Sir: The global trend towards civil wars (report, 14 June) presents particular problems for agencies such as ours, which attempt to provide emergency relief for the victims.
As wars become internal rather than international, the human cost shifts from soldiers to civilians. Victory depends on control of the populace as much as on defeat of an opposing army. In this kind of war, entire social groups are targeted for intimidation, evacuation or extermination. Bosnia, Rwanda and Sierra Leone are hideous examples.
The civilian victims cannot claim protection from their own divided nation or from the international community which is not mandated to assist in a country's internal affairs. As members of persecuted groups, their ability to rebuild their lives after the war has ended is reduced.
Our experience in emergency medical programmes around the the world has shown that civil war has a devastating effect on individuals' ability to resist disease both physically and psychologically. Families are broken up and children abandoned. Infant mortality rates soar, epidemics breed among overcrowded, underfed, displaced people. This is in addition to direct injuries from landmines, shelling, indiscriminate fire and the rest.
The number of people displaced within their own country now far exceeds the number of refugees who have fled to other countries. In 1995 there were 15 million refugees worldwide, but 21 million internally displaced people (IDPs). Experts expect the number of refugees to fall, while the number of IDPs could double by the year 2000.
Medical Emergency Relief International
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