peace building through health zeev wiener phr-israel

Peace Building Through Peace Building Through HealthHealth

Zeev WienerZeev Wiener

PHR-IsraelPHR-Israel

By 2020 The WHO and the World Bank predict that war will be one of the top 10 causes of disability and death.

War and Public HealthWar and Public Health

Economic and social systems are Economic and social systems are

disrupted, famine and epidemics disrupted, famine and epidemics

may follow, and resources are may follow, and resources are

diverted to military rather than diverted to military rather than

health goals-all of which make health goals-all of which make

war a public health problem.war a public health problem.MacQueen G, Santa-Barbara J. Peace building through health initiatives. BMJ 2000; 293-6MacQueen G, Santa-Barbara J. Peace building through health initiatives. BMJ 2000; 293-6

The Role of PhysiciansThe Role of Physicians

“The role of physicians and other health workers in the preservation and promotion of peace is the most significant factor for the attainment of health for all”.

WHO, World Health Assembly, Resolution 34.38, 1981

Health as a Bridge for Peace

A concept based on the idea that A concept based on the idea that shared health concerns can shared health concerns can transcend political, economic, social transcend political, economic, social and ethnic divisions, to promote and ethnic divisions, to promote dialogue, foster solidaritydialogue, foster solidarity, and , and contribute to peace among peoples contribute to peace among peoples and between nations.and between nations.

Guerra de Macedo 1994

WhyWhy??

Why Medicine?Why Medicine?

Is there a coherent intervention Is there a coherent intervention

theory?theory?

Have we the required socio-political Have we the required socio-political

technology?technology?

Do we posses the skills?Do we posses the skills?

Checking Basic Checking Basic AssumptionsAssumptions

War=DiseaseWar=Disease Violence=BacteriaViolence=Bacteria Medical Staff=HealersMedical Staff=Healers Peace=CurePeace=Cure

Health Providers in CrisisHealth Providers in Crisis

Peace Through HealthPeace Through HealthVass A. BMJ (Editorial), Nov. 2001Vass A. BMJ (Editorial), Nov. 2001

“…even the WHO program used anecdotal comments from field teams to say that volatility had reduced and social cohesion improved. The report admits that it could have been the wider peace process and post war fatigue felt by the population that brought about these changes”.

“…With few examples of peace through health initiative, it is idiology that is driving the movement at present”.

“…humanitarian aid had even worsened conflict at times”. (Sudan 1998)

War as a Disease War as a Disease ProcessProcess Primary Prevention-Primary Prevention-”Make love-not war””Make love-not war”

Secondary prevention-Secondary prevention- Early detection of Early detection of conflicts and intervention in high risk areas.conflicts and intervention in high risk areas.

Tertiary Prevention-Tertiary Prevention- Reduce suffering Reduce suffering and disability through treating the victims. and disability through treating the victims.

Alert Signs

Violence

Disease outbreak

Poverty

Unemployment

Food Shortage

Famine Oppression Political

Instability/Corruption Institutional/Social

Disintegration Migration

Health Peace Building Health Peace Building MechanismsMechanisms

Conflict managementConflict management

SolidaritySolidarity

Strengthening the social fabricStrengthening the social fabric

DissentDissent

Restricting destructivenessRestricting destructiveness

Health Peace Health Peace MechanismsMechanismsPalestinian-Israeli Palestinian-Israeli ConflictConflict

Conflict managementConflict management

MedicaMedicall diplomacy and health oriented superordinate goals. diplomacy and health oriented superordinate goals.

• Present data to policy makers and public (both sides)

• Press professional associations to stand out (IMA, Palestine)

• Press Government by international establishments

(Red Cross, Amnesty, professional associations)

Health Peace Health Peace MechanismsMechanismsPalestinian-Israeli Palestinian-Israeli ConflictConflict SolidaritySolidarity

Healthcare workers empowering peacemaking groups.Healthcare workers empowering peacemaking groups.

Empower health and human rights NGO’s by:

• Finance• medical supplies (home equipment, medications)• medical expertise( mental health, infant development)• Out of country medical facilities (special surgery)


Strengthening the social fabricStrengthening the social fabric

Restore and enforce bonds uniting populations through health.Restore and enforce bonds uniting populations through health.

•Joint medical projects relevant to both populations

(DM, HT, PTSD, lifestyle modification)

• Professional knowledge and expertise exchange

•Re-Education (hate, mistrust, violence)


DissentDissent

Using medical knowledge to express disagreement with policies.Using medical knowledge to express disagreement with policies.

•Access to healthcare (Roadblocks, primary care services) •Official responsibility in different types of Palestinian areas


Restricting destructivenessRestricting destructiveness

Arguing for restricting and abolishing destructive Arguing for restricting and abolishing destructive

policies and weapons using healthcare discourse.policies and weapons using healthcare discourse.

•Obstacles to healthcare access•House destruction •Suicide bombing•Prisoners’ health

Public Health Problems Public Health Problems Concerning Both SidesConcerning Both Sides

•Physical trauma (Gun shot ,burns,blast wounds)

•Mental trauma (PTSD)

•Hate ,mistrust, violence

•Road accidents

•Life Style (Obesity, Smoking, ect.)

Violence

Conflict

Acts of killing during war encourage depreciation in the value of human life, legitimizing violence and lead violence to be seen as norm.Archer D. and Gartner R. Violence and crime in cross-national perspective, New Haven: Yale University Press 1984.

The more an individual feels helpless and loss ofControl, the more they are prone to develop anger, anxiety, frustration and depression , expressed in behavioral terms as violence. Milgram NA. Psychological stress and adjustment in time of war and peace: the Israeli experience as presented in tow conferences. Isr Ann Psychiatr Relat Discip 1978; 16(4): 327-38.

What is NeededWhat is Needed??

Redefine goals.Redefine goals.

Create appropriate region-specific tools.Create appropriate region-specific tools.

Educate staff.Educate staff.

Preserve medical neutrality and Preserve medical neutrality and

impartiality.impartiality.

Keep on trying.Keep on trying.

peace building through health zeev wiener phr-israel

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