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Peace Building Through Health. Zeev Wiener PHR-Israel. By 2020 The WHO and the World Bank predict that war will be one of the top 10 causes of disability and death. War and Public Health.

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peace building through health

Peace Building Through Health

Zeev Wiener



By 2020 The WHO and the World Bank predict that war will be one of the top 10 causes of disability and death.

war and public health
War and Public Health

Economic and social systems are disrupted, famine and epidemics may follow, and resources are diverted to military rather than health goals-all of which make war a public health problem.

MacQueen G, Santa-Barbara J. Peace building through health initiatives. BMJ 2000; 293-6

the role of physicians
The Role of Physicians

“The role of physicians and other health workers in the preservation and promotion of peace is the most significant factor for the attainment of health for all”.

WHO, World Health Assembly, Resolution 34.38, 1981

health as a bridge for peace
Health as a Bridge for Peace

A concept based on the idea that shared health concerns can transcend political, economic, social and ethnic divisions, to promote dialogue, foster solidarity, and contribute to peace among peoples and between nations.

Guerra de Macedo 1994

  • Why Medicine?
  • Is there a coherent intervention theory?
  • Have we the required socio-political technology?
  • Do we posses the skills?
checking basic assumptions
Checking Basic Assumptions
  • War=Disease
  • Violence=Bacteria
  • Medical Staff=Healers
  • Peace=Cure

Health Providers in Crisis

peace through health vass a bmj editorial nov 2001
Peace Through HealthVass A. BMJ (Editorial), Nov. 2001
  • “…even the WHO program used anecdotal comments from field teams to say that volatility had reduced and social cohesion improved. The report admits that it could have been the wider peace process and post war fatigue felt by the population that brought about these changes”.
  • “…With few examples of peace through health initiative, it is idiology that is driving the movement at present”.
  • “…humanitarian aid had even worsened conflict at times”. (Sudan 1998)
war as a disease process
War as a Disease Process
  • Primary Prevention-”Make love-not war”
  • Secondary prevention- Early detection of conflicts and intervention in high risk areas.
  • Tertiary Prevention- Reduce suffering and disability through treating the victims.
alert signs

Disease outbreak



Food Shortage



Political Instability/Corruption

Institutional/Social Disintegration


Alert Signs
health peace building mechanisms
Health Peace Building Mechanisms
  • Conflict management
  • Solidarity
  • Strengthening the social fabric
  • Dissent
  • Restricting destructiveness
health peace mechanisms palestinian israeli conflict
Health Peace MechanismsPalestinian-Israeli Conflict

Conflict management

Medical diplomacy and health oriented superordinate goals.

  • Present data to policy makers and public (both sides)
  • Press professional associations to stand out (IMA, Palestine)
  • Press Government by international establishments
  • (Red Cross, Amnesty, professional associations)
health peace mechanisms palestinian israeli conflict1
Health Peace MechanismsPalestinian-Israeli Conflict


Healthcare workers empowering peacemaking groups.

  • Empower health and human rights NGO’s by:
  • Finance
  • medical supplies (home equipment, medications)
  • medical expertise( mental health, infant development)
  • Out of country medical facilities (special surgery)
health peace mechanisms palestinian israeli conflict2
Health Peace MechanismsPalestinian-Israeli Conflict

Strengthening the social fabric

Restore and enforce bonds uniting populations through health.

  • Joint medical projects relevant to both populations
  • (DM, HT, PTSD, lifestyle modification)
  • Professional knowledge and expertise exchange
  • Re-Education (hate, mistrust, violence)
health peace mechanisms palestinian israeli conflict3
Health Peace MechanismsPalestinian-Israeli Conflict


Using medical knowledge to express disagreement with policies.

  • Access to healthcare (Roadblocks, primary care services)
  • Official responsibility in different types of Palestinian areas
health peace mechanisms palestinian israeli conflict4
Health Peace MechanismsPalestinian-Israeli Conflict

Restricting destructiveness

Arguing for restricting and abolishing destructive

policies and weapons using healthcare discourse.

  • Obstacles to healthcare access
  • House destruction
  • Suicide bombing
  • Prisoners’ health
public health problems concerning both sides
Public Health Problems Concerning Both Sides
  • Physical trauma (Gun shot ,burns,blast wounds)
  • Mental trauma (PTSD)
  • Hate ,mistrust, violence
  • Road accidents
  • Life Style (Obesity, Smoking, ect.)



The more an individual feels helpless and loss of

Control, the more they are prone to develop anger,

anxiety, frustration and depression , expressed

in behavioral terms as violence.

Milgram NA. Psychological stress and adjustment in time of war and peace:

the Israeli experience as presented in tow conferences.

Isr Ann Psychiatr Relat Discip 1978; 16(4): 327-38.

Acts of killing during war encourage depreciation in the value of human life, legitimizing violence and lead violence to be seen as norm.

Archer D. and Gartner R. Violence and crime in cross-national perspective, New Haven: Yale University Press 1984.

what is needed
What is Needed?
  • Redefine goals.
  • Create appropriate region-specific tools.
  • Educate staff.
  • Preserve medical neutrality and impartiality.
  • Keep on trying.