Military

DATE=10/31/00

TYPE=BACKGROUND REPORT

NUMBER=5-47287

TITLE=NAMIBIA / ANGOLA / MEDICINE

BYLINE=CHALLISS McDONOUGH

DATELINE=RUNDU, NAMIBIA

CONTENT=

VOICED AT:

INTRO: The long civil war in Angola is spreading over the borders into Zambia and Namibia. Cross-border attacks and newly laid landmines are claiming casualties in areas where health-care workers have little experience dealing with blast injuries and gunshot wounds. One Ukrainian surgeon working at a hospital in northern Namibia is a veteran of war medicine. As V-O-A Correspondent Challiss McDonough reports, he has found himself in all-too-familiar territory as the conflict spreads.

TEXT: Dr. Yuri Yangasov came to Namibia in 1995, after spending years as a trauma surgeon in Algeria, treating victims on both sides of that country's civil war. In 1997, he moved to Rundu, a small town along the Angolan border. He is one of only two surgeons at the local hospital. He thought this was someplace he could relax. He was wrong.

In December of last year, Angola's war burst over the border. Angolan troops began battling UNITA rebels on Namibian soil, with the help of Namibian security forces. UNITA fought back with landmines and raids on civilian villages.

Since then, Dr. Yangasov has treated more than one-thousand patients with war-related injuries - particularly gunshot wounds and landmine blasts. He has amputated the arms or legs nearly 100 people.

/// YANGASOV ACT 1 ///

Here [the] target for terrorists is usually [the] civilian population - a lot of children, a lot of women. Soldiers [are] usually victims of explosion or gunshots. Civilians [are] usually victims of landmine blasts.

/// END ACT ///

Dr. Yangasov says he sees much more deliberate targeting of civilians in this war zone than he did in Algeria. But there is another difference - the other doctors and nurses here have little or no experience in treating war-related trauma injuries.

/// YANGASOV ACT 2 ///

People who have experience in this area, it's only me. Before nobody had experience with the war situation. Wounds from the war situation require a special skill, require a special knowledge.

/// END ACT ///

Especially at first, the treatment patients got in provincial hospitals was insufficient or even harmful. For example, he says, the best way to treat a blast injury from a landmine is by leaving the wound open to prevent infection. But some patients would arrive from other clinics and hospitals with their blast wounds neatly stitched up which, according to the doctor, is absolutely the worst thing you can do.

Little by little, experience is teaching the other health workers in northern Namibia the skills they need to save lives in a war zone.

But even armed with that knowledge, there is often not much the doctors and nurses can do to help their patients. Medical supplies are low. Crucial equipment is old and often broken. Dr. Yangasov says he is losing patients he knows he could help - if he had the materials he needed to save them.

/// YANGASOV ACT 3 ///

Bronchoscope, not working. Laproscope, broken. All this equipment is old. You start feeling yourself helpless.

/// END ACT ///

Although the numbers of war-wounded are still going up, Dr. Yangasov says the encroaching conflict is still not the main cause of death or injury in the (Kavango) region. He says other problems still claim more victims than gunshots or landmines.

/// YANGASOV ACT 4 ///

Car accidents. Victims of domestic violence, which is very high here. Victims of the soccer is also very high

(Reporter off mike) Soccer?

Soccer. It can compare with victims of the war. Soccer I think is the second war against the young generation.

/// END ACT ///

/// OPT /// Dr. Yangasov remembers one time when six patients came in with severe fractures after a soccer game. Five of them were players. One was a referee. /// END OPT ///

Soccer injuries aside, the Ukrainian doctor says alcohol abuse is to blame for most of the region's main health problems, particularly domestic abuse and auto accidents.

Other analysts say the war may in fact contribute to that growing problem. The reasons are economic.

People used to fish in the nearby Kavango river, which forms the border with Angola. But that is now generally considered too dangerous. Even tending cattle and hunting can be treacherous - because of landmines. Fewer tourists come through town now because of the instability. That means local artisans sell fewer of their beautiful woodcarvings made from abundant local teak. Safari lodges and restaurants sit half-empty or closed completely.

The only businesses that seem to be thriving are known locally as cuca shops. Mostly, they sell alcohol. (Signed)

NEB/CEM/KL/JWH