A Personal View

Abstract

The period 1982–2010 covers nearly 30 years and has seen an exponential growth and global spread of war and conflict. Terrorist attacks and revolutionary wars remain a constant threat affecting the world from the United States, Europe, the Middle East, and Africa to Asia. When the 1st Edition of this book was published in 1997 Professor Howard Champion and his colleagues wrote the Foreword and emphasized that intentional injury had reached pandemic proportions of which the most lethal expression was ballistic injury. Although they recognized the existence then of war and insurrection they felt that the risk of mass armed force combat at close quarters seemed to be diminishing and that the greater risk of ballistic injury was within civil society, particularly in the United States. In the Preface to the first edition the editors noted: “The lesson of history is that you cannot take the experience of an urban hospital onto the battlefield. It can also be said that you cannot do the reverse, and nowadays there is further confusion from the deployment of troops to peacekeeping duties performed under the scrutiny of the media. The latter is not the same as war.” The events of the following decade have called these beliefs into question. None could have foreseen the world shaking events that were to occur during the opening years of the twenty-first century – the terrorist attacks in the United States on 9 September 2001, the invasion of Afghanistan the same year by a US led coalition, the invasion of Iraq by a US led coalition in 2003, terrorist bombings in Madrid in 2004, terrorist bombings in London in July 2005, and countless other terrorist and insurgency events on every continent. It is sobering to visit Wikipedia and to note the seemingly endless list of terrorist events recorded for the period 1982–2009. War and terror have come to our streets, towns, and cities causing civilian urban hospitals to take on the mantle of field hospitals in war.