Dr Arun Mitra
Violence is a complex issue with various factors involved in it. Violence may be interpersonal, or self-inflicted. Whereas these carry negative impact, but the collective violence has much larger ramifications and can cause collateral damage. According to ‘World report on Violence and Health’ by the World Health Organization (WHO), over 1.6 million people worldwide lose their lives to violence each year. In the last century an estimated number of 191 million people lost their lives directly or indirectly as a result of armed conflict.
Poor people in the economically under developed countries are worst affected. In addition much larger number are injured. Many of them develop permanent disabilities. Rapes and torture are part of major trauma inflicted in such situations. Children, women and senior citizens who do not indulge in violence are the worst victims. Due to lack of hygiene, poor medical facilities and absence of proper nutrition coupled with mental trauma condition of refugees in detention camps is extremely grave.
Therefore any kind of violence is an issue of serious concern for public health. Violence committed by group of people in the name of ethnicity, religion, caste, creed, pseudo nationalism, beliefs or drug abuse can cause collateral damage, social disharmony and instability. Mob lynching on frivolous grounds is a relatively new phenomenon in our country. This has added to fear psychosis among the vulnerable communities.
Many parts of the world are riddled with low and medium conflicts today. Events in Iraq and Syria are very disturbing. Whole system has crumbled in these places. Here the states, as well as non-state actors are equally responsible for perpetration of violence. In most of the places it is the lust and greed to control natural resources that states resort to violent interventions. Situation in south Asia may not appear that grave but threat is nowhere less since this is a nuclear weapons possessing region. Military industrial complex has developed which creates conditions and perpetuates violence to sell their arsenal. Creation and support to Taliban to intervene in Afghanistan in early 1990 to over throw Najibullah Government is an example of this.
Health is the biggest victim in conditions of violence. The health infrastructure is seriously eroded in such situations. With increasing uncertainties and stress and strain, mental health issues increase manifold.
Terrorism is generally attributed to be violent reaction by the non-state actors. Five countries with the highest impact from terrorism as measured by the Global Terrorism Index (GTI) are Iraq, Afghanistan, Nigeria, Pakistan and Syria. These five countries accounted for 72 per cent of all deaths from terrorism in 2015. Then come Yemen, Somalia and India. India suffered 7835 deaths due to terrorist violence between 2000 to 2016 while Pakistan recorded 14953 deaths during the same period. Terrorism in 2015 cost the global economy US$89.6 billion. Even though this is a big amount, it is important to note that the economic impact of terrorism is small compared to other major forms of violence. This amount is only one per cent of the total global economic impact of violence which reached $13.6 trillion in 2015.
The report further highlights economic resources devoted to peacekeeping and peace building are much less small compared to the economic losses caused by conflict and terrorism. Taking violent conflict and terrorism together, peacekeeping and peace building expenditures amount to two per cent of the economic impact of these intertwined forms of violence.
Terrorism in India is characterized by left radical, Islamists and separatist groups. Left radical terrorist groups are by far the most frequent perpetrators and the main cause of terrorism deaths in India. The majority of Maoist attacks occurred in the provinces of Bihar, Chhattisgarh, Jharkhand and Odisha. India’s north east region has for the last three decades seen continual ethno-political unrest from ethnic secessionist movements.
After the violent attack on World Trade Centre (WTC) USA, there has been an effort to fight the terrorist violence through force. This has in fact not worked. Indian government’s approach too is on these lines only. To contain terrorism we have to understand the causes of such violence. It is true that external forces play a role in such situations, but without internal support, terrorism cannot flourish and sustain. To fight terrorists we have to isolate them from general masses. Experience of Punjab has shown that terrorism abated only after they were cut off from the masses. In that process progressive sections of political parties and civil society played a significant role.
Investment in primary prevention activities may be more cost-effective and have large and long-lasting benefits. While all social classes experience violence, research shows that people with the lowest socioeconomic status are at greatest risk. Therefore strategy has to be planned to focus resources on the most vulnerable groups. In most societies the poor do not get the desired benefits from the welfare schemes by the state. This needs to be corrected to win over confidence of the marginalized sections of the society.
Political commitment to tackling violence is vital to the public health effort. It is important at various levels right from policy making to the implementation.
Inequalities of any form, economic, education, healthcare, job opportunities, social and ethnic create conditions where it is difficult to control violence and creates fertile ground for breeding of terrorists. Inequalities among the nations as a result of globalization also contribute to conflict. None of these factors may be sufficient alone to cause conflicts, but in combination they may create the conditions in which violence will erupt. Therefore focus has to be on social and educational policies, promotion of gender and social equality. Role of media campaigns is very important to strengthen social harmony. Governments have to realize that rhetoric will not yield tangible results. It is important to strengthen measures to close the gap between the rich and poor and to ensure equitable access to goods, services and opportunities.
India has always preached non-violence. It is important to once again to work in that direction. Health professionals can play a vital role in this as health is the biggest victim under such circumstances. They can highlight the impact of violence on health to sensitize the society. (IPA)
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