Conflict

The information here is provided by courtesy of the Network's short online course - "An Introduction to Global Health".

History is full of descriptions of conflict at both individual and national levels. Malthus included it as one of three checks on the growth of the population - hunger, disease and war.

Throughout time, conflict has taken young males away from their normal work on the land to provide food for the family. Travelling to battles, they move to new areas where they take the food cultivated by others. If they are harbouring any disease e.g. the plague, then they take these with them and pass them on to others. They are open to disease and hunger during their travels. They are then either killed in battle or return home to lands that have not been kept up and the planting season may have been missed. They and their families are then at further risk of hunger and disease.

In 2016, humans caused almost as many deaths (546,000) as mosquitoes (780,000), which caused 10 times as many deaths as the next main cause – snakes (75,000). Snakes may be dangerous, but not nearly as dangerous as humans.

Frequency of conflict

Conflicts between the “Great Powers” have been frequent since the 1500s with the most catastrophic being in the 20th century with the two world wards. However, since then, there has been a decline. (Figure 1)

Figure 1

Types of Conflict

There has also been a change in the pattern of conflicts with fewer conflicts between states but more civil conflicts, with or without foreign state interventions. (Figure 2)

Figure 2

Casualties

There has also been a change in the type of people who are killed. Although formal and informal combatants are killed, the burden of death is now substantially carried by non-combatants (civilians). (Figure 3)

Figure 3

Other health effects of conflict on civilians

Conflict interrupts the normal delivery of health care, both preventive and treatment.

Vaccination programmes, management programmes for long-term conditions e.g. hypertension, diabetes are disrupted. Destruction of clean water supplies and crowding of displaced people increase the chances of disease outbreaks such as cholera. Problems with normal food supplies lead to hunger and malnutrition. Disruption to and destruction of civilians businesses lead to poverty. Women and children tend to be most affected and women can be the target of attacks.

Survivors have then to pick up their lives again having lost critical infrastructure and perhaps members of their family. The wounded, often children, may be disabled for life. The hidden mental health scars may take a very long time to heal. In prolonged conflict, children norms may be that of fighting, which they then carry forward in their lives.

To find out more about the Public Health Effects of Armed Conflict, have a look at this You Tube clip

https://www.youtube.com/watch?v=hFTjEHSBkaI

Forced Migration

The other major impact of conflict is displacement where civilians have to move elsewhere for their safety and become refugees.