With the possible exceptions of chemical and biological weapons, Iraq’s armaments would inflict the same kinds of injuries that soldiers have suffered since medieval times: burns, shock, blood loss, organ damage. “It’s not that there’s a whole new breed of injuries,” says Dr. John Pastore of International Physicians for the Prevention of Nuclear War. What has changed is the volume and intensity of possible carnage. Some of the specific hazards American troops could confront:
Iraqi infantry rely largely on Tabuk assault rifles and AK-47s, the Soviet-made guns that U.S. forces encountered in Vietnam. Bullets from these weapons travel at astounding speed and create a shock-wave effect, causing penetration wounds that far exceed their own diameter. A quarter-inch AK-47 slug makes a wound several inches wide and can ravage various systems on its way through the body.
The shrapnel thrown off by mines, mortars and artillery shells can kill without ever penetrating the flesh. The sheer impact of shrapnel shatters bones, severs veins and can damage the brain and other organs. Ground troops might also encounter “improved fragmentation munitions,” artillery shells designed specifically to fill the body with innumerable tiny fragments. Their purpose, notes Dr. Arthur M. Smith, a specialist in military medicine at the Medical College of Georgia, is not to kill but to “create a diverse and widely distributed spectrum of tissue damage.” The grisly logic is that wounded soldiers are a greater burden than dead ones.
Unlike artillery shells, these new devices contain no metal; they’re just highly compressed fuel capsules with horrendous explosive force. (A fuel-air bomb caused the 1983 explosion that killed 241 U.S. Marines in Lebanon.) When one of these devices is detonated above ground, the blast extends hundreds of yards. Everything in its path is incinerated, and the resulting shock waves can damage or destroy lungs and other organs.
Many analysts question the strategic value of chemical agents, but Saddam has threatened to use them. Nerve gases, which Iraq unleashed in Iran and Kurdistan, cause convulsions and death by poisoning the central nervous system. Mustard gases are less lethal (only 1 percent to 5 percent of those exposed to the fumes die), but they’re highly toxic to eyes, skin and lungs.
Saddam denies he is equipped to practice germ warfare, but he is widely thought to have stockpiled the agents responsible for such diseases as typhoid, tularemia, anthrax, botulism and cholera. U.S. officials have shown particular concern over the anthrax toxin (which can be delivered by missile) and over the deadly botulin toxin, a few ounces of which can poison an entire water supply. Botulism can be treated with antitoxin, but keeping the patient alive often requires a respirator.
Inner-city emergency rooms are rife with the kinds of wounds a ground battle might produce; the military actually uses them to train combat doctors. But there are important differences between treating civilian trauma and dealing with war injuries. Battlefield doctors have fewer resources, yet they receive larger onslaughts of patients and the patients tend to suffer multiple wounds.
Consider what happens when a modern antitank weapon hits an armored structure. Flying metal fragments may pierce or fracture the skull, bones and organs. Meanwhile, the blast itself sends a shock wave through the body, destroying delicate lung tissue. As fire breaks out, it not only sears unprotected flesh but creates a cloud of toxic smoke. “The same soldier may be burned, shocked, penetrated and poisoned,” says Col. David Sa’adah, a clinical adviser to the Army surgeon general’s office. And the gulf war could produce such injuries “in numbers we haven’t experienced before.”
Though battlefield treatments have improved vastly in recent decades, analysts say quick evacuation is still the key to saving lives. In Vietnam, ground troops were rarely more than an hour’s helicopter ride from a full-service army hospital. Blowing sands and lack of cover could impede initial rescue efforts in the desert. And as field and floating hospitals fill up, the wounded could end up traveling as far as Europe or the States for definitive treatment. With more than a million troops amassed in the gulf, the potential for carnage is immense. For the U.S. military, dealing with it could prove the toughest part of the gulf mission.
