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