War and armed conflict causes a significant loss to human life and is a major cause of disability worldwide. In addition to those hurt and killed as a direct result of violent conflict, a vast amount of people are also negatively impacted by the wider effect of war on global health.
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War diverts essential and often scarce resources from those who need it to survive towards the war effort. It also damages the infrastructure put in place to support healthcare. War forces people to flee their homes in search of safety, with the latest figures from the UN estimating that around 70 million people are currently displaced due to war. This displacement can be incredibly detrimental to health, with no safe and consistent place to sleep, wash, and shelter from the elements. It also removes a regular source of food and proper nutrition. As well as impacting physical health, war adversely affects the mental health of both those actively involved in conflict and civilians.
Here, we discuss the various consequences of conflict on global health.
War causes civilians to leave their homes in search of safety. Recent data estimates that there are currently 70 million people who have lost their homes due to conflict. These displaced populations are at a greater risk of disease and illness. In particular, refugees are at an elevated risk of contracting infectious diseases. Recent research has reported the prevalence of various infectious diseases in refugee and asylum seeker populations: latent tuberculosis (9–45%), active tuberculosis (up to 11%), and hepatitis B (up to 12%).
The increased prevalence of infectious disease in refugee populations revealed itself during the conflict in Syria, where the collapse of health systems led to a spike in infectious diseases such as leishmaniasis, rabies, and tuberculosis in refugees.
People who are displaced from their homes during times of conflict are subject to numerous factors that contribute to putting them at a greater risk of disease and illness. These factors include increased levels of poverty, overcrowded living conditions, and increased likeliness of taking on work in cramped conditions.
Displacement can double a person’s risk of contracting an infectious disease, with recent studies in OECD countries finding that the risk of infection for immigrants is twice as high as that for the native-born population.
Access to water, food, and sanitation
War inevitably reduces access to clean water, food, and sanitation. This further increases the risk of contracting communicable diseases. It elevates the risk of malnutrition and diseases linked with malnutrition. Lack of access to clean water can also enhance the prevalence of cholera and other water-borne illnesses.
Cholera can spread relatively quickly through a population living closely. This is particularly concerning, given that, if left untreated, cholera can kill in a matter of hours. People forced to live in the kind of conditions where illnesses like cholera can prevail, such as those that are often linked with living in an area actively involved in war, have higher mortality rates than those living in peaceful countries.
The impacts of war on health are strongly gendered. While men are traditionally more likely to die or become injured in battle, women are more likely to be left to face the lasting consequences of conflict on health. Access to family planning serving and obstetric care become challenging. Limited access to such services is thought to significantly impact the safety of giving birth.
Research has shown that between 1980 and 2008, half of all maternal deaths that occurred worldwide happened in six countries, India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of Congo (DRC), all of which were involved in war or an armed conflict that was ongoing or recent at the time of death.
Women also face an increased risk of rape during violent conflict. Rape and sexual violence are often used as a tool of war. These war crimes result in both physical and psychological injury to the women at the hands of the violent assaulters.
Children’s health is strongly linked with maternal health. As discussed above, war can have a significantly detrimental impact on a woman’s health, which can impact the health of their children, particularly children born during conflict.
Children born during conflict are at a higher risk of being of a low birth weight, which is associated with an increased risk of infant mortality, poorer health in later life, and childhood developmental problems. Additionally, vaccination programs are limited during times of armed conflict. This can significantly increase a child’s chances of contracting what are now largely preventable diseases.
Overall, children born into conflict and those who are children at the time conflict breaks out are at a greater risk of a multitude of health issues due to the impact of war on maternal health, the lack of access to healthcare, and the harsh living conditions they face.
Finally, many studies have shown that war has a negative impact on the mental health of both those involved in the conflict and civilians. People who live through war face psychologically challenging situations, often being uprooted from their homes, facing food insecurity, and constant fear of death and injury to name a few. This inevitably causes damage to a person’s psychological well-being and can exacerbate existing problems.
- Eiset, A. and Wejse, C., 2017. Review of infectious diseases in refugees and asylum seekers—current status and going forward. Public Health Reviews, 38(1). https://publichealthreviews.biomedcentral.com/articles/10.1186/s40985-017-0065-4
- Razum, O., Barros, H., Buckingham, R., Codd, M., Czabanowska, K., Künzli, N., Lyubomirova, K., Otok, R., Signorelli, C. and Middleton, J., 2019. Is war a man-made public health problem?. The Lancet, 394(10209), p.1613. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31900-2/fulltext
- Sidel, V. and Levy, B., 2008. The health impact of war†. International Journal of Injury Control and Safety Promotion, 15(4), pp.189-195. https://pubmed.ncbi.nlm.nih.gov/19051082/