The One Bullet StoryThe One Bullet Story

A project of:A project of:

Aiming for Prevention:Aiming for Prevention:An IPPNW Campaign on the An IPPNW Campaign on the

Public Health Consequences of Small ArmsPublic Health Consequences of Small Arms

IPPNWIPPNW727 Massachusetts Avenue727 Massachusetts Avenue

Cambridge, Massachusetts, 02139 USACambridge, Massachusetts, 02139 USAwww.ippnw.orgwww.ippnw.org

Project Design: IPPNWProject Design: IPPNW--Kenya, Walter Odhiambo M.D., & IPPNW Central OfficeKenya, Walter Odhiambo M.D., & IPPNW Central Office

The Human Face of The Human Face of Small Arms ViolenceSmall Arms Violence

The costs of The costs of injuries are injuries are highhigh

MedicalMedical

PsychologicalPsychological

SocialSocial

CommunityCommunityEconomicEconomic

Focus on:Focus on:

IPPNW IPPNW KenyaKenya

Authors: Authors: Dr. Walter Odhiambo, Prof. Dr. Walter Odhiambo, Prof. SymonSymon GuthuaGuthua, ,

and Paul Saokeand Paul Saoke

We present the story of a We present the story of a 1717--year old Congolese boy year old Congolese boy

referred to Nairobi referred to Nairobi University Hospital for University Hospital for surgical treatment and surgical treatment and

management of a gunshot management of a gunshot injury to the face …injury to the face …

The son of a diamond prospector, he The son of a diamond prospector, he was suspected to have diamonds by was suspected to have diamonds by rebel soldiers, who shot him in the rebel soldiers, who shot him in the

face in anger after they failed to get face in anger after they failed to get any from him.any from him.

He was fortunate to receive first aid He was fortunate to receive first aid treatment, but had to travel to treatment, but had to travel to

Nairobi for proper medical care…Nairobi for proper medical care…

A journey of 3000km through Uganda by road!

It took him over one year to It took him over one year to raise the money from family raise the money from family

and friends for travel and and friends for travel and treatment.treatment.

During this period he kept his During this period he kept his mouth, which was disfigured mouth, which was disfigured by the bullet, covered with a by the bullet, covered with a handkerchief in public.handkerchief in public.

His mandible and His mandible and maxillary bones maxillary bones were shattered were shattered by the bullet.by the bullet.

An implant was An implant was required to required to replace the lost replace the lost jaw fragment.jaw fragment.

9 hours of surgery, at a cost of 9 hours of surgery, at a cost of USD $6,000.00USD $6,000.00

Stainless steel bone plate insertedStainless steel bone plate inserted

After 9 hours of surgeryAfter 9 hours of surgery

Five days after surgeryFive days after surgery

9 Hours of theatre time 9 Hours of theatre time + 9 Hours of theatre drugs+ 9 Hours of theatre drugs+ Reconstruction plate+ Reconstruction plate+ Surgeon and nurses+ Surgeon and nurses+ Travel expenses from injury site in + Travel expenses from injury site in

DR CongoDR Congo+ Pre+ Pre--admission hotel expensesadmission hotel expenses+ Post+ Post--operative careoperative care

= $6,000.00 USD= $6,000.00 USD

+ psychological & social + psychological & social costs…like postcosts…like post--traumatic traumatic stress disorder.stress disorder.

SALW injuries are a burden on SALW injuries are a burden on health care facilitieshealth care facilities

$6,000 = One Bullet Injury, $6,000 = One Bullet Injury, or…in Kenya...or…in Kenya...

$6,000 = One year of $6,000 = One year of primary education primary education for 100 childrenfor 100 children

$6,000 = Full $6,000 = Full immunizations for immunizations for 250 children250 children

$6,000 = 1 1/2 years $6,000 = 1 1/2 years education for a education for a medical studentmedical student

$6,000 = 10 years of $6,000 = 10 years of daily daily ugaliugali meal for meal for an average Kenyan an average Kenyan family of sixfamily of six

……22--300,000 deaths per year as a 300,000 deaths per year as a result of small arms result of small arms

……639 million small 639 million small arms and light arms and light weapons are in weapons are in circulation circulation worldwide;worldwide;... Of 49 major ... Of 49 major conflicts in the 1990s, conflicts in the 1990s, 47 were waged with 47 were waged with small arms as the small arms as the weapons of choice;weapons of choice;…Annual global trade …Annual global trade in SALW is estimated in SALW is estimated at $4 billion dollars.at $4 billion dollars.

Small Arms Small Arms ––A manA man--made disease!made disease!

Proliferation Proliferation –– Armed children!Armed children!

Small Arms Violence is a Small Arms Violence is a Public Health CrisisPublic Health Crisis

Solutions Solutions include a include a public health public health approach:approach:Collect dataCollect dataIdentify Risk Identify Risk FactorsFactorsDesign Design interventionsinterventionsPrevent injuriesPrevent injuries

Smalls Arms is a Smalls Arms is a Health Crisis We Health Crisis We

Can Contain!!Can Contain!!

What Can The Medical What Can The Medical Community Do?Community Do?

Educate colleagues Educate colleagues about public health about public health dimensions of SALWdimensions of SALWCollect injury and Collect injury and mortality data to use mortality data to use for advocacy and for advocacy and policy changepolicy changeHelp design violence Help design violence prevention prevention strategiesstrategies

Care + Care + RehabilitationRehabilitation

AcknowledgementsAcknowledgements

1. Patamule Lampanya – The boy who traveled all the way from DR Congo to Nairobi in pursuit of surgical reconstruction after gunshot to the face and whose story inspired the first One Bullet Story, for consenting to the use of his pictures and story in this campaign.

2. University of Nairobi Maxillofacial Surgery department and the hospital staff for providing the theatre facilities and recovery ward for our patient.

3. The Embassy of Finland in Nairobi for sponsoring the initial One Bullet Story campaign in Kenya.

4. IPPNW Central office (Aiming for Prevention) for refining and adopting the OBS as its official small arms campaign tool.

For funding: