Fatality figures suggest medical infrastructure must be proportionate to increasing troop deployment

In three days in June, cadres of the banned Communist Party of India (Maoist) blew up an anti-landmine vehicle, raided a police camp and waylaid a Central Reserve Police Force (CRPF) patrol, killing 18 police and paramilitary troopers in south Chhattisgarh.

Days after the attacks, Union Home Minister P. Chidambaram announced the deployment of 5000 Central paramilitary personnel to assist the 12,600 and 7,200 paramilitary troops deployed in Chhattisgarh and Orissa respectively.

But fatality figures released by the Chhattisgarh police suggest that increasing troop deployment without providing an adequate medical infrastructure will simply mean more casualties more often.

While the number of troops killed every year increased from 30 in 2003 to a high of 199 in 2007 and 172 in 2010, the number of troops injured in battle has fallen sharply as have survival rates, suggesting that the Maoist attacks are becoming more lethal with each passing year.

In 2008, for instance, an injured soldier had a 56 per cent chance of survival; in 2010 his chances halved to 27 per cent. Implying that in 2010, 72 per cent of all soldiers injured in a Maoist attack died.

Statistics elsewhere

By contrast, according to The New York Times, less than 7.9 per cent of American troops wounded in Afghanistan in 2010 died. Survival rates for each year were calculated by dividing the number of the injured by the sum injuries and fatalities. In 2010, 172 troops were killed and only 65 injured, giving a survival rate of 27.4 per cent.

Year on year, IEDs accounted for about 40 per cent of the 624 troop casualties from 2007 to mid-June this year, with 2010 as the sole exception in which IEDs accounted for only 23 per cent of all fatalities.

In 2008, an injured soldier had 70 per cent chance of surviving an IED blast; in 2010 he had only a 46 per cent chance.

Gunshot injuries

In the meantime, survival rates for gunshot injuries have remained steady at about 25 per cent over the last four years.

Noticeable difference

What accounts for this difference in survival trends between IED and gunshot injuries?

Experts believe that the trend is evidence of a shift from a “hit-and-run” guerilla policy to a more evolved (and lethal) “stand and fight” strategy of mobile warfare. Previously, explosions occurred on main roads, which allowed the police to evacuate casualties. Now IED detonations are now conducted by armed Maoist squads backed by significant firepower to eliminate survivors and ambush rescue parties.

Even as ambushes remain as dangerous as ever, IED explosions have become more lethal.

“Ninety to 95 per cent of all ambushes begin with an IED blast,” said a senior police officer in Chhattisgarh, “The explosion disorients our troops and the Maoists fire before they [troops] can take cover.” Interviews with ambush survivors reveal that the guerillas also plant smaller pressure-sensitive anti-personnel IEDs in places where troops are most likely to take cover.

The Maoists have also laid larger, manually triggered IEDs along the potholed highways of Dantewada and Bastar, one of which destroyed a mine-proof vehicle (MPV) on June 10 this year and killed 10 troopers. IEDs have also killed 38 civilians in the last three years, in instances where civilian vehicles were mistaken for military convoys.

“At best, mine-proof vehicles can absorb the force of 25 kg of explosives,” said Chhattisgarh Director-General of Police Vishwa Ranjan, in a recent interview,

“The June bomb used about 80 kg of explosives.” Mr. Ranjan said the force of the explosion threw the eight-tonne MPV nearly 10 feet in the air. The wheels were found 200 metres from the site of the explosion.

He said the police could acquire vehicles capable of withstanding more severe explosions, but the Maoists would simply increase the potency of their IEDs.

The IEDs are also planted well beyond the range of metal detectors and sniffer dogs. “We can usually detect an IED buried up to three feet below the surface,” said Mr. Ranjan, “so they bury them six to eight feet deep.”

Officials say the only way to guard against IED blasts is to conduct frequent road-sweeping operations and by training soldiers to look for tell-tale signs such as exposed electrical wires and loose earth on the side of the road.

Forced to tread

By blowing up ostensibly mine-proof vehicles, the Maoists have forced troops to traverse long distances on foot before trapping the exhausted soldiers in meticulously planned ambushes. The lack of troop mobility has also crippled evacuation efforts, which translate into low survival rates for injured soldiers.

A wealth of medical data indicates that more than 90 per cent of those severely wounded die within the first hour of injury unless treated with life support. However, improvements in medical infrastructure have not kept pace with the deployment of additional troops. There are no dedicated military hospitals in Chhattisgarh to deal with soldiers injured in Maoist attacks.

No qualified doctors

“There are no doctors to treat ordinary patients in Dantewada, so where will we get specialised doctors from?” asked a senior police officer. Troops are usually evacuated to the Jagaldalpur hospital via helicopter, but none of the helicopters is equipped to provide mobile trauma care. Instead, soldiers have been issued “QuikClot,' a haemostatic agent that aids blood coagulation and saves them from bleeding to death before help arrives — if it ever does.