SUBSCRIBE TO OUR FREE NEWSLETTER
Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
5
#000000
#FFFFFF
5
#000000
#FFFFFF
cholera
War Makes the World Sick... Literally
The body of a single child, wasting away from the lack of the basic fluid that runs in my sink or yours, best captures the way war casualties ripple across time and populations.
Jul 09, 2025
War kills in so many ways. These days, Americans are bombarded with images from Gaza and elsewhere of people or broken bodies being ferried on stretchers from the rubble of homes and hospitals, by rescue workers whose thin bodies and stricken faces suggest they are barely better off than those they’re helping. Social media and journalists make us eyewitnesses to emaciated children too weak to cry. And yet, compared with air raids that crush and bloody instantaneously, a slower disaster, more difficult to capture (especially given our made-for-TikTok attention spans), consists of the hours that many people in war zones spend wasting away from infectious diseases of one sort or another.
Let me count a few of the ways.
In Iraq in 2004, three-month-old Ali tries to cry but he’s too weak to make a sound, since his body has been ravaged by diarrhea. Between 2003 and 2007, half of Iraq’s 18,000 doctors left the country due to the deteriorating security situation (with few intending to return). Health facilities had also been bombed out and destroyed. By then, about two-thirds of the deaths of children under the age of five, like Ali, were due to respiratory infections and diarrhea compounded by malnutrition.
Consider what it would do if someone you loved perished because they were born in the wrong place at the wrong time in the storm of war that destroys infrastructure so central to our lives that normally we barely even notice its presence.
In Pakistan in 2017, one of a handful of countries that has yet to eliminate the polio virus, the father of a five-year-old boy is inconsolable when he learns that his son will never walk on his own again. Among displaced people in the Afghan-Pakistani border region where they lived, concerns about counterinsurgency air raids from U.S. and later Pakistani government and opposition forces, security threats toward vaccination teams in conflict-torn parts of that country, and suspicions among parents like that boy’s father that health workers had been sent by the U.S. government to sterilize Pakistani children, all prevented kids from getting the immunizations that they needed.
In Burkina Faso in 2019, three-year-old Abdoulaye dies after contracting malaria while in a shelter for people internally displaced by violence between government forces and Islamic militias. Malnourished and anemic, without direct access to a health clinic, he succumbs to a treatable illness.
In Fayetteville, North Carolina in 2020, as in other military towns across the U.S., rates of sexually transmitted infections like syphilis, herpes simplex, and HIV are among the highest in the country. Bases tend to drive up poverty among civilians by making the surrounding populations dependent on low-wage service work. And stressed-out, war-traumatized American soldiers are more likely to engage in risky sexual behavior that spreads disease among the broader population.
In Ukraine in 2023, a soldier treated for severe burns dies of sepsis, despite being given multiple antibiotics. Doctors found klebsiella, a multi-drug-resistant pathogen, in his body. Despite successful efforts by the Ukrainian government to curb antimicrobial resistance in its population prior to Russia’s 2022 invasion, mounting casualties, along with shortages of supplies and personnel, mean that Ukrainian health workers now try to do whatever they can to keep soldiers alive. In the long term, antibiotic-resistant infections traceable to Ukrainian patients are already beginning to appear in places as distant as Japan.
In May 2025 in the Gaza strip, four-month-old Jenan dies from chronic diarrhea after losing half her bodyweight. She needed hypoallergenic milk formula, but aerial bombardments and blockades of basic food and medical supplies have made that once common product scarce. As anthropologist Sophia Stamatopoulou-Robbins points out, prior to the start of the war between Israel and Hamas in October 2023, cases of diarrhea in young children there averaged about 2,000 per month. In April of the following year, however, such cases already numbered more than 100,000. Likewise, in the decade before the war, there were no large-scale epidemics in Gaza. In just the first seven months of that conflict, however, overcrowding in makeshift shelters, nutritional deficits, shortages of hygiene products—only 1 in every 3 Gazans has soap!—and contaminated water have led to new outbreaks of infectious diseases like measles, cholera, typhoid, and polio, exacerbated by widespread starvation.
At some level, it couldn’t be simpler. War destroys all too many of the modern amenities that make life possible. Preventable illness and death occur even in industrialized settings that are marked by inequality, lack of information, psychological trauma, or just the chaos of combat that hinders long-term thinking. In poor- and middle-income countries like Yemen, Syria, and Nigeria, infectious diseases were already among the top causes of death, even before the outbreak of significant conflicts. Their incidence, however, grew so much worse in wartime, especially among civilians who didn’t have the same access to doctors and medical hospitals as armed groups.
The body of a single child, wasting away from the lack of the basic fluid that runs in my sink or yours, best captures the way war casualties ripple across time and populations. For every soldier who dies in battle, exponentially more people suffer deaths from malnutrition, disease, or trauma-related violence even after battles end. Preventable infections play a large role in this story.
The War on Children
Children are particularly vulnerable to sickness and death in armed conflicts because of their immature immune systems, greater nutritional needs, tendency to succumb more easily to dehydration, and reliance on families who may not even be around to care for them. A study of more than 15,000 armed-conflict events in 35 African countries found that children aged 10 or younger were far more likely to die if they lived within 100 kilometers of a battle zone than they would have in earlier periods of peacetime. Increases in mortality ranged from 3% to about 27%, varying with how many people also died in nearby battles. Strikingly, many more babies under the age of one died annually in the eight years following a conflict’s end than while the battles were going on—infectious disease being a primary killer.
Take Yemen as an example of how war may affect young children and their families over time. Since the start of that country’s civil war in 2015, cholera, a waterborne illness doctors have known how to prevent since 1954, has ravaged the most vulnerable members of that country’s population, particularly children, due to a lack of appropriate sanitation or reasonable access to healthcare. As of December 2017, more than a million people had contracted the disease, nearly half of them children, and more than 2,000 had died of the illness. Compare that to the more than 10,000 Yemenis estimated to have died in direct combat by that time, and you get an idea of how significantly death by illness counts among the casualties of war.
Nearly a decade later, in fact, there are hundreds of thousands of new cases of that illness in Yemen each year and hundreds of annual deaths, making up more than a third of all cases globally. When Rami discovered that his daughters, aged 10 and 7, had cholera, he managed to scrape together the equivalent of about $15 to travel to a clinic so that the family could get lifesaving fluids and information to prevent further cases. Many families like his, however, can’t afford such treatment, forcing all too many of them to delay care or even experience the unthinkable: losing a child.
Consider what it would do if someone you loved perished because they were born in the wrong place at the wrong time in the storm of war that destroys infrastructure so central to our lives that normally we barely even notice its presence. I hope it’s an experience that neither you nor I ever have.
War and Displacement
Still, I think about such things every day, as I bet do many of my colleagues connected to the Costs of War Project. When we first launched that project in 2011, Professors Catherine Lutz, Neta Crawford, and I met with experts in armed conflict to discuss how we would cover the issue of war’s health impacts. Repeatedly, they reminded us of how hard it is to talk about war and health without understanding what it’s like for families to be forced to leave their homes in search of safety.
Unsurprisingly, refugees and internally displaced people (IDPs) are uniquely vulnerable to disease and illness. Anyone who has gotten sick while traveling knows that the challenges of getting care are compounded by a lack of knowledge of the community you find yourself in. In the case of today’s more than 122 million war refugees or displaced people, stigma and harassment are frequent travel companions. According to one meta-analysis, more than one-fifth of refugee and IDP women have experienced some form of sexual violence while living in displacement settings. A study of more than 500 immigrants and refugees in Italy found that nearly half experienced physical violence, sexual abuse, harassment, or workplace discrimination.
How did we get to a time when our leaders seem loath to invest in healthcare and don’t even hide their disdain for poor people, a significant number of whom are military personnel and veterans?
The stories that extremist politicians tell about migrants—think of President Donald Trump’s tall tale of supposedly dog- and cat-eating Haitians in Springfield, Ohio—distract us from the social problems such politicians seem unwilling to deal with like loneliness and poverty. Displaced persons lack political clout and voting power in places that host them and, in actual war zones, fighters rarely respect shelters and camps designated for their survival.
For people who flee their homes, the basic boring stuff is lacking, too. Only 35% of refugees have clean drinking water where they live, while less than a fifth of them have access to toilets. Imagine how that would affect all of the higher-order things you value in your life, including gatherings with people you care about, if you couldn’t even find a decent place to wash your hands or brush your teeth!
Most of all, what stands out to me as both a social worker and a scholar of war is how people forced to leave their communities end up losing connections to health providers they trust. I can’t tell you how many individuals I’ve met in clinical and humanitarian settings who had declined to seek care for Covid-19, pneumonia, severe flu symptoms, and other illnesses because they lacked confidence that professionals in their host communities had their best interests at heart.
My Government’s Assault on Public Health
As Republicans in Congress passed a bill that would deprive millions of Americans of health insurance in the near term, as high-level officials spread disinformation about vaccines for once-eradicated illnesses like measles, and as public health workers and officials face threats of violence, all too many poor Americans are starting to experience the sorts of obstacles to healthcare common in war zones.
Meanwhile, with the Trump administration’s decisions earlier this year to fire at least 2,000 U.S. Agency for International Development workers and freeze foreign aid dollars used (in part) to treat and monitor infectious diseases elsewhere on this planet, the threat that a foreign pandemic might make it to this country has grown considerably.
To quote Senator Joni Ernst (R-Iowa) at a recent town hall with constituents worried about losing healthcare, “We are all going to die.” While that is indeed so, it also matters how. A long life with access to basic services like immunizations and clean water is one of the differences between dying like a human being and dying like one of the wild animals I find in my rural area, infected by bacteria in the water or exhausted from heat exposure.
How, I wonder, did we Americans reach a place where many of us are silent or supportive of a strongman’s $45 million birthday military parade that closed roads to residents and commuters for days? How did we get to a time when our leaders seem loath to invest in healthcare and don’t even hide their disdain for poor people, a significant number of whom are military personnel and veterans?
I’m not sure I know what this country stands for anymore. I don’t know about you, but these days America sometimes feels to me like a treacherous foreign land.
Keep ReadingShow Less
'We Cannot Allow This to Happen Again': Israeli War on Lebanon Sparks Cholera Resurgence
"We have already seen in Gaza how the lethal combination of mass displacement, attacks on healthcare, and lack of nutritious food and water can impact children's lives," said Save the Children's Lebanon director.
Oct 23, 2024
Israel's invasion and intense bombardment of Lebanon—including recent attacks on hospitals and other medical infrastructure—have sparked a potentially catastrophic health crisis in the country, with cholera and other diseases spreading among the more than a million people who have been displaced over the past month.
Last week, the World Health Organization (WHO) announced that it was working to stem the spread of cholera after Lebanon's health ministry confirmed the country's first known case of the bacterial disease since a deadly outbreak that began in October 2022.
Particularly vulnerable to the worsening public health crisis are the hundreds of thousands of children who have been displaced by Israel's bombing and ground attacks. The United Nations Children's Fund stressed that cholera is a severe threat to kids under the age of 5, the unvaccinated, and those suffering from malnutrition.
The humanitarian group Save the Children said Tuesday that "over 400,000 children forced from their homes by the escalating conflict in Lebanon are at risk of skin diseases, cholera, and other waterborne diseases due to overcrowded, basic conditions in collective shelters and a lack of water and sanitation facilities."
Kamal Nasser El Deen, Save the Children Lebanon's emergency response coordinator, said Wednesday that he has been in "multiple" shelters in which families were forced to wait in long lines to access bathrooms.
"The facilities are inadequate for the number of people, and to make matters worse, the water supply is inconsistent," he continued. "This lack of clean, reliable water creates a significant risk for waterborne diseases. It's heartbreaking to know that these children, already displaced and vulnerable, face the additional threat of illness simply because basic needs like sanitation and clean water aren't being met."
"The international community must act now to prevent a humanitarian catastrophe and exert pressure for an immediate cease-fire."
Jennifer Moorehead, Save the Children's country director in Lebanon, likened the intensifying health crisis to the dire conditions in Gaza, which the U.S.-armed Israeli military has decimated with more than a year of relentless bombings and ground attacks, obliterating the enclave's healthcare system and causing the reemergence of polio. Experts have also warned of a looming cholera outbreak in Gaza.
"Thousands of vulnerable children are now unprotected and with winter just round the corner and temperatures dropping, they will become even more susceptible to diseases such as measles, meningitis, and hepatitis A," Moorehead said of the Lebanon crisis. "We have already seen in Gaza how the lethal combination of mass displacement, attacks on healthcare, and lack of nutritious food and water can impact children's lives. We cannot allow this to happen again. The international community must act now to prevent a humanitarian catastrophe and exert pressure for an immediate cease-fire."
Save the Children's warning came as rescue teams searched the rubble for survivors in the aftermath of an Israeli airstrike that hit across the street from Beirut's main public hospital earlier this week, killing at least 18 people including four children.
"Hussein al-Ali, a nurse who was there when the attack happened, said it took him a few minutes to realize it was not the hospital that was hit. Dust and smoke covered the hospital lobby," The Associated Press reported Tuesday. "The glass in the dialysis unit, the pharmacy, and other rooms in the hospital was shattered. The false roof fell over his and his colleagues' heads."
Some hospitals and clinics operated by humanitarian groups have been forced to shut down due to Israel's military campaign. The New York Times noted that facilities that have not been damaged by Israeli bombings "have been abandoned after staff fled, fearing for their safety."
"The ones that remain operational say they are quickly running out of beds as patients evacuated from other facilities are brought in," the newspaper added.
The WHO said last week that it had verified nearly two dozen attacks on healthcare in Lebanon since mid-September. Those attacks killed at least 72 patients and healthcare workers, according to the U.N. body.
Volker Türk, the U.N. high commissioner for human rights, said Tuesday that he was "appalled" by Israel's strike near Beirut's public hospital.
"Hospitals, ambulances, and medical personnel are specifically protected under international humanitarian law because of their lifesaving function for the wounded and the sick," said Türk. "When conducting military operations in the vicinity of hospitals, parties to the conflict must assess the expected impact on healthcare services in relation to the principles of proportionality and precautions. Any incidents which affect hospitals must be subjected to a prompt and thorough investigation."
"I repeat the U.N.'s call for an immediate cessation to hostilities," he added, "and remind all parties that the protection of civilians must be the absolute top priority."
Keep ReadingShow Less
Infectious Diseases Surging in Gaza Amid Israeli Siege, Healthcare System Collapse
"The humanitarian suffering in Gaza has already reached catastrophic levels, and it's set to get worse unless something changes immediately," said one human rights official.
Nov 09, 2023
The infectious disease outbreaks that doctors on the ground, public health officials, and humanitarian groups have been warning about for weeks in Gaza appear to be in full force, the World Health Organization said Thursday as it reiterated its call for a cease-fire to save lives.
The global public health organization said authorities have reported a surge in cases of diarrhea, with more than half of those affected children under the age of 5, as Israel's decision to cut off fuel access in the blockaded enclave has shut down water desalination plants and disrupted waste collection. The circumstances have created "an environment conducive to the rapid and widespread proliferation of insects, rodents that can carry and transit diseases."
By Thursday, said the United Nations Office for the Coordination of Humanitarian Affairs, all of Gaza's 120 municipal water wells were expected to be depleted.
Health officials in the blockaded enclave, where nearly 11,000 civilians have now been killed, are also reporting nearly 9,000 cases of scabies and lice; 12,600 cases of skin rashes; more than 1,000 reports of chickenpox; and nearly 55,000 cases of upper respiratory infections as roughly 1.5 million displaced people crowd into hospitals, churches, schools, and shelters in search of safety from Israel's relentless bombardment.
The International Rescue Committee (IRC) warned that those disease outbreaks could soon give way to the spread of more deadly illnesses like cholera and typhoid due to 95% of residents' forced reliance on unsanitary water in the past month.
"The humanitarian suffering in Gaza has already reached catastrophic levels, and it's set to get worse unless something changes immediately," said Bob Kitchen, vice president of emergencies for IRC. "While the overwhelming driver of mortality remains the ongoing violence and destruction, a humanitarian ceasefire now would also serve to help aid agencies get ahead of a looming public health crisis within an already vast humanitarian crisis... The conditions are ripe for the spread of communicable and waterborne diseases—diseases that adversely affect children and lead to preventable deaths."
Al Jazeera reported earlier this month that experts have surmised Israel is intentionally leaving Palestinians in Gaza with a lack of safe drinking water, using "water access as a weapon of war" and intensifying the humanitarian catastrophe.
In overcrowded shelters run by the United Nations Relief and Works Agency, WHO said, an average of 160 people are sharing one toilet and there is only one shower for every 700 people, compounding the unsanitary conditions and raising the risk of disease outbreaks.
With aid convoys largely blocked at the Rafah crossing between Gaza and Egypt, cleaning supplies as well as medicines have no way of getting to hospitals and shelters, and water supplies that humanitarian groups have managed to get through the crossing are only 4% of what is needed.
Medical workers also don't have sufficient personal protective equipment, making it more likely that they will acquire and transmit infections to the patients they are desperately trying to care for.
The impending colder weather is raising alarm over the potential for worsening malnutrition and food shortages, particularly for more than 50,000 pregnant people and about 337,000 children under the age of 5 in Gaza.
Kitchen said groups including the IRC are working to scale up their infection control programs as quickly as they can but warned that their efforts will remain severely obstructed as long as powerful countries including the United States refuse to support calls for a cease-fire.
"Without a meaningful humanitarian cease-fire to allow the free flow of aid, the suffering of innocent Palestinian civilians will continue," said Kitchen. "Immediate and sustained diplomatic intervention is urgently needed to enable a humanitarian cease-fire, which would pave the way for addressing these pressing humanitarian and protection needs and halt the health catastrophe that will lead to more deaths, particularly among children."
WHO also reiterated its demand for "the unconditional release of all hostages [by Hamas] and a humanitarian cease-fire to prevent further death and suffering."
Keep ReadingShow Less
Most Popular