Monday, 4 September 2017

Worse things than dying

Then a big Turkish shell knocked me arse over head, 
and when I woke up in my hospital bed,
And saw what it had done, well I wished I was dead. 
Never knew there was worse things than dyin'.
For I'll go no more waltzing Matilda, 
all around the green bush far and free
To hump tent and pegs, a man needs both legs-
no more waltzing Matilda for me.
And the band played waltzing Matilda sung by Eric Bogle

Earlier in the Summer I was lent a naval service book by my pal Russ because we both have an interest in naughtyical things and a thriftiness that holds back from lashing out with a credit card on Amazon. Service Most Silent: The Navy’s Fight Against Enemy Mines, a 1955 history by J.H. Taylor, is available on Amazon but only because it was reissued in 2008. It's an understated, stiff upper lipped adventure story about bomb-disposal in WWII. The principal voice is that of Cmdr JDG Ouvry who was the first to dismantle an unexploded WWII parachute-mine on 23 Nov 1939 and lived to be nearly 100. Many of his team died in harness, leaving only small fragments behind. Picking up the pieces of your colleagues was part of the job-description. The book was interesting personally because HMS Vernon was Ouvry's HQ and I lived there, with a little light cross-dressing, for a year in the 1960s. The book is interesting scientifically because it documents an arms race with each side doing research to out-psych, out-manoeuvre and out-engineer the opposition. To devise counter-measures, somebody had to work out what the triggers were and it was cheapest and quickest to do some dimantling and diagnostics by hand even if you lost a few. Standard practice was for the backup team to watch and listen to every move from a safe distance: if the process went horribly wrong at least you had a partial solution for the next time. There's an amazing contemporary tale of mine-sweeping in the comments of this piece about Ourvy on the BBC. Despite the cross-dressing, I am lad enough to have an interest in explosions and have written about them in previous Blobs: TNT - nitroglycerine - BLEVE - Tannerite - deflagration - gunpowder.

That's all 75+ years ago but there are many dirty little wars going on across the world. I don't think you can stop war by pretending that it doesn't happen any more; even by looking at it, as I do from my sofa, from far far away.  I know a few people who signed up for the military:
  • one had a tour of duty in the Azores checking the quality of the local milk for the USAF; 
  • another joined the Irish Defense Forces because there were no jobs in Enniscorthy in the 1970s - the closest he came to war was being accidentally nearby when an IRA bomb went off on Talbot St, Dublin; 
  • and one chap of my daughters' age joined the Irish army because he really like playing in big bands. 
From my sofa, I've written a few pieces about land-mines:
in order to do that, I've had to educate myself: but there's a lot I don't know. Until yesterday, for example, I was ignorant of the difference between anti-personnel mines APMs and anti-personnel improvised explosive devices AP-IEDs. Princess Di and many others campaigned with such high-profile fervour against APMs that the Ottawa Treaty was signed and ratified in December 1997 by Canada, Ireland and Mauritius; followed rapidly or eventually by another 159 sovereign states. 34 countries contrive to reconcile their membership of the UN with a failure to sign up to Ottawa. This ragamuffin motley crew, who presumably are either making, selling or using APMs, include China, Egypt, India, Israel, Pakistan, Russia and the USA - check your country here.

Be careful what you wish for, though. Static charges detonated remotely i.e. mines, have clear utility in the math of war. That's why so many APMs were bought and distributed with such abandon across fields and roads in the Third World. APMs manufactured by recognised munitions firms with high standards of reliability and quality control may be expensive but they are unlikely to blow your own chaps up. Indeed, APMs were designed to disable rather than kill the opposition because a live and writhing casualty ties up more resources than a corpse. If Ottawa destroys the quality market, or if you could never afford it, then you have to make you own kit aka IEDs. These are much less likely to be safe, reliable and uniform in effect. In their campaigns against the status quo ante in North Ireland and a brighter united future for Ireland, the Provisional IRA carried out a sustained campaign of violence against the British establishment. In the 30 years between 1970 and 2001, the Provos relied extensively on IEDs and managed to kill 160 of their own people because they really weren't great at the precision engineering required.

My pal Mac saw it as his duty to volunteer his surgical skills for the Canadian Army serving with The Coalition in Afghanistan and Iraq. He's been out there again recently cleaning up the bloody mess that is left in the wake of a war-party. In such circumstances the medical effectives do the best they can for each presenting patient, of course, but in this case they've also gone the extra mile to gather some data on the extent and nature of the injuries [OpenBMJ paper PDF]. They do this so that first responders are better informed and can apply first aid to the places which are more likely to have been injured: to enhance best practice.
From the data, don't worry too much about neck-bracing your IED casualties (currently standard practice); please spend more time on stablising the pelvis and preventing bleeding, which cannot be dealt with by tourniquet, from the bottom. Apply a tourniquet if there is any limb left even if it's not bleeding now because when blood pressure picks up it may start bleeding then. Mac's team only looked at a cohort of 100 IED casualties but they compared their findings to earlier studies of APM damage.
Summary, AP-IEDs are much worse than APMs: they kill more people, they amputate more limbs and they deliver more contaminated soil to the peritoneal cavity. War is hell. But some aspects are more hellish than others. IEDs are crude, horrible in their effects, and indiscriminate in their victims. There's got to be a better way.
"It is the greatest of all mistakes to do nothing
because you can only do little"
Sydney Smith

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