Transcript CRED_300611
Centre for Research on the Epidemiology of Disasters - CRED The burden of armed conflict: a public health approach Chiara Altare CRED Microcon Conference Brighton, June 30th 2011 1 Understanding heterogeneity Channels Population groups Patterns Understanding heterogeneity through analysis Effective targeted interventions Centre for Research on the Epidemiology of Disasters - CRED 2 Health as peace building tool • Commonly recognised public good & a shared goal for most cultures • Tangible actions can redress felt deprivation among communities Centre for Research on the Epidemiology of Disasters - CRED 3 Impact of conflict on health • • • • • Diseases Malnutrition & Food security Mortality Injuries, Disabilities Sexual violence Centre for Research on the Epidemiology of Disasters - CRED 4 Impact of conflict on health • Diseases • Malnutrition & Food security • Mortality Primary public health indicators used to evaluate the health status of a population in emergency Centre for Research on the Epidemiology of Disasters - CRED 5 Morbidity • Main killers in conflict • Standard killers in developing countries – Measles, diarrhoea, respiratory infections, malaria • Conflict exacerbates disease spreading – Displacement new pathogens – Overcrowding quicker transmission – Break down of health system limited care Centre for Research on the Epidemiology of Disasters - CRED 6 Morbidity Uganda1 Same morbidity prevalence IDP in camps Returnees No impact of displacement on health outcome? 1 Bozzoli, Brück, 2010, “Child morbidity and camp decongestion in post-war Uganda”, Microcon RWP 24 Centre for Research on the Epidemiology of Disasters - CRED 7 Morbidity Uganda Same morbidity prevalence, different causes IDP in camps Returnees Overcrowding Access to safe water Only targeted interventions can be effective Centre for Research on the Epidemiology of Disasters - CRED 8 Malnutrition 2 billion people suffer from it Malnutrition Food Health Care and Hygiene Centre for Research on the Epidemiology of Disasters - CRED 9 Malnutrition 2 billion people suffer from it Malnutrition Food Health Care and Hygiene Reduced local production Collapse of trade Breakdown of the health system Limited income available Displacement Overcrowding Limited access to safe water Centre for Research on the Epidemiology of Disasters - CRED 10 Malnutrition Acute Malnutrition Chronic Malnutrition 20% of under 5 deaths Impairs mental and physical development 35% of under 5 morbidity Limits potential of nations to recover Centre for Research on the Epidemiology of Disasters - CRED 11 Malnutrition Burundi2 Exposure to conflict increases probability of being stunted The longer the exposure the more important the growth retardation Short-run health impact of war have long run welfare impact 2 Bundervoet, Verwimp, Akresh, 2008, “Health and civil war in rural Burundi”, Microcon RWP 5 Centre for Research on the Epidemiology of Disasters - CRED 12 Mortality Expected mortality Deaths occurring during peacetime vs Excess mortality Deaths that would have not occured without the conflict Centre for Research on the Epidemiology of Disasters - CRED 13 Mortality Expected mortality vs Deaths occurring during peacetime Excess mortality Deaths that would have not occured without the conflict - Severity of the crisis - Deaths ascribable to pre-existing conditions or to violence Appropriate response Centre for Research on the Epidemiology of Disasters - CRED 14 Mortality Direct deaths Violence, Warfare vs Indirect deaths Diseases Centre for Research on the Epidemiology of Disasters - CRED 15 Mortality Direct deaths vs Violence, Warfare Diseases 20% 80% - Follow different patterns3 - Affect different population groups 3 Indirect deaths Main cause of death Degomme, Guha-Sapir, 2010 “Patterns of mortality in Darfur conflict”, Lancet 375:294-300 Centre for Research on the Epidemiology of Disasters - CRED 16 Mortality Darfur CMR vMR Centre for Research on the Epidemiology of Disasters - CRED U5MR dMR 17 Mortality Cause of death & population group IDP in camps Residents Diseases Violence Centre for Research on the Epidemiology of Disasters - CRED 18 Concluding Disaggregate Understand Target Centre for Research on the Epidemiology of Disasters - CRED 19 Thank you Centre for Research on the Epidemiology of Disasters - CRED 20