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Centre for Research on the Epidemiology of Disasters - CRED The burden of armed conflict: a public health approach Chiara Altare CRED Microcon Conference.

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Presentation on theme: "Centre for Research on the Epidemiology of Disasters - CRED The burden of armed conflict: a public health approach Chiara Altare CRED Microcon Conference."— Presentation transcript:

1 Centre for Research on the Epidemiology of Disasters - CRED The burden of armed conflict: a public health approach Chiara Altare CRED Microcon Conference Brighton, June 30 th

2 Centre for Research on the Epidemiology of Disasters - CRED Understanding heterogeneity Channels Patterns Population groups Understanding heterogeneity through analysis Effective targeted interventions 2

3 Centre for Research on the Epidemiology of Disasters - CRED Health as peace building tool Commonly recognised public good & a shared goal for most cultures Tangible actions can redress felt deprivation among communities 3

4 Centre for Research on the Epidemiology of Disasters - CRED Impact of conflict on health Diseases Malnutrition & Food security Mortality Injuries, Disabilities Sexual violence 4

5 Centre for Research on the Epidemiology of Disasters - CRED Diseases Malnutrition & Food security Mortality Impact of conflict on health Primary public health indicators used to evaluate the health status of a population in emergency 5

6 Centre for Research on the Epidemiology of Disasters - CRED Morbidity Main killers in conflict Standard killers in developing countries – Measles, diarrhoea, respiratory infections, malaria Conflict exacerbates disease spreading – Displacement new pathogens – Overcrowding quicker transmission – Break down of health system limited care 6

7 Centre for Research on the Epidemiology of Disasters - CRED Morbidity Uganda 1 Same morbidity prevalence No impact of displacement on health outcome? 7 IDP in camps Returnees 1 Bozzoli, Brück, 2010, Child morbidity and camp decongestion in post-war Uganda, Microcon RWP 24

8 Centre for Research on the Epidemiology of Disasters - CRED Morbidity Uganda Same morbidity prevalence, different causes Only targeted interventions can be effective 8 IDP in camps Overcrowding Access to safe water Returnees

9 Centre for Research on the Epidemiology of Disasters - CRED Malnutrition 2 billion people suffer from it 9 Food Health Care and Hygiene Malnutrition

10 Centre for Research on the Epidemiology of Disasters - CRED Malnutrition 2 billion people suffer from it 10 Food Health Care and Hygiene Malnutrition Reduced local production Collapse of trade Reduced local production Collapse of trade Breakdown of the health system Limited income available Breakdown of the health system Limited income available Displacement Overcrowding Limited access to safe water Displacement Overcrowding Limited access to safe water

11 Centre for Research on the Epidemiology of Disasters - CRED Malnutrition 11 Acute Malnutrition Chronic Malnutrition 20% of under 5 deaths 35% of under 5 morbidity 20% of under 5 deaths 35% of under 5 morbidity Impairs mental and physical development Limits potential of nations to recover Impairs mental and physical development Limits potential of nations to recover

12 Centre for Research on the Epidemiology of Disasters - CRED Malnutrition Burundi 2 Exposure to conflict increases probability of being stunted The longer the exposure the more important the growth retardation Short-run health impact of war have long run welfare impact 12 2 Bundervoet, Verwimp, Akresh, 2008, Health and civil war in rural Burundi, Microcon RWP 5

13 Centre for Research on the Epidemiology of Disasters - CRED Mortality Expected mortality vs Excess mortality 13 Deaths occurring during peacetime Deaths that would have not occured without the conflict

14 Centre for Research on the Epidemiology of Disasters - CRED Mortality Expected mortality vs Excess mortality - Severity of the crisis - Deaths ascribable to pre-existing conditions or to violence Appropriate response 14 Deaths occurring during peacetime Deaths that would have not occured without the conflict

15 Centre for Research on the Epidemiology of Disasters - CRED Mortality Direct deaths vs Indirect deaths 15 Violence, Warfare Diseases

16 Centre for Research on the Epidemiology of Disasters - CRED Mortality Direct deaths vs Indirect deaths 20% 80% 16 Violence, Warfare Diseases 3 Degomme, Guha-Sapir, 2010 Patterns of mortality in Darfur conflict, Lancet 375: Main cause of death - Follow different patterns 3 - Affect different population groups

17 Centre for Research on the Epidemiology of Disasters - CRED Mortality 17 CMRU5MR vMRdMR Darfur

18 Centre for Research on the Epidemiology of Disasters - CRED Mortality 18 Cause of death & population group IDP in camps Diseases Violence Residents

19 Centre for Research on the Epidemiology of Disasters - CRED Concluding 19 Disaggregate Understand Target

20 Centre for Research on the Epidemiology of Disasters - CRED Thank you 20


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