Complex political emergencies

摘要

Aute disasters attract international media and political attention-and often funds to support a response. However, if hundreds of thousands of people, or even millions, die over several years because of prolonged conflict this may go almost unnoticed. A recent survey in eastern Congo revealed an excess mortality of 2.5 million people in only 32 months. Of these deaths 350 000 were because of direct violence; most died from malnutrition and disease. The death toll in longstanding and continuing conflicts in Sudan, Angola, Burma, and Sierra Leone has been similarly massive. These too often forgotten crises are complex political emergencies, a term that underlines the political nature of these internal wars, with their complex origins and multiplicity of players. Complex political emergencies are not isolated events but linked with globalisation, foreign policies, and, as Stewart emphasises in this issue, economic interests (p 342). Conflict in the Congo, for example, has been associated with struggles over access and control of coltan, a metallic ore which is an essential component of mobile phones. But although prolonged war may be profitable for some people, most suffer from widespread violence; forced migration; human rights violations; and administrative, economic, social, and political collapse. Health services invariably deteriorate and are less and less capable of addressing increased health needs.