Addressing Human Response to War and Atrocity

Major Challenges in Research and Practices and the Limitations of Western Psychiatric Models
  • Derek Summerfield
Part of the The Plenum Series on Stress and Coping book series (SSSO)


According to studies undertaken for the International Symposium of Children and War in 1983, 5% of all casualties in World War I were civilians, 50% in World War II, and over 80% in the Vietnam war (UNICEF, 1986). In current armed conflicts, over 90% of all casualties are civilians, typically from the poorest sectors of society. What predominates is the use of terror to exert social control, if necessary by disrupting the fabric of grassroots social, economic, and cultural relations. The target is often population rather than territory, and psychological warfare is a central element. Atrocity, including public execution, disappearances, torture and sexual violation, is the norm, and those whose work symbolizes shared values are also targeted: community leaders, priests, health workers, and teachers. These strategies, frequently played out on the terrain of subsistence economies, can be devastatingly effective. Mozambique, Angola, Sudan, Somalia, El Salvador, Guatemala, Nicaragua, Peru, Afghanistan, Iraq, Iran, Indonesia, the Philippines, Sri Lanka, the Israeli occupied territories, and the former Yugoslavia have all provided examples of this pattern of war or civil conflict in the past decade. At present, the United Nations High Commission for Refugees counts about 18 million refugees who have fled across an international frontier, though there are at least as many again, no less destitute, who are internally displaced. There have been an estimated 150 wars in the Third World since 1945, which have left 22 million people dead. So far, we have learned little of the health and social costs for the millions left behind, let alone the patterns of their distress and adaptation over time.


Traumatic Experience Rape Victim Mental Health Field British Medical Association Extreme Violence 
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Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Derek Summerfield
    • 1
    • 2
  1. 1.Medical Foundation for the Care of Victims of TortureLondonUK
  2. 2.Department of Community PsychiatrySt. George’s Hospital Medical SchoolLondonUK

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