me. He argued that the US Department of Defense should openly admit whether there is a standard number of civilian deaths that are considered acceptable for any given airstrike in Afghanistan (many confirmed that there was a “magic number” in Iraq), and what the decision-making process is for authorizing deaths that reach above a certain numerical threshold.

As a human rights advocate, this is the type of measure we tend to call for because it increases transparency over how these life and death calculations are made. Another common argument for releasing this type of information is that families have a ‘right to know.’ But thinking of my friend’s argument that numbers dehumanize a loss, I do wonder whether it’s something that really serves the victims and their families? Based on the interviews I’ve had with Afghan families who have lost a loved one, the last thing they’d want to hear is that their father, mother, or child was deemed expendable by a mean calculation made by an impersonal decision-maker a thousand miles away.

http://www.huffingtonpost.com/erica-gaston/fussing-over-numbers-body_b_250316.html

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SRI LANKA: ‘We have 450 beds and now have 1,700 patients’

This article was originally printed here:  http://www.guardian.co.uk/world/2009/apr/25/sri-lanka-war

Paul McMaster works as a Médecins Sans Frontières surgeon in Vavuniya hospital. This is an excerpt from his diary:

Wednesday 4.45am Woke up and started operating. A 15-year-old boy with severe blast injuries to his abdomen. He was on his own and in shock. Surgery took about two and a half hours and he was reasonably stable. The last I heard, at least, he was stable. But our concern is what happens to him now. This is a hospital with 450 beds, three intensive care beds, and we now have 1,700 patients with up to 50 coming in a day. There are patients on the floor, in the corridors, even outside. This boy is going to be on the floor. Infection is the main worry. The wounded take days to get to us by bus and infection has often set in by the time they get here. Many of them are dying on the buses that bring them, and the bodies are taken off along with the living.

7.45am I did the rounds of the emergency department. We have cases of people with their feet blown off waiting 13 hours to go into theatre. Three-quarters of the patients we see have blast injuries.

10am We had some discussions on how to increase the flow. There are teams working around the clock. We have three surgeons: myself, a Sri Lankan surgeon and another MSF surgeon from Tampa Florida. We have put two operating tables in one theatre. Things are fairly tight and congested but we get by. There are an extremely hardworking team of Sri Lankan anaesthetists and the Sri Lankan nurses here have been working 20 hours a day.

1.45pm Went back to surgery. A head injury to a child – a boy about nine. It took about two and a half hours and went OK. The problem is the internal damage to the brain. Only the next few days will tell how bad that has been.

4pm Began work on a lower leg amputation. A man had stood on a landmine. He had been with his wife and his daughter. We will operate on the wife tonight. The child has already had some surgery to remove pieces from her arm. Technically, the surgery on the man went well, but the problem is the landmine blasted soil into his leg. There is always the fear that infection will set in.

6pm I did a series of small cases – gunshot wounds. Over the course of the day I operated on 16 patients, five of them amputations on children. These are deeply traumatised people. The children in the emergency wards see people brought in with major blast limb injuries and are just sitting silently, emotionless, in the middle of all this, so we try to treat them and move them quickly out to the surgery or the ward.

9pm Finish surgery for the day. Going to find something to eat and then get some sleep.

Friday 2.30pm I have been in the whole time and do not have the big picture, but in the last 24 hours we have seen, for the first time, fewer patients coming in. Only 44 severely wounded patients came in to the hospital yesterday, although more have come in this morning. It might be that some of the other casualties are going elsewhere, to other hospitals. We’ve sent a team on a exploratory mission to try and find out exactly what’s happening.

One of the patients I have seen is a little girl of about seven or eight who has a severe leg injury. Her elder sister is in the same bed with wounds on her arms and legs. A third sister has burns to her face. Their mother has been killed and their father is in intensive care. With the level of aftercare that we can provide at the moment he has a 50/50 chance of making it, at best.

We have done 71 major operations over the past 24 hours. A lot of the these operations have been catching up on the last few days. It has been bedlam in the hospital. But it hasn’t got worse in the last 24 hours. We are only seeing the acute casualties. There are many people who are ill, several of the injured people also have chickenpox. We are hearing reports that there have been outbreaks of chickenpox in the camps because peoples’ immune systems are so weak.

I hear that some extra nurses are being sent to the hospital. The Sri Lankan medical authorities have made a real effort to send extra staff to help out. There are simply too many people to treat them all. We are not able to save some people because we need to provide more aftercare. There are simply not enough nurses.

• Paul McMaster is a retired surgeon from Droitwich, now based in Amsterdam.

GUEST BLOGGER: Monitoring Human Rights in Gaza

GAZA – I trekked across the Sinai Peninsula after watching the fighting from the Armistice line for a few weeks in December and January.  Israel wouldn’t let human rights monitors into Gaza, so I decided to take my team of researchers in through Egypt once the fighting stopped.  I’ve been to Gaza twice before – in 2004 when there were still settlements there, and again in 2006 after they were removed, and I consider myself seasoned to working in war zones.  But the tragedy I faced in Gaza hit me hard.

Watching the rockets rain on Israel, and the bombs fall on Gaza I knew a humanitarian crisis loomed.  With the borders closed people were going without food, water, electricity, and most urgently – medical care.  I’ve been to many war zones, but one constant is always there – civilians bear the brunt.  But as I stood there watching the white phosphorus flames raining down on Gaza city and Beit Lahiya I could only imagine the Dante’s inferno I would find.

The Abu Halima house reeked like a fireplace.  The walls were black and sooty, the wooden beams long since turned to charcoal.  The fire inside had been so intense the electric sockets had melted.  I could only imagine what the family faced inside.  I met Sabah Abu Halima, 44, a housewife and mother of a large family, in the burn unit of the Shiffa Hospital.  She was thoroughly traumatized, laying there with her burned arms trying to grasp at her children no longer there.  Her son Ahmad had to tell me what had happened.  On January 4th an Israeli white phosphorus artillery shell pierced the roof of the house.  It decapitated Ahmad’s father and burned his three brothers and a sister to death.  Sabah and five of her family were burned in the fire and so their ordeal is not over.

In the days after the smoke cleared, the Palestinian Authority tried to pour millions into rebuilding Gaza but was thwarted.  Now some humanitarian aid has been let in and Hamas activists are handing out cash payments of $5,100 to Palestinians whose homes were destroyed.  Seventy-five countries and international organizations made pledges to give billions in reconstruction aid.  Thus far, this is an opportunity lost for Israel.  Moderate Palestinians have no reason to stay moderate.  Israel should be helping with the rebuilding, provide victim assistance and compensation, and open the border to humanitarian aid and monitors.

The stories I heard will live with me for a long time, and the suffering Israelis and Gazans endured will surely last far longer if the warring parties don’t take seriously their moral responsibility to make amends to war’s victims for their violence.

GUEST BLOGGING: Pressure to stay silent…

Posted By: Rebecca A., working with CIVIC’s Erica in Afghanistan

I am in Jalalabad now, a city in the Eastern part of Afghanistan a few hours from the border with Pakistan. US forces are stationed here, and recently came under heavy criticism for an air attack on a wedding party that killed 23 civilians in a village about an hour from Jalalabad city.

This afternoon I was interviewing one man, Ziaul Haq, whose 10-year-old daughter was killed in a shooting incident by US Marines in March 2007. We had already been speaking for quite a while about the shooting, the positive impact of assistance he had received from the USAID-funded ACAP program, and about his hopes for his two sons’ futures. Then, I asked him what else was on his mind. Almost as an afterthought Haq mentioned that his wife, while on the family’s roof cleaning rugs, had been shot and badly injured by international forces doing target practice in the open space near Jalalabad Air Field.

Haq had previously alerted authorities to the dangers of using that space as a shooting range to no avail. Following the shooting he re-approached district leaders. This time they requested that he not bring it to the attention of the Coalition Forces, expressing concern about how doing so might impact that relationship. Keeping silent meant Haq could not request assistance from the PRT to pay his wife’s medical bills or receive any form of apology. And it also meant that live rounds continue to be discharged in the open field.