Ask an Expert: Exploring the Collective Trauma of War with Cari Jo Clark | Rollins School of Public Health | Emory University

The public health impacts of armed conflict and war have immediate, visible consequences for entire populations and long-term health effects that extend across generations. The humanitarian crises in Gaza, Yemen, Sudan, Somalia, the Democratic Republic of Congo and other countries are vivid examples of this.

In addition to the direct physical harm caused by fighting and bombing, there are also associated health consequences caused or exacerbated by war, including:

• Spread of infectious diseases
• Increase in sexual and domestic violence
• The lack of basic medical care due to damaged or destroyed health infrastructure
• Limited or no access to clean water and sanitation
• Hunger and malnutrition
• Environmental impact
• Deterioration of mental health

Cari Jo Clark, ScD, associate professor of global health, has spent much of her career working in developing countries and humanitarian zones affected by war. Her area of ​​interest focuses heavily on understanding the factors that influence women’s risk of violence in the setting of natural and man-made disasters.

“Even in times of war, women continue to be victims of domestic violence in most conflicts,” says Clark. “In most cases, it is a continuation or exacerbation of what was already happening before. And then the conflict context simply changes the dynamic and increases the risks for women.”

“If you want to reduce the risk of violence for women, it’s very simple. The answer lies in politics and patriarchy. There are people at the top who can dramatically change women’s lives by making tough decisions.” But it’s not a high enough political priority.

Here she shares her insights into the human costs of war from the perspective of research and her personal experiences working with refugees and people living in solitary confinement.

Tell me about the impact of conflict and containment on intimate partner violence.

We saw during COVID how difficult it was for victims of domestic violence to get out and get help. There was more stress and financial uncertainty, mobility restrictions, which made it harder to defuse or de-escalate tense situations, so escalation was more likely.

Domestic violence is also more common in conflict situations and is due to a variety of factors, including stress, insecurity, the proliferation of weapons, the militarisation of everyday behaviour and at least temporary normative changes that may challenge existing gender roles, obligations and opportunities.

As you observe what is currently happening to people in Gaza and other active conflict areas, what do you see as the greatest threats to health?

In Gaza, the entire health infrastructure has been destroyed. Conflict does not only have short-term impacts on people, communities, livelihoods and the health system. In cases like Gaza, it is decades of damage and collective trauma on both sides that has shattered everyone’s sense of security and well-being. The human, social and physical infrastructure of communities is being destroyed.

What does research tell us about how war and violence affect the concept of masculinity in different societies?

There have been some really interesting studies in Gaza and the West Bank looking at the impact of war on women’s bodies. You could see the role of women changing quite dramatically. This kind of role change in the household led to some men feeling emasculated and questioning their self-image and their understanding of what it means to be a man. When you think about the social consequences of war, in addition to the proliferation of firearms and weapons, there are these competing challenges of this kind of militarized hypermasculinity and emasculation.

What impact does this have on young boys who witness extreme violence or grow up in the midst of conflict?

In the West Bank, it is traumatic to be repeatedly humiliated and treated like a terrorist. Being forced to pass through checkpoints just to get to school or the grocery store as a child, or having to get family permission to visit relatives elsewhere, is a severe psychological burden. These children grow up under enormous stress. Children in Gaza are living with one trauma after another, and we know that these circumstances dramatically increase the risk of mental, behavioral and physical health risks. They are trapped in an unsafe place and cannot get out.