Public Health, War, and Militarism Martin Donohoe Am I Stoned? A 1999 Utah anti-drug pamphlet warns: “Danger signs that your child may be smoking marijuana include.
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Public Health, War, and Militarism Martin Donohoe Am I Stoned? A 1999 Utah anti-drug pamphlet warns: “Danger signs that your child may be smoking marijuana include excessive preoccupation with social causes, race relations, and environmental issues” Perspective • The earth spins at 1,038 mph at the equator, between 700 mph and 900 mph at midlatitudes • The earth rotates around sun at 18.5 miles/sec • The solar system orbits the center of the Milky Way Galaxy at 137 miles/sec – One rotation per 225 million years Perspective • The sun is one of hundreds of billions of stars in the Milky Way Galaxy • The Milky Way is one of over one hundred billion galaxies in the known universe • The universe may be one of an infinite number of universes The Planets Our Solar System Jupiter = one pixel, Earth = invisible Sun = one pixel, Jupiter = invisible History of war • 10,000 yrs ago – agriculture –Stable populations, division of labor, warrior class • 3500 yrs ago – bronze weapons and armor • 2200 yrs ago – iron • 1900 yrs ago – widespread use of horses History of war • Ninth Century China - bombs • Thirteenth Century China – rockets –Forgotten until the 19th Century • 1783 – Balloon (Montgolfier brothers) History of War • 1803-1814 (Napoleonic Wars): English General Henry Shrapnel fills cannonballs with bullets and exploding charges to increase killing capacity • 1903 – airplane (Wright Brothers) • 20th Century – nuclear weapons, increasingly sophisticated chemical and biological weapons Atomic Weapons - History • Hiroshima, August 6, 1945 –15 kiloton bomb, 140,000 deaths • Nagasaki, August 9, 1945 –22 kiloton bomb, 70,000 casualties Atomic Weapons Today • Approximately 23,360 nuclear weapons at 11 sites in 14 countries (1/2 active or operationally-deployed) – Down from over 71,000 at height of Cold War • 5,200 active U.S. warheads today (more than ½ on hair-trigger alert); 8,000 in Russia – Several thousand megatons (100,000 Hiroshimas) History of War • 20th Century: • Small arms • 90% of the 300,000 yearly deaths from violent conflict • Land mines • 24,000 deaths/yr (est.), tens of thousands more disabled • Predator drones • Weaponization of space • Cyberwar History of War • Belief that each new invention would eliminate warfare • Instead - increased casualties, killing at a distance Epidemiology of Warfare • Deaths in war: – 17th Century = 19/million population – 18th Century = 19/million population – 19th Century = 11/million population – 20th Century = 183/million population • Increasing casualties to civilians – 85-90% in 20th Century (vs. 10% late 19th Century) Contemporary Wars • 250 wars in the 20th Century • 72 million lives lost in 20th Century wars, another 52 million through genocides • Incidence of war rising since 1950 War Deaths, 1945-2010 War Deaths • • • • • • Korean War: 3 million Vietnam War: 1.7 million Iran-Iraq War: 700,000 Soviet War in Afghanistan: 1.5 million Second Congo War: 3.8 million Second Sudanese Civil War: 1.9 million Gulf War I • 105,000 military and 110,000 civilian deaths (almost all Iraqis) –Over 2.25 million refugees • 2/3 of US casualties from “friendly fire” • Cost $61 billion ($82 billion in 2003 dollars) • Environmental devastation War Deaths (as of 12/1/12) • Second Iraq War: – 4,485 U.S. soldiers; 17,000 Iraqi military • U.S. Afghan War: – Over 2,000 U.S. soldiers; 1,200 coalition forces • Civilian deaths • 193,000 violent; 1 million indirect • Financial cost of these two wars: $1.5-5 trillion (est.) • Higher estimate includes fighting, rebuilding, veterans’ health care, economic losses, etc. Casualties Among Soldiers and Civilians Continue • More US soldiers have committed suicide than have died in Afghan War • More military contractors killed than US soldiers • Veteran health care needs massive (TBI, psychiatric disorders, etc.) Josef Stalin “The death of one man is a tragedy. The death of millions is a statistic.” Colonial Exploitation • Christopher Columbus’ log entry upon meeting the Arawaks of the Bahamas: “They…brought us…many…things…They willingly traded everything they owned…They do not bear arms…They would make fine servants…With fifty men we could subjugate them all and make them do whatever we want.” Colonial Exploitation • Cecil Rhodes (Rhodesia, Rhodes Scholarship, DeBeers Mining Company): “We must find new lands from which we can easily obtain raw materials and at the same time exploit the cheap slave labour that is available from the natives of the colonies. The colonies would also provide a dumping ground for the surplus goods produced in our factories.” Exploitation leads to: • Maldistribution of wealth and resources • Environmental degradation • Wars Consequences of War • Deaths, injuries, psychological sequelae • Collapse of health care system (affecting those with acute and chronic illnesses) • Famine Consequences of War • Environmental degradation • Refugees, migrants, internally-displaced persons –26 million displaced • Increasing poverty and debt • All lead to recurrent cycles of violence Environmental Consequences of Militarization • • • • World’s single largest polluter 8% of global air pollution 2-11% of raw material use Almost all high and low level radioactive waste Violence Against Women • Common among U.S. servicewomen • A deployed female soldier is more likely to be raped by a fellow soldier than killed by enemy fire • Rape in war widespread, often genocidal –Some refugee camps unsafe “Comfort Women” • Japanese soldiers forced between 100,000 and 200,000 women into sexual slavery (“comfort women”) • Some underwent forced hysterectomies to prevent menstruation, make them constantly “available” • More than half died due to mistreatment “Comfort Women” • 3-5 year detention • 5-20 rapes per day • For 3 yrs of enslavement, low estimate is 7500 rapes per woman • Japan has not compensated any victims –Historical blindness to atrocities Violence and Rape in War • Occurs against backdrop of ongoing societal forms of violence against women –Legal, educational, social, and political marginalization Economic Disparities • Women 79 cents/$1 Men • Median income of black U.S. families as a percent of white U.S. families 62% –60% in 1968 • 63% for Hispanic families Status of Women • Women do 67% of the world’s work • Receive 10% of global income • Own 1% of all property Worldwide, every minute • 380 women become pregnant (190 unplanned or unwanted) • 110 women experience pregnancy-related complications • 40 women have unsafe abortions • 1 woman dies from childbirth or unsafe abortion • Reason: Lack of access to reproductive health services “Mother’s Day Proclamation, 1870” Julia Ward Howe Arise then...women of this day! Arise, all women who have hearts! … Say firmly: "We will not have questions answered by irrelevant agencies, Our husbands will not come to us, reeking with carnage, For caresses and applause. “Mother’s Day Proclamation, 1870” Julia Ward Howe Our sons shall not be taken from us to unlearn All that we have been able to teach them of charity, mercy and patience.” … From the bosom of a devastated Earth a voice goes up with Our own. It says: "Disarm! Disarm! “Mother’s Day Proclamation, 1870” Julia Ward Howe Let women … …promote the alliance of the different nationalities, The amicable settlement of international questions, The great and general interests of peace. Critical Public Health Issues Poverty and Hunger • US: 15% of residents and 22% of children live in poverty • Rates of poverty in Blacks and Hispanics = 2X Whites • Poverty associated with worse physical and mental health Jacob Riis Dorothea Lange Worldwide Poverty • 1 billion people lack access to clean drinking water • 3 billion lack adequate sanitation services • Hunger-related causes kill as many people in 8 days as the atomic bomb killed at Hiroshima James Nachtwey Maldistribution of Wealth • Top 250 billionaires worldwide worth $1 trillion, the combined income of bottom 2.5 billion people (45% of world’s population) • U.S: Richest 1% of the population owns 40% of the country’s wealth -poorest 80% own 7% -widest gap of any industrialized nation Overconsumption (“Affluenza”) • U.S. = 6.3% of world’s population –Owns 50% of the world’s wealth • U.S. responsible for: –25% of world’s energy consumption –33% of paper use –72% of hazardous waste production Income Inequality Kills Higher income inequality is associated with increased morbidity and mortality at all per capita income levels Maldistribution of Wealth is Deadly • 880,000 deaths/yr in U.S. would be averted if the country had an income gap like Western European nations, with their stronger social safety nets –BMJ 2009;339:b4471 Voltaire “The comfort of the rich rests upon an abundance of the poor” Hudson River, 2009 Primo Levi “A country is considered the more civilized the more the wisdom and efficiency of its laws hinder a weak man from becoming too weak or a powerful one too powerful.” The State of U.S. Health Care • 49 million uninsured patients • Millions more underinsured –Remain in dead-end jobs –Go without needed prescriptions due to skyrocketing drug prices Headline from The Onion Uninsured Man Hopes His Symptoms Diagnosed This Week On House The State of U.S. Health Care • US ranks near the bottom among westernized nations in life expectancy and infant mortality • Est. 51,000 deaths/year due to lack of health insurance • Racial disparities in coverage, processes, and outcomes of care Racial Disparities in Health Care: African-Americans • Equalizing the mortality rates of whites and African-Americans would have averted 686,202 deaths between 1991 and 2000 –Whereas medical advances averted 176,633 deaths • AJPH 2004;94:2078-2081 Environmental Degradation and Social Injustice (Causes) • Overpopulation • • • • Pollution Deforestation Global Warming Unsustainable Agricultural/Fishing Practices – Pesticides, indoor cooking with biomass Environmental Degradation and Social Injustice (Causes) • • • • Overconsumption / Affluenza Militarization Maldistribution of Wealth National and Global Political and Economic Institutions • Exploitation • Corporate Profiteering Environmental Degradation and Social Injustice (Causes) • • • • Poor education Media manipulation and inaccurate reporting Money in politics Citizen apathy Environmental Degradation and Social Injustice (Consequences) • • • • • • Increased poverty and overcrowding Famine Global Warming Weather extremes Species loss Human morbidity and mortality – 40% of world’s yearly deaths linked to water, air, and soil pollution • War • Malthusian chaos and disaster Consequences of Global Warming • 300,000 deaths and 5.5 million disabilityadjusted life years lost per year –WHO, UN Environment Program –Expected to double by 2020 World Military Spending (2012) ($1.7 trillion in 2012; U.S. 34% of total) U.S. Discretionary Spending (2012) War and Peace • World military budget –230X what the UN spends on peacekeeping • US: –Largest arms supplier –Greatest debtor to U.N. (including U.N. peacekeeping fund) Skewed Priorities • The world spends $1.7 trillion/year on military goods and services • For 25% of this, we could: – Eliminate starvation and malnutrition – Provide shelter for all – Eliminate illiteracy – Provide clean and safe water – Prevent soil erosion Skewed Priorities – Prevent global warming – Stop deforestation – Aid all refugees – Retire developing nations’ debt – Provide clean, safe energy (through efficiency and renewables) Skewed Priorities – Prevent acid rain – Fix the ozone hole – Stabilize world population – Provide basic universal health care and AIDS control – Eliminate nuclear weapons and land mines DOD Announcement (September, 2011) “Pentagon Lacks Funding to Fix Public Schools on Military Bases” Dwight Eisenhower “Every gun that is made, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and not clothed” Martin Luther King “A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual death.” Health Costs of Militarization • 3 hours of world arms spending = annual WHO budget • ½ day of world arms spending = immunization for all the world’s children • 3 days of US arms spending = amount spent on health, education and welfare programs for US children in one year Health Costs of Militarization • 3 weeks of world arms spending = primary health care for all in poor countries, including safe drinking water and full immunizations • Brain drain: 2/3 of US scientists work in military-industrial complex (although much work has widespread applicability) Foreign Aid • In total dollars: U.S. #1 • As a % of GDP, U.S. ranks 21st among the world’s wealthiest nations • U.S. Aid: Over 1/3 military, 1/4 economic, 1/3 for food and development • Most U.S. aid benefits U.S. corporations Foreign Aid • Americans think that 24% of the federal budget goes toward foreign aid • 0.9% of the total federal budget, 1.6% of the U.S. discretionary budget U.S. Charitable Giving • 2.5% of income • 2.9% at height of Great Depression The US: Rogue Nation • History: Native Americans, slavery, current excesses, disparities and injustices • Co-opting Nazi and Japanese WWII scientists • Minimum 277 troop deployments by the US in its 225+ year history • Over 1,000 bases worldwide today – In U.S. and 69 other countries The US: Rogue Nation • Since the end of WWII, the US has bombed: – China, Korea, Indonesia, Cuba, Guatemala, Congo, Peru, Vietnam, Laos, Cambodia, Nicaragua, El Salvador, Grenada, Libya, Panama, Afghanistan, Sudan, Yugoslavia, and Iraq The US: Rogue Nation • Conservative estimate = 8 million killed • US invasions/bombings often largely at behest of corporate interests • Drone strikes on allied/other nations and on U.S. citizens The US: Rogue Nation • Continued funding of the Western Hemisphere Institute for Security Cooperation – Formerly the School of the Americas – Over 60,000 graduates, including many of the worst human rights abusers in Latin America (e.g., Manuel Noriega, Omar Torrijos, and the assassins of Archbishop Oscar Romero) Hermann Goering (at the Nuremberg Trials, shortly before being sentenced to death) “Of course the people don't want war. But…it is the leaders of the country who determine the policy, and it is always a simple matter to drag the people along, whether it is a democracy, or a fascist dictatorship, or a parliament, or a communist dictatorship . . . Hermann Goering Voice or no voice, the people can always be brought to the bidding of the leaders…All you have to do is to tell them they are being attacked, and denounce the pacifists for lack of patriotism and exposing the country to danger.” Horace Odes (III.2.13) Dulce et decorum est pro patria mori It is sweet and fitting to die for one’s country "Dulce Et Decorum Est" Wilfred Owen, 1917-18 … In all my dreams, before my helpless sight, He plunges at me, guttering, choking, drowning. If in some smothering dreams you too could pace Behind the wagon that we flung him in, And watch the white eyes writhing in his face, His hanging face, like a devil's sick of sin; "Dulce Et Decorum Est" Wilfred Owen If you could hear, at every jolt, the blood Come gargling from the froth-corrupted lungs, Obscene as cancer, bitter as the cud Of vile, incurable sores on innocent tongues,My friend, you would not tell with such high zest To children ardent for some desperate glory, The old Lie: Dulce et decorum est Pro patria mori. International NonCooperation/Isolationism • Failure to sign or approve: –Kyoto Protocol on Climate Change –Convention on the Prohibition of AntiPersonnel Land Mines –Comprehensive Nuclear Test Ban Treaty International NonCooperation/Isolationism • Failure to sign or approve: – Convention on the Rights of the Child – Convention on the Elimination of Discrimination Against Women Convention on Economic, Social and Cultural Rights – Convention for the Suppression of Traffic in Persons – UN Convention on the Rights of Disabled Persons International NonCooperation/Isolationism • Failure to sign or approve: – Protocol 1, Article 55 of the Geneva Conventions, which bans methods of warfare which can cause severe environmental damage – The Basel Convention on the Control of Transboundary Movements of Hazardous Wastes The US: Rogue Nation • Torture (involving health care professionals) • Death Penalty: – US executes more of its citizens than any other country except China, Iraq, Saudi Arabia, and Iran – Until recently, the US was the only country to execute both juveniles and the mentally ill The US: Rogue Nation • Failure to follow World Court Decisions • Failure to recognize International Criminal Court Solutions • Activism (PSR, IPPNW, etc.) • Education (APHA Militarism Education Group) • Tolerance and appreciation of diversity • Redirect money towards social justice and environmental preservation • Eliminate WMDs Solutions • Eliminate military recruiting in public schools – APHA Resolution • Increase foreign aid • Create Dept. of Peace • Assist victims of war (PHR, MSF, etc.) • Treaties World Health Organization “The role of the physician … in the preservation and promotion of peace is the most significant factor for the attainment of health for all.” Speak Up for the Disenfranchised “The first job of a citizen is to keep your mouth open.” - Günter Grass “First they came for the Jews” by Pastor Niemoller “First they came for the Jews, and I did not speak up, for I was not a Jew. Then they came for the communists, and I did not speak up for I was not a communist. Then they came for the trade unionists, and I did not speak up, for I was not a trade unionist. Then they came for me, and there was no one left to speak up for me.” Have Faith in Your Ability to Affect Change "If you think you are too small to have an impact, try going to bed with a mosquito in your tent“ - African Proverb Act Out of Love • People • Environment • Earth Our Home Earth/Moon Seen by Voyager Spacecraft through Saturn’s Rings Public Health and Social Justice Website http://www.publichealthandsocialjustice.org http://www.phsj.org [email protected]