Module 11: Women, Children, War, and Health

Health Effects of War

Throughout the developed and developing world, conflict is a constant threat to psychological and physical well-being.  Not only does it funnel limited resources and funding away from health care and disease prevention, it creates new and severe health problems. (1)  For example, in Bosnia, the proportion of military and civilian surgeries due to war related trauma rose from 22% to 78% in the city’s major hospital during the first 6 months of the war in 1992. This substantial increase overwhelmed the medical services. In the same period, infant and child mortality nearly doubled, and newly diagnosed tuberculosis cases quadrupled.(2)

“When conflict is extended, public health activities, including immunization and surveillance systems, can be substantially reduced, dismantled and destroyed, as happened during recent conflicts in Rwanda, Sudan, Liberia, Chechnya, and Iraq.” (3)

In fact, during the 20th century, forty-four of every one thousand people died of direct and indirect war-related causes.(4)   Such large casualties may be the result of recent warfare tactics—civil conflicts within countries have no distinct boundaries, and fighters target civilians to kill, rape, and terrorize.(5)   These tactics have been witnessed throughout the world, particularly in conflicts in the Congo, Sierra Leone, and Rwanda.

It is essential to consider the diverse factors that impact health during war.  The World Health Organization defines health as not only the absence of disease but also the presence of social wellbeing, and physical and mental health.(6)  This holistic notion implies that environmental and social factors such as housing, food, education, and a sense of safety from sexual and physical violence are important determinants of health and well-being.(7)  Thus, the health effects of war extend beyond reported mortality and morbidity figures.

“It takes us out of the clinic to look for evidence of physical, mental, sexual, spiritual, and social harm within the multiple environments of deprivation and violence that accompany war and that can fester and worsen during post-conflict periods.”(8)

Child Soldiers

The phenomenon of child soldiers has exploded in areas of political instability and civil warfare in the developing world, and there have been devastating consequences.  The human rights organization Coalition to Stop the Use of Child Soldiers outlines important facts: (9)

“Children involved in armed conflict are frequently killed or injured during combat or while carrying out other tasks. They are forced to engage in hazardous activities such as laying mines or explosives, as well as using weapons. Child soldiers are usually forced to live under harsh conditions with insufficient food and little or no access to healthcare. Girl soldiers are particularly at risk of rape, sexual harassment and abuse.” (10)

In addition to physical injuries and a variety of other health problems such as malnutrition and poor hygiene, child soldiers are emotionally and psychologically affected. (11)   For example, a study in Nepal showed that former child solders were more likely to have severe mental health problems (posttraumatic stress disorder, depression, etc.) than other children in Nepal who were not forced into military service.(12)  As children continue to be abducted and exploited all over the world, there is an increasing need for mental health interventions for child soldiers.

Women, War, and Rape

Many aspects of war affect women and girls disproportionately.  According to recent studies on life expectancy among unarmed civilians caught in armed conflict, women are the primary adult victims of war. (13)  For example, a unique harm of war on women is the trauma inflicted by military brothels, rape camps, sex trafficking for prostitution, and increased domestic violence.  In addition, widows of war and women refugees of war are particularly vulnerable to poverty, prostitution, and higher illness and death following armed conflict.  Furthermore, it has been documented that senior officers of war have commonly accepted and sanctioned the sexual exploitation of local women by military men. (14)(15)(16)

“Rape and sexual exploitation in war have been systematically disregarded (even when documented) as war atrocities and crimes until the recent revelations of the genocidal rape of Muslim women during the conflict in the former Yugoslavia and of Tutsi women in Rwanda.” (17)

Reasons Why Militarism is Bad for Women (18)

A publication by the Population and Development Program at Hampshire College outlines the severe and significant consequences of war on women:

In order to reduce these negative consequences, it has been suggested that more female candidates be present in post-conflict elections, that there be a greater role for women in peace-making and post-conflict reconstruction efforts, and there should be more appointments of women to peacekeeping and diplomatic posts. (19)

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(1) Eban, Katherine (2002). Waiting for bioterror: Is our public health system ready? The Nation, 275(20), 11 –18.

(2) Toole, Michel J., Galson, Steven, & Brady, William (1993). Are war and public health compatible? The Lancet, 341, 1193– 1196.

(3) Hynes, H. Patricia. "On the Battlefield of Women’s Bodies: An Overview of the Harm of War to Women." Women's Studies International Forum 27 (2004): 431-45. Elsevier. Web.

(4) Richard M. Garfield and Alfred I. Neugut, The human consequences of war In: Barry S. Levy and Victor W. Sidel, Editors, War and public health, American Public Health Association, Washington, DC (2000), pp. 27–38.

(5) Michael Renner, Ending violent conflict, Worldwatch Institute, Washington, DC (1999).

(6) Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

(7) Wilkinson, Richard, & Marmot, Michael (Eds.) (2003). Social Determinants of Health: The Solid Facts. Geneva, NY7 World Health Organization.

(8) Hynes, H. Patricia. "On the Battlefield of Women’s Bodies: An Overview of the Harm of War to Women." Women's Studies International Forum 27 (2004): 431-45. Elsevier. Web.

(9) "Some Facts." Child Soldiers International. 2007. Web. 14 May 2010.

(10) Ibid.

(11) Lorey, Mark. Child Soldiers: Care & Protection of Children in Emergencies: A Field Guide. Publication. Ed. Amy Hepburn and Tanya Wolfram. Save The Children, 2001. Web. 14 May 2010.

(12) Brandon A. Kohrt, MA; Mark J. D. Jordans, MA; Wietse A. Tol, MA; Rebecca A. Speckman, BA; Sujen M. Maharjan, BA; Carol M. Worthman, PhD; Ivan H. Komproe, PhD The Comparison of Mental Health Between Former Child Soldiers and Children Never Conscripted by Armed Groups in Nepal JAMA(2008). 300[6]: pp. 691-702.

(13) Ashford, Mary-Wynne, & Huet-Vaughn, Yolanda (2000). The impact of war on women. In Barry S. Levy, & Victor W. Sidel (Eds.), War and public health (pp. 186– 196). Washington, DC7 American Public Health Association.

(14) Barry, Kathleen (1995). The prostitution of sexuality: The global exploitation of women. New York; New York University Press.

(15) Brownmiller, Susan (1975). Against our will: Men, women and rape. New York7 Simon and Schuster.

(16) Moon, Katherine H.S (1997). Sex among allies: Military prostitution in U.S.–Korea relations. New York; Columbia University Press.

(17) Hynes, H. Patricia. "On the Battlefield of Women’s Bodies: An Overview of the Harm of War to Women." Women's Studies International Forum 27 (2004): 431-45. Elsevier. Web.

(18) Hynes, H. Patricia. DifferenTakes10 Reasons Why Militarism Is Bad for Women. Population and Development Program at Hampshire College, 2003. Web. 14 May 2010.

(19) Women, War and Peace: The Independent Experts' Assessment on the Impact of Armed Conflict on Women and Women's Role in Peace-Building. Elisabeth Rehn and Ellen Johnson Sirleaf. United Nations Development Fund for Women. 2002.