Health Experts Warn of Iraq War Consequences
By REUTERS
Minister Tony Blair on Thursday to consider the horrific humanitarian
consequences of war on
In an open letter published in The Lancet and the British Medical
Journal, more than 550 staff, students and alumni at the London School
of Hygiene and Tropical Medicine warned that hundreds of thousands of
people will be killed and injured in a war and most of them will be
civilians.
It is the first time staff and alumni of the prestigious school have
come together to intervene in this way.
``Health professionals worldwide care for the casualties of war. We
accept this responsibility. However, it is also our responsibility to
argue for the prevention of violence and peaceful resolution of
conflict,'' wrote Dr Carolyn Stephens, who was nominated to compose
the letter, sent to Blair last week.
The school is considering sending a similar letter to President Bush.
Stephens said the signatories normally do not step out of being
scientists and academics but they felt compelled to write to Blair
because a war will increase international violence.
``He doesn't seem to realize that every time he talks about a war on
Saddam Hussein what he really means is a war on civilians in Iraq,''
Stephens told Reuters.
``He doesn't seem to realize that the troops are going to be more or
less massacring civilians rather than holding a war with a military
leader.''
The letter, to which Blair has not yet responded, cites evidence from
the World Health Organization (WHO), the United Nations and Medact, a
British charity of health professionals, which have warned of the
far-reaching impact of a war.
Apart from deaths and casualties the aftermath of a conventional war
would include civil war, famine, epidemics, refugees and displaced
people, and catastrophic effects on children's health and development,
according to Medact.
The United Nations estimates a war will result in 500,000 direct and
indirect casualties. The WHO argues the conflict can be averted
through other means.
Stephens said it is not just the staff in London who oppose the use of
military intervention in Iraq but workers and alumni in Asia, Africa
and Latin America, many of whom work for the WHO and in ministries of
health throughout the world.
``We all felt we should argue for peace and, as public health people,
put the view that we are going to have to clean up all the casualties
of any war and that we also have a strong responsibility to argue for
peaceful resolution of conflict,'' Stephens said.
The text of the letter
Open letter to the Right Honourable Tony Blair, Prime Minister of the
Sir--Three important reports have been published in the past month on
the humanitarian effects of international violence and conflict. All
provide evidence of the short-term and long-term adverse health
effects of the use of force internationally. WHO's Global Report on
Violence (1) is a detailed assessment compiled over 3 years by
international health scientists; Collateral damage: the health and
environmental costs of war on Iraq (2) reports a study by Medact, a UK
charity of nurses, doctors, and other health professionals; and the
latest report, released by the Campaign Against Sanctions on Iraq
(CASI) based at Cambridge University, UK, is a United Nations report
on likely humanitarian scenarios of war on Iraq. (3)
Medact estimate that if the threatened war on Iraq ensues, "total
possible deaths on all sides during conflict and in the following
three months range from 48,000 to over 260,000. Civil war within
could add another 20,000 deaths. Additional later deaths from post-war
adverse health effects could reach 200,000. In all scenarios the
majority of casualties will be civilians". The report calculates that
"the aftermath of a 'conventional' war could include civil war, famine
and epidemics, refugees and displaced people, and catastrophic effects
on children's health and development". Knock-on effects could include
exacerbation of international conflicts, inequalities, and divisions.
The most recent UN report also estimates substantial and wide-reaching
humanitarian effects: "as many as 500,000 people could require
treatment to a greater or lesser degree as a result of direct or
indirect injuries", based on WHO estimates of 100 000 direct and 400
000 indirect casualties. It indicates existing shortages of some
medical items, "rendering the existing stocks inadequate" for
war-increased demand, and exacerbated by the "likely absence of a
functioning primary health care system in a post-conflict situation".
The report also "estimated that the nutritional status of some 3·03 m
people countrywide will be dire and that they will require therapeutic
feeding [according to UNICEF estimates]". Finally, "it is estimated
that there will eventually be some 900,000 Iraqi refugees requiring
assistance, of which 100,000 will be in need of immediate assistance
[according to UNHCR]. . . An estimated 2 million people will require
some assistance with shelter". For 130 000 existing refugees in
"it is probable that UNHCR will initially be unable to provide the
support required".
But the most worrying effect of the use of force in
internationally is in its role as an escalator of collective violence.
WHO defines collective violence--by states or non-governmental
groups--as "The instrumental use of violence by people who identify
themselves as members of a group--whether this group is transitory or
has a more permanent identity--against another group or set of
individuals, in order to achieve political, economic or social
objectives". WHO reports that such collective use of force has
long-term negative effects on stability and social well-being.
International violence has been steadily increasing and "overall a
total of 72 million people are believed to have lost their lives
during the 20th century due to conflict, with an additional 52 million
lives lost through genocides". Conflict escalates after use of
collective force, as violence becomes a more common and legitimated
form of political or social action.
Health professionals worldwide care for the casualties of war. We
accept this responsibility. However, it is also our responsibility to
argue for prevention of violence and peaceful resolution of conflict.
Staff and students of the London School of Hygiene and Tropical
Medicine come from and work in over 120 countries, many in conflict.
Our experience and evidence corroborate the views of WHO, the United
Nations, and Medact.
We believe that a war would have disastrous short-term, medium-term,
and long-term social and public-health consequences--not just for
governance. Military intervention in
peaceful routes to disarmament, risks escalating collective violence.
WHO argues that conflict can be averted only by more equitable forms
of development, and by accountable, ethical governance
internationally. We strongly support this perspective and believe that
further acts of violence can be prevented by international and local
governance that shows itself to be peaceful and ethical.
For the reasons above, we oppose the use of military intervention in
members of the Government and the public. We also intend this
statement to support all those who are opposed to military action on
ethical and humanitarian grounds, not originating from any political
or religious viewpoint.
Carolyn Stephens, on behalf of 500 signatories of the London School of
Hygiene and Tropical Medicine (listed at
http://image.thelancet.com/extras/03cor1048webappendix.pdf
Department of Public Health and Policy, London School of Hygiene and
Tropical Medicine,
(e-mail:carolyn.stephens@lshtm.ac.uk)
1 World Health Organization. World report on violence and health,
2002.
2 Medact. Collateral damage: the health and environmental costs of war
on
http:// www.medact.org/tbx/pages/sub.cfm?id=556
(accessed
2003