War as a Public Health Problem

The surgeon Gino Strada, who has worked in war zones around the world, once referred to war as “the biggest tragedy in public health.” It is debatable whether this empirical claim is true, but by re-framing the issue in this way we can see war with fresh eyes and as more than a conflict between political entities. Rarely, if ever, is war a matter that affects solely competing militaries. Recent images from Syria, Gaza, and Israel are the latest reminders of the impact of war on civilians. See these compelling photo essays here and here.

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Aside from the obvious culprits of death, injury, and post-traumatic stress disorder, there are many ways that war can affect public health. As early as February of this year, food shortages were reported in Syria. One displaced woman told a reporter: “I can guarantee you this, people will starve to death.”

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Food shortages in Syria. From CNN (Feb 21, 2012).

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I’ve written elsewhere about the negative impacts of war on growth and development in children, and it is difficult to imagine how war could not be harmful to civilians. During the Cuban Missile Crisis in 1962, Nikita Khrushchev wrote to President Kennedy about the logic of war:

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We must not succumb to intoxication and petty passions, regardless of whether elections are impending in this or that country, or not impending. These are all transient things, but if indeed war should break out, then it would not be in our power to stop it, for such is the logic of war. I have participated in two wars and know that war ends when it has rolled through cities and villages, everywhere sowing death and destruction.

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That’s what war does. I imagine that children growing in these places (those still alive and regardless of whether they fled) will be affected for the rest of their lives.