An indispensable and trying task: casualty clearing
Surgeons have to decide on the order in which the war wounded should be treated when they arrive in ICRC hospitals, especially when the number of admissions is high.
Such a procedure is unknown in industrialized countries where the aim of surgical units is to do as much as possible for everyone immediately, where hospitals are well-equipped, everything is in work- ing order and one rarely has to deal with large-scale disasters. But when a surgeon receives dozens of casualties in the space of a few minutes, sorting is indispensable. Decisions must be taken on techni- cal grounds: six hours of work may be necessary to save a certain patient-six hours during which others, less seriously wounded, might be operated on. Casualty clearing therefore involves sacrificing certain very serious cases in order to save other less severe ones. It is extremely difficult to make this selection and to interpret the criteria on which it is based. Only the most experienced surgeons must be entrusted with this task. It is frustrating for good surgeons to remain outside the operating theatre doing the casualty clearing work while their youn- ger colleagues are performing operations, but necessary when emergency surgery is required by large numbers of victims.
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At the ICRC paraplegic centre (Pascal Gondrand)
THAI-KAMPUCHEAN BORDER:
hazardous conditions, a permanent way of life for 240,000 refugees
The dry season:
camps in the evacuation sites
As happens every year along the Thai- Kampuchean border, the
the refugee camps were the scene of fighting, and the 240,000 people trapped in this buffer-zone again had to seek refuge within Thailand. In 1985, the Khmer refugees did not return to their camps at the end of the dry season, during which the fighting had taken place. They were still living in the evacuation sites where, although their plight is precarious, a minimal degree of safety is guaranteed.
THAILAND
As happens every year, the ICRC and UNBRO (United Nations Border Relief Operation), in co-operation with the Thai authorities, drew up emergency plans for the rapid evacuation of the civilians living in the combat
zones.
The two ICRC hospitals in Kao-I-Dang and Kab Cherng had to deal with an influx of wounded during the violent
10
KHAO -I-DANG
Aranyaprathet ●
Site 8⚫
Borai. Site
KAP CHERNG
Site F
Natra Samrong Kiat
Site B
Site 2⚫
• Site
Nam Yum
LAOS
Green Hill
Site E
Ta Luan Site
TONLE SAP
KAMPUCHEA
PHNOM PENH
clashes which occurred in the camps. In January, the four surgical teams seconded to the ICRC by the Red Cross Societies of Finland, the Federal Republic of Germany, Japan, the Netherlands, Norway and Great Britain were joined for two weeks in Kao-I-Dang by an emergency team from the Thai Red Cross and by an extra surgical team from the Norwegian Red Cross. In March, the influx of war wounded to the hospital in Kab Cherng (60
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