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CRS conference 4 September 2014
Medact
Medact is a charity for health professionals and others
working to improve health worldwide
it conducts research and analysis it campaigns and lobbies it educates and informs it is independent of powerful interest groups and sees health
through the lens of social justice
Health workers can act as witnesses and responders
using evidence of the health consequences of war as a contribution to peace building
speaking on behalf of a community that has to care for those affected by conflict and is frequently targeted in war
Medact work on Iraq
report launched in November 2002 in the aftermath of the 9/11 attack
a military attack on Iraq was currently threatened
served as a contribution to the movement against war
Medact work on Iraq
a military scenario was needed: Medact researched a credible hypothetical scenario based on government reports, non-partisan military and political sources
drew on evidence from previous conflicts of the likely health impact
these conflicts included 1990 to 91 Gulf War, those in Panama, Chechnya, Mogadishu and former Yugoslavia
Medact work on Iraq
at the same time there were concerns from FAO, WFP and other UN agencies about the impact of further conflict on Iraqi societyhttp://reliefweb.int/report/iraq/our-common-responsibility-impact-new-war-iraqi-children
the International Study Team in January 2003 reported on the state of physical and mental health of Iraqi children finding them much more vulnerable to war than in 1991http://reliefweb.int/report/iraq/our-common-responsibility-impact-new-war-iraqi-children
Medact work on Iraq
Medact’s report Collateral damage gave a credible war scenario of
four elements:
sustained and devastating air attacks on government and military facilities and infrastructure in Baghdad and other major urban areas
landing of ground forces to seize oil producing regions in the south east
gaining control of north Iraq rapid deployment forces backed by air attacks to take control of
Baghdad
Medact work on Iraq
Medact’s report Collateral damage found that:
the baseline mental and physical health of the Iraqi people was degraded by the 1991 Gulf War, and over 10 years of crippling economic sanctions
health system was greatly deteriorated and ill-equipped to meet any new demands
as a result the Iraqi population was very vulnerable to further military conflict
Collateral damage
Medact reported:
Immediate effects during initial military action, battle of Baghdad,
northern Iraq and Basra area:
direct deaths and injuries damage to infrastructure: electricity, water, sanitation, food
supply setting off public health crisis damage to hospitals and supply chain
Collateral damage
Medium term as a result of this damage:
epidemic diseases particularly affecting children malnutrition increased maternal mortality- inability to reach skilled care psychological trauma also affecting children pollution of the environment from oil spills, fires, depleted
uranium used in US bunker busters, cluster bombs
Collateral damage
Medium term:
risk of internal conflict
global impact- cascading effect on families communities of returning combatants with physical and psychological trauma
burden on neighbouring countries from refugees
disrupted health services unable to cope with demand
Collateral damage
Long term:
environmental and ecological damage from troop movements and bombardments
cost of war US $50 – 200bn
reconstruction costs, for neighbouring countries and coalition: US $150 – 200bn
Collateral damage
Human cost: Medact estimated deaths on all sides in the immediate conflict
and the following three months ranged from 48,000 to 260,000 civil war could kill another 20,000 people deaths occurring later caused by adverse health effects could
reach 200,000 the number of wounded, civilians and combatants, could range
from 120,000 to 650,000 Medact estimated 300,000 to nearly 4 million deaths in the
event of a nuclear attack IN ALL SCENARIOS THE MAJORITY OF CASUALTIES ARE
CIVILIANS
Collateral damage
The report was disseminated to the media, UK government:
the report was well covered in the media
it was possible for the government to dismiss estimates of deaths
Medact presented report to many peace and community groups
the report was covered in WHO Bulletinhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572414/pdf/12764524.pdf
Further Medact reports on Iraq
Medact followed up Collateral damage with four reports and two
updates subsequent to the 2003 invasion of Iraq examining the
ongoing health and health system consequences of the invasion
and aftermath
Medact work on Iraq
Estimations in Medact’s 2002 report have largely been borne out
apart from numbers initially displaced which were less, but those seeking safety in neighbouring countries like Jordan increased to 700,000 by 2009
tragically consequences continue
Medact work on Iraq
Further from the event in time other factors/ causes have an influence and have been covered in subsequent reports:
dismissal of the Ba’ath party from public office and the military exacerbated civil conflict
failure of CPA to use expert humanitarian advisers and Iraqi expertise impeded effective planning
Medact work on Iraq
Questions arising as a result of report:
how to convince decision makers and the public to take seriously what we predict is likely to happen
how much can we expect to influence those who promote military action as a solution
would it help to refine how we predict the impact of war on health
I will now hand over to Marion who will talk about further work of Medact on Health Impact Assessment