Joanna Santa Barbara

Peace through health: key concepts

The primary task of health workers is health. Why should they involve themselves in work for peace? The argument has been made that peace work is the domain of politicians and diplomats that health workers have no training for such activities and that they can through ignorance worsen situations by meddling. Although we respect these points the fact that war is a major cause of mortality and morbidity has long pushed health workers to develop responses to war that go beyond curative health care. Much current thinking in peace and conflict studies insists that peacemaking and peace building be regarded as tasks for all levels of society not only for elites formal leaders and diplomats. Thus peace work must be multilevel. Grassroots non-violent action for example has had an impressive history in the past century. Recent examples include the deposing of Ferdinand Marcos in the Philippines the protection of parliament in Moscow and the ousting of Slobodan Milosevic in Belgrade. The “middle level” of opinion leaders is likewise important—it will typically include a variety of community and institutional leaders and professionals—and it is one in which many health workers might be thought to operate. Other groups operating at this level are religious leaders the media lawyers educators and so on. Each sector of society moreover—education health etc—has its own distinctive mode of peace work. The health sector is a large and significant sector of most societies. It commands a good deal of respect because of perceived values such as altruism and a scientific or evidence-based approach. The peace-through-health mechanisms listed below make clear the opportunities and strengths of health workers in the promotion of peace. (excerpt)

I: Psychological trauma and social healing in Croatia

A school-based pilot project is described which was designed to promote trauma healing, non-violent conflict resolution, peaceful living, human rights, and reduction of ethnic bias in Croatian children affected by war. A manual was written to guide teachers, who presented the curriculum over a four-month period. The subjects were 250 Fourth and Fifth grade children, divided into an intervention and two control groups. Pre- and post-testing revealed a small but significant reduction in ethnic bias and a reduction in post-traumatic stress symptoms in the intervention group. Follow-up testing showed that these benefits continued. There was a high level of acceptance of the programme by participants. The programme was extended in the subsequent year to 1200 students.

The Use of Health Initiatives as Peace Initiatives

This paper explores the relationship between health initiatives and peace initiatives in the context of armed conflict. Our working definition of a “Health-Peace Initiative” (HPI) is any initiative that intends to improve the health of people and that simultaneously heightens that groups level of peace, whether this peace is internal to the group or between the group and one or more other groups. We seek to identify multiple tracks to peace within a global analysis, arguing that HPIs should comprise an additional “track” in terms of their utility to the peace process. We offer examples of various kinds of HPIs already in use throughout the world.

The roles of the health sector and health workers before, during and after violent conflict.

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.

‘Iraq Water Treatment Vulnerabilities’: a Challenge to Public Health Ethics

A formerly classified US document, ‘Iraq Water Treatment Vulnerabilities,’ provides evidence that ill health was knowingly induced in the population of Iraq through the ruination of that countrys water purification system. We believe that the uncovering of this document should stimulate the public health community to clarify principles of public health ethics and to formulate statements giving voice to these principles. We propose here two statements, one dealing with the broad issue of public health ethics and international relations, and one dealing specifically with public health ethics and water purification.

'War on terrorism' and deep culture.

This article examines the reasons underlying the massive reaction to the terrorist attacks of 11 September 2001 compared with the lack of response to the many thousands of preventable deaths elsewhere daily. It is suggested that the explanation is the ‘deep culture’ of the United States based on the myth of the frontiersman. The world is divided into winners and losers, good and bad; non‐US citizens are of less value as human beings. The only response allowed by this deep culture is striking back at ‘the enemy’. The difficulties with this response are discussed and nonviolent alternatives considered.

Childrearing, Violent and Nonviolent

Caregivers act in goal-oriented ways to socialize children who are adapted to their cultural environment. Violent childrearing induces rapid compliance under surveillance. Its costs are counted in greater childhood violence, in problems of adolescent mental health and delinquency, and in adult spousal abuse and mental health problems. There is no clear dividing line between phsyical punishment and child abuse. Nonviolent childrearing methods require greater parental time investment and empathy. Its benefits are better internalization of expectations, better prosocial reasoning, greater empathy and greater social attractiveness. Eighteen contemporary societies have made the transition to legislating against physical punishment of children and others have put major constraints on its use. The United Nations supports the direction to nonviolent childrearing under the aegis of the Convention on the Rights of the Child. The question of the relationship between violence in childrearing and endorsement of violence in international relations is considered.

Global peace as a professional concern, III

This paper proposes that global peace should be a professional concern because the issues are complex and require critical and creative thinking, and because professionals have status enabling them to convey information to empower others. Professionals must examine priorities in societys needs for application of their particular knowledge areas, and must each make their own unique contribution towards a more peaceful, less threatened planet.