An Essential Primer for Recognizing and Preventing the Health Harms of war

Abstract

War and conflict are undoubtedly disastrous for the health of populations, but this focus has only recently come to the fore of the public health mainstream. A small yet growing coterie of academics and health professionals have worked for decades to demonstrate the health harms of war and conflict, and Dr Barry Levy’s book Horror to Hope: Recognizing and Preventing the Health Impacts of War is one of the most comprehensive and approachable syntheses of this burgeoning multidisciplinary field. It is perhaps the only of its kind to argue for prevention as well. The book follows Levy’s decades of contributions as a physician, epidemiologist, public health leader, speaker, professor, and author on the public health impacts of war, terrorism, social injustice, climate change, and environmental and occupational hazards. Levy is currently an Adjunct Professor of Public Health in the Department of Public Health and Community Medicine at Tufts University School of Medicine, and he is a past president of the American Public Health Association (APHA). Having been sensitized to the health impacts of armed conflict and genocide while working early in his career among displaced Cambodians in Thailand, he has since worked in many other countries, including China, Jamaica, Kenya, and nations in Central and Eastern Europe. Levy is one of the stalwarts straddling the early era of peace and health professionals and a newer generation bringing this work into sync with intersectional, post-9/11 perspectives. In addition to numerous articles and book chapters on the subject of health and conflict, Levy co-edited War & Public Health, Terrorism & Public Health, and Social Justice & Public Health. These seminal volumes were products of his long-standing professional collaboration with Dr. Victor Sidel, another former president of the APHA and a founding member of Physicians for Social Responsibility (PSR), the American affiliate of International Physicians for the Prevention of Nuclear War (IPPNW) which won a Nobel Peace Prize in 1985 for collaboration between American and Soviet physicians to move their governments away from the brink of nuclear war. Because Levy is intimately acquainted with the work of individuals, entities, and conceptual frameworks engaged in health and peace like PSR, IPPNW, APHA, and the APHA Peace Caucus, Peace Through Health, Medical Peace Work, and more, he makes connections unique to the discussion of the health harms of war regarding the operationalization of the research to practice continuum (discussed in Chapter 15). In addition to use as a resource by practicing professionals and advocates, the book would therefore be an essential addition to the syllabi of a growing number of classes taught in public health and other health professions schools attentive to the health impacts of war and their prevention. Proceeding from a theoretical introduction of three chapters on the public health perspective of war, the nature of war, and discussion of human rights, ethics, and international humanitarian law, Levy summarizes the health impacts of war in 10 chapters on weaponry, health impacts of civilians—including assault and injury, malnutrition and communicable disease, mental disorders, reproductive health, noncommunicable disease, and specific vulnerable populations—and other impacts such as those on military personnel and veterans and the environment. He spends the 14th chapter describing methods for determining the health impacts of war, including epidemiologic methods, and concludes with a chapter on “the future,” or how to prevent war and promote peace. Each chapter features summary points at the end helpful for digesting the immense amount of information presented. A modest number of images complementary to the text are included as well. Horror to Hope is a superbly organized, encyclopedic, and systematic synthesis of the health impacts—or harms or consequences as they are characterized in this volume— drawn from more than 800 unique sources. The book’s “wars cited” index makes a specific mention of 34 wars, but at least 80 unique conflicts and geographical contexts Book Review