Challenge of the world order and its implications for health personnel

Non-governmental medical organizations, including amnesty international medical groups, Physicians for Human Rights, and the World Health Organisation (WHO), have for years tried to forge a link between health and peace. Undermining of the rights and dignity of people creates implication for the health of the community and for the responsibilities of its health workers.

These efforts need more fundamental support. The unfolding of a "new world order" can stimulate fresh thinking on a variety of important issues. The Global Burden of Disease Study [1] predicts war will reach the list of 10 most frequent causes of loss of disability-adjusted life-years by the year 2020. But, despite the growing number of armed conflicts throughout the world, not enough attention has been paid to the local patterns of distress and the long-term health impact and psychosocial consequences of political violence against individuals or communities [2]. It has to be emphasized that 90% of all deaths related to recent wars were among civilians [3]. Further, war has also indirect consequences including damage to the social fabric and infrastructure of the society, displacement of people, damage to the environment and fostering of a culture of violence [3]. In complex emergencies, public health activities have been shown to promote peace, prevent violence and reconcile enemies [4].

We propose the establishment of institutionalized partnerships between non-government organizations, such as those mentioned above, and individual medical societies in order to facilitate the exchange of knowledge and to recognize societies at risk for instability and violence. Every national physicians' organization should establish a position responsible for human rights – protected by political immunity, and should issue regular reports to representative international bodies. We agree most warmly with Mac Queen [5] on the unique contributions health workers can contribute to peace-making.

Finally, we should expect that the training of physicians include a serious study of ethics and human rights, as well as acquisition of the skills to deal with conflict and the therapeutic implications of trauma, both physical and mental.