Sal & Inf - Peace and Health

pubblicata da The Lancet Student

War and health go hand-in-hand, not just through the many deaths in warfare itself, but also through the civil unrest left behind. Nilofer Khan continues Peace week with a blog on the after-effectsof war, and its horrific implications on innocent civilians.

“Mamma Sessay, 18, wades through the murky waters in a canoe to reach the Magburaka Government Hospital in Sierra Leone to deliver her second child of a pair of twins. It takes almost 24 hrs after her first child to deliver her second, and this culminates into a struggle for life when she starts to heamorrhage rapidly. Her blood pressure plunges dangerously to 60/40 as she is rushed to the only doctor in the district. Precious seconds slip by as the doctor arrives 30 minutes later to see her. Despite a blood transfusion, there is no heart beat and she is pronounced dead. Now, it is upon her mother to raise her twin newborns. In civil war-torn Sierra Leone, 1,033 women die for every 100,000 live births, one of the world’s highest rates of maternal mortality”(1).

(Photo Essay by Lynsey Addario / VII Network for TIME, June 14th 2010)

World peace is an integral component in advocating for adequate health coverage, especially so in developing countries. A study revealed that 90% of all deaths related to recent wars were among civilians, with a plethora of indirect consequences - some of which were inflicting long-term physical and psychological adverse health effects, depleting the social fabric and infrastructure of society, damage to the environment, depletion of vital resources needed to sustain public health, and fostering a culture of violence (2).Sections of the community are isolated from adequate primary medical care and new public health issues arise. World leaders meet and dialogue, relief and disaster management teams are mobilized, aid is sought and the cycle continues for weeks, months and more often, for years. True victims are vulnerable groups of the population. A study on maternal mortality in Bosnia and Herzegovina found that during the war period the perinatal mortality rate increased average 24.28% as a result of uterine ruptures, sepsis and bleeding due to shell injury of pregnant women and fell to 8.01% in 2003 immediately after the war (3). Sex crimes and child abuse prevail, families are torn apart, women and children bear the brunt of the conflict. The country’s economic framework plummets, making health care less affordable. Conflict plants its formidable seeds deep within veterans, often with a greater impact on female recruits. The American Journal of Public Health recently published a study documenting that female veterans were more likely to receive a diagnosis of depression, while male veterans were more likely to receive a diagnosis of short term PTSD or alcohol use disorders (4).

While rejoicing this festive season, let’s take a moment to ponder how we, health professionals, can promote peace and nurture it by enriching our professional integrity, values, social obligation, vision, and leadership. Conflict and war ‘rape’ our public health fabric, throwing new public health challenges, increasing disparities and sabotage human rights. I implore you to stand in solidarity with those who are alone today, the hapless, who are alone to light the candle of hope, left in wake of grueling human conflict.

Nilofer Khan Habibullah
American International Medical University

References

  1. Lynsey Addario / VII Network .Maternal Mortality in Sierra Leone: The Story of Mamma. TIME 2010 June; 1-12.Available from: http://www.time.com/time/photogallery/0,29307,1993805,00.html#ixzz18Uh3GVZV
  2. Levy BS. Health and Peace. Croatian Medical Journal 2002 Apr; 43(2):114-116. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11885034
  3. Fatusić Z, Kurjak A, Grgić G, Tulumović A.The influence of the war on perinatal and maternal mortality in Bosnia and Herzegovina. Journal of Maternal and Fetal Neonatal Medicine.2005 Oct; 18(4):259-63.Available from: http://www.ncbi.nlm.nih.gov/pubmed/16318977
  4. Maguen S, Ren L, Bosch J,Marmar C, Seal K. Gender Differences in Mental Health Diagnoses Among Iraq and Afghanistan Veterans Enrolled in Veterans Affairs Health Care. American Journal of Public Health. 2010; 100: 2450-2456.Available from: http://ajph.aphapublications.org/cgi/content/abstract/100/12/2450

 

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