Public Health, War, and Militarism

1
Public Health, War, and Militarism

• Martin Donohoe

2
Am I Stoned?

• A 1999 Utah anti-drug pamphlet warns
• Danger signs that your child may be smoking
  marijuana include excessive preoccupation with
  social causes, race relations, and environmental
  issues

3
Perspective

• The earth spins at 1,038 mph at the equator,
  between 700 mph and 900 mph at mid-latitudes
• The earth rotates around sun at 18.5 miles/sec
• The solar system orbits the center of the Milky
  Way Galaxy at 137 miles/sec
• One rotation per 225 million years

4
Perspective

• The sun is one of hundreds of billions of stars
  in the Milky Way Galaxy
• The Milky Way is one of over one hundred billion
  galaxies in the known universe
• The universe may be one of an infinite number of
  universes

5
The Planets
6
Our Solar System
7
Jupiter one pixel, Earth invisible
8
Sun one pixel, Jupiter invisible
9
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 widespread use of horses

10
History of war

• Ninth Century China - bombs
• Thirteenth Century China rockets
• Forgotten until the 19th Century
• 1783 Balloon (Montgolfier brothers)

11
History of War

• 1803-1814 (Napoleonic Wars) English General
  Henry Shrapnel fills cannonballs with bullets and
  exploding charges to increase killing capacity
• 1903 airplane (Wright Brothers)
• 20th Century nuclear weapons, increasingly
  sophisticated chemical and biological weapons

12
Atomic Weapons - History

• Hiroshima, August 6, 1945
• 15 kiloton bomb, 140,000 deaths
• Nagasaki, August 9, 1945
• 22 kiloton bomb, 70,000 casualties

13
Atomic Weapons Today

• Approximately 23,360 nuclear weapons at 11 sites
  in 14 countries (1/2 active or operationally-deplo
  yed)
• 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)

14
History of War

• 20th Century
• Small arms
• 90 of the 300,000 yearly deaths from violent
  conflict
• Land mines
• 24,000 deaths/yr (est.), tens of thousands more
  disabled
• Predator drones
• Weaponization of space
• Cyberwar

15
History of War

• Belief that each new invention would eliminate
  warfare
• Instead - increased casualties, killing at a
  distance

16
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)

17
Contemporary Wars

• 250 wars in the 20th Century
• 72 million lives lost in 20th Century wars,
  another 52 million through genocides
• Incidence of war rising since 1950

18
War Deaths, 1945-2010
19
War Deaths

• Korean War 3 million
• Vietnam War 1.7 million
• Iran-Iraq War 700,000
• Soviet War in Afghanistan 1.5 million
• Second Congo War 3.8 million
• Second Sudanese Civil War 1.9 million

20
Gulf War I

• 105,000 military and 110,000 civilian deaths
  (almost all Iraqis)
• Over 2.25 million refugees
• 2/3 of US casualties from friendly fire
• Cost 61 billion (82 billion in 2003 dollars)
• Environmental devastation

21
War Deaths (as of 12/1/12)

• Second Iraq War
• 4,485 U.S. soldiers 17,000 Iraqi military
• U.S. Afghan War
• Over 2,000 U.S. soldiers 1,200 coalition forces
• Civilian deaths
• 193,000 violent 1 million indirect
• Financial cost of these two wars 1.5-5 trillion
  (est.)
• Higher estimate includes fighting, rebuilding,
  veterans health care, economic losses, etc.

22
Casualties Among Soldiers and Civilians Continue

• More US soldiers have committed suicide than have
  died in Afghan War
• More military contractors killed than US soldiers
• Veteran health care needs massive (TBI,
  psychiatric disorders, etc.)

23
Josef Stalin

• The death of one man is a tragedy. The death of
  millions is a statistic.

24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
Colonial Exploitation

• Christopher Columbus log entry upon meeting the
  Arawaks of the Bahamas
• Theybrought usmanythingsThey willingly
  traded everything they ownedThey do not bear
  armsThey would make fine servantsWith fifty men
  we could subjugate them all and make them do
  whatever we want.

28
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.

29
Exploitation leads to

• Maldistribution of wealth and resources
• Environmental degradation
• Wars

30
Consequences of War

• Deaths, injuries, psychological sequelae
• Collapse of health care system (affecting those
  with acute and chronic illnesses)
• Famine

31
Consequences of War

• Environmental degradation
• Refugees, migrants, internally-displaced persons
• 26 million displaced
• Increasing poverty and debt
• All lead to recurrent cycles of violence

32
Environmental Consequences of Militarization

• Worlds single largest polluter
• 8 of global air pollution
• 2-11 of raw material use
• Almost all high and low level radioactive waste

33
Violence Against Women

• Common among U.S. servicewomen
• A deployed female soldier is more likely to be
  raped by a fellow soldier than killed by enemy
  fire
• Rape in war widespread, often genocidal
• Some refugee camps unsafe

34
(No Transcript)
35
Comfort Women

• Japanese soldiers forced between 100,000 and
  200,000 women into sexual slavery (comfort
  women)
• Some underwent forced hysterectomies to prevent
  menstruation, make them constantly available
• More than half died due to mistreatment

36
Comfort Women

• 3-5 year detention
• 5-20 rapes per day
• For 3 yrs of enslavement, low estimate is 7500
  rapes per woman
• Japan has not compensated any victims
• Historical blindness to atrocities

37
Violence and Rape in War

• Occurs against backdrop of ongoing societal forms
  of violence against women
• Legal, educational, social, and political
  marginalization

38
Economic Disparities

• Women 79 cents/1 Men
• Median income of black U.S. families as a percent
  of white U.S. families 62
• 60 in 1968
• 63 for Hispanic families

39
Status of Women

• Women do 67 of the worlds work
• Receive 10 of global income
• Own 1 of all property

40
Worldwide, every minute

• 380 women become pregnant (190 unplanned or
  unwanted)
• 110 women experience pregnancy-related
  complications
• 40 women have unsafe abortions
• 1 woman dies from childbirth or unsafe abortion
• Reason Lack of access to reproductive health
  services

41
Mothers Day Proclamation, 1870Julia Ward Howe

• Arise then...women of this day!Arise, all women
  who have hearts!
• Say firmly"We will not have questions answered
  by irrelevant agencies,Our husbands will not
  come to us, reeking with carnage,For caresses
  and applause.

42
Mothers Day Proclamation, 1870Julia Ward Howe

• Our sons shall not be taken from us to
  unlearnAll that we have been able to teach them
  of charity, mercy and patience.
• From the bosom of a devastated Earth a voice
  goes up withOur own. It says "Disarm! Disarm!

43
Mothers Day Proclamation, 1870Julia Ward Howe

• Let women
• promote the alliance of the different
  nationalities,The amicable settlement of
  international questions,The great and general
  interests of peace.

44
(No Transcript)
45

• Critical Public Health Issues

46
Poverty and Hunger

• US 15 of residents and 22 of children live in
  poverty
• Rates of poverty in Blacks and Hispanics 2X
  Whites
• Poverty associated with worse physical and mental
  health

47
Jacob Riis
48
Dorothea Lange
49
Worldwide Poverty

• 1 billion people lack access to clean drinking
  water
• 3 billion lack adequate sanitation services
• Hunger-related causes kill as many people in 8
  days as the atomic bomb killed at Hiroshima

50
James Nachtwey
51
(No Transcript)
52
Maldistribution of Wealth

• Top 250 billionaires worldwide worth 1 trillion,
  the combined income of bottom 2.5 billion people
  (45 of worlds population)
• U.S Richest 1 of the population owns 40 of
  the countrys wealth -poorest 80 own 7-widest
  gap of any industrialized nation

53
Overconsumption (Affluenza)

• U.S. 6.3 of worlds population
• Owns 50 of the worlds wealth
• U.S. responsible for
• 25 of worlds energy consumption
• 33 of paper use
• 72 of hazardous waste production

54
Income Inequality Kills

• Higher income inequality is associated with
  increased morbidity and mortality at all per
  capita income levels

55
Maldistribution of Wealth is Deadly

• 880,000 deaths/yr in U.S. would be averted if the
  country had an income gap like Western European
  nations, with their stronger social safety nets
• BMJ 2009339b4471

56
Voltaire

• The comfort of the rich rests upon an abundance
  of the poor

57
Hudson River, 2009
58
Primo Levi

• A country is considered the more civilized the
  more the wisdom and efficiency of its laws hinder
  a weak man from becoming too weak or a powerful
  one too powerful.

59
The State of U.S. Health Care

• 49 million uninsured patients
• Millions more underinsured
• Remain in dead-end jobs
• Go without needed prescriptions due to
  skyrocketing drug prices

60
Headline from The Onion

• Uninsured Man Hopes His Symptoms Diagnosed This
  Week On House

61
The State of U.S. Health Care

• US ranks near the bottom among westernized
  nations in life expectancy and infant mortality
• Est. 51,000 deaths/year due to lack of health
  insurance
• Racial disparities in coverage, processes, and
  outcomes of care

62
Racial Disparities in Health CareAfrican-America
ns

• Equalizing the mortality rates of whites and
  African-Americans would have averted 686,202
  deaths between 1991 and 2000
• Whereas medical advances averted 176,633 deaths
• AJPH 2004942078-2081

63
Environmental Degradation and Social
Injustice(Causes)

• Overpopulation
• Pollution
• Deforestation
• Global Warming
• Unsustainable Agricultural/Fishing Practices
• Pesticides, indoor cooking with biomass

64
Environmental Degradation and Social
Injustice(Causes)

• Overconsumption / Affluenza
• Militarization
• Maldistribution of Wealth
• National and Global Political and Economic
  Institutions
• Exploitation
• Corporate Profiteering

65
Environmental Degradation and Social
Injustice(Causes)

• Poor education
• Media manipulation and inaccurate reporting
• Money in politics
• Citizen apathy

66
Environmental Degradation and Social
Injustice(Consequences)

• Increased poverty and overcrowding
• Famine
• Global Warming
• Weather extremes
• Species loss
• Human morbidity and mortality
• 40 of worlds yearly deaths linked to water,
  air, and soil pollution
• War
• Malthusian chaos and disaster

67
Consequences of Global Warming

• 300,000 deaths and 5.5 million disability-adjusted
  life years lost per year
• WHO, UN Environment Program
• Expected to double by 2020

68
World Military Spending (2012)(1.7 trillion in
2012 U.S. 34 of total)
69
U.S. Discretionary Spending (2012)
70
War and Peace

• World military budget
• 230X what the UN spends on peacekeeping
• US
• Largest arms supplier
• Greatest debtor to U.N. (including U.N.
  peacekeeping fund)

71
(No Transcript)
72
Skewed Priorities

• The world spends 1.7 trillion/year on military
  goods and services
• For 25 of this, we could
• Eliminate starvation and malnutrition
• Provide shelter for all
• Eliminate illiteracy
• Provide clean and safe water
• Prevent soil erosion

73
Skewed Priorities

• Prevent global warming
• Stop deforestation
• Aid all refugees
• Retire developing nations debt
• Provide clean, safe energy (through efficiency
  and renewables)

74
Skewed Priorities

• Prevent acid rain
• Fix the ozone hole
• Stabilize world population
• Provide basic universal health care and AIDS
  control
• Eliminate nuclear weapons and land mines

75
DOD Announcement(September, 2011)

• Pentagon Lacks Funding to Fix Public Schools on
  Military Bases

76
Dwight Eisenhower

• Every gun that is made, every rocket fired,
  signifies in the final sense a theft from those
  who hunger and are not fed, those who are cold
  and not clothed

77
Martin Luther King

• A nation that continues year after year to
  spend more money on military defense than on
  programs of social uplift is approaching
  spiritual death.

78
Health Costs of Militarization

• 3 hours of world arms spending annual WHO
  budget
• ½ day of world arms spending immunization for
  all the worlds children
• 3 days of US arms spending amount spent on
  health, education and welfare programs for US
  children in one year

79
Health Costs of Militarization

• 3 weeks of world arms spending primary health
  care for all in poor countries, including safe
  drinking water and full immunizations
• Brain drain 2/3 of US scientists work in
  military-industrial complex (although much work
  has widespread applicability)

80
Foreign Aid

• In total dollars U.S. 1
• As a of GDP, U.S. ranks 21st among the worlds
  wealthiest nations
• U.S. Aid Over 1/3 military, 1/4 economic, 1/3
  for food and development
• Most U.S. aid benefits U.S. corporations

81
Foreign Aid

• Americans think that 24 of the federal budget
  goes toward foreign aid
• 0.9 of the total federal budget, 1.6 of the
  U.S. discretionary budget

82
U.S. Charitable Giving

• 2.5 of income
• 2.9 at height of Great Depression

83
The US Rogue Nation

• History Native Americans, slavery, current
  excesses, disparities and injustices
• Co-opting Nazi and Japanese WWII scientists
• Minimum 277 troop deployments by the US in its
  225 year history
• Over 1,000 bases worldwide today
• In U.S. and 69 other countries

84
The US Rogue Nation

• Since the end of WWII, the US has bombed
• China, Korea, Indonesia, Cuba, Guatemala, Congo,
  Peru, Vietnam, Laos, Cambodia, Nicaragua, El
  Salvador, Grenada, Libya, Panama, Afghanistan,
  Sudan, Yugoslavia, and Iraq

85
The US Rogue Nation

• Conservative estimate 8 million killed
• US invasions/bombings often largely at behest of
  corporate interests
• Drone strikes on allied/other nations and on U.S.
  citizens

86
The US Rogue Nation

• Continued funding of the Western Hemisphere
  Institute for Security Cooperation
• Formerly the School of the Americas
• Over 60,000 graduates, including many of the
  worst human rights abusers in Latin America
  (e.g., Manuel Noriega, Omar Torrijos, and the
  assassins of Archbishop Oscar Romero)

87
Hermann Goering(at the Nuremberg Trials, shortly
before being sentenced to death)

• Of course the people don't want war. Butit is
  the leaders of the country who determine the
  policy, and it is always a simple matter to drag
  the people along, whether it is a democracy, or a
  fascist dictatorship, or a parliament, or a
  communist dictatorship . . .

88
Hermann Goering

• Voice or no voice, the people can always be
  brought to the bidding of the leadersAll you
  have to do is to tell them they are being
  attacked, and denounce the pacifists for lack of
  patriotism and exposing the country to danger.

89
Horace Odes (III.2.13)

• Dulce et decorum est pro patria mori
• It is sweet and fitting to die for ones country

90
"Dulce Et Decorum Est"Wilfred Owen, 1917-18

• In all my dreams, before my helpless sight, He
  plunges at me, guttering, choking, drowning.
• If in some smothering dreams you too could pace
  Behind the wagon that we flung him in, And
  watch the white eyes writhing in his face, His
  hanging face, like a devil's sick of sin

91
"Dulce Et Decorum Est"Wilfred Owen

• If you could hear, at every jolt, the blood
  Come gargling from the froth-corrupted lungs,
  Obscene as cancer, bitter as the cud Of vile,
  incurable sores on innocent tongues,- My friend,
  you would not tell with such high zest To
  children ardent for some desperate glory, The
  old Lie Dulce et decorum est Pro patria mori.

92
International Non-Cooperation/Isolationism

• Failure to sign or approve
• Kyoto Protocol on Climate Change
• Convention on the Prohibition of Anti-Personnel
  Land Mines
• Comprehensive Nuclear Test Ban Treaty

93
International Non-Cooperation/Isolationism

• Failure to sign or approve
• Convention on the Rights of the Child
• Convention on the Elimination of Discrimination
  Against Women Convention on Economic, Social and
  Cultural Rights
• Convention for the Suppression of Traffic in
  Persons
• UN Convention on the Rights of Disabled Persons

94
International Non-Cooperation/Isolationism

• Failure to sign or approve
• Protocol 1, Article 55 of the Geneva Conventions,
  which bans methods of warfare which can cause
  severe environmental damage
• The Basel Convention on the Control of
  Transboundary Movements of Hazardous Wastes

95
The US Rogue Nation

• Torture (involving health care professionals)
• Death Penalty
• US executes more of its citizens than any other
  country except China, Iraq, Saudi Arabia, and
  Iran
• Until recently, the US was the only country to
  execute both juveniles and the mentally ill

96
The US Rogue Nation

• Failure to follow World Court Decisions
• Failure to recognize International Criminal Court

97
Solutions

• Activism (PSR, IPPNW, etc.)
• Education (APHA Militarism Education Group)
• Tolerance and appreciation of diversity
• Redirect money towards social justice and
  environmental preservation
• Eliminate WMDs

98
Solutions

• Eliminate military recruiting in public schools
• APHA Resolution
• Increase foreign aid
• Create Dept. of Peace
• Assist victims of war (PHR, MSF, etc.)
• Treaties

99
World Health Organization

• The role of the physician in the preservation
  and promotion of peace is the most significant
  factor for the attainment of health for all.

100
Speak Up for the Disenfranchised

• The first job of a citizen is to keep your mouth
  open.
• - Günter Grass

101
First they came for the Jewsby Pastor Niemoller

• First they came for the Jews, and I did not
  speak up, for I was not a Jew.
• Then they came for the communists, and I did not
  speak up for I was not a communist.
• Then they came for the trade unionists, and I did
  not speak up, for I was not a trade unionist.
• Then they came for me, and there was no one left
  to speak up for me.

102
Have Faith in Your Ability to Affect Change

• "If you think you are too small to have an
  impact, try going to bed with a mosquito in your
  tent
• - African Proverb

103
Act Out of Love

• People
• Environment
• Earth

104
Our Home
105
Earth/Moon Seen by Voyager Spacecraft through
Saturns Rings
106

• Public Health and Social Justice Website
• http//www.publichealthandsocialjustice.org
• http//www.phsj.org
• martindonohoe_at_phsj.org