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Iraq War Could Be Bad for World Health
http://www.100md.com 2003年1月25日 Daniel DeNoon
     WebMD Medical News January 23, 2003

    Seventy-two million people died in 20th-century wars. Will the 21st century be better? Not if there's an attack on Iraq, public health experts warn.

    Public Health Experts Oppose Attack on Iraq.Among those experts are more than 500 members of the London School of Hygiene and Tropical Medicine -- one of the world's leading public-health institutions. In a joint publication, England's two top medical journals -- The Lancet and the British Medical Journal -- carry an open letter signed by these experts.
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    Addressed to U.K. Prime Minister Tony Blair, the letter points to U.N. estimates that an attack on Iraq will be a humanitarian disaster. A many as 500,000 Iraqis -- largely civilians -- will be casualties. More than 3 million Iraqis would face starvation without immediate assistance. An eventual 900,000 Iraqis would become refugees. Even more worrying, the letter suggests, is that an attack on Iraq will ratchet up the level of violence all over the world.

    "It is our shared knowledge and experience that this kind of collective violence has a huge impact on world health," letter organizer Carolyn Stephens, PhD, senior lecturer in environment and health policy at the London School, tells WebMD. "Military intervention in Iraq will escalate the use of force and violence all over the world. That is substantially what we are concerned about: the escalation of international violence."
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    The open letter is an unusual display of solidarity among public health experts, says Stan Foster, MD, MPH, visiting professor of international health at Emory University's Rollins School of Public Health.

    "I think it reflects serious study and assessment," Foster tells WebMD. "Not often do we get the opportunity to look in advance at conflicts and put on the table what it would cost."

    Foster agrees with Stephens that war on Iraq would start -- not end -- a new cycle of violence.
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    "Violence begets violence....Violence is becoming more and more a tool of those who are repressed and frustrated. They think, 'If those people who have the most things decide they can use violence to get their way, why shouldn't we?' So military action in Iraq increases the threat to my children and my grandchildren -- it is a risk to their health."

    While the letter offers a sincere and accurate worst-case scenario, it doesn't look at the possible benefits of regime change in Iraq, says Tee L. Guidotti, MD, MPH. Guidotti chairs the department of environmental and occupational health at the George Washington University, Washington, D.C.
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    "This is a warning as opposed to a formal risk assessment," Guidotti tells WebMD. "One aspect they do not consider is that there is a public health benefit if the current regime in Iraq is replaced. There is no indication that the Iraqi regime has the best interests of its people at heart. Much of the suffering among children is the result of sanctions that would be lifted under different leadership. Much of the relief money has been siphoned off to develop war effort and weapons of mass destruction. If there is regime change, there could be an investment in public health that could come from increased trade and lifting of sanctions.", 百拇医药