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Program and Abstracts: The Seventeenth Conference of the International Society for Environmental Epidemiology (ISEE): Abstracts

EPIDEMIOLOGY, ENVIRONMENT, GENOCIDAL WAR AND GENOCIDE: TIME LINES OF UPSTREAM DETERMINANTS, PREDICTORS AND PREVENTION: THE NEED FOR SURVEILLANCE AND EARLY WARNING SYSTEMS

Berman, T; Richter, E D

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ISEE-392

Background:

In genocide, the victims of mass killing and expulsions are defined by whom they are, not what they do. In war, the targets are defined by what they do. In genocidal war, there are both types of victims. In the past decade, genocide, war and genocidal war have ravaged Rwanda, the Congo and Darfur. Malthusian-type upstream environmental determinants producing competition for limiting resources (e.g. water, land) or precious resources (e.g. oil, diamonds) have interacted with religious and ethnic hatreds to cause millions to die in all three scenarios. International agencies, governments, and social systems have failed to respond effectively to early warning signs. Public health agencies and NGO's have mounted heroic disaster relief programs, but these programs have been reactive, not proactive. Epidemiologists have focused on downstream consequences of war, genocide and violence but have not addressed the role of upstream environmental, social and political predictors which trigger prevention and intervention.

Objectives:

To apply lessons from failures to prevent past genocides and genocidal wars.

Methods:

We prepared time lines for so-called upstream environmental determinants (e.g. competition for scarce resources), prodromal political events, and the beginning and progression of genocidal episodes. We examined time intervals between first events and first reports, and between first reports and first responses in major genocides in the last 100 years, from the Armenian genocide to the genocide in Darfur.

Results:

The findings indicate that since the Armenian genocide,

  1. the time interval between first genocidal episodes and first reports to the outside has been of the order of days to weeks,
  2. the time interval between first reports and response, usually ineffective, has been of the order of months to years.
  3. the awareness of the role of upstream determinants in creating the potential for genocide is relatively recent, but can be overly deterministic and create pretexts for non-use of strong measures to respond once genocide starts;
  4. false negatives are inherent in genocidal scenarios, owing to repression and suppression biases;
  5. pseudo public health agendas and vocabularies (e.g. eugenics, ethnic cleansing) serve to mobilize elites within genocidal regimes or downsize the magnitude of the horrors;
  6. incitement has been a highly sensitive and specific indicator of impending genocidal scenarios
  7. outside indifference or unwillingness to respond to the warning signs signals acquiescence in genocidal agendas;
  8. Professional societies in public health have been unwilling to insert themselves into these issues or speak out on them;
  9. The willingness to use force is essential for stopping genocide.

Conclusion:

We call for the establishment of an international surveillance system and early warning system which tracks and reports first signs and predictors of genocidal violence.

Copyright © 2005 Wolters Kluwer Health, Inc. All rights reserved.