Peace Building Through Health

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Peace Building Through Health

• Zeev Wiener
• PHR-Israel

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By 2020 The WHO and the World Bank predict that
war will be one of the top 10 causes of
disability and death.
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War and Public Health

• Economic and social systems are disrupted,
  famine and epidemics may follow, and resources
  are diverted to military rather than health
  goals-all of which make war a public health
  problem.
• MacQueen G, Santa-Barbara J. Peace building
  through health initiatives. BMJ 2000 293-6

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The Role of Physicians

• The role of physicians and other health workers
  in the preservation and promotion of peace is the
  most significant factor for the attainment of
  health for all.
• WHO, World Health Assembly, Resolution 34.38, 1981

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Health as a Bridge for Peace

• A concept based on the idea that shared health
  concerns can transcend political, economic,
  social and ethnic divisions, to promote dialogue,
  foster solidarity, and contribute to peace among
  peoples and between nations.
• Guerra de Macedo 1994

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Why?

• Why Medicine?
• Is there a coherent intervention theory?
• Have we the required socio-political technology?
• Do we posses the skills?

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Checking Basic Assumptions

• WarDisease
• ViolenceBacteria
• Medical StaffHealers
• PeaceCure

Health Providers in Crisis
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Peace Through HealthVass A. BMJ (Editorial),
Nov. 2001

• even the WHO program used anecdotal comments
  from field teams to say that volatility had
  reduced and social cohesion improved. The report
  admits that it could have been the wider peace
  process and post war fatigue felt by the
  population that brought about these changes.
• With few examples of peace through health
  initiative, it is idiology that is driving the
  movement at present.
• humanitarian aid had even worsened conflict at
  times. (Sudan 1998)

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War as a Disease Process

• Primary Prevention-Make love-not war
• Secondary prevention- Early detection of
  conflicts and intervention in high risk areas.
• Tertiary Prevention- Reduce suffering and
  disability through treating the victims.

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Alert Signs

• Violence
• Disease outbreak
• Poverty
• Unemployment
• Food Shortage

• Famine
• Oppression
• Political Instability/Corruption
• Institutional/Social Disintegration
• Migration

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Health Peace Building Mechanisms

• Conflict management
• Solidarity
• Strengthening the social fabric
• Dissent
• Restricting destructiveness

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Health Peace MechanismsPalestinian-Israeli
Conflict

• Conflict management
• Medical diplomacy and health oriented
  superordinate goals.

• Present data to policy makers and public (both
  sides)
• Press professional associations to stand out
  (IMA, Palestine)
• Press Government by international establishments
• (Red Cross, Amnesty, professional associations)

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Health Peace MechanismsPalestinian-Israeli
Conflict

• Solidarity
• Healthcare workers empowering peacemaking
  groups.

• Empower health and human rights NGOs by
• Finance
• medical supplies (home equipment, medications)
• medical expertise( mental health, infant
  development)
• Out of country medical facilities (special
  surgery)

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Health Peace MechanismsPalestinian-Israeli
Conflict

• Strengthening the social fabric
• Restore and enforce bonds uniting populations
  through health.

• Joint medical projects relevant to both
  populations
• (DM, HT, PTSD, lifestyle modification)
• Professional knowledge and expertise exchange
• Re-Education (hate, mistrust, violence)

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Health Peace MechanismsPalestinian-Israeli
Conflict

• Dissent
• Using medical knowledge to express disagreement
  with policies.

• Access to healthcare (Roadblocks, primary care
  services)
• Official responsibility in different types of
  Palestinian areas

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Health Peace MechanismsPalestinian-Israeli
Conflict

• Restricting destructiveness
• Arguing for restricting and abolishing
  destructive
• policies and weapons using healthcare discourse.

• Obstacles to healthcare access
• House destruction
• Suicide bombing
• Prisoners health

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Public Health Problems Concerning Both Sides

• Physical trauma (Gun shot ,burns,blast wounds)
• Mental trauma (PTSD)
• Hate ,mistrust, violence
• Road accidents
• Life Style (Obesity, Smoking, ect.)

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Violence
Conflict
The more an individual feels helpless and loss
of Control, the more they are prone to develop
anger, anxiety, frustration and depression ,
expressed in behavioral terms as violence.
Milgram NA. Psychological stress and adjustment
in time of war and peace the Israeli
experience as presented in tow conferences.
Isr Ann Psychiatr Relat Discip 1978 16(4)
327-38.
Acts of killing during war encourage depreciation
in the value of human life, legitimizing violence
and lead violence to be seen as norm. Archer D.
and Gartner R. Violence and crime in
cross-national perspective, New Haven Yale
University Press 1984.
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What is Needed?

• Redefine goals.
• Create appropriate region-specific tools.
• Educate staff.
• Preserve medical neutrality and impartiality.
• Keep on trying.