Variation of gunshot injury patterns in mortality associated with human rights abuses and armed conflict: an exploratory study

Abstract

The analysis of the distribution of gunshot injuries in a sample of 777 sets of human remains of proven human rights abuse from Somaliland, the Balkans and Peru is compared to frequencies of injuries sustained by combatants in contemporary conflicts reported in the literature. Principal Component Analysis (PCA) reduced the data to three components accounting for 82.94% of the variance. The first component with 38.31% of variance shows segments Arms and thorax/abdomen to be positively correlated (0.887 and 0.662, respectively); the segment head/neck is strongly correlated (0.951) to the second component while the segment thorax/abdomen shows a low, negative correlation (−0.388). Finally in the third component only the legs are strongly correlated (0.991). Data was further subjected to a K-means cluster analysis to determine the likely groupings combining the four types of injuries. Each of the three clusters reproduced similar patterns observed in the PCA: Cluster 1 shows the prevalence of injuries to the thorax/abdomen and extremities in addition to injuries to the head/neck; Cluster 2 shows injuries to the head/neck and Cluster 3 injuries to the thorax/abdomen and a lower representation of the arms and legs. Most of the cases (70.5%), irrespective of geography and type of site (attack or detention), were grouped into Cluster 2. Such comparison shows that in human rights abuse, irrespective of their geography, gunshot injuries tend to follow a pattern favouring the head/neck and thorax/abdomen areas over the extremities, the reverse pattern observed in contemporary combat operations. In those settings gunshot wound trauma is the second cause of mortality/morbidity (after fragmenting ammunition) and its distribution concentrates on the extremities, thorax/abdomen and head; following the pattern of protective armour when it is used. Considering that human rights abuses are often presented as encounters between two armed groups in the context of counter-insurgency operations, a careful analysis of gunshot injury patterns could serve as an indicator that in fact murder, rather than combat, took place and the intention was to kill rather than to maim or render people unfit for battle. ObjectiveTo compare the variation of gunshot injury patterns between mortality associated with human rights abuses and armed conflict in selected samples from different countries. DesignLiterature review and case analysis. SettingsOriginal statistical analysis of gunshot injuries on human remains (n=777) recovered from mass or clandestine graves associated with human rights abuses in countries in Somaliland, the Balkans and Peru (1983–1995) and literature review of mortality caused by armed conflicts. Main outcome measureMechanism of gunshot injury and wound distribution pattern in geographically diverse samples of human rights abuse.