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In: War and public health, edited by Barry S. Levy, Victor W. Sidel. Washington, D.C., American Public Health Association [APHA], 2000. 254-278.War has always been disastrous for civilians, and the Persian Gulf War was no exception. Yet the image that has been perpetuated in the West is that the Gulf War was somehow "clean" and fought with "surgical precision" in a manner that minimized civilian casualties. However, massive wartime damage to Iraq's civilian infrastructure led to a breakdown in virtually all sectors of society. Economic sanctions further paralyzed Iraq's economy and made any meaningful post-war reconstruction all but impossible. Furthermore, the invasion of Kuwait and the subsequent Gulf War unleashed internal political events that have been responsible for further suffering and countless human fights violations. The human impact of these events is incalculable. In 1996, more than five years after the end of the war, the vast majority of Iraqi civilians still subsist in a state of extreme hardship, in which health care, nutrition, education, water, sanitation, and other basic services are minimal. As many as 500,000 children are believed to have died since the beginning of the Persian Gulf War, largely due to malnutrition and a resurgence of diarrheal and vaccine- preventable diseases. Health services are barely functioning due to shortages of supplies and equipment. Medicines, including insulin, antibiotics, and anesthetics, are in short supply. The psychological impact of the war has had a damaging and lasting effect on many of Iraq's estimated eight million children. (excerpt)
Geneva, Switzerland, WHO, 1991. vi, 65 p. (WHO Technical Report Series 807)This report by WHO's Expert Committee on Environmental Health in Urban Development explains that social and physical factors, including the destruction of the natural environment, place the health of urban dwellers at risk. The report discusses the urbanization phenomenon and its consequences, the problems and needs in environmental health, and provides recommendations. From 1950-80, the world's urban population nearly tripled, with most of the growth occurring in developing countries, where urban population quadrupled. Experts predict that many urban centers in developing countries will have an annual growth rate of more than 3% over the next 40 years. While developed countries have seen declines in the level of population growth, the health risks to its urban inhabitants have nonetheless increased. Technological changes, increased energy consumption, and increased levels of waste have placed great stress on the environment and have increased the health risks. But developing countries have seen even more problems associated with urban living. Rapid urbanization levels have led to overcrowding, congestion, and the destruction of previously unsettled ecosystems. Pollution levels have increased. Due to the lack of sanitation services, the threat of communicable diseases has increased. Social problem such as crime and violence also affect the well-being of urban dwellers. The group at greatest risk includes poor women and children. The report explains that tackling the health problems associated with urbanization will require a major conceptual change, considering that current efforts are ineffectual. Some of the recommendations include: strengthening the management of urban development; strengthening the management and technology for environmental health; and strengthening community action.