Presentation includes - definition of key terms, impact of war and terrorism on - society. The issues associated with child soldiers, role of civil society, weapon production has been highlighted with case studies.

1. TERRORISM, WAR AND GLOBAL HEALTH
OPH5 Seminar
DR.VISHAL TIKHUTE
(MM2017PH004)
♖ ♞ ♗ ♟ ♕ ♚ 31 JAN 2018 ♔ ♛ ♙ ♝ ♘ ♜
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WARNING
This Presentation Contains Distrubing Images Viwers Discrition is advised
Text

2. ☯︎
SCHEME OF PRESENTATION
Terrorism
Children at War
A DISTURBING STATISTICS WW 1 & 2 Fatalities due to infections
Background Arms trade
War conflict reasons:
Good things : NAZI - banned tobacco, research on tobacco.
Nuclear war
GH Challenges
Civil Society
World Peace

3. INTRODUCTION
TERRORISM
▸ Definition
▸ Origin
▸ Contemporary issues
▸ Threat to GH
3

4. T ”ERROR”
“TERRORISM AND PERCEIVED THREATS OF TERRORISM CAN
HAVE LONG-LASTING SOCIAL, POLITICAL AND ECONOMIC
CONSEQUENCES: WIDESPREAD FEAR, CURTAILMENT OF CIVIL
LIBERTIES AND THE PROMOTION OF A DYSFUNCTIONAL
CLIMATE OF FEAR.”
(PEOPLE’S HEALTH MOVEMENT & GLOBAL EQUITY GAUGE
ALLIANCE 2008).

5. DEFINITION
FRAMEWORK FOR DEFINING TERRORISM
What does it include?
Politically motivated violence (physical or
psychological), or the threat of violence,
especially against civilians, with the intent to
instil fear and cause damage to health
Who might the
perpetrators be?
State or non-state organisations or individuals
Where might such acts
take place?
Within or across national boundaries
When can it occur? During war, peace, or periods of internal or civil
conflict
(People’s Health Movement & Global Equity Gauge Alliance 2008)

6. SOMETHING ABOUT WAR
VICTIMS
“I see the world gradually being turned into a wilderness, I hear the ever-
approaching thunder, which will destroy us too, I can feel the suffering of millions,
and yet, if I look up into the heavens, I think that it will all come right, that this
cruelty, too, will end.”
— Anne Frank.

7. CHILDREN AT WAR

8. AT THE END OF 1995, CONFLICTS
HAVE BEEN RUNNING IN ANGOLA
FOR OVER 30 YEARS,
AFGHANISTAN FOR 17 YEARS,
IN SRI LANKA FOR 11 YEARS,
IN SOMALIA FOR 7 YEARS.
ENTIRE GENERATIONS HAVE GROWN UP IN
THE: MIDST OF BRUTAL ARMED CONFLICTS.

9. THERE ARE MORE THAN
300,000 CHILD
SOLDIERS IN THE
WORLD TODAY
2 million killed,
4-5 million disabled
10 million psychologically traumatised
12 millions uprooted from homes
IN 1988, 200,000 CHILDREN <16YRS

10. CHILD SOLDIERS -NEW
FORM OF SLAVERY
CHILDREN WHO EXPERIENCE KILLINGS, FIGHTING, AND UPHEAVAL, HAVE TO SUFFER FROM
SOME FORM OF PSYCHOLOGICAL DISTRESS AND ARE THEREFORE IN NEED OF, NOT ONLY
PHYSICAL REHABILITATION (LIKE FOOD, MEDICAL AID, CONSTRUCTION OF HOUSES,
SCHOOLS, ETC), BUT ALSO IN NEED OF FORMS OF MENTAL HEALTH CARE AND
PSYCHOSOCIAL SUPPORT.

11. ALMOST HALF OF THE WORLD’S FORCIBLY DISPLACED PEOPLE ARE
CHILDREN AND MANY SPEND THEIR ENTIRE CHILDHOOD FAR FROM
HOME. IN 2013, AN ESTIMATED 51.2 MILLION PEOPLE WORLDWIDE
WERE FORCIBLY DISPLACED DUE TO CONFLICT (UNHCR 2013).

12. IMPACT
IMPACT AND EFFECTS OF WAR ON CHILDREN
▸ Children experience violence within and outside refugee camps, as well as in
reintegration and urban situations.
▸ Refugee children often experience discrimination by local residents—including
teachers—and sometimes experience discrimination within camps from members of
other ethnic groups.
▸ Gender-based violence directed at girls, including harassment and rape, is
widespread.
▸ Children living without parents are especially vulnerable, due to lack of adult
protection and scarce economic resources. (ICRC 2010).

13. …
IMPACT AND EFFECTS OF WAR ON CHILDREN
▸ A Forced marriages, often resulting from rape and pregnancy, are common in
several camps.
▸ Alcohol and substance abuse by adults often results in violence and sexual
assault against children.
▸ Some of the tasks assigned to children (such as collecting water and gathering
firewood) put them at risk for discrimination and rape. (UNHCR, 2007).

14. CHILD & FAMILY AT WAR
Source: Fegert et al.(2018).

15. WHY WAR
WAR CONFLICT REASONS:
▸ POWER
▸ LAND
▸ PETROLEUM & OTHER RESOURCES
▸ VIOLATION OF CIVIL RIGHTS
▸ ANARCHY

16. DEATHS
WW I
▸ The total number of military and civilian
casualties in World War I was more than 41
million: there were over 18 million deaths and
23 million wounded.
Source: Nadège Mougel (2011). module 1-0 - explanatory notes – World War I casualties – EN REPERES :, CVCE.

17. DEATHS
WW II
▸ Over 60 million people were killed, which was
about 3% of the 1940 world population (est.
2.3 billion). Statistics of military wounded are
available for the major combatants. World War
II fatality statistics vary, with estimates of total
deaths ranging from 50 million to more than
80 million.

18. WORLD@WARGLOBAL ARMS TRADE
REACHES $1.6 TRILLION

19. THE GOOD
ALCOHOLICS WERE STERILISED, AND SMOKING BY CHILDREN WAS A CRIMINAL
OFFENCE.
GERMANY PROMOTED SMOKE-FREE PUBLIC PLACES, ADVERTISING RESTRICTIONS
AND EPIDEMIOLOGY LINKING SMOKING TO LUNG CANCER, INFERTILITY AND HEART
DISEASE. “HEALTH FASCISTS

20. ANTI-TOBACCO
GERMANY HAD THE WORLD'S STRONGEST ANTISMOKING MOVEMENT IN THE 1930S
AND EARLY 1940S, ENCOMPASSING BANS ON SMOKING IN PUBLIC SPACES, BANS ON
ADVERTISING, RESTRICTIONS ON TOBACCO RATIONS FOR WOMEN, AND THE WORLD'S
MOST REFINED TOBACCO EPIDEMIOLOGY, LINKING TOBACCO USE WITH THE ALREADY
EVIDENT EPIDEMIC OF LUNG CANCER (Proctor, 1996).
* Derived from : Schneider & Glantz 2008, commentary on “Nicotine Nazis
strike again”)

21. NUCLEAR WEAPONS
14,900 NUKES
IMMEDIATE HEALTH CONSEQUENCES
LONG-TERM HEALTH CONSEQUENCES

22. EPOCALYPS
CASUALTIES AND DESTRUCTION CAUSED BY THE ATOMIC BOMBS
▸ Deaths:
Hiroshima: 100,000 – 140,000 killed*
Nagasaki: 60,000 – 70,000 killed*
▸ Total area destroyed by heat, blast, radiation:
Hiroshima: 13 sq km (including 4 sq km completely destroyed by a restorm) Nagasaki: 6.7 sq km
▸ Impact on medical services in Hiroshima:
270 out of 300 doctors were killed or injured 1,654 out of 1,780 nurses killed or injured 112 out of 140 pharmacists
killed or injured.
* Number of deaths attributable to the atomic bombs by the end of 1945.

23. WEAPONS FOR
MASS
DESTRUCTION
CURRENT STATUS OF

24. WAR
CHALLENGES & APPROACHES
▸ FOOD AND NUTRITION
▸ WATER AND ENVIRONMENTAL HEALTH
▸ COMMUNICABLE DISEASES
▸ MEDICAL AND SURGICAL CARE
▸ THE HEALTH−CARE SYSTEM
▸ DISASTERS AND DEVELOPMENT
▸ INTERNATIONAL HUMANITARIAN LAW
▸ INTRODUCTION TO HUMANITARIAN ETHICS
▸ PROTECTING THE VICTIMS OF ARMED CONFLICTS

25. THE USE OF
ANTI−PERSONNEL MINES IN
RURAL AREAS CAN REDUCE
THE AREA OF ARABLE LAND
FOOD &
NUTRITION

26. …
WATER & ENVIRONMENTAL HEALTH
▸ Consumption of polluted water:
− Cholera
− Amebiasis
▸ Lack of water engendering inadequate personal hygiene:
− Scabies − Trachoma
▸ Presence in the water of an intermediate host which carries the pathogenic agent: − Schistosomiasis
▸ Development of communicable−disease vectors in water:
− Malaria
− Yellow fever
▸ • Combination of the causes above:
− Amebiasis: polluted water and inadequate personal hygiene

27. VULNERABILITY
NUTRITION
▸ A nutritional vulnerability linked to age:
Children under the age of five years are the most vulnerable nutritionally. This
is because their food intake must respond to specific growth needs, because
they are the most susceptible to infectious diseases, and, finally, because they
may be subject to the detrimental effects of certain feeding practices.
▸ A vulnerability linked to physiological condition:
Pregnant and breastfeeding women are more vulnerable to lack of food owing
to their increased needs.

28. …
ENVIRONMENTAL
▸ Vulnerability linked to environmental conditions:
A. Physical environment
It is recognised that environmental conditions play a predominant role in child
development; a lack of clean water, regular contact with human refuse, and
unhealthy living conditions are a few of the factors that interfere with normal
development.
B. Cultural environment
Certain feeding practices can have a devastating effect on nutritional status −
for example, the custom of not feeding sick children.

29. …
C. Political environment
The insecurity that prevails in most conflict situations tends to break up the
family unit and separate family members, as well as straining family ties
(disrupting the mother−child relationship, for example); this increased family
vulnerability most affects children.
▸ Vulnerability linked to disease:
A malnourished body is prone to infection; infectious diseases, in turn, may be
the first step towards malnutrition. Generally speaking, sick people are
particularly vulnerable to shortages of food appropriate for their condition.

30. ☯︎
PEACE & DEVELOPMENT
▸ Connection between peace and the promotion of human rights
▸ International level inter−State cooperation for development
▸ Linkage between peace and development (development is essential to reduce
the risks of armed conflict, while peace is a prerequisite for development).

31. ☯︎
HEALTH SYSTEMS
▸ In war situations, health−care personnel are confronted with the consequences
of the use of arms (surgeons, for example, see the results of anti−personnel
mines), and those of the military tactics employed (public health personnel and
displaced populations).

32. IMPACT
WAR IMPACT
▸ Most of the 3.8 million civilian deaths that occurred in the DRC, were not
directly due to warfare, but to malnutrition, infectious disease, and other
indirect effects (Roberts and Muganda 2008).
▸ Long-term effects on mental health: PTSD.

33. …
IMPACT ON HEALTH
▸ Mental Health: shell shock
▸ Morbidity
▸ Mortality
▸ Disability

34. …
IMPACT ON OTHER COMPONENTS
▸ Social impact: Anarchy, mass migration (Population migration may introduce
new pathogenic agents into the host region).
▸ Impact on Human Development: prolonged conflict —> Individuals prefer
conflict as way of resolving issues
▸ Economical Impact: More arms less books & medicines.
▸ Healthcare Service: Targeting healthcare centres & professionals.
▸ Human Rights: killing, torture, and widespread devastation

35. …
IMPACT OF GREAT WARS ON GH
▸ High morbidity & mortality —> Public Health Advancement (Hygiene, Sanitation,
Preventive care)
▸ RCT’s —> new drugs & remedies,
▸ Social experiments —> development of new theories
▸ Establishment of GH institutes: WHO.
▸ Focus turned from ‘wealth of nation’ to ‘health of people’.
▸ Outreach services, emphasis on rehabilitation and continuing care, huge advances in
prosthetic limb technology

36. …
GH …
▸ Diseases’ resurgence & Halted Preventive Measures: Decrease in immunisation
rates : Prior to the current conflict in Syria, immunization rates in the country
were among the highest in the Eastern Mediterranean Region. More than 90%
of Syrian children were vaccinated against diseases like measles and polio and
there was no incident of a child being paralysed by polio since the 1990s.
▸ Last year, however, Syria saw the resurgence in the outbreak of measles and
pertussis. In 2013, the country experienced a polio outbreak that paralysed 35
children and spread to Iraq.

37. CIVIL SOCIETY
TRUE WARRIORS: FRONT LINE WORKERS.
PAK- POLIO ERADICATION : CBVS, LHVS.
AF’STAN- EDUCATORS.
ISIS - REHABILITATORS.

38. FRONTLINE HEALTH WORKERS IN PAKISTAN
COMMITTED THEMSELVES TO END POLIO Source: EndPolioPakistan

39. CBV- BACKBONES OF THE POLIO ERADICATION
PROGRAMME.
Source: EndPolioPakistan

40. “SINCE I BEGAN WORKING TO END POLIO, I FEEL LIKE I AM A
SOLDIER. JUST AS AN ARMY FIGHTS TO PROTECT A COUNTRY,
SIMILARLY I FIGHT AGAINST A VIRUS WHICH IS DISABLING OUR
BELOVED CHILDREN. I WILL FIGHT AGAINST THIS CRIPPLING
DISEASE UNTIL THE VIRUS IS PERMANENTLY ERADICATED AND OUR
BELOVED CHILDREN ARE FULLY PROTECTED” ~ KHALIDA
PAKISTAN IS ONE OF ONLY THREE LAST POLIO
ENDEMIC COUNTRIES, ALONG WITH AFGHANISTAN
AND NIGERIA. THE NUMBER OF CASES HAS DECLINED
DRAMATICALLY IN THE PAST YEARS: FROM 306 IN
2014 TO 20 IN 2016. AS OF JUNE 2017, THE NUMBER
OF POLIO CASES REPORTED IN PAKISTAN WAS THREE. Source: EndPolioPakistan

41. WORLD PEACE
“PEACE IS NOT SIMPLY THE ABSENCE OF WAR, BUT RATHER A DYNAMIC PROCESS OF COOPERATION AMONG ALL STATES AND PEOPLES;
CO−OPERATION FOUNDED ON FREEDOM, INDEPENDENCE, NATIONAL SOVEREIGNTY, EQUALITY, RESPECT OF HUMAN RIGHTS, AND A FAIR AND
EQUITABLE DISTRIBUTION OF RESOURCES TO MEET THE NEEDS OF PEOPLES.”
- ICRC 1984.

42. ☯︎
WHAT CAN BE DONE
▸ Action must be taken to alleviate the causes of terrorism, including poverty,
illiteracy and gender inequality.
▸ Alleviate the practice of religious fundamentalists of all persua- sions of
encouraging, justifying or glorifying aggression and violence.

43. …
INTERNATIONAL HUMANITARIAN LAWS
▸ "A set of rules aimed at limiting violence and protecting the fundamental rights of the individual in time of armed conflict." (Geneva:
ICRC, 1993).
▸ To regulate the methods and means of combat. Restricts or prohibits the use of certain means of warfare during a conflict, and includes:
• The Declaration of St. Petersburg (1868), which outlawed the use of certain types of projectiles in time of war.
• The Declaration Concerning Expanding Bullets, prohibiting the use of bullets that expand or flatten easily in the human body (1899).
• The Geneva Protocol for the Prohibition of the Use of Asphyxiating, Poisonous or Other Gases, and of Bacteriological Methods of
Warfare (1925).
• The Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons
and on their Destruction (1972).
• The Convention on the Prohibition of Military or Any Other Hostile Use of Environmental Modification Techniques (1976). • The Protocol
on Non−Detectable Fragments (1980).
• The Protocol on Prohibitions or Restrictions on the Use of Mines, Booby−Traps and Other Devices (1980).

44. REFERENCES
Bennett-Jones, O. (2007). Iraq ‘deaths’ survey was robust. http://news.bbc.co.uk/ /hi/ uk_politics/.stm.
Euwema, M., De Graaff, D., & De Jager, A. (2008). Research with children in war-affected areas. In Research with Children(pp. 205-220).
Routledge.
Fegert et al.(2018). Psychosocial problems intraumatizedrefugee families: overview ofrisks andsomerecommendations forsupport services.
Child Adolesc Psychiatry Ment Health. 12:5 https://doi.org/10.1186/s13034-017-0210-3
International Committee of the Red Cross (2013). ICRC Information Note #1 EN The effects of nuclear weapons on
health. Published online on 22/05/2013. Retrieved online: http://www.icrc.org/eng/war-and-law/weapons/nuclear-weapons
International Committee of the Red Cross (2009). CHILDREN IN WAR report; International Committee of the Red Cross.
Retrieved online: www.icrc.org
International Committee of the Red Cross (1993). Human Rights and the ICRC: International Humanitarian Law (Geneva: ICRC, 1993), p. 3.
International Review of the Red Cross. (1984). ”What the Red Cross and Red Crescent Movement Does and Wants to Do for Peace," International
Review of the Red Cross 750 (Nov./Dec. 1984): 327.

45. REFERENCES
Kristensen & Norria. (nd). Status of World Nuclear Forces. Published online, retrieved on 30 Jan 2018
https://fas.org/issues/nuclear-weapons/status-world-nuclear-forces/
People’s Health Movement & Global Equity Gauge Alliance. (2008). Global Health Watch An alternative world health report 2 ‘C2 Beyond health care:
Terror, war and health.’ pg.114. Retrieved from https://www.ghwatch.org/sites/www.ghwatch.org/files/ghw2.pdf
Proctor, R. N. (1996). The anti-tobacco campaign of the Nazis: a little known aspect of public health
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46. THANK YOU