At the end of 2017, threats to both the physical and political environment can appear somewhat overwhelming. We would nevertheless like to wish all our readers a happy and peaceful 2018 and highlight both some encouraging signs that peace is possible, and some inspiring work aimed at preventing and mitigating the devastating health consequences of conflict.
The award of the Nobel Peace Prize to the International Campaign for the Abolition of Nuclear Weapons (ICAN) was a bright light at the end of the year, and extracts from the speeches are published in this issue. When Beatrice Fihn, the Executive Director of ICAN, said in her acceptance speech: ‘The only rational course of action is to cease living under the conditions where our mutual destruction is only one impulsive tantrum away’ she reflected the view of members of ICAN’s 468 partner organisations. In 2017, Neil Arya’s article Renewing the Call for Public Health Advocacy against Nuclear Weapons (MCS 33.2) highlighted the role of health professionals in the drive for abolition, and the review of A Safer World (MCS 33.3) drew attention to Medact’s report on the urgent need for a change in UK nuclear policy. In 2018 it will be essential to continue to highlight the devastating humanitarian consequences of these weapons, which in a rational world should convince states to abandon them.
While longer term solutions are sought to global injustice and inequities those providing humanitarian assistance during violent conflict continue to work to recognize all the rights of vulnerable populations. Martin Schneider’s article in this issue What do humanitarian emergency organisations do about palliative care? A systematic review reflects an increasing awareness among humanitarian actors that palliative care needs to be incorporated into their assistance, but concludes that there is an urgent need for ‘More emphasis on sharing experiences’ and more research which ‘could accelerate a broader integration of palliative care into humanitarian programmes’.
As of June 2017, UNHCR estimated that 65.6 million people had been forcibly displaced worldwide (approximately 20 people every minute),Footnote1 of which 22.5 million were refugees. The review article by Hoare, Vidgen and Roberts In their own words: A synthesis of the qualitative research on the experiences of adults seeking asylum. A systematic review of qualitative findings in forced migration provides insight into those seeking asylum in the UK. Finding few studies on the subjective experiences of asylum seekers as a specific group, they identify key issues for asylum seekers that warrant further research, and evidence of the need for more targeted mental health services.
Articles in this journal have consistently emphasized that peace is far more than an absence of war, and drawn attention to the devastating effects of structural violence as well a violent conflict. Izzeldin Abuelaish and Kirstie Russell’s commentary on The Flint Water Contamination Crisis: The Corrosion of Positive Peace & Human Decency in this issue describes with passion the damage caused to children’s health and futures, as well as to community trust, when saving money was given priority over health and justice. It also provides an example of the impact health professionals can make if they stand up against injustice and discrimination.
MCS has always welcomed articles on the training of health professionals, and how this has the potential to contribute to the role they can play in conflict prevention and advocacy. Mishori, Kureshi and Ferdowsian’s commentary War Games: Using an Online Game to Teach Medical Students About Survival During Conflict is a fascinating attempt to evaluate the potential of game-based learning to enhance students’ understanding of what people experience in war, and increase the empathy and identification they feel for those caught up in conflict. It is a timely reminder of the huge potential – but also the possible pitfalls – of this type of learning.
The natural tendency is to look forward, but memory is also learning and there are many who deserve to be remembered. This issue contains the first article in what we hope will be a regular ‘Lest we forget’ slot. Written by Leo van Bergen, it covers the life and times of Dr Georg Friedrich Nicolai, a doctor who stood up for peace in Germany, at great personal cost, before and during the First World War.
Every year the Holdstock-Piachaud Student Essay Prize encourages students to explore the themes covered by MCS, and is awarded in memory of Douglas Holdstock and Jack Piachaud who were for many years inspirational editors of the journal. In 2017, there were two winners: Nicholas Heng and Anna Nakamura. Nicholas Heng’s essay on Tackling the health impacts of climate change in the 21st century appears in this issue; Anna Nakamura’s essay will appear in the next.
We consider ourselves lucky to have the opportunity to be co-editors of Medicine, Conflict and Survival, and are very grateful to Simon and Maria for a detailed – and continuing – handover, and for leaving the journal in such good health. We very much appreciate having a large editorial board which enhances the reputation of the journal and provides day-to-day support, including Neil Arya who has joined Vic Sidel as editorial consultant and Michael Pountney, chair of the editorial board and book review editor.
We now have a Facebook page https://www.facebook.com/MedicneConflictSurvival (the missing ‘i’ is correct!) We are aware that Facebook is now meant to be bad for your mental and social health, at least according to some of those who got enormously rich by developing it, but would really appreciate it if you could ‘like’ and share the page to increase the visibility of the journal. We very much look forward to receiving anything you would like to post on it – please send it to [email protected].
Leo van Bergen
Marion Birch
[email protected]
Co-editors