News & blog British Science Festival: Unwell in unrest Written by Alan Barker, Freelance Writer, British Science Festival Dr Mohammed Jawad wants to change the way we think about war and its effects on public health. Mohammed is a public health doctor currently at Imperial College London, and delivered the Charles Darwin Award Lecture at this year’s British Science Festival. Alan Barker was there. Dr Mohammed Jawad wants to change the way we think about war and its effects on public health. About half the world’s population is affected by war. That staggering statistic masks an increasingly complicated situation. War is changing: the age of nation states engaged in large-scale conflict on trench-scarred battlefields is almost certainly over. Today, the most likely theatre of war is a city centre. Attacks are often from aircraft rather than artillery. Conflicts are increasingly protracted, localised, and clandestine. Superpowers interfere in smaller states through proxy civil wars. (Syria is a recent prime example.) And, horrifyingly, we’re seeing unprecedented violations of international law: hospitals bombed, health workers murdered, chemical weapons deployed. Half the world's population is affected by war (Credit: Wikimedia / Voice of America News) These very different kinds of conflict create very different health legacies. War does more than kill and maim people. In fact, Dr Mohammed Jawad believes that the non-violent deaths resulting from war probably far outnumber the violent ones. (And he’ll soon have the numbers to prove it.) But the wider effects of conflict are complex, as Mohammed demonstrated with a carefully explained flow diagram. And they’re long-lasting: it can take years for depleted uranium to trigger cancers, and the mental trauma associated with living in a war zone can last a lifetime. What’s more, much of the information Mohammed needs to do his work is hidden – sometimes deliberately, sometimes through circumstances. Mohammed presented his research at the British Science Festival 2019 As a result, the long-term effects of conflict on health are poorly understood. Mohammed – currently completing his PhD at the Public Health Policy and Evaluation Unit, Imperial College London – is working hard to bring this problem to the forefront of the research agenda. In his Award Lecture at this year’s British Science Festival, he explained how. We’re in the age of big data. Mohammed collects health data and armed conflict data. Both are tricky to capture. Health data comes principally from governments, who usually dispatch it to the World Health Organisation so that the WHO can advise governments on future policy. The WHO in turn sends global data to the Institute for Health Metrics and Evaluation, which also receives data from NGOs and university research – especially when government data dries up in a war. Mohammed also uses data on armed conflict, principally from the Uppsala Conflict Data Program. In war, as he reminded us more than once, the first casualty is often truth. The UCDP relies heavily on journalists. The world sometimes knows that a conflict has broken out only through news reports. Officially, about 51 countries are currently at war. “But my dataset,” he told us, “almost certainly underestimates the number of wars going on.” Screenshot from Mohammed's presentation at the British Science Festival Mohammed now has health data for about 25 conditions – organised by gender and age group – and data about armed conflict, for every country in the world, for every year since 1990. And he’s put that data through what he modestly calls ‘complex analysis’. Identifying direct relationships between conflict and health conditions is tricky: correlation, as he told us, doesn’t equal causation. Nevertheless, his results are shocking. Well over 10 million people have suffered indirect deaths as a result of conflict in the last thirty years. (He proposes to reveal the exact figure when his PhD is published.) Threaded throughout Mohammed’s lecture was the story of his own family, profoundly affected by the repeated conflicts endured by his native Iraq. He knows from close personal experience how war has effects extending across generations and international borders. He has, therefore, a personal interest in quantifying those effects and making use of his results. He hopes that his work can identify the immediate needs of people affected by conflict, to inform both policy and humanitarian aid. Perhaps it will help identify violations of international law and protect human rights. Ultimately, of course, he wants to reduce the likelihood of future conflicts occurring. And what can we do in the face of these huge, appalling problems? Mohammed is very clear: there’s plenty we can do. We can inform ourselves and communicate our findings – at school, in debating chambers, over dinner. In answer to a question from a teacher, Mohammed acknowledged that unbiased information about conflict is hard to find, but the UN is perhaps a good place to start. We can raise money, lobby our MPS, and – as he agreed with an audience member – join the campaign against the arms trade. We could even consider a career in war prevention. We can all do something. If you want an example, look no further than Dr Mohammed Jawad. Alan Barker is a writer, trainer and coach specialising in communication skills. He has been working with the British Science Association since 2015. Alan’s webinar, Storytelling for Scientists, is on the 3M YouTube channel.