Public health, epidemiology and war

The delivery of humanitarian aid in wartime is difficult. However it is essential that aid is provided in the most effective manner possible, targeted on those most in need whilst minimizing waste. Furthermore the delivery of aid should be sensitive to the future needs of the communities in conflict. This requires information on the needs of the vulnerable population. There is little experience of collecting data on the impact of war on a civilian population. The war in Bosnia disrupted surveillance of communicable disease. The local authorities were assisted by the World Health Organization in re-establishing surveillance. The data generated was valuable in planning interventions to minimise the possibility of major outbreaks of infection, reduce the impact of infectious disease and in guiding the humanitarian aid effort. The experience described suggests that public health surveillance of the civilian population in wartime is possible and useful. Besides the need for planning, the public health doctor in wartime has a role as an advocate for those suffering; this function can be carried out much more effectively if it is based on objective data collection rather than hearsay.