Years In Afghanistan Research Articles

Kārwān’s talking forest: Materiality, poetic imagination, and the metaphysics of war violence

ABSTRACT Pir Muhammad Karwan’s 2000 poetry collection Da Xāperey Werghowey traces a history of materiality, emotion, and imagination across human-environmental systems as they are militarized over twenty years in Afghanistan. At the same as it is a unique narration of the wars, this project is a cosmopolitical one. In dialog with other essays in this issue that point to the life of the immaterial in present-day traditions, I show how Kārwān’s bottom-up psycho-history draws on Persianate-classical, Pashto-popular, and embodied knowledges to critique both imperial and Islamist modernity on ontological grounds. It aims to undermine the borders of self and other that geopolitical violence embeds everywhere: barriers between human and other beings, humans and other humans, imagination and material.

Trends and Distribution of Life Expectancy and Health-Adjusted Life Expectancy - Asia-Pacific Region, 1990-2021.

The Asia-Pacific region is the most populous and diverse globally, encompassing nations with both the longest and shortest life expectancies (LE). However, less is known about the health-adjusted life expectancy (HALE) situation in this region. This study found diversity in the levels and trends of HALE among countries in the Asia-Pacific region, with HALE in 2021 ranging from 49.87 years in Afghanistan to 74.96 years in Singapore. The largest HALE increase from 1990 to 2021 was observed in the Lao People's Democratic Republic and the smallest in Fiji. HALE continually increased as SDI increased, but different patterns of HALE across countries varied by SDI level. The diversity among these countries provides a prerequisite and scientific basis for promoting the achievement of health goals in the Asia-Pacific region through multilateral and bilateral cooperation.

Effectiveness and impact of monovalent rotavirus vaccination in Afghanistan: a test-negative case–control analysis

Afghanistan introduced monovalent rotavirus vaccine (Rotarix) into its national immunisation schedule in January, 2018. While post-licensure studies have shown substantial declines in rotavirus gastroenteritis cases and deaths globally, there is little evidence of rotavirus vaccine effectiveness and impact from low-income countries in Asia. We aimed to evaluate the effectiveness of the Rotarix vaccine and the impact of Rotarix vaccine on rotavirus gastroenteritis hospitalisations (ie, hospital admissions) among children younger than 5 years in Afghanistan. We used a test-negative case-control design embedded in an active sentinel surveillance platform to evaluate vaccine effectiveness. Children born on or after Jan 1, 2018, who had documentation of their rotavirus vaccination status and who were admitted for acute gastroenteritis at one of four sentinel hospitals from May, 2018 to December, 2021 were eligible to be included. We used an unconditional logistic regression model to estimate vaccine effectiveness and 95% CIs for a complete series of doses compared with no rotavirus vaccine doses among patients admitted with acute gastroenteritis. Vaccine effectiveness against hospitalisation was calculated as (1 - [odds of being vaccinated in cases] / [odds of being vaccinated in controls]) × 100%. We compared pre-vaccine (2013-15) and post-vaccine (2019-21) surveillance data from two sites to calculate vaccine impact. The vaccine effectiveness analysis included 1172 cases and 2173 controls. Approximately 2108 (63·0%) of 3345 cases and controls were male, 1237 (37·0%) were female, and 2171 (65·0%) were aged 6-11 months. Two doses of Rotarix were 45% (95% CI 22-62) effective against rotavirus hospitalisation in children aged 6-59 months, adjusting for age, severity, admission year, and rotavirus season. Rotavirus positivity decreased from 51% pre-vaccine to 39% post-vaccine, resulting in a 39% adjusted reduction in rotavirus positivity among children younger than 5 years admitted with acute gastroenteritis. Rotarix showed moderate effectiveness in preventing rotavirus gastroenteritis hospitalisations, consistent with findings in other low-income countries. These findings support the continued administration of the rotavirus vaccine in Afghanistan. Gavi, the Vaccine Alliance. For the Dari translation of the abstract see Supplementary Materials section.

The Impacts of Globalization, Economic Growth, Population and Urbanization on Carbon Dioxide Emissions in Afghanistan

The atmospheric carbon dioxide emissions have increased since last few years in Afghanistan. This increasing trend in carbon emissions may cause global warming, climate change and environmental pollution. Consequently, these indicated threats may suffer human life and ecological conditions in near future. Therefore, this study examines the impacts of globalization, economic growth, population and urbanization on carbon emissions in Afghanistan using annual time series data for the period 1990 – 2020. The study used the Augmented Dickey Fuller and Phillips–Perron unit root tests, the Breusch – Godfrey serial correlation Lagrange multiplier (LM) test and the autoregressive distributed lag (ARDL) bounds test to examine the short and long-run relationship of globalization, economic growth, population and urbanization with carbon emissions. The empirical results show that globalization, economic growth and population have a significant positive short and long-run relationship with carbon emissions. While urbanization has a significant short-run negative and long-run positive relationship with carbon emissions. Based on results, it is highly recommended that government should design environment friendly policies related to globalization, economic growth, population and urbanization to reduce environmental pollution in Afghanistan.

Survey-based Women Empowerment Index for Afghanistan (SWEI-A): An Explanatory and Confirmatory Factor Analyses

This study aimed to develop a country-specific index to measure women empowerment among married women aged 15–49 years in Afghanistan. The data from the 2015 Afghanistan demographic health survey (ADHS) was used to develop the index. The data on 26 variables across eight hypothesized domains related to women empowerment were used in EFA to probe the underlying domains in the data. CFA examined the structural validity of hypothesized factors in EFA. Four indicators were dropped during the analysis either due to the low and significantly different loading on one factor as compared to other indicators or due to overlap with other indicators loaded on different factors. The final model included 22 indicators across seven domains (labor force participation, attitude toward violence, decision-making, access to healthcare, literacy, age at critical life events, and property-owning) and had Cronbach’s alpha = 0.69; indicative of good internal reliability. The goodness-of-fit test represented an acceptable level of construct validity with the likelihood ratio, RMSEA, and SRMR values ≤ 0.05 and CFI and TLI > 0.95. The developed index shares a common ground for future research concerning women empowerment in Afghanistan and can enhance the comparability of the results across future studies. In addition, having a standard index for women empowerment at the individual and country level could help assess the progress and efforts that have been made to achieve gender equality (SDG 5), and guide the direction of future policies and interventions.

Role of the Central Bank in preventing the liquidity crisis in recent years in Afghanistan

Purpose: The purpose of this research is to examine the financial situation of Afghanistan with a special focus on the role of the central bank in reducing the liquidity crisis. The purpose of this study is to understand the challenges that Afghan banks face in maintaining sufficient funds and meeting their obligations without incurring significant losses. Methodology: To address the research objective, this study has used a mixed method. First, we analyzed the documents obtained from international organizations, we examined the liquidity situation of Afghan banks. The research method of this research is descriptive with a qualitative approach. The results of this research describe the submissions and field observations so that they can have a clear picture of the financial situation. Banking and especially liquidity, once created, provide financial reports in response. Samples in qualitative research are often referred to as participants or informants. The selection of informed people in this research has been done using a targeted sampling method and with considerations that are directly related to the submissions of international organizations (UNDP), the World Bank, Central Bank Management (DAB) and other departments. Data by monitoring the banking sector and studying the submissions of international and domestic institutions such as Vision and Mission. Results: The findings of this research show that Afghan banks are struggling with severe liquidity problems. The decrease in economic activity, lack of public trust in the banking system and limited capacity have contributed to this issue. In addition, access to physical notes is also limited. This study shows that after the Taliban took over, several Afghan banks faced a lack of funds, which led some of them to declare bankruptcy.

Humanitarian crises in Afghanistan after re-emergence of Taliban and its implications for Pakistan

This article describes about the humanitarian crises in Afghanistan after Re-emergency of Taliban in Afghanistan. When spending more than 19 years in Afghanistan, US signed an agreement with Taliban to leave Afghanistan and US withdrew its troops slowly. Although the US was present through the three periods of administration in Afghanistan but president trump said that US should not be in Afghanistan in fourth period. After withdrawal of NATO forces Afghanistan is suffering with extreme hunger and poverty. In this way Humanitarian crisis has risen from last year after Taliban power. These crises also created serious security challenges to Pakistan. This paper aims to find the humanitarian crises after NATO withdrawal that indicates critical security concerns to Afghanistan and also for Pakistan and also tries to find some solutions through the lens of qualitative approach from existing literature and qualitative analysis.

The role of the Central Bank in preventing the liquidity crisis in recent years in Afghanistan

Purpose: The purpose of this research is to examine the financial situation of Afghanistan with a special focus on the role of the central bank in reducing the liquidity crisis. The purpose of this study is to understand the challenges that Afghan banks face in maintaining sufficient funds and meeting their obligations without incurring significant losses. Methodology: To address the research objective, this study has used a mixed method. First, we analyzed the documents obtained from international organizations, we examined the liquidity situation of Afghan banks. The research method of this research is descriptive with a qualitative approach. The results of this research describe the submissions and field observations so that they can have a clear picture of the financial situation. Banking and especially liquidity, once created, provide financial reports in response. Samples in qualitative research are often referred to as participants or informants. The selection of informed people in this research has been done using a targeted sampling method and with considerations that are directly related to the submissions of international organizations (UNDP), the World Bank, Central Bank Management (DAB) and other departments. Data by monitoring the banking sector and studying the submissions of international and domestic institutions such as Vision and Mission. Results: The findings of this research show that Afghan banks are struggling with severe liquidity problems. The decrease in economic activity, lack of public trust in the banking system and limited capacity have contributed to this issue. In addition, access to physical notes is also limited. This study shows that after the Taliban took over, several Afghan banks faced a lack of funds, which led some of them to declare bankruptcy.

The association of child marriage with morbidities and mortality among children under 5 years in Afghanistan: findings from a national survey

BackgroundThere is still a gap in knowledge of the impact that child marriage could have on the mortality and morbidity of children in Afghanistan. This study used the data from the latest Afghanistan demographic health survey conducted in 2015 (ADHS) to address this gap and advance the current knowledge.MethodsA secondary analysis of the 2015 ADHS, including the births in the past 5 years to ever-married women aged 15–24 years old, was carried out. Logistic regression analyses were employed to examine the association of child marriage (< 18y) with morbidities (diarrhea, acute respiratory infection, and fever in the last 2 weeks), mortality (neonatal, infant, child), and size at birth among the children under 5 born to women aged 15–24 years, before and after adjusting for the effect of sociodemographic and structural inequalities.ResultsApproximately two-thirds of births in the past 5 years belong to 15–24 years old mothers who married at ages < 18. The majority of them were born to mothers residing in rural areas (75.67%) with no education (51.68%) from poor households (39.39%). As compared to the births to women married at ages ≥ 18, there was a significantly higher likelihood of neonatal mortality among births to women married at ages < 18 (crude OR = 2.30, 95% CI: 1.52–3.49 & adjusted OR = 1.94, 95% CI: 1.25–3.01) and higher infant mortality among the births to the women married at ages ≤ 14y (crude OR = 1.94, 95% CI: 1.06–3.53). However, it disappeared for neonatal mortality after adjustment for adequacy of antenatal care (ANC) and infant mortality after adjustment for sociodemographic inequalities.ConclusionAlthough the births to women married as a child (< 18) were more likely to die at an early age, this association disappeared after adjustment for the adequacy of ANC. Given the unavoidable practice of child marriage in Afghanistan, this finding emphasizes the importance of providing adequate ANC for young brides to prevent child mortality. In addition, strong global advocacy is required to empower and support young Afghan women in negotiating their reproductive and maternity rights with their partners by reducing social and gender-based inequalities.

Investigating Relationship Between Liquidity and Profitability Ratios in Banks

There is no doubt that with the intensification of the financial and political crisis in recent years in Afghanistan, many banks faced a severe financial and profitability crisis, in general, among many registered and official banks in the Central Bank of Afghanistan, a large number it suffers from liquidity problem and lack of profitability. Liquidity refers to how assets can be converted into cash at the earliest time or at the lowest cost, which is called an asset with high liquidity. In terms of liquidity, the asset's liquidity is high, so it can be converted into cash at a very low cost and quickly. The higher the liquidity of an asset, the more useful it will be. Also, profitability shows the bank's ability to earn income from its assets. After examining variables such as (benefit or profitability, return on capital and liquid assets), this research examines the relationship between banks' liquidity ratios and profitability using multivariable linear regression during the years (2016-2020). The research findings show a weak but positive relationship between liquidity ratios and profitability of banks, considering the research results and also smaller than α= 0.05, so the null hypothesis can be rejected and the alternative hypothesis can be confirmed.

GERAKAN TALIBAN ANTARA JIHAD, MAKAR SERTA TRAGEDI KEMANUSIAAN DI AFGANISTAN

Afghanistan is back under the control of the Taliban shortly after the United States withdrew its troops after nearly 20 years in Afghanistan. The success of the Taliban group seizing several provinces in Afghanistan faster than the United States predicted, this then made some residents afraid and made the airport in Kabul filled with hundreds of people who wanted to leave Afghanistan. The news of this occupation has attracted the attention of the international community, there are those who are worried about the continuity of the state in Afghanistan, while those who are euphoric think that this is God's promise for Jihad carried out by the Taliban who are considered fighters. But it becomes interesting whether the struggle carried out by the Taliban in the name of Jihad or is a political strategy to control the Afghan state and form its own government. This is still an abstract analysis, but what is certain is that there is now a humanitarian tragedy for refugees who are waiting for the certainty of their survival to obtain asylum from other countries.

Unequal coverage of nutrition and health interventions for women and children in seven countries.

ObjectiveTo examine inequalities and opportunity gaps in co-coverage of health and nutrition interventions in seven countries.MethodsWe used data from the most recent (2015–2018) demographic and health surveys of mothers with children younger than 5 years in Afghanistan (n = 19 632), Bangladesh (n = 5051), India (n = 184 641), Maldives (n = 2368), Nepal (n = 3998), Pakistan (n = 8285) and Sri Lanka (n = 7138). We estimated co-coverage for a set of eight health and eight nutrition interventions and assessed within-country inequalities in co-coverage by wealth and geography. We examined opportunity gaps by comparing coverage of nutrition interventions with coverage of their corresponding health delivery platforms.FindingsOnly 15% of 231 113 mother–child pairs received all eight health interventions (weighted percentage). The percentage of mother–child pairs who received no nutrition interventions was highest in Pakistan (25%). Wealth gaps (richest versus poorest) for co-coverage of health interventions were largest for Pakistan (slope index of inequality: 62 percentage points) and Afghanistan (38 percentage points). Wealth gaps for co-coverage of nutrition interventions were highest in India (32 percentage points) and Bangladesh (20 percentage points). Coverage of nutrition interventions was lower than for associated health interventions, with opportunity gaps ranging from 4 to 54 percentage points.ConclusionCo-coverage of health and nutrition interventions is far from optimal and disproportionately affects poor households in south Asia. Policy and programming efforts should pay attention to closing coverage, equity and opportunity gaps, and improving nutrition delivery through health-care and other delivery platforms.

Creativity in Higher Education; A Way to Achieve Sustainable Development in Afghanistan

In the new age and the conflict of competition between societies, the superiority of countries depends on the extent to which they benefit from modern science and knowledge, and ultimately the scientific effort and technology that generates creative and efficient human resources as the main factor Finding development. Higher education represents an important type of investment in human resources and contributes to sustainable development by providing and promoting the knowledge, skills and attitudes needed by learners. Higher education promotes knowledge and new research and scientific advances. And this new knowledge owes much to human creative thinking. Therefore, creativity is one of the most important and pervasive human activities. Higher education as a manifestation of the culture of any society has a great role in the dynamism and creativity of learners. Looking at the events of the last hundred years in Afghanistan, we will know that what should have been considered in the educational centers has not been observed. A severe blow has been dealt with the various economic, social, political and cultural sectors of Afghanistan. The purpose of this article is to introduce creativity in higher education and examine its role in sustainable development to raise the attitude of educators. Because the key to cultural education, which is the key to the development and progress of society, must be found in the hands of novice and innovative teachers who believe in different creative teaching patterns.

The association between area of residence and sufficient antenatal tetanus vaccination in women ages 15\u201349 in Afghanistan: an analysis of the 2015 DHS dataset

BackgroundNeonatal tetanus (NT) is a deadly nervous system disorder that is endemic to Afghanistan. Administering sufficient doses of tetanus toxoid containing vaccine (TTCV) during pregnancy can pass antibodies to the fetus and therefore prevent NT. Using survey data, we investigated the association between area of residence (urban or rural) and sufficient antenatal TTCV coverage among women aged 15–49 years in Afghanistan during their most recent pregnancy in the past 5 years that resulted in a live birth. Mother’s education level was also assessed as a potential effect modifier.MethodsSecondary analysis was performed on data from the 2015 Afghanistan Demographic and Health Survey (AfDHS). The 2015 AfDHS was a nationally representative survey with participants selected in a stratified two-stage sample design from urban and rural areas across Afghanistan’s 34 provinces. Data were analyzed on 19,737 women ages 15–49 that had a live birth in the 5 years preceding the survey. The relationship between area of residence and sufficient antenatal TTCV was assessed in a multivariable logistic regression model, adjusting for several confounding variables.Results55.1% (95% CI = 51.6–58.5%) of urban women and 53.9% (95% CI = 49.7–57.9%) of rural women had sufficient tetanus vaccination coverage in their most recent pregnancy. In multivariate analysis, there was strong evidence for greater odds of sufficient antenatal tetanus vaccination in rural areas (OR = 1.62; 95% CI = 1.18–2.24, p = 0.003). There was no effect modification on this association by mother’s education level.ConclusionsWomen in rural areas of Afghanistan have greater odds of receiving sufficient antenatal tetanus vaccination than women in urban areas. Further study into factors contributing to this urban-rural disparity is needed. Targeted antenatal tetanus vaccination strategies for urban and rural women will be necessary as Afghanistan continues to work towards NT eradication.

Searching for Significance among Drug Lords and Death Squads: The Covert Netherworld as Invisible Incubator for Illicit Commerce

In a search for appropriate theory, this essay inserts drug trafficking, the world’s largest illicit economic activity, within a wider analytical frame called the ‘covert netherworld.’ Through the convergence of three factors—covert operations, illicit commerce, and social milieu—such netherworlds can form at regional, national, and international levels, thereby transforming social margins of crime and illicit commerce into potent sources of political change. By deftly playing upon this netherworld’s politics and illicit commerce along the Burma-Thai borderlands, a regional ‘drug lord’ amassed sufficient local power to dominate the global heroin trade for over a decade and simultaneously sustain an ethnic revolt for nearly 15 years. In the Philippines, the illicit traffic in synthetic drugs developed a parallel power to influence the character of national politics, compromising three presidential administrations and shaping the moral economy of political life. For the past 40 years in Afghanistan, an illicit commodity, opium, has shaped the fate of military intervention by the world’s sole superpower, allowing it an initial success and later contributing to its ongoing failure. Through the sum of these cases, the essay concludes that the covert netherworld can serve as invisible incubator for a range of extralegal activities and has thereby attained sufficient autonomy to be treated as a significant factor in international politics.

Trends in Life Expectancy and Its Association with Economic Factors in the Belt and Road Countries-Evidence from 2000⁻2014.

In 2013, China launched the Belt and Road (B&R) Initiative in an effort to promote trade and economic collaboration. This study examined the change in life expectancy (LE) among countries along B&R and studied the impact of economic development on LE. Data from 65 B&R countries from 2000 to 2014 were compiled and analyzed. Trend of LE was examined by sex and country. Linear quantile mixed model was used to study the associations between LE and economic factors. In 2014, the average LE in all B&R countries was 69.7 years for men and 73.7 years for women. Across countries in 2014, LE for men ranged from 58.6 years in Afghanistan to 80.2 years in Israel. LE for women ranged from 61.3 years in Afghanistan to 85.9 in Singapore. GDP per capita was positively associated with longevity across B&R countries. The unemployment rate was positively associated with LE only for countries in the top LE quantiles. GDP growth rate and Inflation were negatively associated with LE for the countries in the bottom LE quantiles for men, not for women. LE increased substantially among B&R countries during 2000–2014. The influence of macroeconomic factors on LE was related to the distribution of LE.

Vaccination status of children aged 1–4 years in Afghanistan and associated factors, 2015

BackgroundChildhood mortality in Afghanistan fell by half between 1990 and 2015, due in part to the government’s commitment to improving pediatric immunization services. Although progress has been made, immunization coverage has nonetheless remained low with only 65% of children receiving the third dose of Diphtheria-Pertussis-Tetanus (DPT3) based on WHO estimates. This study aims to calculate the proportion of Afghan children aged 1–4 years who were fully vaccinated, under-vaccinated, or non-vaccinated with government-recommended Expanded Program on Immunization vaccines and identify predictors related to the family’s sociodemographic status and maternal autonomy. MethodsData from the 2015 Afghanistan Demographic and Health Survey was used to calculate the proportion of children who were fully vaccinated (i.e. received all recommended vaccines), under-vaccinated (i.e. received some, but not all), and non-vaccinated (i.e. did not receive any vaccines) according to WHO guidelines. A multivariable multinomial logistic regression model generated odds ratios for under-vaccination and non-vaccination versus full vaccination, and examined associations between independent factors and full vaccination status. ResultsWe found 40.6% of Afghan children age 1–4 were fully vaccinated, 42.4% under-vaccinated, and 17% non-vaccinated. Large disparities characterized immunization coverage among provinces and between urban and rural regions. Birthing in a government institution (vs. non-institutional setting), a higher number of antenatal care visits, and a visit to a health facility in the past 12 months were all associated with increased odds of full immunization. Factors related to maternal autonomy including maternal decision-making and maternal attitudes towards beating were also significantly associated with vaccination status. ConclusionApproximately 60% of children in Afghanistan are under-vaccinated or non-vaccinated, leaving millions of children unnecessarily at risk for vaccine-preventable diseases. Engagement with community and religious leaders to create programs that increase women’s autonomy and expand access to institutional delivery could lead to downstream increases in childhood vaccination coverage.

Trends in infectious disease incidence among children in Afghanistan at a time of public health services expansion.

This study reviewed trends in the incidence of common communicable diseases among children under five years in Afghanistan between 2005 and 2013, a period of expansion of public health services. New visits to outpatient clinics constituted the denominator for calculating proportions. In 2013, almost three-quarters of all new visits of children to public health services were for an infectious disease, with respiratory infections the most common. Because of inconsistent data collection for some infections early in the period, the trend for infectious diseases as a whole cannot be estimated. However, there was a statistically significant downward trend in the proportion of new visits that were diagnosed as one of the 11 leading communicable diseases from 74.5% in 2005 to 62.1% in 2013 (P < 0.001). There was no difference in communicable disease patterns between provinces, but a higher per capita consultation rate was associated with a higher proportion of the leading infections (P = 0.008). Recent improvements in maternal health, hygiene, and preventive services may have had an impact in reducing the burden of infections.

Escalation, Emulation, and the Failure of Hybrid Warfare in Afghanistan

ABSTRACTIn this article, I argue that hybridization is a contingent result of the dynamics of some conflicts but not others. In particular, faced with opponents with great power, weaker powers seek a situation of asymmetry to gain victory. Drawing on within-case analysis of the conduct of war during the past thirty years in Afghanistan, I demonstrate that what we now consider to be “hybrid” represents an important continuity and strategic option in Afghan warfare. Still, the analysis also demonstrates that choosing “hybrid” has not been a strategy that has worked. Hezb-i-Islami's rather limited attempt for conventionalization of the war against the forces of Dostum and Massoud in 1992 failed and the Taliban's more far-reaching attempt for conventionalization has so far also failed to reap strategic success. This suggests that the threat of hybrid war is inflated.

Retrospective Analysis of Role II Military Hospital Emergency Department Admissions in Operation Enduring Freedom of Afghanistan

Background: The North Atlantic treaty organization (NATO)-led international security and assistance force (ISAF) conducted training, development, and humanitarian activities in addition to security operations during its 13 years in Afghanistan. Objectives: The aim of this study was to present the emergency department experiences of Kabul Ataturk Role II military hospital. Materials and Methods: We performed a retrospective observational study of emergency department admissions at Kabul Ataturk Role II Military hospital during a 12-month period from August 2012 through July 2013. Results: During the 12-month study period, 4348 patients were admitted to our emergency department. Admissions were evaluated as two groups according to trauma exposure of the patients and we detected that the Afghan civilian group had a higher number of admissions with stab wounds and burn injuries compared to the other groups. Moreover, our study results presents higher rates of surgical, orthopedic, and mixed treatments on the Afghan civilian group compared with other groups of patients. Conclusions: Humanitarian care facilities, including medical assistance, are still vital for the Afghan society. Participation of women and/or Muslim caregivers may enhance accessibility, particularly for Afghan women. We believe that the availability of emergency medicine facilities in a hospital setting at a reachable location for Afghan civilians is an effective and profitable choice for medical services. In terms of emergency medicine, the department should be prepared for orthopedic traumas, combat injuries including mine and gunshot wounds, and burn injuries.