Medicine, conflict, and survival
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Starting with a view of war as a significant population health problem, this article explores the roles of health workers in relation to violent conflict. Four different roles are identified, defined by goals and values--military, development, humanitarian and peace. In addition, four dimensions of health work are seen as cross-cutting factors influencing health work in violent conflict-- whether the health worker is an insider or outsider to the conflict, whether they are oriented to primary, secondary or tertiary prevention of the mortality and morbidity of war, whether they take an individual clinical or a population health approach, and whether they are oriented to policy and whole-sector change or not. This article explores the nature of these roles, the influence of these cross-cutting dimensions, the challenges of each role and finally commonalities and possibilities for cooperation between roles.
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The concept of human security has developed in significance in the last decade to the point that its meaning and validity is hotly contested in the field of international relations, security, and development studies. A key consideration relates to its ambiguity at best and its amorphousness at worst. ⋯ However, collaboration and co-operation between political scientists and medical practitioners offers even greater potential to this vital programme. The latter offer the technical and methodological skills and approaches lacking in political science, whilst the former develop political frameworks to shift the causal focus towards human, institutional and structural agency in mass avoidable global civilian mortality.
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Economic sanctions are often considered to be a legitimate, more peaceful alternative to war. Using examples, particularly that of Iraq, it is evident that this is not necessarily so. ⋯ These would be similar to those allowing the imposition of war. In the realm of international governance, not only must sanctions be employed by the authority of international society, after other less coercive measures have been attempted, they must be supported by the people whom they are meant to protect, and efforts must be made to minimise and to monitor their consequences.
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Peace through Health (PtH) is an evolving academic discipline that explores how health interventions may contribute to peace in actual and potential war zones and situations of conflict. This article is an attempt to define the scope of PtH activities, to develop a framework for groups and individuals to conceptualise their role in peace work and to develop clearly definable goals for evaluation. ⋯ In particular, the work of International Physicians for the Prevention of Nuclear War and medical war prevention work in Iraq since 1990 is discussed. It is felt that such a model might be used to classify and better direct medical peace work to areas of expertise.