Small Arms Work
Report on current work &
workshop from 1st IPPNW Students' Meeting of ISCASA
(The International Student Coalition to Abolish Small Arms)
Report on current work &
workshop from 1st IPPNW Students' Meeting of ISCASA
(The International Student Coalition to Abolish Small Arms)
ISCASA Meetings
Workshop held March 8th during the IPPNW Students' Congress, 2008
Notes from ISCASA Meeting, March 8th, 2008, New Delhi, India
Moderator - Tova Fuller, NSR - US
Current Countries/Participants in ISCASA
Existent IPPNW Materials and Web Resources
Reports on Small Arms Work (Appendix)
Safety 2008
A report from Cesar Aleman, of Nicaragua.
Dear friends last march World Conference on Injury Prevention and Safety Promotion in Merida, Mexico, was the first one held in a Spanish speaking country, and by all accounts, it was a great success. There were more than 1,000 participants from over 120 countries. There was the great opportunity to have six countries members of IPPNW bringing 13 papers and posters of violence prevention.
9th World Conference on Violence Prevention and Safety Promotion otherwise Safety 2008
I had the chance of meet once again members of IPPNW from Nigeria, Zambia, El Salvador, Puerto Rico, United States and Nicaragua.
As IPPNW Latin American, student’s representative was a new experience to have the opportunity to talk about intra family violence and maltreatment affecting children collectors of trash. There was a world conference, which everybody spoke how to prevent the violence and to have peace in our new challenging society
The enthusiasm of the conference participants – some had never attended an international meeting before – was electric, and the conference sparked in them – and in all of us – the desire to refocus and sustain our efforts to prevent injuries and promote helmet use.
Abstract
Intra-Family violence and maltreatment affecting children collectors of trash in ¨El Fortin¨ León, Nicaragua 2007
Cesar Aleman
7th year medical student
Latin American student representative of IPPNW
Introduction
Child Abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.
(WHO, 1999)
¨Candies in the hell¨
It was a Cross-sectional study in Leon, Nicaragua.
Nearly half the women reported their children witnessed their abuse.
Children of abused women more than
• Twice as likely to suffer from learning, emotional and behavioral problems.
• seven times as likely to be abused
Objectives
Describes techniques of aggressive behavior associated with children collectors of trash and the different types of violence they have in ¨El Fortin¨ Leon, Nicaragua
Determining levels of intra-family violence associated with children collectors of trash
Material and methods
The sample consisted of 100 children and adolescents from 6 to 16 years old collecting trash located in El Fortin, Leon in Nicaragua. The data was collected from a survey in which the children perception of violence in their homes was determinate; data was statistically analyzed by using Epi info 6.0
Results
A high percentage of children had difficulty in communicating with their parents and felt rejected and a lack of love from some of the members in their homes. 92% of those surveyed had a family atmosphere characterized by high levels of violence like physical violence (pushing, hitting, guns and knife attacks). The second most frequent reported type of violence was psychological, 67% of them had had insults with bad words and the rest of them had maltreatment from their parents in front of everybody but unfortunately in just 3 cases the children didn’t have any affections of the psychological maltreatment
Discussions and conclusions
All the children say no. “I don’t want to be mistreated anymore” and they prefer to have other different punishments actions with another way. Just 3% said “It doesn’t matter as they (parents) mistreat myself” constituting a dangerous attitude. Almost all of them felt well with their family relations and they do not desire to change it. They ask give them love and affection than strike them less. Almost all of them said that they desired to be an adult because they wouldn´t like to be injured anymore. They reject the work in the street and they desire to be into the school. The ones that prefer to work are those who are mistreated with frequency (everyday). All children’s families lives in extremely poverty situation
Experts agree that the most effective way to address domestic violence is through a coordinated community response. This requires an effective coordinating body, a state or countywide family violence council that has a public mandate. The family violence council must bring together responsible representatives of public agencies, the court system, service providers, and advocates who have the will and the authority to make changes, the goal is to develop:
1. a comprehensive program of services for abused children;
2. an effective criminal justice response that holds batterers accountable and increases the safety of children
Children and adolescent collectors of trash in El fortin, Leon, Nicaragua are affected by many situations concerning intra family violence
Summary of Small Arms Work in Papua New Guinea
Summary of the scoping study on small arms violence in the Highlands of Papua New Guinea
Andrew Winnington
5th year medical student
University of Otago, Wellington
IPPNW (NZ) is developing a Pacific-focussed program of arms control and disarmament. Papua New Guinea (PNG) was identified in the Small Arm Survey 2006 as a fragile nation chronically affected by armed violence with the potential to destabilise peace and security in the western Pacific. Researchers found illicit firearms in the Southern Highlands are several times more likely to be used in homicide than a similar gun in the world's highest-risk countries, namely Ecuador, Jamaica, Colombia and South Africa.
Project development began at IPPNW 17th World Congress Helsinki 2006. IPPNW's Aiming for Prevention program coordinator, Maria Valenti provided support stating "It is great that you are pursuing research on small arms violence in PNG. More injury research needs to be done to quantify the human toll and design appropriate interventions."
A scoping study was designed with two objectives; firstly to solidify links with relevant organisations in PNG to guide efforts to improve injury epidemiology and secondly to promote peace and security in the Pacific region by producing information that contributes to raising awareness of the level of small arms violence.
A Peace and Disarmament Education Trust (PADET) grant of $3512 and supplementary funding by IPPNW (NZ) allowed 5th year medical student [AW] to work in Papua New Guinea for two weeks in November 2007.
Links were solidified with several relevant organisations in PNG including the Coalition to Stop Gun Violence (CSGV) that advocates for stronger action to combat gun violence; specifically for the government to create a gun control body to commence the process of monitoring and eradicating guns.
A televised press conference followed a coalition meeting and featured Vavine Gabi who had just returned from representing CSGV at Global People's Consultation on Arms Trade Treaty in New York (side event of the 62nd UN General Assembly First Committee). Vavine Gabi's tragic 'One Bullet Story' involves watching her mother fatally shot in the head one day after her 16th birthday during a car-jacking by six youths (they remain unprosecuted).
Written support was obtained from Office of the Secretary for Health and the Southern Highlands Provincial Government to allow the National Research Institute to apply for a three year research visa. Links were also solidifed at the University of PNG Medical School to allow the future transfer of methods to local researchers, and at Port Moresby General Hospital and Mendi Hospital in the Southern Highlands Province for future research.
Information was collected from Mendi Hospital to contribute to raising awareness of the level of small arms violence in the Pacific. Injury data were obtained from Mendi Hospital Admissions Register for the January 2000 to August 2007 period to compare with 1990-95 published data. This included a demographic breakdown of all injury types (and geographic information for weapons-related injuries) and will allow for an assessment of the relative impact of tribal fighting in Mendi (Dec 2001 – Sept 2002) and the impact of martial law during State of Emergency (Aug 2006 – Aug 2007). Data was also obtained for a five year period from the Surgical Ward Admissions Register to assess the average inpatient stay for trauma admissions (days in ward) for each type of injury so a financial cost of each injury can be derived. Specific details were also collected from patient files including the history of presenting complaint and surgical procedures performed for each weapons-related injury (gun n=36, spear and arrow n=20) and from a random sample of knife wounds (n=50) that predominated the cause of injuries in the Southern Highland Province. Outpatient data from 2000-2006 period were also collected to calculate accidents and injuries as a proportion of total monthly attendance.
A lot was accomplished in the two-week visit to Port Moresby and Mendi primarily because of the desperate need for local research evidence and interventions to address the high burden of injuries. Everyone approached was welcoming and extremely helpful because it is obvious the nation is spiralling out of control and into violence and chaos. It is dangerous to go out at night in Port Moresby; of the small number of women I met there, one, a journalist, was robbed the day before I spoke to her and another, an Oxfam worker, was robbed the day after. When I was in Mendi, 30 tribesmen armed with guns, bows and arrows and spears attacked a police-escorted convoy 40 minutes away. They kidnapped the policemen and took seven automatic weapons. The following day a shoot out with police re-enforcements had left one tribesman dead and another, who was shot in the face, under armed guard in Mendi Hospital.
It is hoped that the results of this study will be presented at the IPPNW World Congress in India in March 2008 as well as being fed back to key people and organisations in PNG. Any support and funding for this and further work would be much appreciated.
Nigeria - IPPNW Nigeria, Raypower FM peace Project
THEME OF PROJECT BRINGING PEACE TO THE PEOPLE
PROJECT LOCATION: JOS UNIVERSITY TEACHING HOSPITAL (JUTH) JOS – PLATEAU STATE, NORTH CENTRAL ZONE, NIGERIA
NAME OF COORDINATOR ONAZI OGEBE
INTERNATIONAL ADDRESS IPPNW
727 MASSACHUSETTS AVENUE
CAMBRIDGE MA 02139 USA
WWW.IPPNW.ORG
START AND END DATE MAY’08 TO APRIL ‘09
OUTLINE:
1. DEFINITION OF KEY WORDS
Peace in the context of this project is referred to as a sound atmosphere that respect the coexistence of peoples with different cultures, belief and values, but yet living together with tolerable conflicting opinions.
People on the other hand are a group of individuals with dignity, rights, values and sense of responsibility coexisting together for the purpose of procreation, inhabitation and sustainable development.
2. PROJECT DESCRIPTION
According to the conventional knowledge, peace is defined as a state of rest, and this could also mean a period of non-violence, which is as well related to harmony. Over the years, Nigeria as a country has lost so many resources in the nature of human and material potential, owing to violence of one kind or the other. This confusion has brought about backwardness and paralysis to business growth and economic development leading to inadequate manpower and lack of peaceful and sound environment for productive national and international investments.
It is in this light that this project proposes to use the strongest means of information dissemination to reach and give the people in the country and beyond (Africa) the message on the change of focus and the need for a renewed mindset that will make them think positively about themselves and others, especially on the side of values and dignity.
3. BACKGROUND
This is an IPPNW (International Physicians for the Prevention of Nuclear War) designed project in collaboration with Raypower FM to bring peace to people in Nigeria and Africa communities through media for the purpose of preventing arms trade and all forms of violence that could emerge out of a distorted atmosphere of peace. IPPNW is a non-partisan, global Federation of National Medical Organizations in 58 countries dedicated to research, education and advocacy relevant to the prevention of nuclear war, the demilitarization of the world, abolishment of small arms trade and the paradigm shift needed to create a climate of peace and stability.
Benching on the numerous achieving efforts and records of the IPPNW since formation in 1980: the winning of the UNESCO-Peace prize in 1984 and the Nobel peace prize in 1985, this initiative wishes to create an extension of service for more impact and wider awareness on the need for peace through love and respect, using information dissemination tools available that can change peoples’ focus and mind from instigating any process that leads to disorderliness and lack of stability. The project will be test-run for one-year period and will engage all stakeholders in education, research, advocacy and other sectors in taking the task of injury prevention and peace building to great heights in our societies.
At the National level, the organization has made significant achievement since the Nigerian chapter started in 2004, and we are still working hard to expand our reach to the populace using some of the strategies and approaches that had worked at the international and national levels even as we strive to evolve new ones.
4. STRATEGIES AND ACTIVITIES
5. PAST ACTIVITIES AND EXPERIENCE
6. OBJECTIVES
7. TARGET AUDIENCE AND MARKETABILITY OF PROJECT
a. Target audience
Human pensions in Nigerian and African communities; starting with the areas cover by Raypower Jos, Plateau State: - Plateau – Bauchi – Gombe – Nasarawa – Kaduna States
b. Marketability of the project
8. ANTICIPATING IMPACTS
9. WORKING BUDGET FOR THE 1-YEAR PERIOD IN 2008
Description Unit Cost (N) Total cost (N) Total cost ($)
Air time cost 12 16,389.00 196,668 1530
Appearance fee for guests 36 10,000.00 360,000 2800
Winning packages for the public (from sponsors)
i. Handsets 6 8000 48,000 375
ii. T-shirts 6 1000 6,000 47
iii. Refill cards 24 1000 24,000 93
TOTAL 84 36,389.00 634,668.00 4920.00
The appearance fee will cut across an experienced presenter in the radio house and two other researchers that will communicate to the public the topic for the particular month.
10. PROJECT TIME LINE
May’08 Introducing peace to the people.
June Small arms trade and its effects.
July Governmental policies on small arms
August One bullet story.
September Conflict resolution in the Nigerian society.
October Nuclear energy plant and its hazards.
November Peace and human dignity.
December Why small arms trade in our society should be abolished.
January’09 Nuclear waste dump: the Nigerian perspective.
February Individual responsibility on peace building.
March Protection of human rights: the refugees perspective.
April’09 Peace building for business development: A bane for economic growth.
11. CONCLUSION AND KEY CONTACTS
a. Conclusion
To bring peace to the people, the people themselves have to be ready and make their own resolution on the need for it and show so much interest and responsibility to protect life, respect dignity and have sustainable development. In a way of ensuring this by all means possible, i.e. whether the culture of peace should be instituted by the people themselves or through other mechanisms, this project focuses on reducing and preventing the proliferation of arms that could instigate a process violence, which may lead to harm, injury and death.
Equally vital area of the project is the weakening of all avenues that seek to make the availability and use of violence and crisis to distort peace of the people possible; so that countries hard - earned progress in development of human and material resources will be sustained.
b. Key Contacts
New Zealand - A PILOT MULTINATIONAL INJURY SURVEILLANCE STUDY
A PILOT MULTINATIONAL INJURY SURVEILLANCE STUDY
EXECUTIVE SUMMARY
The purpose of this pilot study is to systematically collect, review and evaluate the context in which specific external injuries occur in a great diversity of socio-cultural populations. The second purpose of this study proposal is to test the implementation of an injury surveillance system in countries where no such system is in place (i.e. Bolivia, Puerto Rico, Zambia, Democratic Republic of Congo, Nigeria, and Kenya). Thirdly, the study aims to collaborate with local efforts in countries where an injury surveillance system is already in place (i.e. Uganda, Colombia, and El Salvador) or in process of implementation (Brazil). The fourth and last objective is to provide evidence-based recommendations to local government health authorities to address the incidence of injury in their communities from a public health perspective, as well as community advocates and public policy makers at the local, state, regional and international levels in order to inform and encourage the development of armed violence prevention strategies.
In 1996, the 49th World Health Organization (WHO) Assembly identified violence as a leading public health problem worldwide. Subsequently a Programme of Action was developed that led to the production of a landmark WHO document on the use of small arms and health, as well as the first WHO world report on violence and health. The public health impact of small arms and light weapons (SALW) in violent deaths worldwide described in the first WHO’s report indicates that in the year of 2000, the largest proportion of firearm related deaths in upper-middle and low income countries were attributed to homicides, while a large proportion of firearm related deaths in high income countries, including the United States, mostly occurred as self-inflicted wounds (suicide).
Small arms and light weapons have been recognized as a humanitarian crisis but the dimensions of the problem are poorly understood. Attempts at the United Nations (most notably the United Nations Conference on the Illicit Trade in Small Arms and Light Weapons in All Its Aspects) and within some regions of the world to control the problem have been slowed down by politics and restricted to more traditional national security and law enforcement approaches.
Sustained high mortality rates from armed violence requires a commitment to develop and support action-oriented research in order to address these types of injury from a public health perspective. Progress in developing a public health response to violence in particular, and injury in general in countries with limited resources has been impeded by the lack of a systematic approach to utilize comparable data sources of injury.
This multinational injury surveillance proposal responds to the WHO’s call for multi-sectoral and collaborative efforts for the prevention of violent injury. In particular, we wish to respond to some of the WHO’s recommendations issued in its World Report on Violence and Health. Specifically, recommendation No. 2 that calls for an increase in the capacity for collection of data on violence, and recommendation No. 3, that calls for carrying out research on violence, its causes, consequences and prevention in different population groups and different cultural settings. We agree with the WHO’s ecological model approach for understanding the causes, consequences and prevention of violence. The ecological model suggests that it is the interaction of several factors at play that makes a particular segment of the population at risk of violent injury. These factors are found at four levels: the individual, the relationship, the community and the societal.
This multinational research effort utilizes a common instrument to collect injury data and thus facilitate the comparison of the context in which violent injury occurs in these countries. This project is a concerted effort in ten countries with dramatically different resources, and different social, cultural and economic backgrounds to provide a scientific base to compare and describe the magnitude of the problem, and where and who is affected in each country. Establishing a surveillance system for external causes of injury will contribute to the development of prevention intervention strategies in each country in a relatively short period of time.
The five countries in Africa and the five countries in Latin America and the Caribbean included in this project will provide a unique opportunity to define and compare a range of variability in their experiences with violent injury.
The study is divided in two phases. Phase I includes the retrospective review of a limited number of injury cases treated at the Emergency Department (ED) in each participating hospital, and the preliminary or formative evaluation in each country led by each co-principal investigator (Co-PI). This preparatory work helps us organize ourselves in terms of logistics and human resources before the prospective collection of injury data in Phase II. Phase II is the actual collection of external injury data at the designated ED in each country for a twelve month period. Both phases are described below.
Due to funding issues, as well as local commitments, we have launched Phase I of the project with International Physicians for the Prevention of Nuclear War (IPPNW) affiliates in 5 African countries – Kenya, DR Congo, Nigeria, Uganda and Zambia, and El Salvador. Phase I in these countries has been being implemented with limited funding support and is indicative of the co-participants commitment to this project. We have field tested the questionnaire designed by the joint Pan American Health Organization (PAHO)/United States Centers for Disease Control (CDC) injury project in Central America, currently being used in Colombia, Nicaragua and El Salvador., by retrospectively collecting data on 30 cases selected at random in each participating hospital within the last six months. We have been working under the guidance of PAHO/CDC injury experts and given support to expand the use of this data gathering instrument in this project. (See attached copy of the questionnaire).
Phase I activities also include the development and implementation of a trainer of trainers workshop for all study co-investigators who in turn will train the personnel involved in data collection at each participating hospital and to systematically collect injury data for a six to twelve month period (depending on funding secured) on new violent injury related cases reported to the emergency department in each participating hospital. A 3 ½ day training for the five African sites was held in Nairobi, Kenya in March of 2006, with Kenyatta Hospital participating as a field site. It was attended by a total of 12 physician researchers from the 5 sites. (See attached agenda.)
DISSEMINATION OF RESULTS
We propose to analyze and summarize findings of data collected in the twelve-month period and compare the context in which violent injury occurs in different socio-cultural settings. The analysis is at two levels: a) individual hospital findings and b) multinational comparisons.
Because this is a pilot project that seeks to foment and provide the initial effort to implement an ongoing or sustainable injury surveillance system in each hospital, recommendations to implement such a system at the hospital level will be included with the presentation of final results obtained for each hospital. It is hoped that with the success of this pilot project we can demonstrate the usefulness of having data on injury collected in a systematic process at the emergency department of hospitals in the participating countries. Therefore, as part of the recommendations from this study to maintain an injury surveillance mechanism at the hospital level, the study questionnaire could be integrated in the documentation of injury patients treated at the hospital’s emergency department.
The objectives above provide an opportunity to analyze and therefore better define and understand the context in which violent incidents occur in several countries in Africa, Latin America and the Caribbean. Results will be presented at several levels: local, national and international level. At the local level, a final report will be presented to the source institutions, i.e. hospital personnel directly involved with the treatment of injury patients. The participating hospitals will be the immediate beneficiary of the proposed analysis providing critical information for the allocation of resources and planning. In addition, participating hospitals will have a copy of their own database created in the project. At the national level in each country, the final report will include recommendations to government institutions responsible for injury prevention and control, including the Ministry of Health, the Police and other agencies of relevance. It is also the intent of this proposal to share the findings of this study with non-governmental or community organizations that are interested or actively involved in the prevention of violent injury. At the international level, we intend to disseminate the analysis and results of this project through scientific-peer reviewed publications and relevant international meetings or conferences.
EVALUATION
Three types of evaluation are incorporated in this project: a) formative evaluation in the planning or Phase I; b) process evaluation during the implementation of Phase II; and c) Impact/Outcome evaluation, after the completion of all objectives in Phase II. The control of data quality will be carried out mainly in the process evaluation, as described in the Methods section of the study protocol.
In addition, we hope that with a surveillance system in place in each of the participating hospitals, health authorities will have reliable data on injury for the region or area that each hospital provides emergency health care services for. Over time, health authorities may use this information to develop injury prevention strategies. This information will also be shared with community organizations interested in the prevention and control of injuries in their communities. The intent is to have an empowered community, aware of the risk factors that precipitate injury incidents in their community and thus seek the resolution of those risk factors that are both within their own decision making abilities and government authorities.
US - Stanford University One Bullet Story Project
The proliferation of trades involving small arms and light weapons world wide continues to directly cause the loss of tens of thousands of lives each year. As a billion dollar business annually, this unregulated flow and distribution of guns and other weapons to virtually every part of the world has spawned what the United Nations called a worldwide “culture of violence and impunity1.” It is estimated that a quarter of global gun trade is illicit, and most of them being small firearms and light assault weapons. As there is no enforceable border for the covert smuggling and trading of weapons, so there is no discrimination of the victims from small arms violence. From civilians caught in the crossfire in conflict regions of the world to violence in communities here in the US, the lives that are lost and social repercussions that follow are intimately linked to the global increase in demand and trade for light weapons.
To help stem this dangerous proliferation of violence caused by small arms, and to educate the public on the devastations to individuals and communities caused by these weapons, the student chapters at IPPNW and PSR have teamed up to work on an education and awareness campaign against small arms violence. This campaign, named “One Bullet Stories,” aims to collect information and stories from victims of small arms violence in a collective effort to show the personal, family, and societal damage caused by these weapons. The campaign hopes to attach human faces to the nameless victims injured or killed by light weapons. Even more importantly, the campaign hopes to raise enough public awareness about this issue to eventually bring about progressive political change to diminish or abolish illicit arms trade world wide. The project is spearheaded by the student IPPNW chapter in Nigeria and by SPSR students at Stanford University in the US. The project aims to steadily increase participation from other IPPNW and PSR chapters, as well as universities and medical schools across the US and the world. The information and images collected will be formatted into visual exhibits and documents that can be easily disseminated and presented to the public. An independent research team will also collect vital statistics and known quantitative data on the social and global health impact of illicit small arms trade. As enough interest and project momentum pick up, and as more patient stories and information are collected, the project hopes to culminate in a documentary about this educational campaign and on the global issue of small arms violence through a public health perspective.
For more information on the One Bullet Stories campaign, please contact Jack Wang (jtw@stanford.edu) or Ageyno Ehase (agyeno@hotmail.com). Please also visit the website (http://www.ippnw-students.org/OBS/index.html) for project template, more contact info, and sample archived One Bullet Stories.
1. From Report of the United Nations Conference on the Illicit Trade in Small Arms and Light Weapons in All Its Aspects. New York, 9-20 July 2001
Methods (from IRB Proposal):
We propose a prospective study to identify the epidemiological components and modifiable factors for intervention of medical and surgical patients admitted for traumatic injuries due to small firearms. The study intends to uncover systemic data on the magnitude, scope, characteristics and consequences of gun violence at local, and by pooling similar data from other institutions, national and international levels. The purpose of this study is therefore to examine and expand upon existing understanding of the public health impact of personal violence involving firearms. We hope to identify the causes and correlates of gun violence in the community, the factors that increase or decrease risk for small firearms violence and the modifiable factors for intervention and prevention. Addressing these factors will better guide health care professionals in designing, implementing and evaluating interventional measures to reduce or prevent personal injuries from small firearms in the community.
Proposed research involves the collection and study of existing clinical data, documents, and medical records from medical and surgical patients admitted for traumatic injuries due to small firearms. Sources are from patient interviews and hospital records and will be recorded without identifiers linked to the subjects. All data will be collected and reviewed without usage of identifiers to confidential patient information.
Population (from IRB Proposal):
Eligible patients in the inpatient medical or surgical unit will be contacted directly for consent. A brief interview will be conducted with the patients and their medical records will be reviewed. Only existing hospital charts with clinical treatment and outcome data will be used.
US - Philadelphia Handgun Lobbying
Past
Sept, 2007 - About 12 Philadelphia PSR members joined more than 2,000 Philadelphians for a Rally and Lobby day in Harrisburg, PA. Goals of the event included increasing state-wide awareness of the increased interpersonal violence in PA and Philadelphia and lobbying for strengthened handgun legislation including "One handgun a month" and "Report lost or stolen handguns" legislation. This rally was in response to Philadelphia's most deadly year on record, which included 406 homicides and murders.
April, 2007 - Legs Against Arms. Community members, Philadelphia area youths and medical students joined in making this first annual race a success. More details on LAA below. Philadelphia PSR members attempted to have one medical student run in honor of each of the 406 slain Philadelphians during the 2006 calendar year - but unfortunately the number of deaths just outpaced our ability to involved medical students.
Upcoming
We're still working on finding a date for our Spring Harrisburg lobby day to promote handgun registration legislation and "One handgun a Month" limitations. Our prior date fell through because it turns out that our state congress has a rather erratic session schedule.
On April 13th, Philadelphia PSR is hosting the 2nd annual Legs Against Arms Race. Following the race will be a Celebration of Youth which will celebrate the positive accomplishments of local youths and work to change the social norms that celebrate violence in our community. Interactive educational displays and speakers will provide an opportunity for attendees to learn about the impact of interpersonal violence on both a community and international level. More info at: http://www.legsagainstarms.org
We're working on putting together an interpersonal violence panel that will include physicians and interpersonal violence workers who focus on domestic violence, trauma, and research of and intervention on behalf of victims of interpersonal violence in the ED. This will be a collaborative Philly PSR event, but we're still working on a date. The hope is that this panel will be both educational to our medical student communities and provide an opportunity for us to brainstorm direct action with local professionals who have experience in interpersonal violence reduction.
- Roll Call of attendees at IPPNW Conference
- Discussion of projects in attendees' countries - Presentations from Walter Odhiamso (Kenya), Mansur Ramalan (Nigeria), Nidia Rodriguez (Ecuador), Cesar Aleman (Nicaragua), Tova Fuller (USA)
- One Bullet Stories
- US work - Jack Wang at Stanford University
- Current OBS's that are available (see below)
- Local work - this work may not inherently be international in nature but may serve as a template for other chapters
- US - Philadelphia/Harrisburg work on lobbying against handguns & the Legs Against Arms Race
- Other countries/regions of interest
- Kenya
- Australia
- Nepal
- Nigeria
- Sudan
- New Zealand
- Australia
- Ecuador
- El Salvador
- Nicaragua
- Future directions
- OBS's
- How we will share them - on new webpage via IPPNW Students' Site
- How they will be used - traveling exhibition?
- How we will share them - on new webpage via IPPNW Students' Site
- Desired resources in addition to OBSs to be posted on webpage
- List of funding opportunities
- Forms / Proposals used by students currently doing work on Small Arms
- Picture Galleries
- OBS's
- Organizational details
- Where to store OBS's - on IPPNW's Aiming for Prevention site
- Google group
- Format and dates for future conference calls
- Skype - Late April / May
- How often should we have conference calls - Every 2/3 months
- Skype - Late April / May
Current Countries/Participants in ISCASA
- Australia
- Ruth Mitchell
- Sarah Gardiner - NSR, Australia
- Angela Wilson - NSR, Australia
- Ruth Mitchell
- Bangladesh
- Colombia
- Paola Ortiz - NSR, Colombia
- Paola Ortiz - NSR, Colombia
- Ecuador
- Nidia Rodriguez - NSR, Ecuador / RSR, Latin America
- Egypt
- Mohamed Geneid - RSR, Middle East
- Mohamed Geneid - RSR, Middle East
- El Salvador
- Ademar Guardado - NSR, El Salvador
- Vanessa Artiga
- India
- Suheir Khajura
- Ujjwal Ramtekker - NSR, India
- Ankita Choudhary - NSR, India
- Suheir Khajura
- Iran
- Leila Moein - NSR, Iran
- Italy
- Luca Astarita - NSR, Italy
- Kenya
- Nepal
- Khagendra Dahal
- Chudamani Giri - NSR, Nepal
- Dinesh Dharel
- Khagendra Dahal
- New Zealand / Papua New Guinea
- Jash Agraval - NSR, New Zealand
- Andrew Winnington - Papua New Guinea
- Nicaragua
- Cesar Aleman - NSR, Nicaragua / RSR, Latin America
- Cesar Aleman - NSR, Nicaragua / RSR, Latin America
- Nigeria
- Agyeno Ehase - ISR
- Mansur Ramalan
- Onazi Ogebe - RSR, Africa and coordinator of IPPNW Nigeria Raypower FM Peace Project
- Agyeno Ehase - ISR
- Norway
- Mari Jetlund - NSR, Norway
- Palestine
- Mahmoud Abu Issah - NSR, Palestine
- Mahmoud Abu Issah - NSR, Palestine
- Romania
- Andra Corbu - NSR, Romania / RSR, Europe
- Sudan
- Samahir Hussein - NSR, Sudan
- Samahir Hussein - NSR, Sudan
- Ukraine
- Elena Bezsmertna - RSR, Europe
- Elena Bezsmertna - RSR, Europe
- United States
- Andrew S. Kanter - Board of Directors, PSR
- Maria Valenti of IPPNW's Central Office in Cambridge, MA
- Tova Fuller & Lauren Zajac - NSRs, USA
- Ira Shorr - Field Director, PSR
- Jack Wang of Stanford University One Bullet Story Project
- Helen Basyuk of Pennsylvania College of Medicine, Philly Lobbying Project
- Michael Russo of the University of Pennsylvania, Philly Lobbying Project
- Leanne Marcotrigiano of Jefferson University, Philly Lobbying Project
- Kate Hawk of Drexel University, Philly Lobbying Project
- Leigh Anne DiCicco of Temple University School of Medicine, Philly Lobbying Project
- Scott Nass of UCLA
Existent IPPNW Materials and Web Resources
- Google Group
- IPPNW Blog Entry on Small Arms work and Aiming For Prevention
- One Bullet Stories
- Other Aiming for Prevention Campaign Materials
- Target Safety, an article in the January, 2007 edition of ePulse
- Cult activities in Nigerian Universities and Small Arms Violence, an article in the March, 2006 edition of ePulse (pdf download, p3)
- IPPNW US / Student PSR Social Justice Site
- IPPNW Publications in the Journal of Public Health Policy Special Section - Small Arms and Light Weapons in Africa - A Major Challenge to Public Health and Development
- IPPNW Students' Page on Small Arms Work
- Aiming for Prevention's December 2007 Newsletter
- El Salvador Page on Small Arms Research - old
Reports on Small Arms Work (Appendix)
Safety 2008
A report from Cesar Aleman, of Nicaragua.
Dear friends last march World Conference on Injury Prevention and Safety Promotion in Merida, Mexico, was the first one held in a Spanish speaking country, and by all accounts, it was a great success. There were more than 1,000 participants from over 120 countries. There was the great opportunity to have six countries members of IPPNW bringing 13 papers and posters of violence prevention.
9th World Conference on Violence Prevention and Safety Promotion otherwise Safety 2008
I had the chance of meet once again members of IPPNW from Nigeria, Zambia, El Salvador, Puerto Rico, United States and Nicaragua.
As IPPNW Latin American, student’s representative was a new experience to have the opportunity to talk about intra family violence and maltreatment affecting children collectors of trash. There was a world conference, which everybody spoke how to prevent the violence and to have peace in our new challenging society
The enthusiasm of the conference participants – some had never attended an international meeting before – was electric, and the conference sparked in them – and in all of us – the desire to refocus and sustain our efforts to prevent injuries and promote helmet use.
Intra-Family violence and maltreatment affecting children collectors of trash in ¨El Fortin¨ León, Nicaragua 2007
Cesar Aleman
7th year medical student
Latin American student representative of IPPNW
Introduction
Child Abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.
(WHO, 1999)
¨Candies in the hell¨
It was a Cross-sectional study in Leon, Nicaragua.
Nearly half the women reported their children witnessed their abuse.
Children of abused women more than
• Twice as likely to suffer from learning, emotional and behavioral problems.
• seven times as likely to be abused
Objectives
Describes techniques of aggressive behavior associated with children collectors of trash and the different types of violence they have in ¨El Fortin¨ Leon, Nicaragua
Determining levels of intra-family violence associated with children collectors of trash
Material and methods
The sample consisted of 100 children and adolescents from 6 to 16 years old collecting trash located in El Fortin, Leon in Nicaragua. The data was collected from a survey in which the children perception of violence in their homes was determinate; data was statistically analyzed by using Epi info 6.0
Results
A high percentage of children had difficulty in communicating with their parents and felt rejected and a lack of love from some of the members in their homes. 92% of those surveyed had a family atmosphere characterized by high levels of violence like physical violence (pushing, hitting, guns and knife attacks). The second most frequent reported type of violence was psychological, 67% of them had had insults with bad words and the rest of them had maltreatment from their parents in front of everybody but unfortunately in just 3 cases the children didn’t have any affections of the psychological maltreatment
Discussions and conclusions
All the children say no. “I don’t want to be mistreated anymore” and they prefer to have other different punishments actions with another way. Just 3% said “It doesn’t matter as they (parents) mistreat myself” constituting a dangerous attitude. Almost all of them felt well with their family relations and they do not desire to change it. They ask give them love and affection than strike them less. Almost all of them said that they desired to be an adult because they wouldn´t like to be injured anymore. They reject the work in the street and they desire to be into the school. The ones that prefer to work are those who are mistreated with frequency (everyday). All children’s families lives in extremely poverty situation
Experts agree that the most effective way to address domestic violence is through a coordinated community response. This requires an effective coordinating body, a state or countywide family violence council that has a public mandate. The family violence council must bring together responsible representatives of public agencies, the court system, service providers, and advocates who have the will and the authority to make changes, the goal is to develop:
1. a comprehensive program of services for abused children;
2. an effective criminal justice response that holds batterers accountable and increases the safety of children
Children and adolescent collectors of trash in El fortin, Leon, Nicaragua are affected by many situations concerning intra family violence
Summary of Small Arms Work in Papua New Guinea
Summary of the scoping study on small arms violence in the Highlands of Papua New Guinea
Andrew Winnington
5th year medical student
University of Otago, Wellington
IPPNW (NZ) is developing a Pacific-focussed program of arms control and disarmament. Papua New Guinea (PNG) was identified in the Small Arm Survey 2006 as a fragile nation chronically affected by armed violence with the potential to destabilise peace and security in the western Pacific. Researchers found illicit firearms in the Southern Highlands are several times more likely to be used in homicide than a similar gun in the world's highest-risk countries, namely Ecuador, Jamaica, Colombia and South Africa.
Project development began at IPPNW 17th World Congress Helsinki 2006. IPPNW's Aiming for Prevention program coordinator, Maria Valenti provided support stating "It is great that you are pursuing research on small arms violence in PNG. More injury research needs to be done to quantify the human toll and design appropriate interventions."
A scoping study was designed with two objectives; firstly to solidify links with relevant organisations in PNG to guide efforts to improve injury epidemiology and secondly to promote peace and security in the Pacific region by producing information that contributes to raising awareness of the level of small arms violence.
A Peace and Disarmament Education Trust (PADET) grant of $3512 and supplementary funding by IPPNW (NZ) allowed 5th year medical student [AW] to work in Papua New Guinea for two weeks in November 2007.
Links were solidified with several relevant organisations in PNG including the Coalition to Stop Gun Violence (CSGV) that advocates for stronger action to combat gun violence; specifically for the government to create a gun control body to commence the process of monitoring and eradicating guns.
A televised press conference followed a coalition meeting and featured Vavine Gabi who had just returned from representing CSGV at Global People's Consultation on Arms Trade Treaty in New York (side event of the 62nd UN General Assembly First Committee). Vavine Gabi's tragic 'One Bullet Story' involves watching her mother fatally shot in the head one day after her 16th birthday during a car-jacking by six youths (they remain unprosecuted).
Written support was obtained from Office of the Secretary for Health and the Southern Highlands Provincial Government to allow the National Research Institute to apply for a three year research visa. Links were also solidifed at the University of PNG Medical School to allow the future transfer of methods to local researchers, and at Port Moresby General Hospital and Mendi Hospital in the Southern Highlands Province for future research.
Information was collected from Mendi Hospital to contribute to raising awareness of the level of small arms violence in the Pacific. Injury data were obtained from Mendi Hospital Admissions Register for the January 2000 to August 2007 period to compare with 1990-95 published data. This included a demographic breakdown of all injury types (and geographic information for weapons-related injuries) and will allow for an assessment of the relative impact of tribal fighting in Mendi (Dec 2001 – Sept 2002) and the impact of martial law during State of Emergency (Aug 2006 – Aug 2007). Data was also obtained for a five year period from the Surgical Ward Admissions Register to assess the average inpatient stay for trauma admissions (days in ward) for each type of injury so a financial cost of each injury can be derived. Specific details were also collected from patient files including the history of presenting complaint and surgical procedures performed for each weapons-related injury (gun n=36, spear and arrow n=20) and from a random sample of knife wounds (n=50) that predominated the cause of injuries in the Southern Highland Province. Outpatient data from 2000-2006 period were also collected to calculate accidents and injuries as a proportion of total monthly attendance.
A lot was accomplished in the two-week visit to Port Moresby and Mendi primarily because of the desperate need for local research evidence and interventions to address the high burden of injuries. Everyone approached was welcoming and extremely helpful because it is obvious the nation is spiralling out of control and into violence and chaos. It is dangerous to go out at night in Port Moresby; of the small number of women I met there, one, a journalist, was robbed the day before I spoke to her and another, an Oxfam worker, was robbed the day after. When I was in Mendi, 30 tribesmen armed with guns, bows and arrows and spears attacked a police-escorted convoy 40 minutes away. They kidnapped the policemen and took seven automatic weapons. The following day a shoot out with police re-enforcements had left one tribesman dead and another, who was shot in the face, under armed guard in Mendi Hospital.
It is hoped that the results of this study will be presented at the IPPNW World Congress in India in March 2008 as well as being fed back to key people and organisations in PNG. Any support and funding for this and further work would be much appreciated.
Nigeria - IPPNW Nigeria, Raypower FM peace Project
THEME OF PROJECT BRINGING PEACE TO THE PEOPLE
PROJECT LOCATION: JOS UNIVERSITY TEACHING HOSPITAL (JUTH) JOS – PLATEAU STATE, NORTH CENTRAL ZONE, NIGERIA
NAME OF COORDINATOR ONAZI OGEBE
INTERNATIONAL ADDRESS IPPNW
727 MASSACHUSETTS AVENUE
CAMBRIDGE MA 02139 USA
WWW.IPPNW.ORG
START AND END DATE MAY’08 TO APRIL ‘09
OUTLINE:
- Definition of key words.
- Project description.
- Background.
- Strategies and activities.
- Past activities and experience.
- Objectives.
- Target audience and marketability of the project.
- Anticipating impacts.
- Budget.
- Project timeline.
- Conclusion and key contacts.
1. DEFINITION OF KEY WORDS
Peace in the context of this project is referred to as a sound atmosphere that respect the coexistence of peoples with different cultures, belief and values, but yet living together with tolerable conflicting opinions.
People on the other hand are a group of individuals with dignity, rights, values and sense of responsibility coexisting together for the purpose of procreation, inhabitation and sustainable development.
2. PROJECT DESCRIPTION
According to the conventional knowledge, peace is defined as a state of rest, and this could also mean a period of non-violence, which is as well related to harmony. Over the years, Nigeria as a country has lost so many resources in the nature of human and material potential, owing to violence of one kind or the other. This confusion has brought about backwardness and paralysis to business growth and economic development leading to inadequate manpower and lack of peaceful and sound environment for productive national and international investments.
It is in this light that this project proposes to use the strongest means of information dissemination to reach and give the people in the country and beyond (Africa) the message on the change of focus and the need for a renewed mindset that will make them think positively about themselves and others, especially on the side of values and dignity.
3. BACKGROUND
This is an IPPNW (International Physicians for the Prevention of Nuclear War) designed project in collaboration with Raypower FM to bring peace to people in Nigeria and Africa communities through media for the purpose of preventing arms trade and all forms of violence that could emerge out of a distorted atmosphere of peace. IPPNW is a non-partisan, global Federation of National Medical Organizations in 58 countries dedicated to research, education and advocacy relevant to the prevention of nuclear war, the demilitarization of the world, abolishment of small arms trade and the paradigm shift needed to create a climate of peace and stability.
Benching on the numerous achieving efforts and records of the IPPNW since formation in 1980: the winning of the UNESCO-Peace prize in 1984 and the Nobel peace prize in 1985, this initiative wishes to create an extension of service for more impact and wider awareness on the need for peace through love and respect, using information dissemination tools available that can change peoples’ focus and mind from instigating any process that leads to disorderliness and lack of stability. The project will be test-run for one-year period and will engage all stakeholders in education, research, advocacy and other sectors in taking the task of injury prevention and peace building to great heights in our societies.
At the National level, the organization has made significant achievement since the Nigerian chapter started in 2004, and we are still working hard to expand our reach to the populace using some of the strategies and approaches that had worked at the international and national levels even as we strive to evolve new ones.
4. STRATEGIES AND ACTIVITIES
- Strategies
- Holding of conferences.
- Seminars and interactive media exchanges with professionals, celebrities and models.
- Distribution of reading materials and street walks.
- And other means of timely dissemination of information on prevention measures to violence and trading of arms.
- Activities
- Radio and Television program: focusing on distinct attractive topics that are pressing and curative methods to societal state of disorderliness and lack of peace.
- Information and awareness centers: this will be a place where articles, journals, and magazines are published and made available for dispatch to different locations of the country and beyond.
- Conference: This event will receive delegates from different states where we have chapters to engage in interactions that are informing, fun and problem solving.
- Advocacy programs: Will involve so many projects such as society for small arms prevention, refugees x-camp project, the brain drain project, society for nuclear weapon prevention, one bullet story project and workers training project.
5. PAST ACTIVITIES AND EXPERIENCE
- We hosted Africa here in Jos Nigeria Dec. 16th - 18th 2005 for the AFRICAN MEDICAL STUDENTS REGIONAL CONFERENCE.
- We sent a delegation of medical students (3) and doctors to the World Congress in Finland October 2006.
- We carried out an injury surveillance on gun shot injuries in three States (Port Harcourt, Kano and Jos) , from December 2006 - May 2007.
- We have had the African Regional Co-coordinator Dr. Mansur Ramalan a Nigerian, whose tenure brought in one affiliate- Sudan
- The present President of IPPNW International is a Nigerian, Dr. John Ime (Consultant) who resides in Sweden, who got elected after the October World Congress in Helsinki 2006, Finland and re-elected in the Delhi World congress, March 2008
- We have had the E-pulse magazine director at the international level, Sunday Agyeno, who is now the new International Student Representative after the Delhi congress, March 2008.
- We had a national meeting at Abuja July 27th, 2007 to re-enforce the Nigerian chapter.
- We sent a two-man delegation to the African Regional Congress meeting hosted by Kenya September 3rd - 7th 2007.
- We had eleven Nigerians attending the Delhi World Congress, March 2008, of which five were students.
- We have presently Ogebe Onazi, formerly the Nigerian Student Representative as the Co-Regional Student Representative for Africa.
6. OBJECTIVES
- To bring peace to the society through information dissemination.
- To reduce and prevent reactions that could lead to injury and disorderliness.
- To reduce the unnecessary circulation and use of small arms in Nigeria and the African communities.
- To create viable peaceful communities that business thrives and economy develops.
- To work with equipped health facilities at all levels of the society to detect and monitor small arms injuries.
- To reallocate resources from military to civilian needs, especially to basic health care and human necessities.
- Sustainable and ecologically sound economic development.
- And to increase awareness, knowledge, understanding and commitment of people in various communities on the need for peace building and living together in the spirit of brotherhood.
7. TARGET AUDIENCE AND MARKETABILITY OF PROJECT
a. Target audience
Human pensions in Nigerian and African communities; starting with the areas cover by Raypower Jos, Plateau State: - Plateau – Bauchi – Gombe – Nasarawa – Kaduna States
b. Marketability of the project
- The project will create a wider awareness on what IPPNW stands for as a body and some of her achievement over the years and provide information on the strength and weaknesses of the Nigerian state chapters to donors for supports.
- It will provide opportunity for organizers to involve new key contacts and sponsors in projects initiations and running at local and urban areas and at the same time achieving government policies on peace building and arms trading control in the society.
- The project will have provision for callers inputs on various topics of interest after which prizes will be given to best contributors who asked or answer related question and make best contribution.
- It is going to be opened up for donors to show case their product through adverts, packages (prizes) for winners and interview with their marketers on their ideas, successes, innovations and other activities of the organ of our sponsors or donors. It means the project will be an avenue for them to sell their products and concepts. (Important for sponsors).
- The project will give out little appearance fee to resource persons and facilitators after programs and/or T-shirts, caps and other for use during the interactive sessions.
- There will be publishing of communiqué in national dallies of contents of deliberations and interviews. Also, papers will be produced for distributions to donors to follow up and monitor progress.
- Project will produce video CDs and tapes for sale to the larger community monthly.
8. ANTICIPATING IMPACTS
- Cutting down the circulation of small arms in Nigeria by 25% before the end of 2009.
- Targeting more than 250,000 persons to have a change of mind-sets through speedy informed messages on living together in peace and spirit of oneness.
- Putting up outlets in about 25 states of the federation before the end of the target year.
- Solving the societal problems of social, civil, political and religious unrest through education and information dissemination channels.
- Promote and strengthen injury prevention projects through awareness creation on the need for peaceful co-existence in 36 states of the country and extending to other African countries.
- Encourage peace-building activities in our various locations of reach to create conducive ground for business thriving economic development and job creation for the youth and women.
9. WORKING BUDGET FOR THE 1-YEAR PERIOD IN 2008
Description Unit Cost (N) Total cost (N) Total cost ($)
Air time cost 12 16,389.00 196,668 1530
Appearance fee for guests 36 10,000.00 360,000 2800
Winning packages for the public (from sponsors)
i. Handsets 6 8000 48,000 375
ii. T-shirts 6 1000 6,000 47
iii. Refill cards 24 1000 24,000 93
TOTAL 84 36,389.00 634,668.00 4920.00
The appearance fee will cut across an experienced presenter in the radio house and two other researchers that will communicate to the public the topic for the particular month.
10. PROJECT TIME LINE
May’08 Introducing peace to the people.
June Small arms trade and its effects.
July Governmental policies on small arms
August One bullet story.
September Conflict resolution in the Nigerian society.
October Nuclear energy plant and its hazards.
November Peace and human dignity.
December Why small arms trade in our society should be abolished.
January’09 Nuclear waste dump: the Nigerian perspective.
February Individual responsibility on peace building.
March Protection of human rights: the refugees perspective.
April’09 Peace building for business development: A bane for economic growth.
11. CONCLUSION AND KEY CONTACTS
a. Conclusion
To bring peace to the people, the people themselves have to be ready and make their own resolution on the need for it and show so much interest and responsibility to protect life, respect dignity and have sustainable development. In a way of ensuring this by all means possible, i.e. whether the culture of peace should be instituted by the people themselves or through other mechanisms, this project focuses on reducing and preventing the proliferation of arms that could instigate a process violence, which may lead to harm, injury and death.
Equally vital area of the project is the weakening of all avenues that seek to make the availability and use of violence and crisis to distort peace of the people possible; so that countries hard - earned progress in development of human and material resources will be sustained.
b. Key Contacts
- Dr. John Ime (Consultant)
International President, IPPNW.
www.ippnw.org.
Email:imejohn@yahoo.com
www.ippnw.org.
Email:imejohn@yahoo.com
- Maria Valenti
Co-ordinator,Aiming for Prevention,
IPPNW,USA.
Email: mvalenti@ippnw.org
IPPNW,USA.
Email: mvalenti@ippnw.org
- Dr Aminu Z M
Vice President IPPNW Nigeria
Email: aminuzm@yahoo.com
Email: aminuzm@yahoo.com
- Agyeno Sunday
International Representative, IPPNW Student Movement.
Email: agyeno@hotmail.com.
Email: agyeno@hotmail.com.
- Prof. Clement C. Okam
Arête International Consortium, Keffi - Nigeria.
- A. M. Amedu, President and Founder
Ercon International, Jos - Nigeria.
www.ercon.int.org.
www.ercon.int.org.
- Prof. K. L. Fwa, NIPSS, Vom-Nigeria
A PILOT MULTINATIONAL INJURY SURVEILLANCE STUDY
EXECUTIVE SUMMARY
The purpose of this pilot study is to systematically collect, review and evaluate the context in which specific external injuries occur in a great diversity of socio-cultural populations. The second purpose of this study proposal is to test the implementation of an injury surveillance system in countries where no such system is in place (i.e. Bolivia, Puerto Rico, Zambia, Democratic Republic of Congo, Nigeria, and Kenya). Thirdly, the study aims to collaborate with local efforts in countries where an injury surveillance system is already in place (i.e. Uganda, Colombia, and El Salvador) or in process of implementation (Brazil). The fourth and last objective is to provide evidence-based recommendations to local government health authorities to address the incidence of injury in their communities from a public health perspective, as well as community advocates and public policy makers at the local, state, regional and international levels in order to inform and encourage the development of armed violence prevention strategies.
In 1996, the 49th World Health Organization (WHO) Assembly identified violence as a leading public health problem worldwide. Subsequently a Programme of Action was developed that led to the production of a landmark WHO document on the use of small arms and health, as well as the first WHO world report on violence and health. The public health impact of small arms and light weapons (SALW) in violent deaths worldwide described in the first WHO’s report indicates that in the year of 2000, the largest proportion of firearm related deaths in upper-middle and low income countries were attributed to homicides, while a large proportion of firearm related deaths in high income countries, including the United States, mostly occurred as self-inflicted wounds (suicide).
Small arms and light weapons have been recognized as a humanitarian crisis but the dimensions of the problem are poorly understood. Attempts at the United Nations (most notably the United Nations Conference on the Illicit Trade in Small Arms and Light Weapons in All Its Aspects) and within some regions of the world to control the problem have been slowed down by politics and restricted to more traditional national security and law enforcement approaches.
Sustained high mortality rates from armed violence requires a commitment to develop and support action-oriented research in order to address these types of injury from a public health perspective. Progress in developing a public health response to violence in particular, and injury in general in countries with limited resources has been impeded by the lack of a systematic approach to utilize comparable data sources of injury.
This multinational injury surveillance proposal responds to the WHO’s call for multi-sectoral and collaborative efforts for the prevention of violent injury. In particular, we wish to respond to some of the WHO’s recommendations issued in its World Report on Violence and Health. Specifically, recommendation No. 2 that calls for an increase in the capacity for collection of data on violence, and recommendation No. 3, that calls for carrying out research on violence, its causes, consequences and prevention in different population groups and different cultural settings. We agree with the WHO’s ecological model approach for understanding the causes, consequences and prevention of violence. The ecological model suggests that it is the interaction of several factors at play that makes a particular segment of the population at risk of violent injury. These factors are found at four levels: the individual, the relationship, the community and the societal.
This multinational research effort utilizes a common instrument to collect injury data and thus facilitate the comparison of the context in which violent injury occurs in these countries. This project is a concerted effort in ten countries with dramatically different resources, and different social, cultural and economic backgrounds to provide a scientific base to compare and describe the magnitude of the problem, and where and who is affected in each country. Establishing a surveillance system for external causes of injury will contribute to the development of prevention intervention strategies in each country in a relatively short period of time.
The five countries in Africa and the five countries in Latin America and the Caribbean included in this project will provide a unique opportunity to define and compare a range of variability in their experiences with violent injury.
The study is divided in two phases. Phase I includes the retrospective review of a limited number of injury cases treated at the Emergency Department (ED) in each participating hospital, and the preliminary or formative evaluation in each country led by each co-principal investigator (Co-PI). This preparatory work helps us organize ourselves in terms of logistics and human resources before the prospective collection of injury data in Phase II. Phase II is the actual collection of external injury data at the designated ED in each country for a twelve month period. Both phases are described below.
Due to funding issues, as well as local commitments, we have launched Phase I of the project with International Physicians for the Prevention of Nuclear War (IPPNW) affiliates in 5 African countries – Kenya, DR Congo, Nigeria, Uganda and Zambia, and El Salvador. Phase I in these countries has been being implemented with limited funding support and is indicative of the co-participants commitment to this project. We have field tested the questionnaire designed by the joint Pan American Health Organization (PAHO)/United States Centers for Disease Control (CDC) injury project in Central America, currently being used in Colombia, Nicaragua and El Salvador., by retrospectively collecting data on 30 cases selected at random in each participating hospital within the last six months. We have been working under the guidance of PAHO/CDC injury experts and given support to expand the use of this data gathering instrument in this project. (See attached copy of the questionnaire).
Phase I activities also include the development and implementation of a trainer of trainers workshop for all study co-investigators who in turn will train the personnel involved in data collection at each participating hospital and to systematically collect injury data for a six to twelve month period (depending on funding secured) on new violent injury related cases reported to the emergency department in each participating hospital. A 3 ½ day training for the five African sites was held in Nairobi, Kenya in March of 2006, with Kenyatta Hospital participating as a field site. It was attended by a total of 12 physician researchers from the 5 sites. (See attached agenda.)
DISSEMINATION OF RESULTS
We propose to analyze and summarize findings of data collected in the twelve-month period and compare the context in which violent injury occurs in different socio-cultural settings. The analysis is at two levels: a) individual hospital findings and b) multinational comparisons.
Because this is a pilot project that seeks to foment and provide the initial effort to implement an ongoing or sustainable injury surveillance system in each hospital, recommendations to implement such a system at the hospital level will be included with the presentation of final results obtained for each hospital. It is hoped that with the success of this pilot project we can demonstrate the usefulness of having data on injury collected in a systematic process at the emergency department of hospitals in the participating countries. Therefore, as part of the recommendations from this study to maintain an injury surveillance mechanism at the hospital level, the study questionnaire could be integrated in the documentation of injury patients treated at the hospital’s emergency department.
The objectives above provide an opportunity to analyze and therefore better define and understand the context in which violent incidents occur in several countries in Africa, Latin America and the Caribbean. Results will be presented at several levels: local, national and international level. At the local level, a final report will be presented to the source institutions, i.e. hospital personnel directly involved with the treatment of injury patients. The participating hospitals will be the immediate beneficiary of the proposed analysis providing critical information for the allocation of resources and planning. In addition, participating hospitals will have a copy of their own database created in the project. At the national level in each country, the final report will include recommendations to government institutions responsible for injury prevention and control, including the Ministry of Health, the Police and other agencies of relevance. It is also the intent of this proposal to share the findings of this study with non-governmental or community organizations that are interested or actively involved in the prevention of violent injury. At the international level, we intend to disseminate the analysis and results of this project through scientific-peer reviewed publications and relevant international meetings or conferences.
EVALUATION
Three types of evaluation are incorporated in this project: a) formative evaluation in the planning or Phase I; b) process evaluation during the implementation of Phase II; and c) Impact/Outcome evaluation, after the completion of all objectives in Phase II. The control of data quality will be carried out mainly in the process evaluation, as described in the Methods section of the study protocol.
In addition, we hope that with a surveillance system in place in each of the participating hospitals, health authorities will have reliable data on injury for the region or area that each hospital provides emergency health care services for. Over time, health authorities may use this information to develop injury prevention strategies. This information will also be shared with community organizations interested in the prevention and control of injuries in their communities. The intent is to have an empowered community, aware of the risk factors that precipitate injury incidents in their community and thus seek the resolution of those risk factors that are both within their own decision making abilities and government authorities.
US - Stanford University One Bullet Story Project
The proliferation of trades involving small arms and light weapons world wide continues to directly cause the loss of tens of thousands of lives each year. As a billion dollar business annually, this unregulated flow and distribution of guns and other weapons to virtually every part of the world has spawned what the United Nations called a worldwide “culture of violence and impunity1.” It is estimated that a quarter of global gun trade is illicit, and most of them being small firearms and light assault weapons. As there is no enforceable border for the covert smuggling and trading of weapons, so there is no discrimination of the victims from small arms violence. From civilians caught in the crossfire in conflict regions of the world to violence in communities here in the US, the lives that are lost and social repercussions that follow are intimately linked to the global increase in demand and trade for light weapons.
To help stem this dangerous proliferation of violence caused by small arms, and to educate the public on the devastations to individuals and communities caused by these weapons, the student chapters at IPPNW and PSR have teamed up to work on an education and awareness campaign against small arms violence. This campaign, named “One Bullet Stories,” aims to collect information and stories from victims of small arms violence in a collective effort to show the personal, family, and societal damage caused by these weapons. The campaign hopes to attach human faces to the nameless victims injured or killed by light weapons. Even more importantly, the campaign hopes to raise enough public awareness about this issue to eventually bring about progressive political change to diminish or abolish illicit arms trade world wide. The project is spearheaded by the student IPPNW chapter in Nigeria and by SPSR students at Stanford University in the US. The project aims to steadily increase participation from other IPPNW and PSR chapters, as well as universities and medical schools across the US and the world. The information and images collected will be formatted into visual exhibits and documents that can be easily disseminated and presented to the public. An independent research team will also collect vital statistics and known quantitative data on the social and global health impact of illicit small arms trade. As enough interest and project momentum pick up, and as more patient stories and information are collected, the project hopes to culminate in a documentary about this educational campaign and on the global issue of small arms violence through a public health perspective.
For more information on the One Bullet Stories campaign, please contact Jack Wang (jtw@stanford.edu) or Ageyno Ehase (agyeno@hotmail.com). Please also visit the website (http://www.ippnw-students.org/OBS/index.html) for project template, more contact info, and sample archived One Bullet Stories.
1. From Report of the United Nations Conference on the Illicit Trade in Small Arms and Light Weapons in All Its Aspects. New York, 9-20 July 2001
Methods (from IRB Proposal):
We propose a prospective study to identify the epidemiological components and modifiable factors for intervention of medical and surgical patients admitted for traumatic injuries due to small firearms. The study intends to uncover systemic data on the magnitude, scope, characteristics and consequences of gun violence at local, and by pooling similar data from other institutions, national and international levels. The purpose of this study is therefore to examine and expand upon existing understanding of the public health impact of personal violence involving firearms. We hope to identify the causes and correlates of gun violence in the community, the factors that increase or decrease risk for small firearms violence and the modifiable factors for intervention and prevention. Addressing these factors will better guide health care professionals in designing, implementing and evaluating interventional measures to reduce or prevent personal injuries from small firearms in the community.
Proposed research involves the collection and study of existing clinical data, documents, and medical records from medical and surgical patients admitted for traumatic injuries due to small firearms. Sources are from patient interviews and hospital records and will be recorded without identifiers linked to the subjects. All data will be collected and reviewed without usage of identifiers to confidential patient information.
Population (from IRB Proposal):
Eligible patients in the inpatient medical or surgical unit will be contacted directly for consent. A brief interview will be conducted with the patients and their medical records will be reviewed. Only existing hospital charts with clinical treatment and outcome data will be used.
US - Philadelphia Handgun Lobbying
Past
Sept, 2007 - About 12 Philadelphia PSR members joined more than 2,000 Philadelphians for a Rally and Lobby day in Harrisburg, PA. Goals of the event included increasing state-wide awareness of the increased interpersonal violence in PA and Philadelphia and lobbying for strengthened handgun legislation including "One handgun a month" and "Report lost or stolen handguns" legislation. This rally was in response to Philadelphia's most deadly year on record, which included 406 homicides and murders.
April, 2007 - Legs Against Arms. Community members, Philadelphia area youths and medical students joined in making this first annual race a success. More details on LAA below. Philadelphia PSR members attempted to have one medical student run in honor of each of the 406 slain Philadelphians during the 2006 calendar year - but unfortunately the number of deaths just outpaced our ability to involved medical students.
Upcoming
We're still working on finding a date for our Spring Harrisburg lobby day to promote handgun registration legislation and "One handgun a Month" limitations. Our prior date fell through because it turns out that our state congress has a rather erratic session schedule.
On April 13th, Philadelphia PSR is hosting the 2nd annual Legs Against Arms Race. Following the race will be a Celebration of Youth which will celebrate the positive accomplishments of local youths and work to change the social norms that celebrate violence in our community. Interactive educational displays and speakers will provide an opportunity for attendees to learn about the impact of interpersonal violence on both a community and international level. More info at: http://www.legsagainstarms.org
We're working on putting together an interpersonal violence panel that will include physicians and interpersonal violence workers who focus on domestic violence, trauma, and research of and intervention on behalf of victims of interpersonal violence in the ED. This will be a collaborative Philly PSR event, but we're still working on a date. The hope is that this panel will be both educational to our medical student communities and provide an opportunity for us to brainstorm direct action with local professionals who have experience in interpersonal violence reduction.