SMHS Casualties: indicative of brutal force

A medical assessment of casualty list of SMHS hospital of Saturday, the 9th of July is indicative of brutal force used to combat protesters.
SMHS Casualties: indicative of brutal force
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A medical assessment of casualty list of SMHS hospital of Saturday, the 9th of July is indicative of brutal force used to combat protesters. It also gives lie to the statement of Additional Director General of Police (ADGP) SB Sahai, wherein he stated in a press conference on July, the 9th that forces were compelled to open fire when the protesters entered police stations and camps of armed forces. The lie was repeated by government spokesman-Nayeem Akhter in the press conference of July, the 10th.  Out of 55 names in the list, as many as 19 have pellet injuries in the eyes, the eye injuries hiked to 90 plus over subsequent days.  Many stand to lose their eyesight permanently. Given that most of them are in their teens or early twenties, it means a major life-long impairment, a living hell.

It is highly improbable that protesters alleged to have entered police stations or camps of armed forces personnel would be combatted with pellet guns. The use of pellet gun as crowd control measure has obviously been wide and not necessarily used for crowds alleged to have entered police stations and camps. ADGP Sahai was at pains to stress that lethal measures of 2010 have been to a large measure set aside, and the priority remains the use non-lethal measures of crowd control. 19 eye injuries out of initial list of 55 constitute over one third cases being registered in hospital casualty and it indicates that supposedly non-lethal weapon has been used lethally. It is catastrophic. 

Pellet gun is propagated to be non-lethal; however over years of working in trauma units, I have seen its lethal effect.  From a short distance, pellet fired from a pellet gun could cause lethal injuries. It can puncture vital thoracic &/or abdominal blood vessels, as well as damage internal organs in thoracic and abdominal cavity. In 2010 pellet injuries caused recorded deaths, including that of a Maisuma youth—a cousin of JKLF leader—Yaseen Malik. He sustained internal vascular and visceral injuries and in spite a massive blood transfusion and surgical repair died of kidney failure—a result of being in a state of hypotension (low B.P) over considerable period of time. Out of 55 cases, 30 odd cases are pellet injury cases, which includes the 19 cases registered as pellet injury to eyes, some cases have associated pellet injuries to head, face, chest, abdomen and limbs. As already noted, apart from fatal injury to eyes, these injuries could be fatal to internal organs or vessel depending on other factors, like distance at which the pellet is fired and the target.  

An indication of how brutal has been the response of armed forces could be gauged from the fact that barely seven cases out of 55 cases registered on July, the 9th have been below the waist injuries. This indicates, yet again that effort has been to kill or maim. Six cases of bullet injury to the abdomen are recorded, which could be fatal, as vital organs called the visceral organs, because of being deep-set are located in the abdominal cavity. Besides, vital blood vessels, such as abdominal aorta and its many branches supplying various visceral organs are located in abdominal cavity. An injury to these vital visceral organs &/or blood vessel could be fatal. Much depends on how soon after sustaining the injury; the injured is brought to hospital. And, how soon, he is operated, given the fact that operation theatres are limited, with many casualties to cater. I have had an experience of such emergency situation, having worked in trauma units of Iranian hospitals during a decade long Iran-Iraq war. On occasions, cases which could otherwise be saved face fatal consequences, as infrastructural facilities were disproportionate to number of casualties to cater in the given space of time.  

Umar Shafi, a 16 year old youth from Achbal with a bullet injury to the head died, and it is recorded that his dead body was handed over to the family. Showkat Ahmad Rather, 22 years old from Bijbehara is registered as having bullet injury on left side of neck. He is noted to be critical.  These two cases are again evidences of above the waist fatal injuries.  I am not sure whether seven below the waist injuries could be categorized as less fatal; as many as three cases are registered as bullet injuries to the buttock, otherwise known in the medical idiom as gluteal region. Bullet injury in this region can cause fatal injury to the pelvic bone and pelvic organs. Fracture of pelvic bone can cause major blood loss, as pelvic region is highly vascular. Urinary and genital (urogenital) organs are located in this region. Besides injury to urinary organs, injury to genital organs could be fatal for reproductive system. Another case is registered as bullet injury to left thigh. This injury could also be fatal, if the bullet pierces the femoral artery—one of the major vessels in the body. 

The conclusion on clinical grounds is obvious, brutal force has been used with lethal effect. 

Yaar Zinda, Sohbat Baqi [Reunion is subordinate to survival]
(The author is doctor in medicine, a social activist, and a senior columnist)

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