MISSING PIECES - Inter-Parliamentary Union
MISSING PIECES - Inter-Parliamentary Union
MISSING PIECES - Inter-Parliamentary Union
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THEME 3<br />
texts it will not be possible to achieve a comprehensive and integrated<br />
victim-services policy, but the coordination of policy development between<br />
the different sectors that interact with victims of violence is a reasonable<br />
policy strategy for strengthening victim services. . . .It is equally important<br />
to identify institutional policies guiding service provision to victims of<br />
violence, for example in hospitals, specialised medical and forensic services,<br />
police stations and counselling centres.” 39 Assistance to survivors of gun<br />
violence raises the same challenge – identifying where support services<br />
and assistance can be integrated into existing systems using approaches<br />
that would develop, strengthen or re-orient services, rather than creating<br />
vertical specialised services in resource-limited settings.<br />
Studies in a number of low income countries note that low-cost sustainable<br />
improvements can be made to health care through training of ‘first<br />
responders’ and existing medical staff, as well as better organisation of<br />
existing resources and equipment. 40 This is a critical policy response governments<br />
can ensure exists or provide assistance for. The WHO notes that<br />
“. . .50-80% of trauma deaths occur before arrival at hospital in both developed<br />
and developing countries, rapid and effective trauma care can substantially<br />
reduce death and disability following injury.” 41 One study confirmed<br />
that improvements in the provision of pre-hospital trauma care are possible<br />
by training those most likely to be at the site of an accident first. 42 As<br />
one example, long distance truck drivers in Ghana—often first on the<br />
scene of road-accidents—were trained in basic emergency trauma care to<br />
bolster weak formal emergency medical services with positive results. The<br />
same type of approach can be considered in many instances for trauma care<br />
related to gun violence.<br />
Much of what low income countries need to do to prevent deaths occurring<br />
soon after injury is well within the reach of these economies—<br />
they are simple and relatively inexpensive interventions which are<br />
not being instituted yet. And most don’t require surgeons—but first<br />
aiders, nurses, drivers . . .<br />
—Dr. Olive Kobusingye, Ugandan trauma surgeon and prevention advocate 43<br />
Another study of mine-affected areas in Kurdistan and Cambodia<br />
also noted the value of investing in training, and providing or reorganising<br />
supplies and equipment. In these settings where ambulances still remained<br />
unavailable, death rates among injured people fell from 40 to 9 per cent<br />
thanks to training of first responders, and advanced training in trauma<br />
71