Managing the health effects of the explosive remnants of war

Many civilian deaths and injuries across the globe are a consequence of 'explosive remnants of war' (ERW). These ERW include mines, unexploded ordnance (UXO) and cluster bombs. The numbers of deaths, injuries and resulting disabilities from ERW are expected to increase as armed conflicts proliferate. This will have a substantial effect on all aspects of health. This article first describes the mechanisms of these ERW and the nature of the injuries they can cause. It then briefly outlines the immediate medical management such injuries require; the long-term outcomes and sequelae, and what can be done to manage them. It highlights how research and medical interventions must take into account cultural, social and economic factors in addition to utilising safe and appropriate techniques and practices. The article concludes by noting that medical personnel are well placed not only to intervene and manage the direct health effects of ERW, but also indirectly by advocating on behalf of those affected by adding their voices to campaigns against their proliferation.