title: Impact of the political violence in Natal on emergency surgical services of a tertiary hospital.
abstract: In order to investigate the impact of the political violence in Natal on a tertiary hospital's emergency surgical services, 5 days in February 1990 (based on newspaper reports of political violence) were identified and matched for the day of week and time of month to obtain comparable control days in February 1989. Data for each of the 10 days were obtained from casualty department attendance registers and a 40% random sample of emergency outpatients' charts. Comparing violence to control days, the total number of patients treated in casualty increased by 9.6% (1,915 v. 1,747), first visits to casualty by black patients increased by 34.4% (1,741 v. 1,295) and emergency patients treated in the casualty department increased by 29.6% (206 v. 159). Gunshot injuries accounted for 21.4% and 3.1% of surgical emergencies on violence and control days, respectively (relative risk 6.79; 95% confidence interval 2.76-16,73; P less than 0.001). Men comprised 76.2% and 65.4% of surgical emergencies on violence and control days, respectively (P less than 0.05). The mean age of surgical emergency patients with gunshot injuries was 26.4 years on violence days and 31.4 years on control days. Among surgical emergencies, gunshot injuries accounted for 19.2% of ward admissions on violence days compared with 5% on control days. Political violence in Natal increased the utilisation of tertiary hospital emergency surgical services, particularly for young black men with gunshot injuries requiring inpatient care. Until there is peace in this region, tertiary hospital emergency surgical services need to be strengthened and prepared to cope with the trauma resulting from the political violence.
authors.affiliation: Department of Community Health, University of Natal, Durban.
authors.forename: S S
authors.initials: SS
authors.lastname: Abdool Karim
authors.forename: R
authors.initials: R
authors.lastname: Andelman
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D011057:Politics; D013019:South Africa; D014754:Violence