Civilian deaths from weapons used in the Syrian conflict

Abstract

The ongoing Syrian conflict is one of the largest humanitarian crises of the 21st century so far. Debarati Guha-Sapir and colleagues analyse the impact of weapons on civilian deaths, with a focus on women and children What started as a peaceful uprising in Syria in March 2011 escalated quickly to an armed conflict. By 2012 conflict had become the leading cause of death of Syrians. 1 Health systems have been reshaped, now being separated into areas controlled by the government, the opposition, or self proclaimed Islamic State factions-we group the last two as non-state armed groups (NSAG; fig 1⇓). These areas differ vastly in terms of service delivery capacity, number of trained staff, and access to essential medicines. 2 Indirect conflict related deaths have arisen from poor sanitation and severe disruption to Syria's healthcare system. [3][4][5] In December 2014, 20% of Syria's public hospitals were completely non-functional, and another 35% provided only partial services.4 Direct conflict related deaths are those that are caused by weapons and other violent methods used in warfare.In this article we assess the direct conflict related deaths (hereafter termed violent deaths) of women and children among civilians killed in the Syrian conflict, because they are identified as vulnerable populations in public health and under specific laws of war such as the Geneva Conventions. 6-9 War related deaths in SyriaViolent deaths have been considerable in Syria. A report commissioned by the United Nations found that from March 2011 to April 2014 over 191 369 verifiable violent deaths of individuals had occurred, including both combatants and civilians. Individuals were identified by their name and the date and location of their death, thus representing the minimum number of violent deaths from the Syrian conflict at the time. 10Population surveys can provide estimates of overall deaths and excess fatalities in a war. [11][12][13][14] But epidemiological analyses of war deaths from specific weapon types have been hampered by small sample sizes and uncertainties that limit their usefulness. Associations between weapon types and victim characteristics in armed civil conflicts are not well understood and are rarely studied.15 16 Individual records of violent deaths and their causes are difficult to obtain from death registration systems as they progressively lose functionality or become unreliable in conflict.11 The VDC considers any member of any NSAG or of the Syrian Army to be a non-civilian. 20We used VDC data to examine 78 769 civilian violent deaths that occurred in Syria from 18 March 2011 to 21 January 2015 for associations between weapon types and demographic groups. Of these deaths, 77 646 were in NSAG controlled areas and 1123 in government controlled areas (see appendix A on thebmj.com for a full description of our methods). Although the majority of deaths were of men, nearly 25% of Syrian civilians killed were women and children (see tables B1 and B2 in appendix on thebmj.com). Trends and patterns in weapon rela...

Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet –American University of Beirut Commission on Syria

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Documenting deaths in the Syrian war

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