Journal of Public Health Policy

, Volume 34, Issue 1, pp 46–54

Preventing violent conflict: A revised mandate for the public health professional?

  • Sean Whitaker
Original Article

Abstract

Violent conflict disrupts livelihoods, healthcare systems, and food security, with dire public health consequences. My intention in this article is to conceptualise violent conflict as a public health hazard and delineate the strategies public health professionals might adopt to minimise that hazard. There is continued support among commentators for the role of the public health professional in addressing the underlying causes of conflict. Importantly, there has been a trend for foreign donors to design public health initiatives in ways that meet socio-political criteria deemed important to preventing conflict. The underlying causes of conflict can be mitigated by specific strategies employed by public health professionals and they should be key players in preventing the public health disaster that is violent conflict.

Keywords

violent conflict war public health medicine doctors peace 

References

  1. Geneva Declaration on Armed Violence and Development. (2011) The Global Burden of Armed Violence. Geneva: Geneva Declaration Secretariat.Google Scholar
  2. Sidel, V.W. and Levy, B.S. (2002) The health and social consequences of diversion of economic resources to war and preparation for war. In: I. Taipale et al (eds.) War or Health? A Reader. London: Zed Books.Google Scholar
  3. Levy, B.S. and Sidel, V.W. (2008) War and Public Health. Oxford: Oxford University Press.CrossRefGoogle Scholar
  4. Murray, C.J.L., King, G., Lopez, A.D.,, Tomijima, N. and, Krug, E.G. (2002) Armed conflict as a public health problem. British Medical Journal 324 (7333): 346–349.CrossRefGoogle Scholar
  5. Saracci, R. (1991) Preventing war. Journal of Public Health Policy 12 (3): 265–269.CrossRefGoogle Scholar
  6. Yusuf, S., Anand, S. and MacQueen, G. (1998) Can medicine prevent war? Imaginative thinking shows it might. British Medical Journal 317 (7174): 1669–1670.CrossRefGoogle Scholar
  7. Vass, A. (2001) Peace through health. British Medical Journal 323 (7320): 1020.CrossRefGoogle Scholar
  8. Arya, N. (2004) Peace through health I: Development and use of a working model. Medicine, Conflict and Survival 20 (3): 242–257.CrossRefGoogle Scholar
  9. Santa Barbara, J. (2004) Can medicine contribute to preventing war? Croatian Medical Journal 45 (6): 783–785.Google Scholar
  10. Pinto, A., Sharma, M. and Muggah, R. (2011) An agent-vector-host-environment model for controlling small arms and light weapons. Medicine, Conflict and Survival 27 (2): 111–127.CrossRefGoogle Scholar
  11. Stott, R. and Holdstock, D. (2000) Eradicating war is essential to eliminate poverty and improve health. British Medical Journal 320 (7243): 1208.CrossRefGoogle Scholar
  12. De Jong, J.T.V.M. (2010) A public health framework to translate risk factors related to political violence and war into multi-level preventive interventions. Social Science and Medicine 70 (1): 71–79.CrossRefGoogle Scholar
  13. Pinstrup-Andersen, P. and Shimokawa, S. (2008) Do poverty and poor health and nutrition increase the risk of armed conflict onset? Food Policy 33 (6): 513–520.CrossRefGoogle Scholar
  14. Gendron, R. and Hoffman, E. (2009) Resource scarcity and prevention of violent conflict. Peace and Conflict Review 4 (1): 1–11.Google Scholar
  15. Raleigh, C. and Urda, H. (2007) Climate change, environmental degradation and armed conflict. Political Geography 26 (6): 674–694.CrossRefGoogle Scholar
  16. Ohlsson, L. (2000) Livelihood Conflicts: Linking Poverty and Environment as Causes of Conflict. Stockholm: Swedish International Development Agency, Department of Natural Resources and the Environment.Google Scholar
  17. MacQueen, G., McCutcheon, R. and Santa Barbara, J. (1997) Use of health initiative as peace initiatives. Peace and Change 22 (2): 175–197.CrossRefGoogle Scholar
  18. MacQueen, G. and Santa Barbara, J. (2000) Peace building through health initiatives. British Medical Journal 321 (7256): 293–296.CrossRefGoogle Scholar
  19. Santa Barbara, J. and MacQueen, G (2004) Peace through health: Key concepts. Lancet 364 (9431): 384–386.CrossRefGoogle Scholar
  20. Cliff, J. and Noormahomed, A.R. (1988) Health as a target: South Africa's destabilization of Mozambique. Social Science and Medicine 27 (7): 717–722.CrossRefGoogle Scholar
  21. Ashford, M. (2002) Stubborn peace: Communities that refuse to fight. In: I. Taipale et al (eds.) War or Health? A Reader. London: Zed Books.Google Scholar
  22. Walker, J. (1993) Orphans of the Storm: Peacebuilding for Children of War. Toronto: Between the Lines.Google Scholar
  23. Brandenburg, H. (2004) Journalists embedded in culture: War stories as political strategy. In: L. Artz (ed.) Bring ‘em on: Media and Politics in the Iraq War. Lanham, MD: Rowman & Littlefield.Google Scholar
  24. Kamalipour, Y.R. and Snow, N. (2004) War Media and Propaganda – A Global Perspective. Lanham, MD: Rowman & Littlefield.Google Scholar
  25. Chomsky, N. and Herman, E. (1958) Manufacturing Consent: The Political Economy of the Mass Media. New York: Pantheon.Google Scholar
  26. Marmon, L., Seniw, C. and Goodman, A. (1994) The diplomat/physician in the emerging international system. Medicine and Global Survival 1 (4): 234–237.Google Scholar
  27. Geiger, H.J. and Cook-Deegan, R.M. (1993) The role of physicians in conflicts and humanitarian crises. Journal of the American Medical Association 270 (5): 616–620.CrossRefGoogle Scholar
  28. Doll, R. et al (1951) Prospect of war. Lancet 257 (6647): 170.CrossRefGoogle Scholar
  29. Ervin, F.R. et al (1962) Human and ecologic effects in Massachusetts of an assumed thermonuclear attack on the United States. New England Journal of Medicine 266: 1127–1137.CrossRefGoogle Scholar
  30. Ascherio, A., Chase, R. and Cote, T. (1992) Effect of the Gulf War on infant and child mortality in Iraq. New England Journal of Medicine 327 (13): 931–936.CrossRefGoogle Scholar
  31. Roberts, L., Lafta, R., Garfield, R., Khudhairi, J. and Burnham, G. (2004) Mortality before and after the 2003 invasion of Iraq: Cluster sample survey. Lancet 364 (9448): 1857–1864.CrossRefGoogle Scholar
  32. Burnham, G., Lafta, R., Doocy, S. and Roberts, L. (2006) Mortality after the 2003 invasion of Iraq: A cross-sectional cluster sample survey. Lancet 368 (9545): 1421–1428.CrossRefGoogle Scholar
  33. Iraq Family Health Survey Study Group. (2008) Violence related mortality in Iraq 2002–2006. New England Journal of Medicine 358 (5): 484–493.Google Scholar
  34. Clark, J. (2002) War on Iraq could produce a humanitarian disaster, health professionals warn. British Medical Journal 325 (7373): 1134.CrossRefGoogle Scholar
  35. Bohannon, J. (2006) Iraqi death estimates called too high; methods faulted. Science 314 (5798): 396–397.CrossRefGoogle Scholar
  36. Ahuja, A. (2007) Could 650,000 Iraqis really have died because of the invasion? The Times (UK) 5 March, http://www.thetimes.co.uk/tto/news/world/middleeast/iraq/article1991099.ece, accessed 18 September 2012.
  37. Boseley, S. (2004) 100,000 Iraqi civilians dead, says study. The Guardian (UK) 29 October, http://www.guardian.co.uk/world/2004/oct/29/iraq.sarahboseley, accessed 18 September 2012.
  38. Boseley, S. (2006) UK scientists attack Lancet study over death toll. The Guardian (UK) 24 October, http://www.guardian.co.uk/science/2006/oct/24/iraq.internationalnews, accessed 18 September 2012.
  39. Orbinski, J., Beyrer, C. and Singh, S. (2007) Violations of human rights: Health practitioners as witnesses. Lancet 370 (9588): 698–704.CrossRefGoogle Scholar
  40. Jenssen, C. (2002) Medicine against war: An historical review of the anti-war activities of physicians. In: I. Taipale et al (eds.) War or Health? A Reader. London: Zed Books.Google Scholar
  41. Ackerknecht, E.H. (1953) Rudolf Virchow: Doctor, Statesman, Anthropologist. Madison, WI: University of Wisconsin Press.Google Scholar
  42. Christ, M. (2002) A brief history of International Physicians for the Prevention of War. In: I. Taipale et al (eds.) War or Health? A Reader. London: Zed Books.Google Scholar
  43. Forrow, L., Sidel, V.W. and Slutzman, J.E. (2007) Medicine and nuclear war: Preventing proliferation and achieving abolition. In: Nuclear Weapons: The Final Pandemic – Preventing Proliferation and Achieving Abolition, International Conference Sponsored by International Physicians for the Prevention of Nuclear War and the Royal Society of Medicine, London, 3–4 October 2007.Google Scholar
  44. Middleton, J.D. (1988) Health promotion is peace promotion. Health Promotion 2 (4): 341–345.CrossRefGoogle Scholar
  45. Prokosch, E. and Hogendoorn, E.J. (2002) Antipersonnel weapons. In: I. Taipale et al (eds.) War or Health? A Reader. London: Zed Books.Google Scholar
  46. Fine, J. and Sirkin, S. (2002) Physicians for human rights. In: I. Taipale et al (eds.) War or Health? A Reader. London: Zed Books.Google Scholar
  47. Parikh, S.M. (2010) Cluster munitions: A threat to health and human rights. Medicine, Conflict and Survival 26 (2): 101–107.CrossRefGoogle Scholar
  48. Kruk, M.E., Freedman, L.P., Anglin, G.A. and Waldman, R.J. (2010) Rebuilding health systems to improve health and promote state building in post conflict countries: A theoretical framework and research agenda. Social Science and Medicine 70 (1): 89–97.CrossRefGoogle Scholar
  49. Marmot, M. (2007) Achieving health equity: From root causes to fair outcomes. Lancet 370 (9593): 1153–1163.CrossRefGoogle Scholar
  50. WHO, World Health Organization. WHO/DfID Peace through Health Programme: A Cases Study Prepared by the WHO Field Team in Bosnia and Herzegovina, Report reference: EUR/ICP/CORD 03 05 01.Google Scholar
  51. McInnes, C. and Rushton, S. (2010) Medical Initiatives in Conflict and Peacebuilding. Global Health and Foreign Policy Initiative. Baltimore: John Hopkins University.Google Scholar
  52. Kahan, E. (2002) Trust-building among nations in conflict through medical actions: The case of the Middle East. In: I. Taipale et al (eds.) War or Health? A Reader. London: Zed Books.Google Scholar
  53. Sriharan, A. et al (2009) Academic medicine as a bridge to peace: Building Arab and Israeli cooperation. Academic Medicine 84 (11): 1488–1489.CrossRefGoogle Scholar
  54. Levy, B.S. and Sidel, V.W. (2009) How academic medicine can contribute to peace-building efforts worldwide. Academic Medicine 84 (11): 1487.CrossRefGoogle Scholar
  55. Williams, K., Rivera, L., Neighbours, R. and Reznik, V. (2007) Youth violence prevention comes of age: Research, training and future directions. Annual Review of Public Health 28: 195–211.CrossRefGoogle Scholar
  56. Khan, A.M., Janneck, L.M., Bhatt, J. and Panjabi, R. (2009) Building a health-peace movement: Academic medicine's role in generating solutions to global problems. Academic Medicine 84 (11): 1486.CrossRefGoogle Scholar
  57. Hagopian, A., Ratevosian, J. and deRiel, E. (2009) Gathering in groups: Peace advocacy in health professional associations. Academic Medicine 84 (11): 1485.CrossRefGoogle Scholar
  58. Gillan, A. (2005) Doctor stands by decision to refuse to serve in ‘illegal’ Iraq War. The Guardian (UK) 28 October, http://www.guardian.co.uk/uk/2005/oct/28/military.audreygillan, accessed 7 November 2012.
  59. BBC, British Broadcasting Corporation. (2006) Iraq service refusal ‘justified’. News report, http://news.bbc.co.uk/1/hi/uk/4897960.stm, accessed 7 November 2012.
  60. Zwi, A.B. (1987) The political abuse of medicine and the challenge of opposing it. Social Science and Medicine 25 (6): 649–657.CrossRefGoogle Scholar
  61. Miles, S.H. (2004) Abu Ghraib: Its legacy for military medicine. Lancet 364 (9435): 725–729.CrossRefGoogle Scholar
  62. Chen Reis, J.D., Ahmed, A.T., Amowitz, L.L., Kushner, A.L., Elahi, M. and Iacopino, V. (2004) Physician participation in human rights abuses in Southern Iraq. Journal of the American Medical Association 291 (12): 1480–1486.CrossRefGoogle Scholar
  63. Nicholl, D.J., Jenkins, T., Miles, S.H., Hopkins, W., Siddiqui, A. and Boulton, F. (2007) Biko to Guantanamo: 30 years of medical involvement in torture. Lancet 370 (9590): 823.CrossRefGoogle Scholar
  64. Langston, E.L. (2007) Ethical treatment of military detainees. Lancet 370 (9590): 1999.CrossRefGoogle Scholar
  65. Navarro, V. (2008) Politics and health: A neglected area of research. European Journal of Public Health 18 (4): 354–356.CrossRefGoogle Scholar
  66. Krug, E.G., Dahlberg, L.L., Mercy, J.A., Zwi, A.B. and Lozano, R. (eds.) (2002) World Report on Violence and Health. Geneva: World Health Organization.Google Scholar

Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2012

Authors and Affiliations

  • Sean Whitaker
    • 1
  1. 1.Royal Devon and Exeter Hospital (Wonford)ExeterUK

Personalised recommendations