War and health

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Civilians, Refugees, and the 2nd Indochina War in Laos

[Note (June 2020): I’m seeing an uptick in the number of views on this essay. Is there any reason? Since this site is a labor of love, I’m just curious how it is being used.]

“In Houa Phanh and Xieng Khouang provinces, the war (in Laos) has reached into every home and forced every individual, down to the very youngest, to make the agonizing choice of flight or death.” (Yang 1993: 104)

“Those who suffered the most from the escalating conflict were populations living in the east of the country: overwhelmingly highland minorities, Lao Thoeng and particularly Lao Sung (Mien as well as Hmong), but also upland Tai, the Phuan of Xiang Khouang and the Phu-Tai of east central Laos.” (Stuart-Fox, 1997: 139)

“Military Region II (northeastern Laos) bore the brunt of the war for almost fifteen years. Nearly 80% of the refugee population in Laos originated in MR II, including the refugees on the Vientiane Plaine. Almost the entire population of Houa Phan (Sam Neua) and Xieng Khouang Provinces were gradually forced south into the Long Tieng, Ban Xon, Muang Cha crescent.” (USAID, 1976: 210)

Displaced Hmong in Laos, probably in the early 1970s. Source: Roger Warner. 1998.

Displaced Hmong in Laos, probably in the early 1970s. Source: Roger Warner. 1998.

A consistent feature of war is the harming of civilian lives. The extent of harm is not always easy to ascertain, but is sometimes quantified in the number of “excess deaths” that occur during a war. For example, Hagopian et al (2013) surveyed two thousand randomly selected households throughout Iraq, interviewing residents about their family members before and during the US-led invasion and occupation. They estimated that from March 2003-2011 approximately 405,000 deaths occurred as a result of the war, mostly from violence.

However, such studies always have limitations – recall bias, survivor bias (the dead cannot be interviewed), and logistics in surveying high violence areas – meaning that mortality estimates will never be perfect, and Hagopian et al. gave a range around their figure (a 95% uncertainty interval of 48,000 to 751,000 excess deaths). Whatever the exact number, which we will probably never know, we can still be confident that mortality rates increased during the war years.  

The same challenges apply to all wars, including one that I have been interested in for a while – the Second Indochina War in Laos. The Australian historian Martin Stuart-Fox wrote that: “loss of life can only be guessed at, but 200,000 dead and twice that number of wounded would be a conservative estimate” (1997: 144). Mortality estimates for Laos are further complicated by the fact that it was one the least developed countries in Asia at the time of the war, likely with unreliable census data and other record keeping (though, for those who are interested, see the 1961 Joel Halpern “Laos Project Papers” from UCLA, which contain demographic and health statistics).

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Global Refugee Trends

At the end of 2013, there were more than 50 million displaced people globally, the highest number since WW2. I’m working on another post on how these experiences may impact biology and health, particularly for children. In the meantime, this UNHCR video shows some of the places that are most affected by forced displacement.

“Displacement is brutal. Many children stumble into exile barely alive after weeks in the bush.”

 

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Developmental Plasticity and the “Hard-Wired” Problem

“Development is the missing link between genotype and phenotype, a place too often occupied by metaphors in the past … But a strong emphasis on the genome means that environmental influence is systematically ignored. If you begin with DNA and view development as “hard-wired,” you overlook the flexible phenotype and the causes of its variation that are the mainsprings of adaptive evolution.” (Mary Jane West-Eberhard, 2003: 89-90)

“Genes, unlike gods, are conditional. They are exquisitely good at simple if-then logic: if in a certain environment, then develop in a certain way… So here is the first moral of the tale: Don’t be frightened of genes. They are not gods; they are cogs. (Matt Ridley, 2003: 250)

 

Plasticity: actor Christian Bale at two points in time. Same genes, different phenotypes.

Plasticity: actor Christian Bale at two points in time. Same genes, different phenotypes.

In his book The Triple Helix, Richard Lewontin told the story of the molecular biologist and Nobel laureate Sydney Brenner, who – while speaking at a conference – predicted that one day we would be able to “compute” an organism (2002). All we would need are two things: the organism’s full genome and powerful enough computers that were up to the task.

The idea is seductive. Genes are sometimes seen as self-sufficient molecules, almost existing in a vacuum, that contain all the information necessary to code for proteins. From there, it’s not a very big logical leap to think that if you had the genome, you could enter the code in some database, hit “run,” and then watch some digitized version of the organism unfold.

In fact, scientists are doing something much like this for the tiny roundworm C. elegans with the project OpenWorm. Yet even for a relatively simple organism such as this, with only about a thousand cells in total, there are reasons to be cautious. As The Economist warned in its write-up of OpenWorm: “Attempting to simulate everything faithfully would bring even a supercomputer to its knees.” However, this isn’t due solely to the limits of computing power (what if we had a super-duper computer!?). Rather, it’s a matter of how the question is framed.

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Two Million Tons of Bombs over Laos in One Minute

This is a simple, yet powerful, video cataloging the 600,000 bombing missions and 2 million tons of bombs the U.S. dropped over Laos from 1964-73. I’ve never been able to comprehend the scale of the bombing in Laos because it’s hard to get a handle on such large numbers. This short video helps put it into perspective.

The person who made the video, Jerry Redfern, also has a new book out Eternal Harvest: The Legacy of American Bombs in Laos (co-authored with his wife, Karen Coates). 

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What War Does to Children

This is a powerful message from Save the Children, meant to raise awareness of recent events in Syria:

I think the power of the video comes from the fact that it follows a single child over time, as we watch the vibrancy of her personality gradually fade away as the conditions around her deteriorate. We see her become more anxious, and even her physical health falters as her hair starts falling out. By extension, all we have to do is make a short mental leap from this fictional British girl to that of any child, anywhere, who is currently living under war conditions, knowing that they have probably undergone a similar transition. 

The reality is that the impacts of war on child health are consistently negative, not only for Syria, but virtually everywhere. On one hand, it’s important to remember that children living in such harsh conditions can be resilient, and that they are not lost causes, broken beyond repair. On the other hand, they shouldn’t have to be put in that position in the first place. 

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Infant Mortality Rates, War & Laos

I finished my dissertation on how the war in Laos was correlated to the physical growth of Hmong refugees in 2004. The general idea was that early stressors, particularly prenatally and in infancy, can have long-term impacts on growth and health. The model I was working with came largely from David Barker’s (and others’) ‘fetal origins hypothesis,’ based on evidence that low birth-weight infants tended to grow up to have higher rates of things like type 2 diabates, coronary heart disease, hypertension, etc. A classmate in graduate school, Stephanie Rutledge, introduced me to Barker’s work and told me that I’d find it really enlightening. I did. Sadly, Barker passed away earlier this year, but his work helped spawn a new direction in research. 

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Recent Civil Wars

Here is a handy graphic on several recent civil wars, their duration, and the number of lives cost (source: The Economist). To explain the relative decline in number of deaths in more recent years…

“So far, nothing has done more to end the world’s hot little wars than winding up its big cold one. From 1945 to 1989 the number of civil wars rose by leaps and bounds, as America and the Soviet Union fueled internecine fighting in weak young states, either to gain advantage or to stop the other doing so.”

 

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Bombing of Laos, Animated

The organization Legacies of War shared this animated video on the impacts of U.S. bombing of Laos during the Vietnam War. I thought the filmmaker, Corey Sheldon, put together a very attractive and informative video, although the history is perhaps understandably simplified. Today, the remnants of unexploded bombs are still a problem in Laos, decades after the war has ended, so I think projects like this one are helpful in raising awareness, particularly in the United States.  <div style=”text-align:center”>

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Related posts

The Lingering Effects of the War in Laos 

Laos: The Not So Secret War 

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Mythic War

From Chris Hedges:

“Lawrence LeShan in The Psychology of War differentiates between “mythic reality” and “sensory reality” in wartime. In sensory reality we see events for what they are. Most of those who are thrust into combat soon find it impossible to maintain the mythic perception of war. They would not survive if they did. Wars that lose their mythic stature for the public, such as Korea or Vietnam, are doomed to failure, for war is exposed for what it is– organized murder.

But in mythic war we imbue events with meanings they do not have. We see defeats as signposts on the road to ultimate victory. We demonize the enemy so that our opponent is no longer human. We view ourselves, our people, as the embodiment of absolute goodness. Our enemies invert our view of the world to justify their own cruelty. In most mythic wars this is the case. Each side reduces the other to objects – eventually in the form of corpses.

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for the lie in war is almost always the lie of omission. The blunders and senseless slaughter by our generals, the execution of prisoners and innocents, and the horror of wounds are rarely disclosed, at least during a mythic war, to the public. Only when the myth is punctured, as it eventually was in Vietnam, does the press begin to report in a sensory rather than a mythic manner. But even then it is it reacting to a public that has changed its perception of war.” 

 

― Chris Hedges (2002) War Is a Force That Gives Us Meaning (p. 21-22)

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How War Gets Under Our Skin

beinghuman.org front page

I wrote this piece on BeingHuman.org about how war (and the world in general) gets under our skin. It looks at the Hmong example, as well as examples from a few other wars around the world (the Dutch Hunger Winter, the Biafran famine, and the Khmer Rouge period), and how these experiences get into our bodies. 

 

http://www.beinghuman.org/article/how-world-gets-under-our-skin

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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.