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The Epidemiology of War

When war rages, the death, injury, and misery of thousands and millions seems to be inevitable. The consequences of war are regularly blamed on tenacious belligerents that are reluctant to compromise, cycles of violence, culture of violence frequent in one region or another, human nature, and even on religious and cosmic ideas of ultimate struggle between good and evil. Those approaches encourage a deterministic outlook of war and the horrors it brings. Meaning, war is inevitable and there isn’t much we can do to reduce the level of violence and ameliorate mortality and morbidity rates associated with it.

However, this is not the case. War, like any other human activity, has causes, trends, and patterns. These patterns can be disrupted, altered, and stopped. Understanding them is the first step in finding a solution to the mortality and morbidity associated with war. This approach calls for assessment of war in epidemiological terms, mapping direct and indirect outcomes, looking at violence and the spread of disease that follows the devastation. It begins with mapping obvious outcomes such as mortality and morbidity, understanding who are the victims, their associations, age groups, ethnicity, sex, location of violence, type of weaponry used, death and injury rates, direct causes for death and injury, type of injuries that are prevalent, who are the perpetrators of violence, what is their profile and more. Mapping the epidemiology of the conflict can help us understand it empirically rather treating it as this horrible thing that happens in Syria or Ukraine. For example, throughout the Iraq War authorities and the media often mentioned the issue of civilian casualties yet treated it as a minor trend that is unfortunate yet unavoidable in war, as they focused more on combatant casualties. The scope of this trend was unclear until the Iraq Body Count project (IBC) started collecting these data systematically. IBC researchers collected data from news media, government sources, and nongovernmental organization reports, while standardizing and corroborating each case. Their findings were astonishing, indicating that out of the 268,000 violent deaths in the conflict between 179,399 to 201,013 were civilians. Those findings altered the discourse around the conflict as political. As a result, academics, and aid expert began addressing the issue and tried to find and advocate for policy related solutions. Without the IBC’s project, this trend would have been another hidden horror of a long conflict.

By understanding causes, trends, and patterns we can start talking about particular solutions. For example, several studies have shown that humanitarian aid in small conflicts can be counterproductive as they may in fact fuel violence instead of mitigating it. Militant groups use aid to support their armed groups and offensive. Identifying this link can inform better aid and distribution programs; ones that may be more limited yet will deliver aid to non-combatants rather to militant groups. Another example of how epidemiology of war can help reducing violence is the case of refugee camps’ security. A common misconception is viewing refugee camps as a safe and humane solution for displaced individuals that escape war. Yet, in many cases, refugee camps are lawless settings where violence against women and minorities are prevalent. Refugee camps can also be militarized, used as de-faco barracks for militant groups. Understanding those trends helped with devising new security policies and protocols to make sure that refugee camps are actually safe.

War is not different from many other social problems, be it social and economic inequality, poverty, crime, or global health. All are mammoth challenges, that seems insurmountable. Yet we constantly attempt to understand them better and see where we can improve the trend if not halt it altogether.

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