War rivals infectious disease as a global cause of morbidity and mortality, not only during active fighting, but also as a consequence of the destruction of infrastructures and the environment, the displacement of populations and the ongoing presence of radioactivity, weapons and toxins. Four wartime activities have a prolonged and pervasive impact on the environment: nuclear weapons production and testing, aerial and naval bombardment, dispersal and persistence of land mines and military ordnance, and the use and storage of military despoilants, toxins and waste.
Dr. Jennifer Leaning surveys the scale and impact of military activities on the environment and human health and concludes that much still needs to be understood about the destructive potential of war on ecosystems.
Another tragic consequence of war is sexual violence against women and children. It occurs because of the breakdown of social structures, but it can also be used systematically to subdue and demoralize a population and to force pregnancy as a means of "ethnic cleansing." According to Drs. Leslie Shanks and Michael Schull, the immediate actions of medical personnel working in conflicts should include recognition and documentation of the sexual violence, and provision of antibiotic prophylaxis and emergency contraception. Public advocacy can sometimes be effective in bring pressure to bear on responsible governments, and recently cases of rape have been successfully prosecuted as a war crime and as an act of genocide.
In a related commentary, Dr. Pauline Alakija writes about her work as a forensic pathologist investigating war crimes in Kosovo for the United Nations.
The ravages of war — P. Alakija
Rape in war: the humanitarian response — L. Shanks, M.J. Schull
Environment and health: 5. Impact of war — J. Leaning
Journal
Canadian Medical Association Journal