Retrospective observational study of characteristics of persons with amputations accessing International Committee of the Red Cross (ICRC) rehabilitation centres in five conflict and postconflict countries

ObjectivesLimb amputation incidence is particularly high in fragile contexts due to conflict, accidents and poorly managed diabetes. The study aim was to analyse (1) demographic and amputation characteristics of persons with any type of acquired amputation (PwA) and (2) time between amputation and first access to rehabilitation in five conflict and postconflict countries.DesignA retrospective, observational study analysing differences in demographic and clinical factors and time to access rehabilitation between users with traumatic and non-traumatic amputations.SettingFive countries with the highest numbers of PwA in the global International Committee of the Red Cross database (Afghanistan, Cambodia, Iraq, Myanmar, Sudan). Cleaned and merged data from 2009 to 2018 were aggregated by sex; age at amputation and registration; cause, combination and anatomical level of amputation(s); living environment.ParticipantsAll PwA newly attending rehabilitation.ResultsData for 28 446 individuals were included (4329 (15.2%) female). Most were traumatic amputations (73.4%, 208 90); of these, 48.6% (138 01) were conflict related. Average age at traumatic amputation for men and women was 26.9 and 24.1 years, respectively; for non-traumatic amputation it was 49.1 years and 45.9 years, respectively. Sex differences in age were statistically significant for traumatic and non-traumatic causes (p<0.001, p=0.003). Delay between amputation and rehabilitation was on average 8.2 years for those with traumatic amputation, significantly higher than an average 3 years for those with non-traumatic amputation (p<0.001).ConclusionsYoung age for traumatic and non-traumatic amputations indicates the devastating impact of war and fragile health systems on a society. Long delays between amputation and rehabilitation reveal the mismatch of needs and resources. For rehabilitation service providers in fragile settings, it is an enormous task to manage the diversity of PwA of various causes, age, sex and additional conditions. Improved collaboration between primary healthcare, surgical and rehabilitation services, a prioritisation of rehabilitation and increased resource provision are recommended to ensure adequate access to comprehensive rehabilitation care for PwA.

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An Account of ‘Life after Guantánamo’: a rehabilitation project for former Guantánamo detainees across continents

Torture Journal ◽

10.7146/torture.v27i2.97218 ◽

2017 ◽

Vol 27 (2) ◽

Author(s):

Polly Rossdale ◽

Katie Taylor

Keyword(s):

Psychological Control ◽

Service Providers ◽

Home Country ◽

International Committee ◽

Red Cross ◽

Project Coordinator ◽

Guantanamo Bay ◽

Clinical Observations ◽

High Commissioner ◽

Future Work

This paper describes a project established in 2009 by the human rights charity, Reprieve, to coordinate rehabilitation for men who have been released from long-term detention at the US military base of Guantánamo Bay. The majority of the men referred to the project were deemed unable to return to their home country because of the risk they faced of torture or other persecution and were therefore resettled in a third country. This paper also refers to Tunisian former Guantánamo detainees with whom Reprieve worked, who had initially been resettled in a third country but then following the Jasmine Revolution and the fall of the Ben Ali regime, were able to return to their home country. Reprieve then provided assistance to them and their families under the Life after Guantánamo in Tunisia project. This paper briefly outlines the abuse and nature of psychological control at Guantánamo and, based on the first-hand experiences of the Project Coordinator and Caseworker, offers non-clinical observations of the apparent consequences of this control on the former detainees who were referred to the project. The Life after Guantánamo project facilitated social, medical, psychological, legal and financial assistance in partnership with local service providers and through liaison with host governments and intergovernmental organisations, such as the International Organisation for Migration (IOM), United Nations High Commissioner for Refugees (UNHCR) and the International Committee of the Red Cross (ICRC). The paper recounts the type of assistance provided, highlights some of the challenges faced and, based on learnings made over the project’s eight year duration, makes recommendations, for future work with former Guantánamo detainees and others who have been detained and subject to torture and inhuman and degrading treatment in the ‘War on Terror’.

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Do wars ever end? The work of the International Committee of the Red Cross when the guns fall silent

Revue Internationale de la Croix-Rouge/International Review of the Red Cross ◽

10.1017/s1560775500183786 ◽

2003 ◽

Vol 85 (851) ◽

pp. 465 ◽

Cited By ~ 5

Author(s):

Marion Harroff-Tavel

Keyword(s):

International Committee ◽

Red Cross

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Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

Hämostaseologie ◽

10.1055/s-0037-1619773 ◽

2012 ◽

Vol 32 (S 01) ◽

pp. S39-S42 ◽

Cited By ~ 1

Author(s):

S. Kocher ◽

G. Asmelash ◽

V. Makki ◽

S. Müller ◽

S. Krekeler ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Observational Study ◽

Retrospective Observational Study ◽

Frequent Change ◽

Patient Age ◽

Treatment Regimens ◽

Patient Âgé ◽

The Relationship ◽

Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

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