Beginning in the mid-1990s, medical studies reported an ominous trend toward the use of larger caliber firearms. But recent study found that despite that trend, in-hospital death rates from gunshot wounds had not changed. The study attributed this seeming paradox to improvements in treatment, including resuscitation and surgical techniques.

But to survive a serious gunshot wound, a victim must first make it to the hospital. Large-caliber gunshot wounds meant more victims were dying in the field and being transported to the morgue rather than the hospital. Doctors in the Hospital see no patients with gunshots to the heart even though, they appear so innocent. The health ministry reported 15 to 20 fatalities a year involving gunshot wounds to the heart, meaning that all the victims died before getting to the hospital. The "ominous rise of semiautomatic weapon use in assaults in the last 20 years" may mean an end to further gains in preventing gun assaults from becoming homicides, according to a 2002 study at the University of Massachusetts Amherst.

 One survey found that about 85% of the crimes against people occurred outside the home, thus underscoring the importance of making it easier for people to legally carry concealed firearms. Gunshot and blast wounds are increasingly seen in civilian practice, Military and civilian wounds however differ in several key respects, Military wounds are often heavily contaminated with delays in treatment and The same principals apply to their treatment. But when you are bleeding from a wound or have a hole in one of your organs, what works best could be gotten from a dedicated trauma team that knows what to do, when to do it with the minimal amount of human error possible.

The bullet damage is determined largely by the type of tissue it hits and the kind of bullet, whether it is a piercing full-metal jacket or a hollow point, which widens on impact. The route it, creates, can cause a permanent cavity in tissue and organs. That cavity is at least as wide as the bullet - and wider if the bullet turns sideways as it travels through the body. Hollow-point bullets create a wider permanent cavity than a full-metal jacket. Bullets also create a much wider temporary cavity, a rapidly expanding and collapsing tunnel caused by a sonic pressure wave. If the bullet slashes through flexible tissue, such as muscle or the lungs, the tissue can bounce back more easily. However, if the bullet hits an organ such as the liver, with extremely dense tissue, the bullet can do severe damage. There are no elastic components (in the liver); there is a lot of bleeding. The brain is especially vulnerable because it is enclosed in bone, which doesn't allow the energy from the bullet and the resulting pressure wave to dissipate as easily. Bullet size is especially important in a head shot.

 If you go to the hospital or clinic or anywhere else to seek any kind of medical treatment, whether it is from a stab wound, a bullet wound or an "alleged" rape, either your physician is responsible for abating or arresting blood suction for proper rescue of the victim at that time. The healthcare industry may not wait for trials and appeals, etc. to be handled before they save life, as far as justice is valued. It is your responsibility when you go to court against your accused attacker to ask for medical treatment to be handled while a case could get established. And if your alleged attacker is found wanting, then yes, it becomes your responsibility to face the law having revived at the hospital. This is not just the way they do it here in Nigeria; it's the way they do it in advanced countries. Let us stop twisting the truth, call a hospital in New Hampshire, Montreal or Sidney and ask them if their policy is any different.

One way of trying to ascertain how many criminals have been wounded by armed victims is to get emergency room figures. Problem is, many criminals will not go to a hospital with a bullet wound that they can treat themselves. This avoids the risk of the mandatory report of their bullet wound ending up with the police who might then determine that they were wounded during the commission of a crime. For this reason, it is not an easy matter to get accurate data. Anti-gunners have argued that there are few hospital-based on emergency room bullet wound reports. Victims are happy to accept any (and only) those data that support their predetermined conclusions.

Nigerian doctors have strangely allowed themselves to be bound with the rope of ridiculous rules. Some of the rules do not even exist. Doctors insist on seeing a police report before treating victims of automobile accidents. Doctors have a duty to treat a person injured in auto accident, even if he caused it by driving while drunk. The police have not said that doctors should not treat auto accident victims, at least not to our knowledge. The police, until two years ago, warned doctors not to treat people with gunshot wounds until they were given a police report authorizing them to do so.

The doctors obeyed the order, which did not have the force of law, with unquestioning slavishness. People shot by robbers that could have been saved were allowed to die. Hospitals, including teaching hospitals, refused to treat gunshot victims, or even offer them first aid until they saw a police report. Many private hospitals told the people who brought the victims that they did not want “police trouble” and should take them to another hospital. Needless to say that most of the victims did not survive.

A national outcry against the directive of death and its facilitation by doctors forced the police to issue a statement. The police authorities said it had never told doctors not to treat people with gunshot wounds until the police gave them the permission to do so. They said they had merely insisted on the hospitals informing the police after stabilizing the condition of the victims and making them available to be questioned. The police lied shamelessly. They had always threatened doctors with arrest if they treated people with gunshot wounds without first obtaining police permission. They said they gave the order because many armed robbers managed to escape after being shot by the police. But everybody knows that shot armed robbers do not go to hospitals for treatment. They usually go to herbalists. Doctors are still refusing to treat gunshot victims, and even accident victims, though the police have clearly stated that their request – and not a rule – is that the doctors should inform them immediately after stabilizing the condition of the patients.

The Government of Nigeria should consider reviewing separate stand-alone legislation requiring mandatory reporting by custodians to police services of gunshot wounds, stabbings and severe beatings. It is worth emphasizing that no other law-maker, other than Hon Chukwudi Mayor Eze, has taken formal steps to introduce this type of legislation. Whatever may be the position in this country, the mandatory reporting of gunshot wounds is not Nigerian law. The ongoing law did not provide any details about the contemplated legislation (e.g. when, exactly, reporting would be required; what, exactly, would be permissible uses of the information; how, exactly, police services would protect the information from improper use or disclosure; whether custodians would be granted immunity from civil or criminal proceedings for good-faith reporting).

Nonetheless, despite its high level of generality, some observations may be made about the Recommendation's constitutional viability and political advisability. Mandatory reporting legislation, I suggest, is not necessary; current legislation permits reporting when it is warranted. The legislation, moreover, would face two types of constitutional difficulties: the legislation may fall outside legislative authority and it may not be sustainable under the proposed bill. And even if the legislation could be supported under the proposed bill, there are good reasons for not enacting it.

When he came out in 2002 to vie for chairmanship of Orlu L.G.A, Hon Mayor Eze promised to do one term only and stuck to it not because he was afraid of anybody or that may not win again but to respect the age long zoning in my local government. Besides, life is about moving forward, about further challenges. Having acquitted as an effective chairman; the time to move forward remains now. Having served as the ALGON chairman in Imo State, a position that exposed him, he felt going to the National Assembly could bring down to his people what have been denied them. Hon. Mayor Eze, who was the sponsor of the bill, declared that victims of bullet wounds were usually not treated following this legal obstruction, which affects more innocent victims than robbers since the robbers could make specialized arrangement for the treatments of their bullet wounds. This was neither the position of the Constitution or the practice around the world. The refusal of hospitals to treat gunshot wounds resulting from a police directive was made in good faith, yet a live lost is a destiny Nigeria loose. "Doctors and nurses are not happy that they are not saving lives,"

Mbonu Linus Nwabueze (FB) writes from Port Harcourt

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Robot  # 1 | 22.09.2008 06:04

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