Global Conflict, War Zones, and Human Health
An ethical, theoretical and philosophical analysis on global conflict, war zones and
human health, particularly focusing on the impact war has on population health,
culture and society.
No More Abuse: The King Khalid’s Anti-Domestic violence Campaign
No more abuse is Saudi Arabia’s first anti-domestic abuse campaign released in 2013
by the King Khalid Foundation (Carrington, 2013). The full-page advertisement
addresses gender inequality and domestic violence in war conditions through an
emotive image of a woman with a black eye clearly visible beneath her burka
(Kownacky, 2013). The Arabic script below the image reads, “Some things can’t be
covered, fighting women’s abuse together”. This was a powerful and shocking
message for Saudi Arabia, as the nation’s laws do not criminalize domestic violence
or spousal rape (Carrington, 2013). In Saudi culture the prevalent attitude that it is
acceptable to beat women for insubordination has led to the intervention of the King
Khalid Foundation who aim to educate and raise awareness of women’s health in the
Middle East.
The Public Health Issue:
The World Health Organization’s Report on Violence and Health reveals that
approximately 1.6 million deaths occur each year due to conflict and war (Iqbal,
2006). In addition, war has been found to cause high mortality rates, infectious
disease outbreaks, and social divisions in society, as well as the destruction of health
care systems, cultures and resources (Sidel & levy, 2008). This highlights the need to
address the public health issue of war and the negative impact on global health
(levy, 2008). Furthermore, this report will explore the consequences of war including
the destruction of infrastructure and the health care system, the impact on the
environment, the decline in human health and women in war.
What is Current Literature Saying?
1.0 Consequences of War:
1.1 Destruction of Infrastructure and Health care systems:
Conflict and war often cause damage to infrastructure such as the destruction of
hospitals, water supplies, sanitation systems and power grids (Iqbal, 2006). This
limits the ability for a society to provide basic health care for its population and puts
an enormous burden on the health care system (levy, 2008). Limited resources are
often seen in volatile war situations including shortages of medical supplies, staff,
food, fuel, electricity, and clean drinking water (levy, 2008). This only exacerbates
the situation and creates poor sanitation and reduces environmental health
conditions (Sidel & levy, 2008). It is these unhygienic conditions and poverty that
lead the high prevalence rates of infectious diseases and the top causes of mortality
in war situations (Hoeffler, 2008). Furthermore, the lack of vital infrastructure means
it is hard to treat patients with life-threatening diseases without access to structured
health care (Iqbal, 2006). Resources are also diverted to military purposes and away
from education, housing and medical services (Sidel & levy, 2008). This reinforces
that the environment, in which many civilians are exposed to, lacks the resources,
financial funding, infrastructure and health care systems it needs to be effective
(Hoeffler, 2008).
1.2 Impact on the Environment:
In war circumstances the environment is often damaged by the use of weaponry and
polluted by exposure to radiation, toxic substances and infectious agents (Sidel &
levy, 2008). This creates an environment that has detrimental and sometimes
unforeseen human health impacts (levy, 2008). An example of this was seen in the
Vietnam War when U.S military forces used Agent Orange, a powerful chemical
herbicide, during the Vietnam War from 1961 to 1972 (Le Cao Dai, 2010). As the
Vietnam troops relied heavily on the dense forest terrain as a source of food and
shelter, the aim of Agent Orange was to intentionally defoliate tree cover and
destroy croplands (Azim, 2010). It is known that the U.S sprayed more than 19
million gallons of herbicides over 4.5 million acres of land in Vietnam (Institute of
Medicine of the National Academies (IMNA), 2009). As planned this had devastating
effects on the land, ecosystems and water supplies (Le Cao Dai, 2010). Later
however, it was discovered that dioxin, a toxic contaminant found in the herbicide,
severely affects human health (IMNA, 2009). The chemical was found to cause
serious health issues including neurological damage, birth defects, cancer, and
tumors (IMNA, 2009). A number of illness also have strong associations with
exposure to the chemical, including Type 2 Diabetes, Parkinson’s disease, Ischemic
heart disease and prostate cancer (Azim, 2010). Five million Vietnamese civilians and
U.S veterans were found to suffer from health issues due to the exposure to Agent
Orange (Azim, 2010). Although 50 years has passed since Agent Orange was used in
Vietnam, approximately two million people still suffer from side effects (Le Cao Dai,
2010). This emphasizes that war creates large-scale population health issues and
affects the environment and human health for years following conflict.
Detrimental Human Health impacts of Agent Orange (Azim, 2010)
1.3 Declines in Human Health:
Although the most recognized consequence of war is mortality due to combat; most
war related deaths are actually due to infectious diseases and the lack of clean living
conditions (levy, 2008). Lacina and Gleditsch (2005) investigated the trends in global
combat and gathered a clear data set of the number of deaths due to combat. The
data set below in Table 1.1 shows the number of military deaths in selected African
countries, as this nation has one of the highest prevalence’s of conflict (levy, 2008).
The last column of Table 1.1 shows the percentage of combat deaths in relation to
the total deaths. This indicates that deaths from military forces are less than one
third of all deaths due to war (Hoeffler, 2008). Furthermore, this highlights that
indirect deaths such as disease and unhygienic conditions are responsible for the
high mortality rates in war situations.
Table 1.1 Military War Deaths in Selected African Countries
Country
Years
Total Deaths
Battle Deaths
Angola
1975-2002
1.5 million
Mozambique
1967-1992
0.5- 1 million
Sudan
1983-2002
2 million
DRC
1998-2002
2.5 million
Source: (Lacina & Gleditsch, 2005, p.159)
160,500
145,400
55,000
145,000
% Battle Deaths
11%
15-29%
3%
6%
The Syrian civil war is a clear example of how conditions of war exacerbate the risk
factors for the spread of infectious diseases (levy, 2008). The outbreak of war in Syria
led to the destruction of medical infrastructure and the deterioration of
immunization programs, leaving civilians vulnerable and exposed to preventable
diseases (Kanj & Sharara, 2014). According to the World Health Organization,
between 2010 and 2013 vaccination coverage in Syria dropped from 91% to 45%,
which lead to more than 3500 preventable cases of measles and 170 unnecessary
deaths in Syria (World Health Organization, 2014). In addition to measles, since the
onset of the Syrian war there have been increased occurrences of hepatitis A,
leishmaniasis, poliomyelitis, meningitis, and scabies (Kanj & Sharara, 2014). This
reinforces that human health conditions severely decline in war conditions.
Furthermore, the spread of infectious diseases is a global health threat due to the
increasing numbers of refugees seeking safety in other countries (Kanj & Sharara,
2014). As seen in the Syrian crisis, refuges introduced communicable diseases into
neighboring countries including Lebanon, Jordan and Iraq (Kanj & Sharara, 2014).
These rippling consequences of war pose significant health threats globally.
1.4 Women in war:
Civilians are increasingly targeted and subjected to human rights abuses in war
conditions (Arcel & Kastrup, 2010). Women in particular face severe health risks as
several surveys reveal that women are exposed to gender-based violence in war
such as rape, sexual mutilation, slavery and forced prostitution (Usta, Farver & Zein,
2008). Furthermore, women’s health in war is significantly disproportional to the
risks men face in the same circumstances (Hoeffler, 2008). A reason for this could be
due to the modern approach to war where rape and sexual abuse are used as
premeditated military strategies (Spark, 2010). As explained by a report by Medecins
Sans Frontieres, sexual violence is used as a tool to destroy opposing communities
and to emphasize their control and power (Spark, 2010). The direct quote from the
Women’s Health Journal reinforces this:
“Women’s bodies [are] the battlegrounds where sexual violence becomes a weapon
of war used to express power and to humiliate, dominate, and disrupt”
(Ustra, Farver & Zein, 2008).
The vulnerability of women is strongly related to their gender, socioeconomic
position, and refugee status (Arcel & Kastrup, 2010). Literature supports this
statement as reports reveal that displaced women are at the greatest risk for
discrimination, rape and domestic violence (Iqbal, 2006). An example of this was
seen during the Lebanese civil war where two hundred and seventy-five women
were reported to have left their homes during the conflict (Usta, Farver & Zein,
2008). Of these women, many were exposed to violence and abuse as 25% were hit,
16% were threatened with a weapon, 14% were sexually abused, and 71% were
fearful and worried about their safety (Usta, Farver & Zein, 2008). This reinforces
that women’s health in war is constantly at risk due to the sexual and gender-based
violence especially in displaced populations (Arcel & Kastrup, 2010).
Cultural and Social analysis:
In order to understand important public health issues, such as the impact of war on
global health, it is important to apply social and philosophical theories to gain a
comprehensive analysis of the issue. This issue is particularly significant as war has
helped shape modern society and has caused great social and political changes
throughout history (Malesevic, 2011). Furthermore, without violent conflict and war
the present world would be inconceivable (Malesevic, 2011).
2.0 Conflict Theory:
A number of social theories focus on war and the inevitable social changes and
transformations that follow (Malesevic, 2011). In particular, conflict theory is a
predominant theory which applies strongly to war and focuses on the inequalities
between social classes (New world Encyclopedia, 2013). Conflict theory is based on a
pyramid like structure, as seen below in Figure 1.1, which represents the idea that
laws and traditions in society are designed solely to support those in power
(Malesevic, 2011). Wealthy people are considered to be superior and are placed at
the top of the structure, while the working class are positioned below them and are
considered to be inferior (New World Encyclopedia, 2013). According to this theory,
the constant competition for power between social classes leads to social changes in
society (New World Encyclopedia, 2013). Specifically, these changes are not due to
adaptation but conflict between competing groups (Malesevic, 2011).
Figure 1.1. Conflict Theory Pyramid
Ruling
Class
Educated Class
Working Class
Conflict theory offers a useful perspective on the analysis of war and the impact on
society (Malesevic, 2011). In particular, conflict theorists Karl Marx, Émile Durkheim,
Max Weber and Janet Chafetz will be used to further analyze conflict theory and
explain the public health issue of war and global health.
2.1 Marx and Durkheim:
Karl Marx and Émile Durkheim both produced theories that focused on social
changes as a consequence of war (Malesevic, 2011). Durkheim (1952) investigated
the association between suicide rates and war (Malesevic, 2011). As war creates
harmony and positive changes in society, Durkheim concluded that the outbreak of
war leads to a substantial decrease in suicide rates (Malesevic, 2011). Similarly, Marx
(1999) claimed that war lead to beneficial growth, development and advancements
within a society (New World Encyclopedia, 2013). In relation to conflict theory, Marx
believed class divisions were one of the most important sources of social conflict
(Shortell, 2010). Furthermore, he explained that material conditions, such as land
and labor, allowed social groups to rise to power as material wealth allowed them to
propagate their views easily to society (Shortell, 2010). Marx also reinforced the
inequality in society as he stated that capitalists exploit the working classes for labor
and do not share the profits equally (Shortell, 2010).
2.2 Max Weber:
Max Weber developed a theory that redefined Marx’s theory of social stratification
and power distinction (Shortell, 2010). Unlike Marx, Weber did not believe that
material wealth led to power and superiority in society (Shortell, 2010). Instead
Weber introduced the idea that in addition to material possessions, other factors
such as social status and political influences contribute to the rise and power of
groups (Malesevic, 2011). The incorporation of other variables led to a more flexible
view of social differences and the hierarchy of society (Shortell, 2010). Furthermore,
it is this hierarchy and distribution of power, which leads to conflict as those without
power seek social change (Malesevic, 2011).
2.3 Janet Chafetz and Feminism:
Janet Chafetz is a feminist theorist who focuses on explaining gender stratification in
societies and incorporates Marx theories of class inequalities (Turner, 2003). Chafetz
believes that gender inequality is strongly related to divisions of labor in society
(Turner, 2003). More specifically, she explains that males typically receive more
resources than women, which gives them a greater material advantage. Considering
Marx’s theory, this allows for the differences in power between men and women
(New World Encyclopedia, 2013). This idea is reinforced by conflict theory, which
explains that war affects men and women disproportionally (Malesevic, 2011). This
theory suggests that men are in a position of power, wealth and status due to their
gender, whilst women are considered inferior and are positioned at the bottom of
the pyramid (Malesevic, 2011). This idea that men are superior leads to the
submission of women and the legitimization of violence and war (Turner, 2013).
Analysis of the Artifact:
Saudi Arabia is known for its involvement in numerous wars, particularly for their
assistance in the Syrian Civil War and support for major Sunni states in the Middle
East (Dewey, 2010). As mentioned throughout this report, war and the oppression of
women are interchangeable linked. This is the case in Saudi Arabia as gender based
violence and spousal rape is common and often ignored (Dewey, 2010). A report
from the Journal of Muslim Affairs reinforces this as a poll revealed that 53% of
Saudi men abuse their wives (Carrington, 2013). This violence and mistreatment of
women in Saudi Arabia is conveyed through the anti-domestic abuse campaign
entitled No More Abuse. This allows the campaign to have great relevance and
importance to the public issue of war and the impact on human health.
As discussed in section 1.4 of this report, women in particular face severe health
risks in war conditions as they are used as military strategies and are exposed to
gender-based violence such as rape, sexual mutilation, slavery and forced
prostitution (Usta, Farver & Zein, 2008). This mistreatment of women in war
conditions is exactly what the anti-abuse campaign is conveying. Furthermore, when
the campaign was released in newspapers, social media channels, twitter and
Facebook, the powerful message shocked the Saudi Arabia population as the
nation’s laws do not criminalize this kind of behaviour (Carrington, 2013). Ultimately,
as achieved by the King Khalid Foundation, this advertisement raises awareness of
violence against women and provides a great example of the conditions women are
exposed to in war.
Writing this literature review and gathering research throughout this report has
provided me with detailed knowledge and a thorough understanding of the topic of
war and global health. Furthermore, analyzing social theories regarding the topic has
allowed me to develop my critical analytical skills and has allowed me to understand
different perspective and theories of the construction of society. As conflict has been
one of the most significant generators of social change and has shaped the modern
world, I feel it is important to educate ourselves and others about the negative
health outcomes of war.
Reference List
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Reflections: