War is Hell. And Bad for Your Health.

Some interesting articles in the current issue of The Lancet (registration required to read some of the articles, sorry — but worth it) on the effect of war on health, and how these impacts on health are continually minimized. When we as nurses think of threats to health and well-being, we tend to think of things like smoking or diet, without considering larger systemic problems. Like war. Too inconvenient and challenging, maybe: war is an accepted instrument of foreign and domestic policy in every first world nation. We consume time and energy in our public discourse convincing ourselves that war is necessary evil, and even glorifying the carnage, while at the same time minimizing its very real and human impacts. As a culture, we like war.

And maybe as nurses being concerned with health and well-being, should challenge the culture a bit on this one?

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The Lancet also published in the same issue a scathing editorial regarding the humanitarian response to the Haitian earthquake:

We have repeatedly drawn attention to the fact that when viewed through the distorted lens of politics, economics, religion, and history, some lives are judged more important than others—a situation not helped by the influence of news media, including ourselves. This regrettable situation has resulted in an implicit hierarchy of crisis situations further influenced by artificial criteria, such as whether disasters are natural or man-made. . .

. . .The Lancet has been observing aid agencies and NGOs for several years and has also spoken with staff members working for major charities. Several themes have emerged from these conversations. Large aid agencies and humanitarian organisations are often highly competitive with each other. Polluted by the internal power politics and the unsavoury characteristics seen in many big corporations, large aid agencies can be obsessed with raising money through their own appeal efforts. Media coverage as an end in itself is too often an aim of their activities. Marketing and branding have too high a profile. Perhaps worst of all, relief efforts in the field are sometimes competitive with little collaboration between agencies, including smaller, grass-roots charities that may have have better networks in affected counties and so are well placed to immediately implement emergency relief.

Given the ongoing crisis in Haiti, it may seem unpalatable to scrutinise and criticise the motives and activities of humanitarian organisations. But just like any other industry, the aid industry must be examined, not just financially as is current practice, but also in how it operates from headquarter level to field level. It seems increasingly obvious that many aid agencies sometimes act according to their own best interests rather than in the interests of individuals whom they claim to help. Although many aid agencies do important work, humanitarianism is no longer the ethos for many organisations within the aid industry. For the people of Haiti and those living in parallel situations of destruction, humanitarianism remains the most crucial motivation and means for intervention.

No further comment seems necessary.

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