Letter From America

The millions condemned to war without end


Memorial Day, and I am with my son and his American wife and two darling granddaughters as we line the streets with neighbours and friends – armed with picnic baskets and waving Stars ‘n’ Stripes – to watch the Big Parade honouring America’s fallen soldiers – 7,000 troops and 8,000 private contractors since 9/11.

What are cited as ‘indirect deaths’ are deaths caused not by violence but by consequent, ensuing economic collapse, loss of livelihoods, malnourishment, destruction of health services, and continuing mental health problems, and domestic and sexual abuse and displacement.

Released here on Memorial Day, anthropologist Stephanie Savell’s report, How Death Outlives War: The Reverberating Impact of the Post-9/11 Wars on Human Health, focuses on what she terms those ‘indirect deaths’ – which, taken onboard, sees the number of deaths as a result of post-9/11 ‘war on terror’ in Afghanistan, Pakistan, Iraq, Syria, Yemen, Libya and Somalia rise dramatically from an upper estimate of 937,000 to at least 4.5 million, of which up to 3.6 million were ‘indirect deaths’. Such deaths continue to escalate.

In Afghanistan, where the war ignited by the 2001 US-led invasion ended in 2021, the indirect death toll and related health problems are still rising.

“A reasonable, conservative average estimate for any contemporary conflict is a ratio of four indirect deaths for every one direct death,” says Ms Savell, an American who researches societies and people in the wake of America’s ‘war on terror’.

The poorer the population, the higher the indirect mortality when conflict erupts. “Indirect deaths are devastating, not least because so many could be prevented, were it not for war,” she says. Generally, men are more likely to die in combat, whereas women and children are disproportionately affected indirectly.

Ms Savell does not attempt to apportion blame between various perpetrators, although the US, which launched the global ‘war on terror’ in 2001, bears heavy responsibility. She concedes that establishing definitive figures for war deaths of any kind is problematic and politically divisive. Using the best available sources and data, her aim, she says, is to expand awareness of the fuller human costs of these wars and support calls for governments to alleviate ongoing harm and devastation.

“The mental health effects of war reverberate through generations, impacting on parents and children, and then their children after that. Anxiety and depression are two to four times greater among conflict-affected populations than the global average,” she says. “Women tend to suffer more acutely due to gender-based violence, which is heightened in wartime. In Iraq, rape and sexual violence increased sharply after 2003 [when the US and UK invaded]. Children are also particularly vulnerable. Those who experience high levels of collective violence are twice as likely to develop chronic diseases.”

High incidences of child malnutrition show the scale of war-related damage. “More than 7.6 million children under five are suffering from acute malnutrition, or wasting, in Afghanistan, Iraq, Syria, Yemen, and Somalia,” the report says. ‘Wasting’ means not getting enough food, literally wasting to skin and bones, putting these children at greater risk of death.

In Afghanistan specifically, where the economy has collapsed after the Taliban takeover in 2021, more than half the population now lives in extreme poverty. Tens of thousands of children under five are dying of preventable diseases such as cholera and measles, of acute malnutrition and neonatal complications.

“As much as anyone killed by an airstrike or a gunshot wound, their deaths must be counted among the costs of war,” Ms Savell says.

This no-holds-barred examination of war’s long-term lethal impacts is, literally, shocking to read. In many conflict zones, deliberate attacks on healthcare facilities are a favoured tactic. Both direct and indirect deaths result. At one point in Syria’s civil war, “each attack on a healthcare facility corresponded to an estimated 260 reported civilian casualties in the same month” because of the lack of medical aid.

Displacement is another big cause of indirect deaths, caused by physical insecurity, heightened mental stress, and abuse, exploitation and indifference suffered during attempted flights to safety – some, notably Syrians and Somalians, to Ireland.

An estimated 38 million people have been displaced since 2001.

Those who have died are beyond help. But for millions of adults and children still suffering the consequences of the post-9/11 conflicts, they are seemingly condemned to war without end.

A harrowing fact to which my two baby granddaughters are oblivious, as they watch the last float of the Memorial parade pass by, eagerly waiving their flags.

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