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Excerpt
War in Yugoslavia occurred from June 1991 to February 1992. The Yugoslav Peoples Army (YPA) was engaged in this war. In many aspects, this war was different from recent wars.
The specifity of the conflict has been the violation of the existing war regulations leading to unethical, irrational, and unscrupulous war, with the mass engagement of semiregular, paramilitary troops and civilians under the leadership of their national party leaders. In this war, the YPA found itself split among various opposed and implacable interests, and exposed to serious human and material losses and other consequences of an effect of modern weapons.
The blockade of YPA troops in the barracks, with temporary attacks and very often a nonexisting front line, made the work of the Medical Service of the YPA exceptionally difficult.
The MMA serves as a central military hospital for YPA. During war time, most of the casualties were evacuated directly from the front line. The hospital received most of the severely wounded, about one-half of the moderately wounded, and about one-third of the slightly injured from all casualties that occurred in Yugoslavia.
Regarding the age of casualties, the most prominent category among the wounded and sick was between 20 and 25 years (Figure 1).
Military forces and civilians (volunteers and population) were injured by the variety of weapons. More than 50% of the injured in action were inflicted by the explosive devices, such as fragments of exploded bombs, grenades, high-velocity missiles, mortar and artillery sheels, antitank weapons, and particularly land mines. Also, a high percentage of bullet injuries (40.75%) could be attributed to the fact that, in combat, almost every soldier (friendly as well as enemy) carried an automatic rifle with or without a telescope. A similar relationship in percentage, with the exception of the self-wounded, could be seen in noncombat casualties (wounded out of action) (Table 2).
Classification of casualties according to place of injury showed that the highest percentage occurred at the open position (terrain), following vehicles, buildings, shelters, fortifications, and others (Figure 2).
Observation of casualties produced by bullets and fragments with those from six different wars showed that fragment injuries were dominant in World War I, World War II, the Korean, Arab-Israeli, and Yugoslavian wars. Actually, Figure 3 indicates the relative frequency of bullet-related and fragment-related wounds in seven conflicts.
For those concerned with military medicine, it is interesting to know the frequency of war wounds in different anatomic sites of the human body. Information we presented in Figure 4 is based on data from eight conflicts. The increase of trunk and head wounds can be attributed to close-range urban fighting (use of automatic rifle and high numbers of snipers) and the use of fragmentation missile multiple injuries (Figure 4).
Our data of frequency distribution of wounds after anatomic sites were different from those in World War II and following wars until today. In our data, multiple injuries represented 22.64% of the total percentage (Figure 5).
The number of casualties that received different medical care for first-aid (buddy aid) was 1714 (74.42%); for medical aid, it was 251 (54.32%); and for specialized medical care, it was 2303 patients (100%). It is interesting to point out that first-aid treatment according to the qualification of the "aid man" was: first-aid, 7%; buddy aid, 51.8%; squad and company "aid man," 13.8%; technicians and nurses, 1.8%; doctors--general, 24.1%; and doctors--specialists, 1.5% (Figure 6).
