Conflict-related Deaths Research Articles

Comparative analysis and evolution of civilian versus combatant mortality ratios in Israel-Gaza conflicts, 2008-2023.

There is a need for statistical methodologies that scrutinize civilian casualties in conflicts, evaluating the degree to which the conduct of war affects civilians and breaches the laws of war. Employing an epidemiological method, this study introduced, developed, and applied a novel approach for investigating mortality of civilians versus combatants in conflicts. A deterministic mathematical model, structured by age and sex, was developed to describe the process of conflict-related deaths among both combatants and civilians. The model was calibrated using demographic and conflict-related data from different Israel-Gaza conflicts. To quantify the extent of the impact on civilians and determine whether they are the primary focus of a conflict, a statistical metric, the index of killing civilians, along with associated criteria, was devised. The model-estimated proportion of deaths in Gaza categorized as combatants was 62.1% (95% uncertainty interval (UI): 57.6-66.2%), 51.1% (95% UI: 47.1-54.9%), and 12.7% (95% UI: 9.7-15.4%) in the 2008-2009, 2014, and 2023 Israel-Gaza conflicts, respectively. The index of killing civilians was 0.61 (95% UI: 0.51-0.74), 0.96 (95% UI: 0.82-1.12), and 7.01 (95% UI: 5.50-9.29) in the 2008-2009, 2014, and 2023 conflicts, respectively. These index values indicate strong evidence for civilians being an object of war in the 2008-2009 and 2014 conflicts, but combatants were still identified as the primary focus of the conflict. In the 2023 conflict, there is robust evidence for civilians being an object of war, with civilians identified as the primary focus of the conflict. Findings imply a progressive shift in Israel's rules of engagement over time, with a trend towards higher acceptance of casualties among civilians. The 2023 conflict stands apart from preceding Israel-Gaza conflicts, with civilians identified as the primary focus of the conflict.

A mini-review on safeguarding global health amidst a "Pandemic" of armed conflicts.

The year 2022 witnessed an alarming surge in state-based armed conflicts globally, reaching a staggering 56, with major hostilities in Ukraine, Myanmar, and Nigeria resulting in over 10,000 estimated conflict-related deaths. This trend continued with the onset of a significant conflict between Israel and Hamas in October 2023. The escalating frequency of armed conflicts, reaching the highest number since 1946, poses a critical threat to global health. This paper explores the multifaceted health impacts of armed conflicts, encompassing physical injuries, infectious diseases, malnutrition, and profound mental health consequences. Healthcare systems in conflict zones face severe strain, and achieving Sustainable Development Goals by 2030 becomes increasingly challenging. The surge in armed conflicts globally is characterized as a "pandemic," justifying urgent attention. The paper identifies and discusses strategies to safeguard public health in conflict zones, emphasizing humanitarian response, protecting healthcare workers and infrastructure, building preparedness and resilience, and promoting mental health support. In navigating this "pandemic" of armed conflicts, comprehensive strategies are imperative to address the intricate challenges and secure a healthier global future.

A global assessment of the impact of violence on lifetime uncertainty.

Uncertainty around age at death, or lifetime uncertainty, is a key public health indicator and a marker of inequality in survival. How does the extent of violence affect lifetime uncertainty? We address this question by quantifying the impact of violence on dispersion in the ages at death, the metric most used to measure lifetime uncertainty. Using mortality data from the Global Burden of Disease Study and the Internal Peace Index between 2008 and 2017, we find that the most violent countries are also those with the highest lifetime uncertainty. In the Middle East, conflict-related deaths are the largest contributor to lifetime uncertainty. In Latin America, a similar pattern is attributable to homicides. The effects are larger in magnitude for men, but the consequences remain considerable for women. Our study points to a double burden of violence on longevity: Not only does violence shorten individual lives, but it also makes the length of life less predictable.

Postkonfliktno područje - "Post" kao nevažeće za civilne žrtve

Civilian casualties in an armed conflict are often directly related to the time period of the armed conflict and the geographical area where it takes place. Accordingly, the data on civilian casualties are often referred to only those casualties that occur in the conflict area during the armed conflict, that is, civilian battle-related deaths. This raises the question of whether the post-conflict area, which is etymologically composed from a compound meaning the area "after the conflict", means that the end of the armed conflict, in a certain area also means the end of all the causes that arose as a result of the conflict and which lead to the occurance of civilian casualties? In response to this question, the author comes to the data that civilian victims can also occur due to various indirect (non-violent) causes of death, that is conflict-related deaths, which are a consequence of an armed conflict, but which are not territorially or temporally limited by an armed conflict. Accordingly, the post-conflict area is "post"-conflict when it comes to the manifest nature of the armed conflict, it means the area in which armed activities have ended and in which there are no more battle-related deaths. However, the post-conflict area is not "post"-conflict when it comes to the latent nature of armed conflicts, and the end of the armed conflict does not mean the end of its negative consequences that lead to civilian casualties. Thus, a large number of civilian victims caused by conflict-related deaths also appear in the post-conflict area.

Tracking the SDGs: A methodological note on measuring deaths caused by collective violence

As part of recording the progress toward promoting peaceful societies as envisioned in the Sustainable Development Goal (SDG) 16, it is important to provide accurate estimates of violence-related deaths (SDG 16.1). These estimations face a number of methodological challenges, resulting in rather conservative estimates in the social sciences. In this article, we discuss SDG indicator 16.1.2 on conflict-related deaths, proposing its enlargement to cover different forms of collective violence. Various types of collective violence, their definition, measurement, and methods to combine them without double counting are reviewed. Comparing the Georeferenced Events Dataset (GED) to the Global Terrorism Database (GTD) shows that events of armed conflict and terrorism overlap to a certain degree. Our argument is that merging data from different event databases can provide a more accurate account of collective violence. We augment the GED data on organized armed conflict with data on terrorism—as a result, our estimates of the numbers of collective violence-related deaths are indeed significantly higher than suggested by GED (one of the most widely used databases in the social sciences).

Diversity and violence during conflict migration: The Troubles in Northern Ireland

AbstractDiversity's effect on violence is ambiguous. Some studies find that diverse areas experience more violence; others find the opposite. Yet conflict displaces and intimidates people, creating measurement challenges. We propose a novel indicator of diversity that circumvents these problems: the location of physical structures at disaggregated geographical levels. We introduce this solution in the context of the Troubles in Northern Ireland. Our data reveal a curvilinear relationship between diversity and conflict-related deaths, with the steepest increase at low diversity, driven by an increase in violence when our proxy for the Catholic proportion of the population rises from 0 to 20 percent. These patterns are consistent with a theory of group threat through exposure.

Conflict-related excess mortality and disability in Northwest Syria

IntroductionThe Syrian conflict that started in 2011 has been ongoing for over a decade without an end in sight. Estimates regarding excess mortality and conflict-related disability vary widely, and little...

Access to primary healthcare Services in Conflict-Affected Fragile States: a subnational descriptive analysis of educational and wealth disparities in Cameroon, Democratic Republic of Congo, Mali, and Nigeria

BackgroundMeasuring and improving equitable access to care is a necessity to achieve universal health coverage. Pre-pandemic estimates showed that most conflict-affected and fragile situations were off-track to meet the Sustainable Development Goals on health and equity by 2030. Yet, there is a paucity of studies examining health inequalities in these settings. This study addresses the literature gap by applying a conflict intensity lens to the analysis of disparities in access to essential Primary Health Care (PHC) services in four conflict-affected fragile states: Cameroon, Democratic Republic of Congo, Mali and Nigeria.MethodsFor each studied country, disparities in geographic and financial access to care were compared across education and wealth strata in areas with differing levels of conflict intensity. The Demographic Health Survey (DHS) and the Uppsala Conflict Data Program were the main sources of information on access to PHC and conflict events, respectively. To define conflict intensity, household clusters were linked to conflict events within a 50-km distance. A cut-off of more than two conflict-related deaths per 100,000 population was used to differentiate medium or high intensity conflict from no or low intensity conflict. We utilized three measures to assess inequalities: an absolute difference, a concentration index, and a multivariate logistic regression coefficient. Each disparity measure was compared based on the intensity of conflict the year the DHS data was collected.ResultsWe found that PHC access varied across subnational regions in the four countries studied; with more prevalent financial than geographic barriers to care. The magnitude of both educational and wealth disparities in access to care was higher with geographic proximity to medium or high intensity conflict. A higher magnitude of wealth rather than educational disparities was also likely to be observed in the four studied contexts. Meanwhile, only Nigeria showed statistically significant interaction between conflict intensity and educational disparities in access to care.ConclusionBoth educational and wealth disparities in access to PHC services can be exacerbated by geographic proximity to organized violence. This paper provides additional evidence that, despite limitations, household surveys can contribute to healthcare assessment in conflict-affected and fragile settings.

Counting the costs of trauma: the need for a new paediatric injury severity score

While the COVID-19 pandemic continues to dominate news headlines, little attention has been given to the announcement that the USA and UK will withdraw combat forces deployed to the so-called war on terror in Afghanistan. Protracted conflicts in the Middle East (eg, Syria, Yemen, and Afghanistan) and Africa (eg, Libya and the Sahel) continue unabated and under-reported, with well over 100 000 conflict-related deaths in 2020.1 The toll on populations, especially children, is a shameful signal lost in the noise of other world events.

Build back fairer: achieving health equity in the Eastern Mediterranean region of WHO

Build back fairer: achieving health equity in the Eastern Mediterranean region of WHO

Queuing to leave: A new approach to immigration

Abstract This paper uses queuing theory to examine the linkages between legal and illegal immigration. This approach is particularly appropriate for periods of mass migration and can be used to look at how the magnitude of people trying to migrate affects the choice between legal and illegal channels. An empirical illustration shows how origin-country conflict and past migration differently affect current legal and illegal flows. With data for Schengen countries from Eurostat for documented immigration and the European Agency for the Management of Operational Cooperation at the External Borders of the Member States of the European Union (Frontex) for illegal border crossings (IBCs), I implement a generalized method of moments (GMM) strategy using different estimates of conflict-related deaths and lagged flows of immigration as external and internal instruments, respectively. Violent conflict has a positive and significant effect on IBCs but not on documented migration flows. I find evidence of positive spillovers from the legal channel of immigration into the illegal channel but not vice versa.

Poverty and conflict in Thailand’s Deep South

Thailand’s so-called Deep South has experienced much deadly violence since the early 2000s. This article investigates its determining factors in the context of the larger civil unrest/civil war literature—work on Southeast Asia being sparse and work on Thailand almost non-existent. The focus is on 37 sub-provincial districts of four of Thailand’s 77 provinces covering the years from 2012 to 2019. Centering on descriptive statistics with additional panel regressions, it is found that reduced poverty incidence, increased educational attainment for males, and increased district-level per capita income are all associated with reduced conflict intensity (a smaller number of conflict-related deaths). In contrast, ethno-religious backgrounds and certain geographic features are not associated with either increases or decreases in conflict-related deaths.

Women and children living in areas of armed conflict in Africa: a geospatial analysis of mortality and orphanhood

SummaryBackgroundThe population effects of armed conflict on non-combatant vulnerable populations are incompletely understood. We aimed to study the effects of conflict on mortality among women of childbearing age (15–49 years) and on orphanhood among children younger than 15 years in Africa.MethodsWe tested the extent to which mortality among women aged 15–49 years, and orphanhood among children younger than 15 years, increased in response to nearby armed conflict in Africa. Data on location, timing, and intensity of armed conflicts were obtained from the Uppsala Conflict Data Program, and data on the location, timing, and outcomes of women and children from Demographic and Health Surveys done in 35 African countries from 1990 to 2016. Mortality among women was obtained from sibling survival data. We used cluster-area fixed-effects regression models to compare survival of women during periods of nearby conflict (within 50 km) to survival of women in the same area during times without conflict. We used similar methods to examine the extent to which children living near armed conflicts are at increased risk of becoming orphans. We examined the effects of varying conflict intensity using number of direct battle deaths and duration of consecutive conflict exposure.FindingsWe analysed data on 1 629 352 women (19 286 387 person-years), of which 103 011 (6·3%) died (534·1 deaths per 100 000 women-years), and 2 354 041 children younger than 15 years, of which 204 276 (8·7%) had lost a parent. On average, conflict within 50 km increased women's mortality by 112 deaths per 100 000 person-years (95% CI 97–128; a 21% increase above baseline), and the probability that a child has lost at least one parent by 6·0% (95% CI 3–8). This effect was driven by high-intensity conflicts: exposure to the highest (tenth) decile conflict in terms of conflict-related deaths increased the probability of female mortality by 202% (187–218) and increased the likelihood of orphanhood by 42% compared with a conflict-free period. Among the conflict-attributed deaths, 10% were due to maternal mortality.InterpretationAfrican women of childbearing age are at a substantially increased risk of death from nearby high-intensity armed conflicts. Children exposed to conflict are analogously at increased risk of becoming orphans. This work fills gaps in literature on the harmful effects of armed conflict on non-combatants and highlights the need for humanitarian interventions to protect vulnerable populations.FundingBill & Melinda Gates Foundation to the BRANCH Consortium.

Trends and patterns of deaths, injuries and intentional disabilities within the Libyan armed conflict: 2012-2017.

BackgroundThe consequences of armed conflicts impose considerable burdens on the economy and health care services, particularly in countries that are not equipped to deal with them, such as in the Middle-East, and North African countries. Little is known about the burden of mortality and injury resulting from the Libyan armed conflict. This study aimed to determine the trends and patterns of mortality, injury and disabilities directly associated with the Libyan armed conflict and analyze the geographic variation within the country during 2012–2107.MethodsData on conflict-related deaths, injuries, and disabilities were obtained from the national registry offices. The information included date, place, and demographic information. A questionnaire was also used to obtain information from the affected individuals and their families. National and regional trends of mortality, injury and disabilities were calculated. Spatial analysis was performed using geographic data available on all documented cases to analyze clustering of mortality and injury.ResultsA total of 16,126 deaths and 42,633 injuries were recorded with complete information during the Libyan conflict from 2012 till 2017. The overall mortality rate was 2.7/1000 population and injury rate was 7.1/1000. The overall male-to-female ratio of mortality and injury was 4.4:1; 42.3% were single and aged 20–30 years old, and 26.4% were aged 31–40 years. Moreover, injuries resulted in death in 20.1% of cases and disability in 33.5% of the cases. Most of the disabilities were caused by blasts, while gun shots resulted in more deaths. The overall mortality and injury rates were highest during 2015–2017. These rates were highest in the eastern region. Injuries were most concentrated in Benghazi and Derna in the east, followed by Sert and Musrata in the central region.ConclusionsConflict-related mortality, injury and disability has inflicted a heavy burden on the Libyan society that may persist for a long time. The rates of these casualties varied in time and place. National, well-planned efforts are needed to address this serious situation and its consequences.

Unpacking Violent Contention: The Troubles in Northern Ireland, 1968–1972

ABSTRACT This paper systematically describes the different types of political violence that occurred in Northern Ireland between 1968 and 1972, examining how they interacted and fueled each other. To measure the level of political violence in Northern Ireland, traditional quantitative approaches use variables such as the number of conflict-related deaths, paramilitary attacks, or riots; the goal of this paper, instead, is to disaggregate acts of violent contention by actor, type, and target. Relying on Quantitative Narrative Analysis (QNA), all the violent actions perpetrated by the actors participating in the conflict have been recorded, coded, and analyzed. Three main types of violence in Northern Ireland are identified: a) protest-related violence—violent interactions among protesters, counterprotesters, and police before, during, and after mass demonstrations; b) sectarian violence—includes riots and clashes between members of the two main ethno-national communities; and c) armed conflict—violent actions by paramilitary groups and security forces. While originating from different conflict situations, these three types of violence affected each other, as they altered, and were altered by, the broader political context. Conceptual and methodological disaggregation of political violence are encouraged to better understand violent conflicts.

Does Peacekeeping Reduce Violence? Assessing Comprehensive Security of Contemporary Peace Operations in Africa

Quantitative research evaluating the effect of peacekeeping operations usually links conflict abatement to the number of casualties in order to measure mission success. Such an approach is incomplete as security concerns extend far beyond the number of conflict related deaths. This narrow understanding of mission success leaves a significant assessment gap. Therefore this study is the first which presents comprehensive data using a wider understanding of violence and peace. We apply 11 indicators measuring security comprehensively. These range from the number of battle death, to violence against civilians, domestic unrest as well as domestic governance and political stability. In contrast to the mainstream quantitative literature our analysis shows that conflict often persists even with the deployment of peacekeepers. The absence of war (decline of battle death) does not automatically equate for non-violence and peace. In order to explain variation between cases we are also exploring the significance of different peacekeeping types, the size of developmental aid, rents from natural resources and the role of governance on conflict.

Tourism as an economic development tool. Key factors

Tourism may serve as tool of economic development (ED). The aim of this article is to determine, through the analysis of determining factors identified in previous studies, which are the most important variables in channelling tourism growth into ED. Using a multivariate linear regression model, the main push and brake factors have been identified, for both developed and developing countries. It has been concluded that countries should maintain low initial provisions for CO2 emissions, hospital beds, unemployment, energy without CO2 emissions, and working population. It is also necessary to reduce conflict-related deaths. These results may be crucial in the decision-making processes implemented by policymakers and destination managers, given that they provide extremely useful information for the planning of their actions.

Redress for past harms? Official apologies in Northern Ireland

This article critically examines the nature, role and function of official apologies with respect to conflict-related deaths in Northern Ireland. It draws on empirical research of investigations carried out by the Historical Enquiries Team (HET) in state involvement cases and in particular a sample of unpublished reports that prompted official apologies. These reports also contain individual ‘perpetrator’ apologies or expressions of regret. Apologies are promoted as an important transitional justice tool, and the topic has generated considerable literature. However, while that literature has touched upon the possible adverse effects of apologies, there has been less focus on examining the empirical evidence of situations where apologies have turned out to have negative effects. This article addresses aspects of this research gap through the lens of three key transitional justice themes: redress, reparation and victims’ agency. Pivotal questions are raised about the value of apology to the victim on the one hand and the state on the other. The conceding or withholding of official apologies is examined: who qualifies and why, and whether certain victims are deemed ‘undeserving’ of an apology. The article concludes by suggesting that a pattern of official apologies without accountability and acceptance of responsibility is emerging in Northern Ireland; that official apologies can function as a way to shield state institutions, deflect further scrutiny, deny culpability, avoid effective redress and placate and silence victims. In this context historical injustice may be intensified rather than rectified, causing more harm than good, at best glossing over past wrongs and at worst facilitating impunity and re-traumatising victims.

An overview of conflict in Africa in 2014

Violent conflict escalated in Africa in 2014, with five sub-Saharan states – the Central African Republic (CAR), Nigeria, Somalia, South Sudan and Sudan – accounting for an estimated 75% of all conflict-related deaths on the continent. This paper provides an overview of the five major sub-Saharan African conflicts in 2014 and considers the underlying causes and dynamics in the Seleka/anti-Balaka conflict in the CAR, the Islamist threats of Boko Haram and al-Shabaab in Nigeria and Somalia, the civil war in South Sudan, and the long-running conflict between Sudan's government and southern and Darfuri rebels. The paper unpacks the general trends evident in these conflicts and the implications for the settlement thereof, including the targeting of civilians, ethnic and religious mobilisation and the state as epicentre of violence. The paper concludes with a brief look ahead to 2015.

Blast Injury and the Human Skeleton: An Important Emerging Aspect of Conflict‐Related Trauma

Recent decades have seen an accelerating trend in warfare whereby a growing proportion of conflict-related deaths have been caused by explosions. Analysis of blast injury features little in anthropological literature. We present a review of clinical literature that includes prevalence of injury to anatomical regions and potential indicators of blast injury which can be used by forensic anthropologists. This includes high prevalence of extremity (22.8-91.2%) and facial (19.6-40%) injury in combat contexts, lower limb fractures (19-74.3%) in suicide bombing, traumatic amputation (3-43%) and diffuse fracture patterns in terrorist bombings. Potential indicators of blast trauma include blowout fractures in sinus cavities from blast overpressure, transverse mandibular fractures, and visceral surface rib fractures. Ability to recognize blast trauma and distinguish it in the skeleton is of importance in investigations and judicial proceedings relating to war crimes, terrorism, and human rights violations and likely to become increasingly crucial to forensic anthropology knowledge.