Crude Amputation: Africa’s Epidemic of Violence

1. Crude Amputation:Africa’s Epidemic of Violence Africa Project PT 270A

3. Crude Amputation Defined as: • The deliberate dismemberment of a body part to inflict pain, fear, disablement, and control of a person or population • Primarily: hands/arms, feet/legs, lips, ears, nose

4. Who is spared? • No one • Young and old • Sick and mentally ill • Men and women • Pregnant

6. Three Primary Categories of Amputations: • Crude Amputations – performed by non-surgical edged weapons (machetes, knives) • Collateral Amputations – caused by landmines and other IED’s • Islamic Sharia – laws that enforce crimes with amputations (stealing)

7. Prevalance of Amputation in Africa: • Sierra Leone • Angola • Democratic Repulic of Congo • Liberia • Rwanda

8. Crude Amputation Incidence • Sierra Leone – from 1999-2002: 20,000 amputations, 50,000 killed – in 1998 UNICEF designated Sierra Leone as the 2nd most dangerous country for children in the world • Liberia – 1989-1996: 40,000 amputations, 150,000 killed • Angola – 1992-1999: 100,000 amputations, 500,000 killed – in 1998 UNICEF designated Angola as the 1st most dangerous country for children in the world • Democratic Republic of Congo – 1998-1999: 30,000 amputations, 80,000 killed

9. Crude Amputation Incidence (cont) • Rwanda – 1994 genocide of Tutsis by Hutu militia: figures unknown but approx. 1 million people were killed over a 100 day period • Estimated that 1/3 of these fatalities were from crude amputations • 4 million people killed in Africa since 1998 – many by crude amputation • In all of these regions statistics are probably higher (gvmt cover-ups and lack of documentation)

11. Precipitating Factors for Crude Amputation • Diamond Trade • Interesting fact – Sierra Leone’s neighbor Liberia has an annual diamond mining capacity of 150,000 carats. Yet between 1994-1998, more than 31 million carats were imported from Liberia. Where did these come from? • Civil War • Socio-Economic / Political Factors • Symbolism

12. Diamond Trade • Fighting over diamond stockpiles which finance rebels and civil wars • From 1994-1998, 31 million carats were mined from Liberia alone • “Diamonds are forever, so are amputations.”

13. Civil War • Amputations used to cause fear and disablement to weaken enemy resistance – can’t fight back • Revolutionary United Front (RUF) – rebel army group that carried out most of Sierra Leone amputations (disbanded circa 2007) “Blood Diamond” movie • “You don’t hold your weapon against your brother”

14. Revolutionary United Front (RUF)

15. Socio-Economic / Political reasons • To prevent farmers/workers from harvesting crops • To prevent people from voting; through intimidation and cutting off the “voting” arm • Popular voting slogan: people “had power in their hands”

16. Rwanda political propaganda poster – translates: “What weapons are we going to use to beat the cockroaches to death.”

17. Symbolic • Emotional impact of suffering crude amputation – daily reminder • Stigma – esp. with amputations involving noses, ears, lips (isolation); but also for those who can’t work from their injuries • Women who suffered amputations also have high probability of having been raped

20. Collateral Amputations • Caused by landmines or other IED’s • Especially high statistics among children • Children see the explosive devices as things to play with (a potential toy) • Explosives are usually left over from civil wars and forgotten

22. Collateral Amputations (cont) • Over 20,000 amputations annually (largely in Africa) • 80% of those maimed are civilians • Many victims were displaced refugees trying to return back home (esp. from Angola and Sudan)

23. Collateral Amputation impacts: • Children often removed from school which limits education and socialization • Survivors often seen as a burden to family/village • Takes $3.00 to make a single landmine, $1,000 to find and safely disarm

24. Not Miss Angola …… Miss Landmine?

25. Islamic Sharia • Islamic law that allows amputation against certain crimes • Primarily used for theft (hand amputation) • Very controversial and deemed a crime against humanity by Human Rights Watch and other groups • Example: Buba Jangebe, in 2000 had his hand amputated for stealing a cow

26. Islamic Sharia

27. Islamic Sharia • Prevalent in Northern Africa (Nigeria) • Muslims hoped that it would curb high crime rates • Falling out of favor due to international pressure as well as gvmt corruption • Double standard: women often penalized more severely than men

28. Mending the Wounds • Surgical amputations performed over crude amputation sites (wound mgmt & reshaping) • Ending the violence and reeducating the people • Trauma counseling for survivors • Justice (RUF, rebel, gvmt prosecutions) • Restore Pride: Amputee’s cup, Miss Landmine, Bubble wrap prosthetics

29. Outreach & Outlook • Foreign aid which provides wheel chairs, prosthetics, and ambulation devices • Therapy services from across the world • Creating awareness of these atrocities (media) • Providing jobs to amputee survivors • Creating an inter-gvmt coalition of cooperation among African countries and states

30. Hope for the Future • Educating the people (esp. children) • Amputee survivors as advocates • Continued foreign aid • Improved medical services

31. Ultimately …even if their hands have been taken, the people must know that they still have the power to make change.

32. References • Amato, Len (Producer), Zwick, Edward (Director). 2006. Blood Diamond [DVD]. Warner Brothers Pictures. • Hawley, C (2000). The War Amputees of Sierra Leone. Canadian Medical Association Journal, 2000/06/27. • Kendall, Clare (2008). Kroo Bay, Sierra Leone. British Telegraph, 2008/04/07. • The Progress of Nations 1999. New York: UNICEF; 1999. • Smillie, I. The Heart of the Matter – Sierra Leone, Diamonds and Human Security. Partnership Africa Canada. 2000/05/31. • Yaounde, Cameron (2005). Diabetes and Foot Care: Put Feet First – Prevent Amputations. International Diabetes Federation, 2005/04/12.

33. Review questions • What areas of the body are subject to crude amputations in Africa? • Hands • Feet • Tongues • All of the above • Crude amputation is defined as: • Medically necessary amputation performed in a sterile clinical setting • Amputations done to prevent the spread of gangrene. • The deliberate dismemberment of a body part to inflict pain, fear, disablement, and control of a person or population • None of the above • Collateral amputations are caused by: • IED’s, mines, and other warfare induced amputations • Amputations done above the limb which is gangrenous to prevent further spread of the disease • Removal of a cyst and its surrounding tissue • None of the above • What is Islamic Sharia: • Religious scripture which allows holy wars to be fought against those considered unjust • Time of the month when special prayers must be offered • Religious laws which dictates that the society is to be patriarchal • Religious laws which allow for amputations to occur due to committal of certain crimes • What is the number one cause of crude amputation in Africa? • Religious belief • Medically unmanageable diseases • Diamond trade and war • Self-expression