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August 4, 1993

Effective Humanitarian AidOur Only Hope for Intervention in Civil War

Author Affiliations

From Health Volunteers Overseas, Washington, DC (Dr Cobey); the Department of JAMA Programs and International Activities, Scientific Publications Group, American Medical Association, Chicago, Ill (Ms Flanagin); and the Task Force for Child Survival and Development, the Carter Center, Atlanta, Ga (Dr Foege).

JAMA. 1993;270(5):632-634. doi:10.1001/jama.1993.03510050098037

Despite the dissolution of the Soviet Union and other totalitarian regimes, the world has yet to see a "peace dividend." Instead of two superpowers competing for sole possession of the best economic and political system, we now see numerous ethnic groups trying to found nations, define separate identities, and vent long-standing resentments. These seemingly sudden and unprecedented conflicts have centuries-old historical roots.1

Today, of approximately 130 armed conflicts in the world, 32 have each produced more than 1000 battlefield deaths, the majority occurring within the boundaries of individual countries. Since World War II, the number of civilian deaths has surpassed military fatalities in most wars and conflicts.2 In Cambodia, for example, half the land mine casualties in 1991 were civilian.3 The International Human Rights Law Institute of DePaul University, Chicago, Ill, estimates that there have been 140 000 to 150 000 war fatalities in the former Yugoslavia