Skip to main content

Communicable and Noncommunicable Diseases in Conflict Zones

Handbook of Healthcare in the Arab World

Abstract

Modern armed conflict represents a significant risk to global health. This risk is partly inherent in the use of mass violence to advance political goals but also arises in large part from the contemporary trend of warring parties failing in their duty to abide by International Humanitarian Law. The deliberate targeting (or negligent destruction) of civilian and health infrastructure, the endangerment of health workers, and the subjection of a civilian population to starvation, unnecessary forced displacement, and other cruelties are war crimes which should not be normalized. As well as the direct toll of morbidity and mortality that they bring in the form of short-term injuries and deaths, these actions dramatically increase the risk of communicable and noncommunicable disease incidence and simultaneously reduce the ability of a society to prevent and control such risks. Armed conflict degrades the capacity of health systems to gather vital data and plan effectively for future emergencies, and all of these impacts can persist long after the guns have fallen silent. A fuller understanding of the many and various ways in which warfare affects public health (in the separate but linked senses of the professional discipline and the collective health and well-being of the public) would be highly beneficial to international policy-makers, humanitarian workers, and health professionals of whatever background who work (or are planning to work) in or near conflict zones.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Abbara A, Rawson TM, Karah N et al (2018) Antimicrobial resistance in the context of the Syrian conflict: drivers before and after the onset of conflict and key recommendations. Int J Infect Dis 73:1–6

    Article  Google Scholar 

  • Ammar W, Kdouh O, Hammoud R et al (2016) Health system resilience: Lebanon and the Syrian refugee crisis. J Glob Health 6(2):020704

    Article  Google Scholar 

  • Camacho A, Bouhenia M, Alyusfi R et al (2018) Cholera epidemic in Yemen, 2016–18: an analysis of surveillance data. Lancet Glob Health 6(6):e680–e690

    Article  Google Scholar 

  • Collier P, Hoeffler A, Rohner D (2009) Beyond greed and grievance: feasibility and civil war. Oxf Econ Pap 61:1–27

    Article  Google Scholar 

  • Craig AT, Joshua CA, Sio AR et al (2018) Enhanced surveillance during a public health emergency in a resource-limited setting: experience from a large dengue outbreak in Solomon Islands, 2016–17. PLoS One 13(6):e0198487

    Article  Google Scholar 

  • Dehner G (2012) Influenza – a century of science and public health response. University of Pittsburgh Press, Pittsburgh

    Book  Google Scholar 

  • Eldis (2018) Global peace index: methodology, reports and findings. http://bit.ly/2rY9lxU. Accessed 08 Jun 2018

  • Flecknoe D, Wakefield BC, Simmons A (2018) Plagues & wars: the ‘Spanish flu’ pandemic as a lesson from history. Med Confl Surviv 34(2):61–68

    Article  Google Scholar 

  • Forouzanfar MH, Alexander L, Anderson HR, et al (2015) Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 386(10010): 2287–2323

    Google Scholar 

  • Fouad FM, Sparrow A, Tarakji A et al (2017) Health workers and the weaponisation of health care in Syria: a preliminary inquiry for the lancet–American University of Beirut Commission on Syria. Lancet 390(10111):2516–2526

    Article  Google Scholar 

  • Gayer M, Legros D, Formenty P et al (2007) Conflict and emerging infectious diseases. Emerg Infect Dis 13(11):1625–1631. https://doi.org/10.3201/eid1311.061093

    Article  PubMed  PubMed Central  Google Scholar 

  • Gonzalez JP, Souris M, Valdivia-Granda W (2018) Global spread of hemorrhagic fever viruses: predicting pandemics. Methods Mol Biol 1604:3–31

    Article  CAS  Google Scholar 

  • Haar RJ, Rubenstein LS (2012) Health in fragile and post-conflict states: a review of current understanding and challenges ahead. Med Confl Surviv 28(4):289–316

    Article  Google Scholar 

  • International Committee of the Red Cross (1949) Convention (III) relative to the treatment of prisoners of war. Geneva, 12 August 1949. https://ihl-databases.icrc.org/ihl/WebART/375-590006. Accessed 23 Aug 2018

  • International Committee of the Red Cross (2008) How is the term “armed conflict” Defined in International Humanitarian Law? https://www.icrc.org/eng/assets/files/other/opinion-paper-armed-conflict.pdf. Accessed 01 Oct 2018

  • Ismail SA, Abbara A, Collin SM, Orcutt M, Coutts AP, Maziak W, Sahloul Z, Dar O, Corrah T, Fouad FM (2016) Communicable disease surveillance and control in the context of conflict and mass displacement in Syria. Int J Infect Dis 47:15–22

    Article  Google Scholar 

  • Jawad M, Vamos EP, Najim M, et al. (2019) The impact of armed conflict on cardiovascular disease risk among civilian populations in low- and middle-income countries: a systematic review. Heart. [in press]

    Google Scholar 

  • Karasapan O (2016) The war on Syria’s health system. https://brook.gs/2lPByDE. Accessed 01 Sept 2018

  • Kennedy J, Michailidou D (2017) Civil war, contested sovereignty and the limits of global health partnerships: a case study of the Syrian polio outbreak in 2013. Health Policy Plan 32(5): 690–698

    Article  Google Scholar 

  • Kruk ME, Ling EJ, Bitton A et al (2017) Building resilient health systems: a proposal for a resilience index. BMJ 357:j2323

    Article  Google Scholar 

  • Lowcock M (2018) Under-secretary-general for humanitarian affairs and emergency relief coordinator, statement on the situation in Yemen. https://reliefweb.int/report/yemen/under-secretary-general-humanitarian-affairs-and-emergency-relief-coordinator-mr-mark-3. Accessed 11 Sept 2018

  • Médecins Sans Frontières (1997) Refugee health: an approach to emergency situations. Macmillan Education, Oxford

    Google Scholar 

  • Meiqari L, Hoetjes M, Baxter L et al (2018) Impact of war on child health in northern Syria: the experience of Medecins Sans Frontieres. Eur J Pediatr 177(3):371–380

    Article  Google Scholar 

  • Mohammed E (2010) Iraq’s crumbling, corrupt healthcare. https://bit.ly/2ouEGVW. Accessed 01 Sept 2018

  • Nelson C, Lurie N, Wasserman J et al (2007a) Conceptualizing and defining public health emergency preparedness. Am J Public Health 97(Suppl 1):s9–s11

    Article  Google Scholar 

  • Nelson C, Lurie N, Wasserman J (2007b) Assessing public health emergency preparedness: concepts, tools, and challenges. Annu Rev Public Health 28:1–18

    Article  Google Scholar 

  • Nimer NA (2018) A review on emerging and re-emerging of infectious diseases in Jordan: the aftermath of the Syrian crisis. Can J Infect Dis Med Microbiol. https://www.hindawi.com/journals/cjidmm/2018/8679174/. Accessed 07 Oct 2018

  • Nishtar S (2009) Pakistan, politics and polio. Bull World Health Organ. http://www.who.int/bulletin/volumes/88/2/09-066480/en/ Accessed 16 Sept 2018

  • Nnadi C, Etsano A, Uba B et al (2017) Approaches to vaccination among populations in areas of conflict. J Infect Dis 216(Suppl 1):s368–s372

    Article  Google Scholar 

  • Pettersson T, Wallensteen P (2015) Armed conflicts, 1946–2014. J Peace Res 52(4):536–550

    Article  Google Scholar 

  • Roberts B, Patel P, McKee M (2012) Non-communicable diseases and post-conflict countries. Bull World Health Organ 90(1):2, 2A

    Article  Google Scholar 

  • Rowland M, Nosten F (2001) Malaria epidemiology and control in refugee camps and complex emergencies. Ann Trop Med Parasitol 95(8):741–754

    Article  CAS  Google Scholar 

  • Scientific American (2013) How the CIA’s fake vaccination campaign endangers us all: the U.S. was wrong to use health workers to target Osama bin Laden. https://www.scientificamerican.com/article/how-cia-fake-vaccination-campaign-endangers-us-all/. Accessed 01 Oct 2018

  • Spiegel PB, Checchi F, Colombo S, Paik E (2010) Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet 375:341–345

    Article  Google Scholar 

  • Spiegel PB (2017) The humanitarian system is not just broke, but broken: recommendations for future humanitarian action. Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31278-3/fulltext. Accessed 02 Oct 2018

  • Starbird K, Arif A, Wilson T (2018) Ecosystem or echo-system? Exploring content sharing across alternative media domains. http://faculty.washington.edu/kstarbi/Starbird-et-al-ICWSM-2018-Echosystem-final.pdf. Accessed 28 Sept 2018

  • Tacitus C (1872) The works of Tacitus: the Oxford translation [volume II] – the history, Germany, Agricola, and dialogue on orators. Bell & Daldy, London

    Google Scholar 

  • Thomas S, Keegan C, Barry S et al (2013) A framework for assessing health system resilience in an economic crisis: Ireland as a test case. BMC Health Serv Res 13:450

    Article  Google Scholar 

  • Verma AA, Jimenez MP, Tangermann RH et al (2018) Insecurity, polio vaccination rates, and polio incidence in Northwest Pakistan. PNAS 115(7):1593–1598

    Article  CAS  Google Scholar 

  • World Health Organization (2008) Social determinants of health in countries in conflict: a perspective from the eastern Mediterranean region. http://applications.emro.who.int/dsaf/dsa955.pdf. Accessed 03 Sept 2018

  • World Health Organization (2014) WHO-OIE operational framework for good governance at the human-animal interface: bridging WHO and OIE tools for the assessment of national capacities. http://www.who.int/ihr/publications/WHO-OIE_Operational_Framework.pdf. Accessed 01 Sept 2018

  • World Health Organization (2017a) WHO annual report 2017 Yemen. http://www.who.int/emergencies/crises/yem/yemen-annual-report-2017.pdf?ua=1. Accessed 01 Sept 2018

  • World Health Organization (2017b) Regional malaria action plan 2016–2020: towards a malaria free region. http://applications.emro.who.int/docs/EMROPUB_2017_EN_19546.pdf?ua=1. Accessed 01 Sept 2018

  • World Health Organization (2018a) Health as a bridge for peace – humanitarian Cease-Fires Project. http://www.who.int/hac/techguidance/hbp/cease_fires/en/. Accessed 20 Sept 2018

  • World Health Organization (2018b) Ebola virus disease – Democratic Republic of the Congo. http://www.who.int/csr/don/17-august-2018-ebola-drc/en/. Accessed 01 Sept 2018

  • World Health Organization (2018c) Micronutrient deficiencies: vitamin A deficiency. http://www.who.int/nutrition/topics/vad/en/. Accessed 01 Sept 2018

  • World Health Organization (2018d) Humanitarian health action. Health resources availability monitoring system (HeRAMS) [online]. https://bit.ly/2tpOsuF. Accessed 01 Sept 2018

  • World Health Organization (2018e) Syrian Arab Republic. HeRams [online]. http://bit.ly/2xGnjsc. Accessed 01 Sept 2018

  • World Health Organization (2018f) Media centre. Survey reveals extent of damage to Yemen’s health system. https://bit.ly/2ex2DV8. Accessed 01 Sept 2018

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Daniel Flecknoe .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Flecknoe, M.D., Jawad, M., Latif, S., Nozad, B. (2019). Communicable and Noncommunicable Diseases in Conflict Zones. In: Laher, I. (eds) Handbook of Healthcare in the Arab World. Springer, Cham. https://doi.org/10.1007/978-3-319-74365-3_33-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-74365-3_33-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74365-3

  • Online ISBN: 978-3-319-74365-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Communicable and Noncommunicable Diseases in Conflict Zones
    Published:
    07 May 2019

    DOI: https://doi.org/10.1007/978-3-319-74365-3_33-2

  2. Original

    Communicable and Noncommunicable Diseases in Conflict Zones
    Published:
    25 March 2019

    DOI: https://doi.org/10.1007/978-3-319-74365-3_33-1