Joint bid to tackle blast injuries

Blast injury research has typically been dominated by the medical sciences, but a new transdisciplinary initiative is under way to bridge the gap between medicine and engineering, aimed at reducing the injuries and deaths that result from explosive detonations.

On Wednesday, 27 March, the Blast Injury Research Network (BIRN) hosted its first workshop in South Africa in collaboration with the Blast Impact and Survivability Research Unit (BISRU) at the University of Cape Town (UCT), co-hosted by the University of Southampton.

“UCT has been doing blast research probably since the 1980s,” said Genevieve Langdon, professor in the Department of Mechanical Engineering and director of BISRU.

“We started looking at injury criteria in approximately the last five years, but not anti-personnel landmines.”

She added that BISRU has also been investigating what happens to the people in a vehicle that runs over a landmine, and ways to institute appropriate safety measures.

“But civilian injuries, like a child playing soccer in a field [who steps on a landmine] – what kind of injury would they sustain? We haven’t looked at that before, that’s brand new.”

There is no global database of historic and current blast injury research, and it is widely accepted that the evidence base that does exist is inadequate and outdated.

The Blast Injury Research Network has grown out of a collaboration between Dr Jack Denny (Bioengineering Sciences Research Group, University of Southampton), Dr Rebecca Brown (Clinical Informatics Research Unit, University of Southampton) and Langdon.

Remnants of war

Blast injuries caused by conflict, legacy landmines and explosive remnants of war (ERW) represent a global humanitarian challenge. The threat of blast injuries affects millions of people globally, particularly vulnerable populations in low- and middle-income countries.

“There are a lot of legacy landmines that were planted in civil wars and other wars on the African continent. They were buried to try and stop people crossing borders or moving areas, but once the conflict is over they remain in the ground,” said Langdon.

Along with landmines, there are ERW “which could be undetonated ordnance, like missiles”, she explained.

“Where there is still conflict in Africa, there are also a lot of improvised explosive devices which are used to try and disrupt transport. Most of these affect the civilians who are left behind when the conflict ends.”

Landmines and ERW caused an estimated 113 000 blast casualties worldwide between 1999 and 2016. In 2016, an estimated 78% of blast-related casualties were civilians, 42% of them children.

It is estimated that 110 million legacy landmines still exist around the world. Among the worst affected countries are Afghanistan, Angola, Bosnia-Herzegovina, Cambodia, Iraq, Mozambique, Turkey and Zimbabwe.

“The landmine problem is a blight on the lives of many African people. Part of our mission as a university in Africa, and for Africa, is to engage in socially responsive research that addresses real issues faced on the African continent,” Langdon said.

“Part of our mission as a university in Africa, and for Africa, is to engage in socially responsive research that addresses real issues faced on the African continent.”

“We are committed to channelling our blast engineering expertise towards reducing the injuries and deaths that result from explosive detonations, particularly those caused by landmines and explosive remnants of war.”

A transdisciplinary approach

Blast injury research has traditionally been a clinically-driven field of study, but the new network is hoping to facilitate ongoing research cooperation between the fields of engineering and medicine.

The workshop represents the first step in this partnership, which also includes stakeholders from outside of academia, to address the problem in the context of sub-Saharan Africa.

It was attended by scientists, clinicians and academics from the UK and South Africa, as well as people involved practically with demining, such as professionals from Zimbabwe who design personal protective equipment for humanitarian demining, the non-governmental organisation Action on Armed Violence (AOAV), and the HALO Trust demining charity.

“It’s complex because you’re bringing together engineers as well as medics and charities. These different faculties don’t usually talk to each other,” said Langdon.

“[Engineers] don’t read [clinical] papers because they’re published in clinical journals, and [clinicians] don’t read [engineering] papers because they’re published in engineering journals, and so we don’t speak anything like the same language.

“We each have an academic discourse and now it’s about demystifying that. So this is a first attempt at getting us to speak the same language, and actually meet each other.”

A shared language

She added: “The biggest problem in this research is that we have worked in separate disciplines for so long. I think we will be able to develop a shared language, I just think it will take time.”

“The biggest problem in this research is that we have worked in separate disciplines for so long. I think we will be able to develop a shared language, I just think it will take time.”

Funding is an additional challenge as demining is expensive and time-consuming.

“It’s not critical to anyone’s economic well-being except the poor people on the ground.

“The other hurdle is that a lot of the information that we really need is held by military and private companies that would be unwilling to share it,” she said.

They intend running another workshop later in the year, which they would like to see include people from affected sub-Saharan Africa countries. In the coming months, they will also work to broaden the network.

“We identified that we need to do a systematic study of what has gone before us, what the impact of that has been, and what the relevant things are to be researching. That’s a big question and it’s not fully answered yet. We need to try and understand the whole problem from many different angles.”

Ultimately, Langdon hopes that lives can be saved as result of this research collaboration.

“I think it would be amazing if we were able to come up with solutions; that the findings could be translated into policy that saves people’s lives. And that the blight of landmines could be eradicated in some way.

“I know that’s a vast and huge aim, but you have to aim high to achieve anything.”