Epidemiology

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Lingering Effects of the War in Laos

Destroyed temple in Moang Khoune (Xieng Khouangville)

The Lao National Regulatory Authority (LNRA) recently released an impressive, 106-page report on the victims of unexploded ordnance (UXO) over the last few decades. The authors, Mike Boddington and Bountao Chanthavongsa, and all of the associated researchers should be commended for this invaluable contribution, which documents in a systematic fashion the damage done by the war. Researchers covered more than 9,000 villages in Laos (95%), collecting retrospective data from interviews with residents about injuries or deaths caused by mines, large bombs, mortars, bombies, etc. from 1964 to 2008. In all, the report found that more than 50,000 people were injured or killed by UXO in Laos, though the authors acknowledge that this is likely an underestimate, perhaps by as much as 20%. Results revealed that Savannakhet and Xieng Khouang provinces were the two most affected in terms of the number of casualties, which makes sense, given their strategic and geographic importance in the southern and northern parts of the country, respectively.

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The Costs of War

There’s a bit of controversy surrounding “The Human Security Report,” (HSR) published a couple of weeks ago by Andrew Mack and colleagues at Simon Fraser University. It suggests that improvements in public health over the last few decades have continued to lower mortality rates in many African nations, even during times of war. Looking at Figure 2.1, it just seems counter-intuitive that Under-5 mortality would not increase in more countries during periods of conflict.

Epidemiologist Les Roberts (Columbia Univ.) argues forcefully that the report is not very good scholarship (to put it kindly). In his words, “this report draws unjustified conclusions and will leave the world more ignorant and misguided for its release.” Ouch. Roberts makes a strong case to back up his statement, including points like this:

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