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Section B
Epidemiology of Armed Conflicts
Photo by Wietse A. Tol.
Complex Emergencies Epidemiology

In 2007, 34 armed conflicts were taking place (one more than in
2006)

Since 2004, only two new conflicts have begun (Niger, DRC)—all
others are ongoing or re-emerging

Most conflicts are intra-state

Most conflicts are of a protracted nature

Most conflicts take place in low- and middle-income countries
(LAMIC)
How do these facts compare with your expectations?
3
Number of Armed Conflicts 1946–2007
4
Armed Conflicts in the 1990s
5
Summary: Changes Due to Changing Trends in Warfare

Local population targeted

Violence occurring where the
populations are vs. on the
battlefield

Mass population displacement
—particularly internally

Rebel groups and governments
controlling populations
through violence and
violations of human rights
Source: UNHCR/R. Nuri/August 2009.
Yemen. IDPs recently uprooted due to violence
in the north. UNHCR provided them with plastic
sheets and tents.
6
Context of Complex Emergencies

Legacy of colonialism
(independence wars, postcolonial state restructuring)
Sources: WHO. (2002); Pedersen. (2002). Photo by Julien Harneis. Creative Commons BY-SA. Retrieved from
http://www.flickr.com/photos/julien_harneis/434783739/sizes/l/
7
Context of Complex Emergencies

Unequal access to resources/power
within states

Systematic marginalization of sociodemographic groups, e.g., women,
ethnic/religious groups

Poverty
Sources: WHO. (2002); Pedersen. (2002). Photo by MikeBlyth. Creative Commons BY-SA. Retrieved from
http://www.flickr.com/photos/blyth/165173293/sizes/o/
8
Context of Complex Emergencies

Lack of democratic processes

Rapidly changing demographic
factors (e.g., population size
increase, population
movements)
Sources: WHO. (2002); Pedersen. (2002). Photo by Wietse A. Tol.
9
Consequences of Complex Emergencies

Individual
-  Mortality: 191 million
lives lost in the 25 largest
wars of the twentieth
century, 60% not engaged
in fighting
-
Morbidity: injuries,
infectious diseases
(cholera, typhoid,
malaria, HIV/AIDS),
reproductive health
(stillbirths, premature
births, low birth weight),
nutrition problems,
mental health
Source: UNHCR/A. Kirchhof/July 2008.
Burundi. Voluntary repatriation convoy from
Tanzania arrives at Nyabitare transit center,
Ruyigi. In July 2008, shortly before the transfer
of Nduta camp, some 3,500 refugees per week
returned to Ruyigi.
10
Consequences of Complex Emergencies

Contextual
-  Destruction of food
production/
infrastructure/health
care
-
Human rights abuse:
torture, rape as a weapon
of war, disappearance
(WHO, 2002)
-
Displacement: internal
displacement and
refugees: 67 million
people, out of whom 26
million are conflictrelated IDPs (UNHRC,
2007)
Source: UNHCR/Z. Sinclair/26 April 2009.
IDPs in Sri Lanka. New arrivals following an
escalation in fighting between government
forces and Tamil rebels. Menik Farm Zone 2,
Vavuniya.
11
Discussion
12
Cycle of Violence

Consequences of violence breed new violence
13
In Summary

Consequences and epidemiology of complex emergencies

How complex emergencies impact public health, particularly mental
health
14