Circumstances around weapon injury in Cambodia after departure of a peacekeeping force: prospective cohort study.

OBJECTIVE To examine the circumstances surrounding weapon injury and combatant status of those injured by weapons. DESIGN Prospective cohort study. SETTING Northwestern Cambodia after departure of United Nations peacekeeping force. SUBJECTS 863 people admitted to hospital for weapon injuries over 12 months. MAIN OUTCOME MEASURES Annual incidence of weapon injury by time period; proportions of injuries inflicted as a result of interfactional combat (combat injuries) and outside such combat (non-combat injuries) by combatant status and weapon type. RESULTS The annual incidence of weapon injuries was higher than the rate observed before the peacekeeping operation. 30% of weapon injuries occurred in contexts other than interfactional combat. Most commonly these were firearm injuries inflicted intentionally on civilians. Civilians accounted for 71% of those with non-combat injuries, 42% of those with combat related injuries, and 51% of those with weapon injuries of either type. CONCLUSIONS The incidence of weapon injuries remained high when the disarmament component of a peacekeeping operation achieved only limited success. Furthermore, injuries occurring outside the context of interfactional combat accounted for a substantial proportion of all weapon injuries, were experienced disproportionately by civilians, and were most likely to entail the intentional use of a firearm against a civilian.