War and health

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Weapon$ over Civilians

President Trump’s made some more controversial comments this week, this time in a statement downplaying the murder of journalist Jamal Khashoggi, which the intelligence community said likely came at the behest of Saudi Crown Prince Mohammed bin Salman. Instead, he emphasized that the United States would maintain its business relationship with Saudi Arabia, including the importance of KSA’s oil supply and their desire to purchase weapons from the United States.

President Trump’s made some more controversial comments this week, this time in a statement downplaying the murder of journalist Jamal Khashoggi, which the intelligence community said likely came at the behest of Saudi Crown Prince Mohammed bin Salman. Instead, he emphasized that the United States would maintain its business relationship with Saudi Arabia, including the importance of KSA’s oil supply and their desire to purchase weapons from the United States.

I’ve seen a lot of public criticism of these comments, and rightfully so, but they seemed to focus primarily on Trump’s willingness to overlook the ability of a head of state to order a murder of a single person. However, I wanted to focus on a bigger problem, which is the cold calculation of the desire to profit from the sale of weapons and military equipment. He wrote:  

After my heavily negotiated trip to Saudi Arabia last year, the Kingdom agreed to spend and invest $450 billion in the United States. This is a record amount of money. It will create hundreds of thousands of jobs, tremendous economic development, and much additional wealth for the United States. Of the $450 billion, $110 billion will be spent on the purchase of military equipment from Boeing, Lockheed Martin, Raytheon and many other great U.S. defense contractors. If we foolishly cancel these contracts, Russia and China would be the enormous beneficiaries – and very happy to acquire all of this newfound business. It would be a wonderful gift to them directly from the United States!

I’m not that naive. I understand that the sale of military equipment is a business. In this case however, the crass prioritization of profit is happening at the very same time that civilians of Yemen are dying by the droves, to a large extent from weapons sold by the U.S. to Saudi Arabia. An estimated 85,000 Yemeni children may have starved to death as a result of the war (so far), with the wider population on the brink of famine. It is a pattern of war that civilians consistently bear the brunt of it all, dying at a higher rate than combatants.

A 10-year-old Yemeni boy suffering from severe malnutrition. (Photo: Ahmad al-Basha/AFP/Getty Images)

It seems to me that the celebration of military contracts worth billions of dollars while the very source of that profit inflicts incalculable suffering on actual lives is extremely callous and obscene. The emphasis on the injustice of letting people get away with Khashoggi’s murder is well-placed. But I think there could be much more emphasis in our public discourse that American companies are profiting by inflicting pain and death on innocent people. It is dirty money.    

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Links Between War & Famine: From the Chevauchée to Yemen, S. Sudan, Ukraine, and Syria

“Armed conflicts lead to hunger and reduced food production and economic growth in developing and transition countries. Reciprocally, food and economic insecurity and natural resource scarcities–real and perceived–often precipitate violence.”

-Marc Cohen and Per Pinstrup-Andersen (1999)

Recent images coming out of war-torn Yemen are heartbreaking. After three years of fighting between Houthi rebels and a Saudi-led coalition (backed by the US, UK and France), an estimated eight million people are near starvation. The war has exacerbated the nutritional situation in what was already one of the poorest countries in the region, causing infrastructure to crumble and unemployment rates to skyrocket. A blockade of Yemen’s ports has also led to a rise in food prices and to a lack of medical supplies, leaving people dependent on insufficient amounts of food aid.

BBC

A malnourished infant in Yemen, with a low upper arm circumference (source: BBC).

This has been building for a while. Nearly two years ago, a BBC report cited statistics from the UN that 370,000 children in Yemen were starving. Even infants, who may be buffered from difficult economic conditions via breastfeeding, were not spared as many mothers were too malnourished to produce milk.

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How War Gets “Under the Skin”

Unbending rigor is the mate of death,
And wielding softness the company of life
Unbending soldiers get no victories;
The stiffest tree is readiest for the axe.
(Tao Te Ching: 76)

 

Early in life, our bodies are like unmolded clay, ready to be shaped by our experiences. For some of us, that matching process can create problems. If circumstances change, we could end up poorly adapted to our adult environment. A child born into harsh conditions, though, may have to take that risk in order to make it to adulthood at all.

The Hmong in French Guiana may be an example of this process. They are a fascinating population for many reasons, the most obvious being that they are there at all. A few dozen refugees from Laos first resettled in French Guiana in 1977, a few years after the Vietnam War, after they and the French government agreed that life in small, ethnically homogenous villages in a tropical environment was a better option than acculturating to the cities of Métropole France. The experiment paid off. Today, more than two thousand Hmong are farmers in the Amazonian jungle, producing most of the fruits and vegetables in the country. The result is a level of economic autonomy and cultural retention that is likely unique in the Southeast Asian refugee diaspora.

scenes in fg

Scenes from Hmong villages in French Guiana. (Clockwise from top left: fields of Cacao, young men going on a hunting trip in Javouhey, swidden agriculture of Cacao, a street lined with farmers’ trucks in Javouhey.

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Children in Conflict

“If a bomb is deliberately dropped on a house or a vehicle on the grounds that a “suspected terrorist” is inside (note the frequent use of the word suspected as evidence of the uncertainty surrounding targets), the resulting deaths of women and children may not be intentional. But neither are they accidental. The proper description is “inevitable.” 

-Howard Zinn, “War is not a solution for terrorism” The Boston Globe 2, 2006

Screen captures featuring headlines concerned with civilian victims of war.

 

 

UNICEF recently released a list of some of the most dangerous places for children to live. In various wars around the world, children have been killed, abducted, injured, raped, lost family members, and been forced into military service (“child soldiers”). In addition to the direct targeting of civilians, including children, war also creates indirect adversities including psychological stress, infections, and malnutrition. For example, in the ongoing conflict in Yemen, one million people have contracted the deadly diarrheal disease cholera, 600,000 of whom are children.

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No More Trouble

Killing the brother

Destroying the country

For nothing

For nothing

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Prenatal “Shocks” and Birth Outcomes

Birth weight is often used as a rough gauge for the quality of the prenatal environment. A newborn who weighs 2500g or less (about 5.5 pounds) is considered to be “low birth weight” (LBW). At the individual level, weight alone is an imperfect measure because of confounders such as gestational length (it’s axiomatic that the less time spent in the womb, the less time there is to grow). However, at the population level, if average birth weight fluctuates, then it is an indication that something in the environment probably has changed.

Sometimes, stressful changes can be low-intensity and chronic; at other times, they can be abrupt and dramatic. Biologists, psychologists, and bioanthropologists might call these changes “stressors” or “insults.” Economists might use the term “shocks.” They’re both getting at the same idea: to what extent can harmful environmental factors affect growth and health outcomes? 

In the case of a natural disaster, the harm done can be substantial. Florencia Torche (2011) found that rates of LBW increased following the 2005 Tarapaca earthquake in northern Chile. Despite the magnitude of the earthquake (7.9 on the Richter scale), the amount of destruction was relatively limited: eleven people died, and 0.035% of the population had to temporarily relocate to shelters. This was attributed to the low population density of the region as well as Chilean preparedness and building codes to withstand earthquakes. Although the damage was not as severe as it could have been, Torche reasoned that the earthquake likely caused acute maternal stress, which in turn could affect prenatal development. 

Looking at over half a million births, Torche used maternal county of residence as an estimate of the earthquake’s intensity across different trimesters of exposure. She found that mothers who were lived in the most intensely affected regions during the first trimester were the most affected. The probability of LBW increased from 4.7% to 6.5%, while rates of pre-term births also increased from 5.2% to 8.0%. Later periods of gestation were not substantially affected, and for infants who were conceived after the earthquake, the probability of LBW returned to baseline.

Again, these outcomes seemed to result primarily from acute psychological stress stemming from the earthquake. Torche reasoned that – given the relatively low amount of damage to infrastructure – the increases in LBW and pre-term births were unlikely to have resulted from other factors such as malnutrition, infection, stress resulting from deprivation, strenuous workloads, or exposure to environmental toxins. In reality, it’s not possible to control for all of these variables entirely, but overall it seems plausible that maternal psychological stress played a substantial role in birth outcomes.

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The Long Reach of War: More UXO Casualties in Laos

“It was said that after the war (WW1) when the earth was restored, there was one-third metal and war materials, one-third real earth, and one-third human flesh.” source

“Wars are not paid for in war time. The bill comes later.”   – Ben Franklin

 

This week, a leftover bomb from the war in Laos detonated in Paek district, Xieng Khouang province. One child was killed, and twelve other people were injured (five adults and seven other children). It appears that this was a “bombie,” a tennis-ball sized cluster bomb dropped by the U.S.

Over 2 million tons of ordnance was dropped on Laos from 1964-1973. Many of these bombs failed to detonate on impact, leaving behind unexploded ordnance (UXO) that remains active to the present day. That means that this particular bombie remained dormant for at least 44 years. The villagers who were interviewed in the video below said they think the bomb could have been detonated by children playing jump-rope nearby.

That the tragedies of war can last for so long, and can be triggered by something as innocent as children jumping rope (who were born well after the war ended) only provides more factor to consider when deciding whether to engage in military conflict. It is yet another reason for caution.

And it’s not just Laos. Leftover UXO from World War 2 and even World War 1 still remain active in Europe and Egypt (and probably elsewhere). The Ben Franklin quote above (“the bill comes later”) referred to the paying of war debts, accrued by borrowing to pay for war efforts. But it also apply to the costs paid by civilians and soldiers alike, lasting for decades. 

 

 

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Should Cambodia Pay War Debts to the United States?

The Sydney Morning Herald reported that the U.S. is seeking $500 million in repayment from Cambodia for a Vietnam War-era loan, primarily in the form of excess maize. According to the SMH:

The debt started out as a US$274 million loan mostly for food supplies to the then US-backed Lon Nol government but has almost doubled over the years as Cambodia refused to enter into a re-payment program.

As the article also pointed out, many people across the political spectrum are outraged by the request, given the role the U.S. played in bombing Cambodia. According to Yale historian Ben Kiernan, from 1965-73 U.S. planes dropped nearly 2.8 million tons of bombs over the eastern part of the country. This was part of a larger war meant to deny communist troops and supplies from North Vietnam from reaching the South via Laos and Cambodia.

Although casualty estimates from war are notoriously difficult, U.S. bombing was estimated to have killed 50,000 to perhaps hundreds of thousands of Cambodians, many of them civilians. Furthermore, historians such as Kiernan have argued that without the bombing, the Khmer Rouge might not have grown as much as it did, with people radicalized against U.S. brutality and into the arms of the K.R. Their rise to power, of course, led to more atrocities and genocide only a few years later. 

Given all of that, it seems preposterous, or at least tone-deaf, for the U.S. to request repayment. And it’s not just Cambodians who think so. Also noted in the SMH article was a quote from James Pringle, a former Reuters bureau chief in Ho Chi Minh City, who was near Cambodia during the war: 

“Cambodia does not owe a brass farthing to the US for help in destroying its people, its wild animals, its rice fields and forest cover.”

 

U.S. bombing of Cambodia from 1965-1973 (by Taylor Owen and Ben Kiernan). Source.

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The Dignity and Future of the People of Laos

Today, President Obama became the first sitting U.S. president to visit Laos. It’s kind a big deal. So far, I think he’s hit all the right notes, pledging a substantial increase in funds to help clear unexploded ordnance dropped by U.S. planes decades ago during the Second Indochina War. Whereas the U.S. had given about $100 million over the last 20 years to help clear some of the bombing, this will now be increased to $90 million over the next three. The effects of these bombs have lingered for too long, causing about 20,000 casualties since the war officially ended, so it is good to see Obama take this seriously. (And, by the way, the New York Times has just published a story on how this increase in funds is almost entirely due to the amazing Channapha Khamvongsa. She has worked on this for a long time, and she is to be admired).

Others have observed that because Obama was too young to have served in the military during the Vietnam War, he has a fresher perspective and can therefore act as a generational page-turner. Perhaps that is sometimes necessary in order to rise above the past, as people often become entrenched in their views. The old guard phases out, and new blood enters the picture. In fact, Obama declared that his visit marked a new era in U.S.- Lao relations, based on mutual respect and “a shared desire to heal the wounds of the past.”

I’ve given this some thought. When I was younger, whenever I read a story about some tragedy — a car accident, a war, a terrorist attack, refugees forcibly displaced from their homes, a victim of sexual violence, etc. — I don’t think I quite understood the magnitude of how long that type of emotional pain could endure. Those things don’t just clear up overnight. They can persist well beyond the actual offense, even for decades. Because we are such a social species, intensely connected to others and highly attuned to the thoughts and emotions of the people around us, it seems that one of the key ingredients to healing is to hear that others recognize and respect our pain.

I think Obama recognized this. If I were a poor Laotian farmer whose fields were contaminated with leftover bombs, I would probably put more weight on the $90 million than on any speech or anything Obama might say. Yet, symbolic gestures can also go a long way. Obama’s statement that he recognized and had high hopes for “the dignity and the future of the people of Laos” is a potentially powerful one. At least I think so. Let’s see what happens during the next few days of his visit there.

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The “Deep Roots” of War

The debate continues as to whether war extends deep into human pre-history. This tends to break down into two camps: (1) the “deep roots” advocates, who argue that inter-group aggression extends to the origins of our species (or perhaps even earlier), and (2) those who propose that hunter-gatherers were essentially peaceful until the advent of agriculture. 

On his website “Why Evolution is True,” Jerry Coyne has been summarizing the various critiques that deep-rooters like Steven Pinker and Michael Shermer have been piling on against the science writer John Horgan, who has argued that war is a recent innovation.

I think the reason for all the confusion is that the best way to resolve the debate is to have a systematic review of the archaeological record. Of course, that is very hard to do, since there are gaps in what we know about the past, and not all humans leave traces of their existence. But the public debates often encourage cherry-picking of the data, sometimes highlighting prehistoric groups that show signs of intergroup violence (and they did exist), or at other times highlighting peaceful groups (so did they!). Rarely is there a systematic, big-picture approach. 

In an essay I wrote last year, “Genocidal Altruists,” I took a different approach, arguing that our ancestors were complex. I cited the archaeologists Jonathan Haas and Matthew Piscitelli, who actually did attempt a systematic review. To quote myself… 

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