Author Affiliation: Program on Forced Migration and Health, Heilbrunn Center for Population and Family Health, Mailman School of Public Health of Columbia University, New York, NY.
In this issue of THE JOURNAL, 2 articles and a letter to the Editor
argue, yet again, that war and public health are incompatible pursuits. The
article from Guinea-Bissau by Gustafson et al1
is an elegant analysis of what happens when patients with a chronic disease,
in this case tuberculosis, are forced to interrupt or abandon treatment because
of war, civil strife, or other societal upheaval. By comparing the experiences
of patients with tuberculosis forced to flee from the capital city of Bissau
because of violent fighting with those who had completed an entire course
of treatment during peacetime in the year before the fighting, the authors
are able to estimate a war-specific relative risk for tuberculosis mortality
of 3.1 (95% confidence interval, 1.20-8.12). In other words, patients with
tuberculosis whose treatment was disrupted because of war were 3 times as
likely to die as those who were fully treated in peacetime.
Waldman RJ. Public Health in Times of War and FamineWhat Can Be Done? What Should Be Done?. JAMA. 2001;286(5):588-590. doi:10.1001/jama.286.5.588