In March 2018, Dr. Erin Smith had the opportunity to interview a long-time friend of WADEM, Professor Frederick “Skip” Burkle, Jr. for the Psychosocial Special Interest Group (SIG). Prof. Burkle is a world-renowned expert in post-conflict health, and he generously shared his unique experience and insight regarding the long-term psychosocial impact of conflict and war. Throughout the interview, Skip reflects on the perplexing nature of war-related psychological problems, highlighting that this challenge is unlike any other faced in healthcare today.
Nothing has been more complex and contentious, he argues, than the debate over the existence and impact of war on the development of post-traumatic stress disorder (PTSD). Prof. Burkle describes the problems there are in defining the nature of and response to psychological events, witnessed in both the military and civilian war-related populations, which have not led to consensus in either cause or response. He believes that the subject is important enough to recommend that the Psychosocial SIG consider it a priority issue suitable for further study that may lead to educational and operational recommendations and competencies, especially as the WADEM membership become more involved in mental health decisions impacting war, armed conflicts, and refugee populations.
Prof. Burkle notes that the nature of war has changed, not for the better. He predicts that psychological issues, especially among civilians, will escalate. The combination of the marked diversity of conflicts, numerous parties in conflict, prolonged urban warfare, denial of applicability, political will, and politicalization of protections under international humanitarian law (IHL) have increased since 2003. This has resulted in unprecedented “disproportionate attacks” or so-called “violations of proportionality,” causing loss of civilian life, injury to civilians, damage to property, or a combination thereof, which would be excessive in relation to the concrete and direct military advantage anticipated. The total destruction by the Syrian government of east Aleppo and Western-based bombing campaigns that flattened Raqqa have been condemned by the UN as violations of proportionality, risking a collapse of efforts to increase respect for IHL and to regulate the behavior of the parties to conflicts.
The June issue (Volume 33, Issue 3) of Prehospital and Disaster Medicine (PDM) is now available through Cambridge Core. This issue features articles on needle thoracostomy, behavioral concerns resulting from the Flint water crisis (Michigan, USA), electronic versus manual MCI triage, as well as three papers by Dr. Mark Keim on defining, assessing, and managing disaster-related health risk. These are in addition to 12 other articles appearing in June’s issue.
WADEM members have unlimited access to every issue of PDM through Cambridge Core. Check back often for the most recent content in disaster and emergency health!
Please log into the website and click on the PDM graphic or link to be directed to PDM’s webpage on Cambridge Core. Click on the “Latest Issue” tab to view 33:3.