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Health Consequences of War and Militarism

Health Consequences of War and Militarism. Martin Donohoe, MD, FACP. Outline. The history and epidemiology of war Nuclear weapons Chemical weapons Biological weapons. Outline. Economic and environmental consequences of militarism and war Health consequences of militarism and war

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Health Consequences of War and Militarism

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  1. Health Consequences of War and Militarism Martin Donohoe, MD, FACP

  2. Outline • The history and epidemiology of war • Nuclear weapons • Chemical weapons • Biological weapons

  3. Outline • Economic and environmental consequences of militarism and war • Health consequences of militarism and war • Contemporary conflicts • Afghanistan, “War on terror”, Middle East • Solutions

  4. History of War • Violent conflict ubiquitous in the animal kingdom: • Interspecies conflict – food, territory • Intraspecies conflict – food, territory, mates (usually not directly fatal) • Violence among non-human primates • Gorilla infanticide • Chimpanzee killing bands

  5. History of war • 10,000 yrs ago – agriculture • Stable populations, division of labor, warrior class • 3500 yrs ago – bronze weapons and armor • 2200 yrs ago – iron • 1900 yrs ago - horses

  6. History of war • Ninth Century China - bombs developed • Thirteenth Century China – rockets • Forgotten until the 19th Century • 1783 – Balloon • Montgolfier brothers • Prussian general JCG Heyne – used for bombing

  7. History of War • 1903 – Wright brothers/Kitty Hawk – airplane • 20th Century – nuclear submarines, predator drones, weaponization of space

  8. History of War • Belief that each new invention would eliminate warfare • Instead, increased casualties, killing at a distance

  9. Epidemiology of Warfare • Deaths in war: • 17th Century = 19/million population • 18th Century = 19/million population • 19th Century = 11/million population • 20th Century = 183/million population • Increasing casualties to civilians • 85-90% in 20th Century (vs. 10% late 19th Century)

  10. War Deaths, 1945-2000

  11. Legacies of Colonial Exploitation • Christopher Columbus’ log entry upon meeting the Arawaks of the Bahamas: “They…brought us…many…things…They willingly traded everything they owned…They do not bear arms…They would make fine servants…With fifty men we could subjugate them all and make them do whatever we want.”

  12. Legacies of Colonial Exploitation • Winston Churchill (speaking in favor of RAF’s “experimental” bombing of Iraqis in 1920s, which killed 9,000 people with 97 tons of bombs): “I am strongly in favor of using poisoned gas against uncivilized tribes to spread a lively terror…against recalcitrant Arabs as an experiment”

  13. Legacies of Colonial Exploitation • Cecil Rhodes (Rhodesia, Rhodes Scholarship, DeBeers Mining Company): “We must find new lands from which we can easily obtain raw materials and at the same time exploit the cheap slave labour that is available from the natives of the colonies. The colonies would also provide a dumping ground for the surplus goods produced in our factories.”

  14. Contemporary Wars • 250 wars in the 20th Century • Incidence of war rising since 1950 • Most conflicts within poor states • 27 separate civil wars currently underway • 19 involve U.S.-supplied weapons

  15. Contemporary Wars • 72 million lives lost in 20th Century wars, another 52 million through genocides • WW II: first war with more battle deaths than deaths from other causes, such as accidents, disease, and infections

  16. Vietnam War • US dropped the equivalent of one 500 lb. bomb on every person in Vietnam • Vietnam War: 11.5 to 3 million Vietnamese casualties; 58,000 American • More US soldiers died of suicide after Vietnam than died in combat during the war.

  17. Contemporary Wars • Gulf War I: US planted one land mine for every Iraqi citizen • 310,000 direct war-related deaths in 2000 (0.5% of worldwide mortality); indirect deaths much larger

  18. Consequences of War • Deaths, injuries, psychological sequelae • Collapse of health care system affecting those with acute and chronic illnesses • Famine • Environmental degradation • Increasing poverty and debt • All lead to recurrent cycles of violence

  19. Consequences of War • Contributes, along with persecution, poverty, and environmental degradation, to the 240 million people “on the move” • International migrants – 168 million • Refugees, including Palestinians – 16 million • Internally displaced due to conflict or persecution (25 million) or natural disasters and other causes (30 million) • Asylum seekers – 940,000

  20. Atomic Weapons - History • Hiroshima, August 6, 1945 • “The day that humanity started taking its final exam” – Buckminster Fuller • 15 kiloton bomb, 140,000 deaths • Nagasaki, August 9, 1945 • 22 kiloton bomb, 70,000 casualties

  21. The Hiroshima Bomb

  22. Atomic Explosion

  23. Atomic Weapons – Other Victims • Hundreds of thousands of hibakusha – atomic bomb survivors • 1054 U.S. nuclear tests since 1940s, 331 in atmosphere • 80,000 cancers (15,000 fatal) in US citizens as a result of fallout from atmospheric testing • NCI/CDC

  24. Atomic Weapons – Other Victims • Thousands of illnesses and deaths, higher CA risk in 600,000 former employees - DOE • Bush administration trying to limit payments mandated by Congress in 2001 ($150,000 plus lifetime medical benefits)

  25. Atomic Weapons Today • Approximately 23,360 nuclear weapons at 11 sites in 14 countries (1/2 active or operationally-deployed) • Down from over 71,000 at height of Cold War • 5,200 active U.S. warheads today (more than ½ on hair-trigger alert); 8,000 in Russia • Several thousand megatons (100,000 Hiroshimas)

  26. Atomic Weapons Today • US and Russia have 13,000 actively deployed warheads • 2500 (US) and 2000 (Russia) on high alert • Fired within 15 minutes, reach targets in 30 minutes • Vastly redundant arsenal • 150-200 weapons adequate to destroy all major urban centers in Russia

  27. Atomic Weapons Today Accidental intermediate-sized launch of weapons from a single Russian submarine would immediately kill 6.8 million Americans in 8 cities

  28. Nuclear Weapons – Oops! • Pentagon: 32 nuclear weapons accidents since 1950 • GAO: 233 • Since 1950, 10 nuclear weapons lost and never recovered • All laying on seabed, potentially leaking radioactivity

  29. Effects of a Nuclear Explosion • Immediate: • Vaporized by thermal radiation • Crushed by blast wave • Burned and suffocated by firestorm

  30. Effects of a Nuclear Explosion • Intermediate: • Suffering, painful deaths • Health care personnel/resources overwhelmed • Famine • Refugees • Devastated transportation infrastructure

  31. Effects of a Nuclear Explosion • Late effects: • Cancer • Psychological trauma (PTSD, anxiety, depression) • nuclear winter (mass starvation due to disruption of agricultural, transportation, industrial and health care systems)

  32. Effects of a 20 megaton nuclear explosion • Ground zero - 2 miles: • Within 1/100 second fireball hotter than sun; everything vaporized • 2 - 4 miles: • 25 psi pressures; 650 mph winds • Buildings ripped apart and leveled

  33. Effects of a 20 megaton nuclear explosion • 4 - 10 miles: • 7 – 10 psi; 200 mph winds • Sheet metal melts; concrete buildings heavily damaged (all others leveled) • 16 miles: • 100 mph winds, firestorm, T = 1400° C • 100% mortality

  34. Effects of a 20 megaton nuclear explosion • 21 miles: • 2 psi; 100 mph winds • Shattered glass, flying debri • 29 miles: • 3° burns over all exposed skin • 40 miles: • Retinal burns blind all who witness explosion

  35. Effects of a 20 megaton nuclear explosion over Boston • Death toll: • 1,000,000 within minutes • 1,800,000 survivors: • 1,100,000 fatally injured • 500,000 with major injuries • 200,000 without injuries

  36. Types of Injuries • Burns • Blindings • Deafenings • PTX • Fxs • Shrapnel wounds

  37. Radiation Sickness • Very high dose: cerebral edema, N/V/D, speech and gait difficulties, convulsions, coma, death within 1-2 days • Medium doses: N/V/D → resolves → recurrent hematemesis, bloody D → majority die • Low doses: BM failure, infections, bleeding, sores, ± death

  38. Effects on health professionals • 70% killed or fatally wounded • 15% injured • < 1000 survive

  39. Effects on health care system • Most major hospitals destroyed • EMS system debilitated • No X-ray machines, electricity, water, antibiotics or other meds, blood/plasma, bandages • 2000 burn unit beds in US (100 per major city) – essentially destroyed

  40. Effects on Health Care System • 1500 patients/doctor • 10 min/pt • 4 hours sleep/noc • 2 weeks to see all injured

  41. Ultimate Outcomes • Boston (pop. 2.8 million in 1998) • > 2.5 million dead after one month • More than 6x as many Americans as died in WW II

  42. Health hazards of the Nuclear Cycle • Ecosystem degradation: e.g., Bikini Island • Uranium mining: 5-fold increase in lung cancer • Depleted uranium: • increased stillbirths, birth defects, childhood leukemias, other cancers in Southern Iraq • Possible increase in lung CA in U.S. soldiers (data sparse)

  43. Nuclear Waste Disposal • On-site storage: • 118 commercial reactors • 10 weapons plants • 37 research reactors

  44. Nuclear Waste Disposal • Skull Valley, Goshute Indian Reservation, Utah • Private fuel storage consortium • Temporary storage of 44,000 tons of high-level nuclear waste • Bribes to tribes; environmental injustice • Waste Isolation Pilot Plant, New Mexico • Defense Dept. waste

  45. Nuclear Waste Disposal – Yucca Mountain • On DOE land claimed by Western Shoshone Nation under the Ruby Valley Treaty of 1863 • 100 miles from Las Vegas • Near aquifer and earthquake fault

  46. Nuclear Waste Disposal – Yucca Mountain • Est. 100,000 shipments of 70,000 – 120,000 tons of waste over 25 yrs • Coming within ½ mile of 50 million Americans • Est. 200-350 accidents • Nuclear roulette • Unlikely to occur – other options being considered

  47. Nuclear Power Plants • 104 plants in US • Aging, equipment failures (8 from 3/00-4/01 → shutdowns) • 435 plants worldwide (generate 16% of planet’s electricity) • 60 plants in Russia • ? Condition, safety

  48. Nuclear Power • Supply of uranium for fission to run out by 2050 • Alternate sources: • MOX (mixed oxide) fuel (reprocessed spent fuel – plutonium and uranium) • Breeder reactors – make more fuel (plutonium) than they consume • Fission – currently impractical

  49. Nuclear Power Plant Accidents • Three Mile Island (1979) • 50,000 to 100,000 excess deaths • Chernobyl, USSR, 1986 - nuclear power plant explosion • 200 times the radiation of Hiroshima + Nagasaki • 25-100 died immediately, up to 1,000 injured acutely, NCI estimates 10-75K thyroid cancers (other estimates much lower) • Some estimates as high as almost 1 million deaths

  50. Chernobyl • Higher risk of neural tube defects and childhood leukemia among those living near nuclear power plants • Anxiety a major problem • Ukraine still spends 6% of its GDP each year on Chernobyl-related matters

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