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Famine and disease

Whether they are on their own or with their parents, most of the children who die in wartime have not been hit by bombs or bullets but have succumbed to starvation or sickness. In African wars, lack of food and medical services, combined with the stress of flight, have killed about 20 times more people than have armaments. One 1980 study in a war zone in Uganda attributed only 2 per cent of the deaths to violence—whereas 20 per cent were caused by disease and 78 per cent by hunger.29 And when war is combined with drought, the death toll can be enormous: in Somalia, during 1992, half or more of all the children under five on 1 January were dead by 31 December—and around 90 per cent of these died from the interaction of malnutrition and disease.30

Most such deaths arise from disruption of the normal production and distribution of food. The manipulation of food supplies has always been a significant tactic of war but has been used particularly ruthlessly of late. For example, in the early 1980s, the Ethiopian Government used scorched-earth tactics to destroy hundreds of thousands of acres of food-producing land in Tigray.31 And in Angola, the UNITA forces sowed large areas of land with anti-personnel mines to hamper food production in government-controlled areas, while mobilizing and relocating its own supporters to create food production bases. In many countries, grain stores have also been subject to attack by rebel and government forces.

War also hinders the distribution of food relief. Governments often feed their armies first, distributing to the civilian populations only the food that remains. In Somalia in the 1980s, one estimate suggested that only 12 per cent of some food aid shipments reached the people for whom they were intended.32

Not only does war interrupt the distribution of food, but it also cuts supplies of water, with particular risks in cities. The long and devastating war in Lebanon had a very damaging effect on the quantity and quality of drinking water. One 1990 study found that 66 per cent of urban water sources were contaminated and that one third of urban communities were using cesspools for sewage disposal.33 Water can also be a weapon of war. In Sarajevo, water systems have deliberately been destroyed to isolate and break down residential neighbourhoods; during the course of the war, 30 per cent of the pumping system and 60 per cent of the water mains' piping have been ruined.34

Communities at war also inevitably see attacks on their health infrastructure. In Mozambique, between 1982 and 1986, over 40 per cent of health centres were destroyed.35 Health personnel are also often scattered, or may leave the country. In Uganda between 1972 and 1985, half the doctors and 80 per cent of the pharmacists abandoned the country in search of better opportunities elsewhere.

The lack of food, clean water and adequate health care in war zones exacts a terrible toll on children. For example, it is estimated that, in the period of conflict from 1980 to 1988, Angola lost 330,000 children and Mozambique 490,000 to war-related causes.36

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