Public Health and Conflict: Expert Panel Surveys a Thorny Terrain
The theme for the 2024-2025 Dean’s Grand Rounds Series is “Urgent Care: Public Health and the World Today.” The latest talk in the series explored the theme in the context of war and conflict with three leading experts moderated by Thoại D. Ngô, professor and chair of the Heilbrunn Department of Population and Family Health. (Watch the video below.)
Today, there are 56 active armed conflicts around the world—the highest rate since World War II. In opening remarks, Ngô noted that present-day conflicts are driving unprecedented levels of forced migration: more than 114 million people are displaced by war and violence worldwide. Media attention often focuses on Ukraine and the Middle East. However, the largest numbers of refugees globally today are from Afghanistan and Syria, followed by Venezuela. “Growing conflict exacerbates health disparities, deepens poverty, and presents unparalleled challenges to the global health system,” he said.
In the discussion, Grand Rounds panelists spoke to the role of public health in conflicts, both as witness and victim and how researchers and practitioners can make a difference. Sid Naing, a research scholar at Yale University who has been tracking vaccine access for displaced populations in a Myanmar border region, said public health, once above the fray, has become part of many conflicts—not just as collateral damage, but also a deliberate target when aggressors disrupt or destroy supplies of food, medicine, medical equipment, and infrastructure. “Public health is in the line of fire,” Naing said. In this context, responding to conflicts and serving the most deprived can be challenging, especially when global humanitarian groups and institutions are designed to work and provide aid only through governments, yet workarounds involving crowd-funding campaigns are possible, and evidence of successful pilots are helpful in getting the attention of those global donors and partners.
L.H. Lumey, a Columbia Mailman professor of epidemiology who studies the long-term health effects of famines like the Dutch Hunger Winter during World War II, opened his remarks, saying, “Famines are manmade and reflect societal priorities.” He said getting access to data about famines can be a challenge when they are suppressed by the regimes responsible for them. The Ukraine Famine of 1932-33 and the Chinese Famine of 1950-61 were practically unknown to outsiders until decades later, despite the deaths of millions of people. Even so far removed, Lumey said, it is important to study these famines, to honor the memory of those affected, and to understand famines’ enduring consequences.
Seema Jilani, a pediatrician at Texas Children's Hospital and professor at Baylor College of Medicine in Houston, introduced her decades-long work on the humanitarian front lines in Bosnia, Syria, and Gaza. In Syria, she recalled facing skepticism twice over, both as someone who is Pakistani-American and because she was working in partnership with the U.S. military. Despite an overall bleak outlook for global conflicts, Jilani said she is inspired by health providers on the ground and—addressing Columbia Mailman students—the next generation of public health leaders. “If anybody can solve [this problem] and move forward, it’s you; you’ve been given the tools to move forward,” she said.