The long shadow of conflict

Regardless of one's political viewpoint, we can agree that armed conflicts lead to loss of innocent lives. That person may be a concert goer in the desert, a worker at an airport in a foreign land, a child buried under the rubble in an elementary school or someone whose dwelling happens to be near the border. Perhaps some may dismiss these incidents as inevitable outcomes of modern war, but that line of thinking takes away from our collective humanity. We tend to dismiss this 'collateral' loss of life because we do not think of the victims as our own. We think of these people as mere numbers or faceless statistics. But they are people with families, loved ones, aspirations, a past, present and a future. Perhaps another way to think about them is to imagine them as our relatives, friends or loved ones – because after all they are someone's relative, friend or loved one. What if that someone was us?

The impact on the innocent goes beyond the present. For many caught up in the conflict, the physical and psychological wounds are real and permanent. But we now know that some of the actual wounds also affect future generations. Modern conflicts lead to not just loss of life in the current moment, but also affect health of generations born long after the guns go silent. The nature of weapons used in modern wars is such that it affects land, waterways and environment and allows for the development and proliferation of pathogens that quickly become drug-resistant and fail to respond to front-line antibiotics. As a result, manageable infection becomes deadly and a routine surgical procedure can be a death sentence.

Research within the last decade from Lebanon, Iraq, Syria, Ukraine, Sudan, Yemen and Afghanistan, among other countries, has shown that the presence of heavy metals in the weapons of war leads to mutations in pathogenic bacteria that allow for the development of drug-resistant infections, making existing drugs impotent, and affecting not just those who are caught in conflict, but those in surrounding areas as well. There is a substantial body of research and evidence, both in basic science and in public health, showing how these pathogens become superbugs and affect even distant communities. Research from Iraq and Lebanon has shown that even decades after the hostilities end, local and regional communities pay a heavy price when it comes to life threatening infections.

I have, in the past decade, been part of multi-disciplinary research teams studying the impact of conflict on the development of drug-resistant infections. Scholars from humanities, social sciences, medicine, basic sciences and engineering have been part of these international teams. As part of our research, we have spoken to physicians who are unable to save children – born years after the conflict – because no drugs would treat their infections. I have met patients and caregivers, in urban environments and refugee camps, whose lives and limbs have been permanently altered by living in the lands shaped by past conflicts. Some of these people were not even born when the last war in the region ended, others lived elsewhere and had to move to these places for one reason or another. Some have lived at the same place for generations, in shifting borders, barely alive to share their stories.

Much is being written about the laws of war, the ethics of combat, the public pressure and the political posture. Some 'experts' are working overtime to predict the future – coming up with analyses that range from sound to inane, thoughtful to bizarre. I recognise that there is going to be disagreement on those points. But I hope that there is agreement on the fact that we should not just predict the future but also protect it. Especially for those who end up paying the price for just being born in the wrong place.