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Dr. Neil Arya Mr. Chairman, distinguished delegates, ladies and gentlemen, I am a family physician in Waterloo, Ontario, Canada, and President of Physicians for Global Survival, IPPNW-Canada. For many reasons, this conference has not focused on the effects of small arms in developed nations that are not at war. But, from a public health perspective, the problem of small arms, including civilian or commercial firearms, extends to those nations of relative peace and prosperity. I will try to summarize the health impact of small arms in Canada and the United States in terms of scope, patterns, and costs. The adverse health effects of small arms are well-known to emergency room physicians, trauma surgeons, psychiatrists, pediatricians and family doctors. A physician who must stem a bleed in the chest of a gunshot victim, is not concerned with whether the shooting was a suicide, accident or homicide, whether it took place in a conflict-situation or in peacetime, or whether the perpetrator was a gang member, a soldier, a non-state actor or a law-abiding gun owner. What matters to us is whether bullet struck bone, whether bone shattered, whether metal and bone splinters punctured vital organs, blood vessels, or severed the spinal cord - in short, whether the patient will survive and if so, what his or her future health will be. Ultimately though, what matters to physicians is whether this ongoing tragedy can be prevented. Every year since 1972, over 30,000 people have died from gunshot in the United States, far higher than the US toll in the entire Vietnam war. This amounts to one million deaths since 1970. The world knows of massacres such as the one at Colombine High School, but few realise that in the US, guns are the leading cause of death in the 15-24 age category surpassing even traffic accidents, and in Canada the third leading cause of death in this age group. Studies in several US cities have demonstrated that households with guns have rates of homicide and suicide that are 3-5 times those in similar households without firearms. In terms of total firearm deaths, the US rate is about three and a half times that of Canada and the number of firearms per capita in the US is 3.6 times. And the Canadian rate both for homicides and suicides is far higher than those in countries with stricter controls on access and fewer weapons. Consistent with this, studies in Canada have shown that percentage of households with firearms in each province correlates directly with the rate of firearm death. A study of more than 20 developed countries demonstrated that this correlation of % of households with firearms and firearm death rate was true across borders. And both in developed and developing countries, the vast majority of the weapons that kill or wound in crime begin as legal weapons and end up 'leaking' into situations in which they are misused in deadly ways. There are data too on the huge financial costs imposed by small arms. The direct cost of deaths and injuries due to firearms in the US has been calculated as being $14,000 for each fatal gunshot and $38,000 for each injured person. The total impact goes much further than emergency medical care. It extends to police services, to lost productivity, to rehabilitation, to psychological support for victims and their families, to children growing up without parents, and to those relations and contacts who continue to live in fear. The total cost of firearm-related problems has been estimated as being $195 per person per year in Canada and $495 in the US. But as many victims and families will attest, this does not begin to take the measure the total damage of these arms. These tolls -- human and financial -- are why major physicians organisations recognize gun injuries as a major public health problem. In the US, all large and highly respected medical organizations including the American Medical Association, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the American College of Physicians, and Physicians for Social Responsibility have been strong advocates for stricter gun control. Growing up in a small town in Ontario, I too, indirectly experienced the impact of small arms. In Grade 4, one classmate was killed accidentally by his brother in the barn; another grade school playmate was killed in hunting accident in his early twenties. For this reason too, I urge you -- both as a professional and as a private citizen -- to do what you can to reduce the toll of the global epidemic of death and injury from small arms. |