Faheem Ahmed  ( Department of Community Medicine, Baqai Medical University, Karachi. )
Nighat Nisar  ( Department of Community Medicine, Dow University of Health Sciences, Karachi. )

Madam, Environmental health is an important component of any major undertaking. It requires an understanding of the complex relation between people and their physical, social and work environment and its effects on human health. In many cases, the issues are highly technical and require expert scientific, engineering, and medical or laboratory assistance.¹ However, one of the major human undertaking for better or worse, is conflict and environmental health is no less than other components a major consideration to look at the affected society and the effect of conflict on the environmental health infrastructure.² The World Health Organization has defined environmental health to comprise those aspects of human health and disease that are determined by factors in the environment. It also refers to the theory and practice of assessing and controlling factors in the environment that can potentially affect health. But during conflict, measures to prevent diseases become a much more difficult task because of the multiple disruptions to environment and infrastructure, the release of toxic materials and the mass migration of populations.³ On the other side, environmental health services are provided protection under law but modern war claims the lives of more civilians than military personnel and is more disruptive of civilian populations than it is of military. The social dislocations and displacement; overcrowding and disruption of public health programmes, interferes with diseases eradication, vaccination campaigns, disruption of public/ environmental health infrastructures and breakdown of sanitary systems.⁴ Destruction of infrastructures providing water, food, fuel and sanitation are not widely acknowledged as a violation of human rights and are often not seen as environmental health concerns. Finally, indirect health related effects are no clean water, no sewage disposal, or destroyed electrical power generation and transmission capacity in all areas. This can lead to the rapid epidemic spread of water borne infectious diseases, diarrhoea, typhoid fever, cholera, destroyed civilian communication networks, and immobilized civilian communication with ministry of health. The consequences are increased mortality of civilians- especially infants and children.⁵

It is imperative that civil defence include in its planning for conflict an appreciation of and contingency plans for environmental health services. These must be properly integrated into disaster and defence planning systems. Therefore, it is suggested that there must be proper integration, properly prepared plans and identified resources and personnel if the health consequences of conflict are to be minimized.

1. Foreign Policy: The Global War for Public health. 2002 Issue 128; pp 24.
2. Iacopino V, Waldaman RJ. War and Health from Solferino to Kosovo - the evolving role of physicians.. JAMA 1999; 282: 479-81.
3. Levy, Barry S, Sidel VW, eds. War and Public Health. Washington DC: American Public Health Association, 2000.
4. Report of Graca Machel, Expert of the Secretary-General of the United Nation. An agenda for Peace, 1995. Available from URL: http://onlinebooks.library.upenn.edu/webbin/book/lookupid?key=olbp22702. Accessed 15 November 2008.
5. Murray CJ, King G, Lopez AD, Tomijima N, Krug EG. Armed Conflict as a Public Health Problem. Br Med J 2002; 324:346-9.