Violation of the Global Ceasefire in Nagorno-Karabagh: A Viral Amplification of Aggression

Chekijian, Sharon; Bazarchyan, Alexander

doi:10.1017/s1049023x21000121

“…With the outbreak of war, providers found themselves treating gruesome war injuries, transporting war casualties up to six hours, and https://doi.org/10.1017/S1049023X22001522 Published online by Cambridge University Press additionally tending to wounded or deceased colleagues as ambulances, health care workers, and medical facilities became the target of enemy drone attacks and artillery. 6,18 In this study, the vast majority of participants (89.6%) felt that they were personally in danger during the fighting at least sometimes.…”

Section: Discussionmentioning

confidence: 62%

“…The 2020 Nagorno-Karabakh War saw a variety of attack modalities, including drone attacks, phosphorus bombs, shelling, and rocket strikes. 8,18 The war in turn led to massive population displacement and resulted in a humanitarian crisis as disruption of access to electricity, clean water, and medical services ensued, and people fled to shelters or bunkers to escape attack, causing an exacerbation of the existing COVID-19 pandemic. 13 Forced to respond on multiple fronts, EMS providers were challenged with treating a combination of gruesome war wounds, ill patients in respiratory distress, and displaced victims of the humanitarian crisis.…”

Section: Discussionmentioning

confidence: 99%

Emergency Medical Services Preparedness in Dual Disasters: War in the Era of COVID-19 in Armenia

Woodward

¹

,

Hertelendy²,

Hart³

et al. 2022

Prehosp. Disaster med.

0

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Introduction: Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties. Armenia is also a country prone to disasters, and recently, the Armenian EMS system was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic. Study Objective: This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers. Methods: This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients. Results: Survey response rate was 70.6%. Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score -3.26; P value <.01) or as an EMS physician (z-score -2.76; P value <.01) as well as being at least 30 years old (z-score -2.11; P value = .03). Most participants felt they were personally in danger during the war at least sometimes (89.6%). Conclusion: Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh War, EMS physicians in Armenia had limited training and experience in Disaster Medicine. This system, and the frontline physicians on whom it relies, was strained by the dual disaster, highlighting the need for Disaster Medicine training in all prehospital medical providers.

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“…The 2020 Nagorno-Karabakh War saw a variety of attack modalities, including drone attacks, phosphorus bombs, shelling, and rocket strikes. 8,18 The war in turn led to massive population displacement and resulted in a humanitarian crisis as disruption of access to electricity, clean water, and medical services ensued, and people fled to shelters or bunkers to escape attack, causing an exacerbation of the existing COVID-19 pandemic. 13 Forced to respond on multiple fronts, EMS providers were challenged with treating a combination of gruesome war wounds, ill patients in respiratory distress, and displaced victims of the humanitarian crisis.…”

Section: Discussionmentioning

confidence: 99%

Emergency Medical Services Preparedness in Dual Disasters: War in the Era of COVID-19 in Armenia

Woodward

¹

,

Hertelendy

²

,

Hart

³

et al. 2022

Prehosp. Disaster med.

0

View full text Add to dashboard Cite

Introduction: Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties. Armenia is also a country prone to disasters, and recently, the Armenian EMS system was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic. Study Objective: This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers. Methods: This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients. Results: Survey response rate was 70.6%. Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score -3.26; P value <.01) or as an EMS physician (z-score -2.76; P value <.01) as well as being at least 30 years old (z-score -2.11; P value = .03). Most participants felt they were personally in danger during the war at least sometimes (89.6%). Conclusion: Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh War, EMS physicians in Armenia had limited training and experience in Disaster Medicine. This system, and the frontline physicians on whom it relies, was strained by the dual disaster, highlighting the need for Disaster Medicine training in all prehospital medical providers.

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“…We consider an alternative, but potentially compatible, approach, i.e., the Universal Global Peace Treaty (UGPT; Carayannis et al 2019 ), currently under development by the peacebuilding NGOs-backed Global Ceasefire to Universal Global Peace Treaty Project. This article’s conceptualization of a UGPT transcends the UN’s ongoing COVID-19-inspired Global Ceasefire (Chekijian and Bazarchyan 2021 ) to adopt the Kantian concept of a ‘perpetual peace’, founded on a cosmopolitanism and a democratic state of states (Terminski 2010 ), the foundational notion which underpins the UN’s transitioning the world from war to peace. Kantian cosmopolitanism is based on respect for fellow intelligences and so is of particular relevance to ASI researchers (Totschnig 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Optimising peace through a Universal Global Peace Treaty to constrain the risk of war from a militarised artificial superintelligence

Carayannis

¹

,

Draper²

2022

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This article argues that an artificial superintelligence (ASI) emerging in a world where war is still normalised constitutes a catastrophic existential risk, either because the ASI might be employed by a nation–state to war for global domination, i.e., ASI-enabled warfare, or because the ASI wars on behalf of itself to establish global domination, i.e., ASI-directed warfare. Presently, few states declare war or even war on each other, in part due to the 1945 UN Charter, which states Member States should “refrain in their international relations from the threat or use of force”, while allowing for UN Security Council-endorsed military measures and self-defense. As UN Member States no longer declare war on each other, instead, only ‘international armed conflicts’ occur. However, costly interstate conflicts, both hot and cold and tantamount to wars, still take place. Further, a New Cold War between AI superpowers looms. An ASI-directed/enabled future conflict could trigger total war, including nuclear conflict, and is therefore high risk. Via conforming instrumentalism, an international relations theory, we advocate risk reduction by optimising peace through a Universal Global Peace Treaty (UGPT), contributing towards the ending of existing wars and prevention of future wars, as well as a Cyberweapons and Artificial Intelligence Convention. This strategy could influence state actors, including those developing ASIs, or an agential ASI, particularly if it values conforming instrumentalism and peace. Supplementary Information The online version contains supplementary material available at 10.1007/s00146-021-01382-y.

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Violation of the Global Ceasefire in Nagorno-Karabagh: A Viral Amplification of Aggression

Cited by 6 publications

References 5 publications

Emergency Medical Services Preparedness in Dual Disasters: War in the Era of COVID-19 in Armenia

Emergency Medical Services Preparedness in Dual Disasters: War in the Era of COVID-19 in Armenia

Emergency Medical Services Preparedness in Dual Disasters: War in the Era of COVID-19 in Armenia

Optimising peace through a Universal Global Peace Treaty to constrain the risk of war from a militarised artificial superintelligence

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