Thread by @veruka2

We imagine the carnage of war as happening on the battlefield. That happens and it's devastating.
But most devastation from war happens through infectious disease due to destroyed health infrastructure, crumbling sanitation capacities, and lack of public health surveillance. 1/

A great review of what we know about war's relationship with infectious disease was recently published. The authors conclude: "Wars trigger and
become promoters of infectious diseases, the lack of and difficulty in accessing medical care.... 2/
mdpi.com/2071-1050/13/1…

"...as well as the necessity of resettlement and migration, that perpetuate unfavorable conditions and indirectly translate into incidence and mortality rates."
In other words, blowing up sewers and hospitals hurts a lot of people in a lot of ways for a very, very long time.
3/

There are lots of ways war trigger and create hotbeds of disease. Crowded refugee camps can produce hard-to-control epidemics of infections long thought to be controlled, as we saw in the typhoid outbreak among Bosnian refugees in the 1990s. 4/
wapo.st/3HPFVFn

The Yemen civil war has been devastating and resulted in numerous infectious disease outbreaks. One study found that active conflict caused an ELEVEN FOLD increase in the probability of a diphtheria outbreak in. Yemeni communities. 5/
conflictandhealth.biomedcentral.com/articles/10.11…

And then there was the Iraq war, started by the US, which evolved into multiple stages of war over the decades, and which devastated basic infrastructure (i.e. to keep sewage out of drinking water) and led to massive cholera outbreaks. 6/
thehill.com/blogs/congress…

This is why water sanitation is one of the largest sectors of humanitarian assistance led by the UN's OCHA in Iraq right now, especially in camps housing Iraq's approximately 1.2 MILLION internally displaced persons. 7/
humanitarianresponse.info/en/operations/…