We are mired in a U.S.-led pre-emptive war against Iraq that violates international law and the UN Charter. With one exception, none of the U.S. administration protagonists has fought in a war. As one veteran recently wrote, “those who declare war should know [its price].” They should also know who pays the price. The greatest casualties of modern war are non-combatant civilians. Among civilian casualties, women and girls are deliberately targeted and grievously harmed by war.

1. Massive numbers of women civilians are killed and injured in modern warfare.

Bombs and weapons kill and maim civilian women in equal numbers with civilian men during armed conflict. Throughout the 20th century a growing percentage of those killed in war were civilians. By the 1990s, nine of ten people who died in war from direct and indirect effects were civilians. The rise in the proportion of civilian, and notably women’s and children’s deaths, in 20th century warfare is attributed to changes in war technology and war tactics, including urban warfare. High-tech war from the sky coupled with massive firepower has replaced army combat in the field; and military strategy employs so-called precision bombing to destroy civilian infrastructure such as power plants, water works, hospitals, industrial plants and communications systems, as the U.S. did in Iraq in 1991. Further, conflicts within countries have no definite battlefield, and armed fighters target civilians to kill, rape, terrorize and expel. A U.S. military sharpshooter who recently shot a civilian woman explained that he killed “the chick” because she was standing too close to the Iraqi soldier he was targeting.

As of March 30, 2003, the International Committee of the Red Cross (ICRC) reported that an average of 100 people have been killed and wounded each day in Baghdad since the war began; the majority are civilians. On April 2, 2003, The Guardian reported that a Red Crescent maternity hospital in Baghdad had been hit by US aircraft, killing several civilians and wounding at least 25, including three doctors and nurses working there. By Sunday, April 6, the ICRC reported that hospitals in Baghdad were seeing so many casualties that they could not keep count. Medical personnel were working round the clock under conditions of power outages and lack of clean water, while other medical staff could not get to the hospitals because of bombing.

2. Rape, Sexual Torture and Sexual Exploitation are Fueled by War.

A unique harm of war for women is the trauma inflicted when men wield their penises as weapons to demean, assault, and torture. Women were raped by knights and pilgrims in the Crusades; by soldiers in the American Revolutionary war; by Germans marching through Belgium in World War I and through Poland and Russia in World War II; by Russians as they took Berlin in World War II; by Pakistanis in the Bangladesh war of independence; by U.S. soldiers during the occupation of Japan, in the Vietnam War, and in military bases in the Philippines and Korea; by Serbs and Rwandans for the intent of "ethnic cleansing"; and by Indonesian pro-militia in retreat from East Timor as that country was voting for independence.

Military brothels, rape camps, and the growing sex trafficking for prostitution are fueled by the culture of war which relies on, licenses, and admires male aggression, and by the social and economic ruin left in the wake of war which is particularly devastating for women and children. Rape and sexual exploitation in war, however, were not systematically documented and named as war atrocities and crimes until the recent investigations of the genocidal rape of Muslim women during the conflict in the former Yugoslavia and of Tutsi women in Rwanda. Yet, history reveals that senior officers of war and military occupation have sanctioned and normalized the sexual exploitation of local women by military men. Governments on all sides of war have initiated, accommodated, and tolerated military brothels under the aegis of “rest and recreation” for their soldiers, with the private admission that a regulated system of brothels will contain male sexual aggression, limit sexually-transmitted diseases in the military, and boost soldiers’ morale for war.

3. Women and girls are sexually exploited by aid workers and UN peacekeepers in post-conflict areas.

In February 2002, The United Nations High Commissioner for Refugees (UNHCR) and Save the Children released a report on their investigation into allegations of sexual abuse of West African refugee children in Guinea, Liberia, and Sierra Leone. Their interviews with 1,500 women, men, and child refugees revealed that girls between the ages of 13 and 18 were sexually exploited by male aid workers, many of whom were employed by national and international non-governmental organizations (NGOs) and the UN, and also by UN peacekeepers and community leaders. “They say ‘a kilo for sex,’” reported a woman from Guinea about the rampant extortion of sex for food by aid workers who abused their positions of power over the distribution of goods and services. A man interviewed stated that without a sister, wife or daughter to “offer the NGO workers,” one doesn’t have access to oil, tents, medicines, loans, education and skills training, and ration cards. The sexual exploitation of girls, fueled by the disparity between the relative wealth and power of the aid workers and peacekeepers and the poverty and dependency of refugees, was most extensive in camps with large, well-established programs.

An insidious outcome for women and girls in post-conflict areas is the epidemic of sexual exploitation that has been aggravated by UN peacekeeping forces and international police. In Bosnia-Herzegovina, the trafficking of women and girls for prostitution has grown exponentially during the past seven years since the Western protectorate was established at the end of the war in 1995. The number of women and girls trafficked into the protectorate is estimated to be between 6,000 and 10,000. International police serving with the U.N. mission there have facilitated the trafficking, accepted bribes from traffickers and brothel owners, purchased women and girls from traffickers, frequented brothels and arranged for trafficked women and girls to be delivered to their residences.

4. Women and girls are at higher risk of STDs, including HIV infection, from soldiers and peacekeepers.

Rape and sexual exploitation by the military during war and in post-conflict situations have resulted in an epidemic of HIV infection, AIDS, and sexually-transmitted diseases (STDs) among women and girls in war-torn countries. Some of the highest prevalence of STDs, HIV, and AIDS worldwide—as high as 50 to 60 percent in the case of HIV--are found in male military personnel. Rates of sexually-transmitted diseases are generally two to five times higher in male military then in civilian populations and rise much higher during war.

The first recorded cases of HIV among women in Cambodia occurred after peacekeepers were assigned to that country in 1992. Prior to their arrival, there was little prostitution. By 2002, an extensive sex industry existed in Cambodia and the country had the highest prevalence of HIV infection in Asia.

5. Women are injured and killed by landmines

Women and children are common casualties in agrarian and subsistence-farming societies where landmines were deliberately placed in agricultural fields and along routes to water sources and markets, intended to starve a people by killing its farmers. More than 100 million antipersonnel landmines and unexploded ordnance lie dispersed and unmarked in fields, roadways, pasturelands, and near borders in 90 countries throughout the world. From 15,000 to 20,000 people are maimed or killed each year by these “weapons of mass destruction in slow motion,” as landmines have been called; and more than 70 percent of the reported victims are civilians. In Bajaur, Pakistan, thousands of landmines are scattered, having been dropped on the Pakistan-Afghanistan border by the Soviet military during their war against Afghanistan. Women and girls constitute almost 35 percent of mine victims, injured while fetching fodder for animals, crossing agricultural fields, and carrying out their daily activities. Yet mine awareness sessions in the conservative tribal society are provided in mosques and schools to men and boys who are then relied upon to educate women and girls at home.

Women are a larger percent of farmers than men in Asia and Africa, responsible for up to 80 percent of food produced in many parts of Africa. When maimed, they lose the ability to farm and feed their family; and their husbands often abandon them, leaving them to beg on the streets or be sexually exploited. Nearly one-half of land in Cambodia, where one of every 236 people is an amputee due to landmine injury, is unsafe for cultivation and human use. So as the recovery from war continues, it is likely that an even greater percent of those injured and killed by landmines will be women and children as they return to peacetime sustenance activities, collecting firewood and water, tending animals and farming.

The five-year-old Mine Ban Treaty (first signed in December 1997) has been ratified by 131 countries with another 15 signatories, including every member of NATO except the United States. The United States employed antipersonnel landmines in the Persian Gulf War; and reports suggest that mines are being used again (in an already heavily-mined Iraq from previous wars) by both the United States and Iraq. While policy from the Clinton administration has the U.S. signing on with conditions to the treaty in 2006, the current Department of Defense has recommended that the U.S. ignore and abandon the growing global consensus against landmine manufacture, trade, and use, an arrogant and morally bankrupt posture it has taken with many international agreements.

6. Widows of War are displaced, disinherited, and impoverished.

UN studies reveal that the household census in developing countries fails to document the inequality and poverty of widows within intergenerational households and misses completely those who are homeless. Widows who have survived political and personal crises, are often uncounted and unidentified, and are the least likely voices heard. “The poorest widows,” concludes the UN, “are the old and frail, those with young children to shelter and feed, the internally displaced and refugees, and those who have been widowed due to armed conflict.”

In Cambodia, 35 percent of rural households are headed by women, many of whom are widows. Many young widows raising children in poverty have had to turn to prostitution as a survival strategy. In regions such as Nepal and Bangladesh, where girls are trafficked into Indian brothels, the daughters of widows are more likely to be taken out of school to help their mothers and are particularly at risk of being trafficked into prostitution.

In the recent war-torn countries of Angola, Bosnia and Herzegovina, Kosovo, Mozambique, and Somalia, the majority of adult women are widows. Seventy percent of Rwandan children are supported solely by mothers, grandmothers, or oldest girl children. Girls in Rwanda are heads of family for an estimated 58,500 households. Many war widows live as recluses in refugee camps because they have no male relative to assist in repairing their homes. In Kosovo, where an estimated 10,000 men died or disappeared, many widows who returned from refugee camps had no social safety nets and no advocacy organizations and became indigent and socially marginalized.

7. Women and children are the majority of war refugees.

Eighty percent of the world's refugees and internally displaced persons are women and children. The scale and nature of war in the late 20th century has resulted in unprecedented numbers of people fleeing conflict, such that the displacement of people by war in the 1990s has had more severe public health impact, in many situations, than the conflict itself. Despite the dearth of gender-based data, it is known that women and girls in refugee camps are more exposed to contaminated water supplies and human waste as well as more at risk of rape, sexual exploitation, and, in some cases, mutilation by landmines than men and boys. Women and girls are responsible for basic household needs, including procuring food, fuel, fodder, and water and for disposal of waste; and men more easily prey upon them in the milieu of conflict-related scarcity. Recent revelations of the sexual exploitation of women and girls by UN peacekeepers and aid workers in West African refugee camps and of the trafficking of women and girls by international police in the post-conflict protectorate area of Bosnia have cast a spotlight on predatory male peacekeepers, aid workers and police and the particular vulnerability of women and girl refugees reliant on them for food, basic life provisions, and physical security.
Crude mortality rate data mask the health impact of displacement on women and girls because (like other social and environmental impact data) it is rarely disaggregated by gender. In one of the few documented cases, a refugee camp in Bangladesh, Burmese girls less than one year of age died at twice the rate of boys, and girls over five years of age and women died at 3.5 times the rate of males. In another case, Rwandan refugee families headed by women suffered more malnutrition than those headed by men in an eastern Zaire refugee camp. Despite little gender-based data, many conclude that refugee women and girls have a higher mortality rate than men and boys because systems of health services and food provision in refugee camps privilege men and boys over women and girls. Single female heads of household, widows, and girl children will be last in line for food and medical services in refugee camps unless gender equity is assured. Without protection and equity, women and girls are also prey to sexual extortion for food and medicine.

8. Poor women and their children lose health, housing, education and welfare services due to war-related pressures on services and the priorities of the military budget.

On the eve of the U.S. attack on Iraq, Iraqi hospitals were overwhelmed with pregnant women seeking caesarian sections and induced births.

Conflict diverts health resources away from health care delivery and disease prevention to treating trauma. In Zenica, Bosnia, for example, the proportion of military and civilian surgical cases due to war-related trauma rose from 22 percent to 78 percent in the city’s major hospital during the first six months of the war in 1992, overwhelming medical services. In the same period, infant and child mortality nearly doubled and newly diagnosed tuberculosis cases quadrupled. When conflict is extended, public health activities, including maternal and child health care and immunization and surveillance systems, can be substantially reduced, dismantled, and destroyed, as happened during recent conflicts in Rwanda, Sudan, Liberia, and Chechnya.

Similarly, the U.S. war against terrorism is siphoning resources from social and health programs that are vital and life-saving for the poorest of our country, single mothers and their children. In 2002, reliance on emergency food from soup kitchens/pantries and emergency housing in shelters rose and state and federal programs for dental and health insurance for the uninsured as well as for youth-oriented drug prevention, HIV/AIDS prevention, and smoking cessation were radically cut, while homeland defense against bio-terrorism enjoyed windfalls. The 2003 budget for biodefense is $5.9 billion, up more than 300% from 2002, while 41 million Americans lack health insurance and medical and public health infrastructures are overburdened and understaffed from two decades of managed care and government cuts in funding. The recently departed head of the Centers for Disease Control and Prevention, Dr. Jeffrey Koplan, likened the surge of funding to create a health system prepared for bioterrorist attacks, while the primary health care system languishes, to “‘building walls in a bog’ where they are sure to sink…”

9. Women suffer higher rates of domestic violence from military husbands and partners.

The first U.S. conscientious objector of the war on Iraq, the marine reservist Stephen Eagle Funk, reported that combat training required recruits to constantly yell, “Kill! Kill!” and they were pressured to hurt their partner in hand-to-hand combat training. Unwilling to deliberately injure others, he was intentionally paired with very violent recruits. Being trained and socialized to kill—the heart of military training—and then killing civilians and other soldiers in war disposes men in the military to be physically aggressive and de-sensitizes them to violence.

The culture and training of violence spills over from the battlefield to the bedroom. Violence against women is endemic in military marriages. According to the Miles Foundation, military men are two to five times as violent towards their wives as are other men. Four women at Fort Bragg, North Carolina were brutally killed by their military officer husbands in the summer of 2002; three of the murderers had recently returned from the war in Afghanistan. This domestic atrocity and others committed by veterans, including ten people killed in 2002 by the Beltway sniper who had also battered his wife, and three nursing school professors killed by their Gulf War veteran student, and the 1995 bombing of the federal building by veteran Timothy McVeigh, form part of a continuum of violence that trains in, inculcates, legitimizes, and carries out killing.

10. Women are exposed to toxic chemical weapons and environmental contamination during and after war and from military activities.

By the end of the war in Vietnam, the United States had sprayed 72 million liters of chemicals on more than ten percent of Vietnam, an ecosystem of forests and wetlands. Two-thirds of the chemicals dispersed, in what was the most massive use of chemical warfare in history, were the dioxin-contaminated herbicide Agent Orange. Today an estimated 650,000 Vietnamese suffer from a mysterious complex of illnesses and chronic conditions. Five hundred thousand Vietnamese have already died from conditions attributed to the chemical warfare exposure. Generations of women have given birth to tens of thousands of deformed and disabled children.

Worldwide, the military is the most secretive, shielded, and privileged of polluters; thus, in most cases, we lack the data for definitive health studies that enable us to attribute reproductive disorders, cancers, illness, and death in exposed populations to military pollution. But it is known that the U.S. military is the largest polluter in the United States. Some 20,000 military sites, including weapons production plants, chemical and biological warfare research facilities; training and maneuver bases; plane, ship, and tank manufacture and repair facilities; and abandoned disposal pits rank as the most polluted hazardous waste sites. The Pentagon generates a ton of toxic waste per minute, more toxic waste than the five largest US chemical companies together. This figure does not include the Department of Energy’s nuclear weapons plants and the Pentagon’s civilian contractors. The Research Institute for Peace Policy in Starnberg, Germany estimates that 20 percent of all global environmental degradation is due to military and related activities, likely the single largest polluter on earth.

Conclusion

The U.S.-led aerial war on Iraq in 1991 and the continuing embargo together erased the socio-economic gains made in Iraq during the 1980s (despite the repressive regime and Iraq’s war with Iran), creating immense setbacks for women. Domestic violence against women and divorce increased; and some impoverished single mothers and widows—the most indigent casualties of that war—resorted to prostitution to survive and feed their families. Literacy and education gains among women and girls in Iraqi society have been eroded, and early marriage of preadolescent girls has resurged in rural regions.

Many forecast a much larger death toll from the impending U.S. war on Iraq than from the 1991 Gulf War. The firepower rained on cities is the most intense in history; and Iraqi cities are under siege by U.S. military, a war tactic that endangers civilians equally with soldiers. U.S. and British bombing hit electric cables to the water treatment plant in Basra leaving much of the city without potable water and forcing women to collect sewage-contaminated water from local rivers. In Iraq, where the majority of citizens are under the age of 15, the highest price of the U.S.-led war will be paid by women and their children with their lives. In the United States, where the domestic cost of war is projected to be $100 billion, poor women and their children are already paying the price with their lives, as housing, food, education and health insurance for those most in need are cut and eliminated at the federal and state levels.

By all principles of just war, the U.S.-led war of aggression against Iraq is unjust and a moral failure on the part of those who wage it.

Sources

Amnesty International USA. (1997). Forsaken cries: The story of Rwanda (100 p. educational binder accompanying video, "Forsaken cries"). New York: Amnesty International USA. http://www.amnestyusa.org/countries/rwanda/genocide/vidbook.html.

Ashford, M.-W., & Huet-Vaughn, Y. (2000). The impact of war on women. In B. S. Levy & V. W. Sidel (Eds.), War and public health (pp. 186-196). Washington, D.C.: American Public Health Association.

Barry, K. (1995). The prostitution of sexuality: The global exploitation of women. New York and London: New York University Press.

Brownmiller, S. (1975). Against our will: Men, women and rape. New York: Simon and Schuster.

CATW-Asia Pacific, Enriquez, J. Filipinas in prostitution around U.S. military bases in Korea: A recurring nightmare. www.catwinternational.org.

Eban, K. (2002). Waiting for bioterror: Is our public health system ready? The Nation, 275(20), 11-18.

Fayyaz, F. M. (2003). Pakistan: the landmine problem in federally administered tribal areas. Journal of Mine Action, 5.1. http://maic.jmu.edu/journal/5.1.

Foege, W. H. (2000). Arms and public health: A global perspective. In B. S. Levy & V. W. Sidel (Eds.), War and public health (pp. 3-11). Washington, D.C.: American Public Health Association.

Garfield, R. M., & Neugut, A. I. (1991). Epidemiologic analysis of warfare: A historical view. JAMA, 226, 688-692.

Ginsberg, T. (2003, January 5). War's toll: 158,000 Iraqis and a researcher's position. The Philadelphia Inquirer. http://www.philly.com/mld/inquirer/news/nation/4874382.htm.

Hoskins, E. (2000). Public health and the Persian Gulf war. In B. S. Levy & V. W. Sidel (Eds.), War and public health (pp. 254-278). Washington, D.C.: American Public Health Association.

International Campaign to Ban Landmines. (2002). Toward a mine-free world: Human Rights Watch. http://www.icbl.org.

Lynch, A.M. (2002, Summer). Summary of judgment of “The women’s international war crimes tribunal on Japan’s military sexual slavery.” Women’s Asia 21, 9, 25-31.

Matsui, Y. (1999, Sept.). Women’s international war crimes tribunal on Japan’s military sexual slavery. Women’s Asia 21. 5, 90-96.

Medact. (2002). Collateral damage: The health and environmental costs of war on Iraq. London: Medact. www.medact.org.

Moon, K. H. S. (1997). Sex among allies: Military prostitution in U.S.-Korea relations. New York: Columbia University Press.

Muska, S., & Olafsdottir, G. (2002). Women, the forgotten face of war. New York: Bless Bless Productions.

Nagy, T. (2001). The secret behind the sanctions: How the U.S. intentionally destroyed Iraq's water supply. The Progressive.

Physicians for Human Rights, & Human Rights Watch. (1993). Landmines: A deadly legacy. Boston/New York.

Pollock Sturdevant, S., & & Stoltzfus, B. (Eds.). (1992). Let the good times roll: Prostitution and the U.S. military in Asia. New York: The New Press.

Rehn, E., & Johnson Sirleaf, E. (2002). Women, war and peace: The independent experts' assessment on the impact of armed conflict on women and women's role in peace-building: United Nations Development Fund for Women. http://www.unifem.undp.org.

Reza, A., Mercy, J. A., & Krug, E. (2001). Epidemiology of violent deaths in the world. Injury Prevention, 7, 104-111.

Rojas, C., Okazawa-Rey, M., & Arriola, M. (2002). War hits home for U.S. women. WarTimes, 6,5.

Robson, T. (2002). Bosnia: the United Nations, human trafficking and prostitution. http://www.wsws.org.

Sajor, L. (1993). Women, war and human rights. Laya Feminist Quarterly, 2(3), 18-28.

Sarin, R. (2003). HIV/AIDS in the military. WorldWatch, March/April, 17-22.

Save the Children US. (2002). Mothers and children in war and conflict, State of the world's mothers 2002.

Shulman, S. (1992). The Threat at Home: Confronting the Toxic Legacy of the U.S. Military. Boston: Beacon Press.

Spectre orange. (2003). The Guardian, March 29. http://www.guardian.co.uk/usa/story/0,12271,923831,00.html.
Swiss, S., & Giller, J. E. (1993). Rape as a crime of war: A medical perspective. JAMA, 270, 612-615.

Toole, M. J., & Waldman, R. J. (1997). The public health aspects of complex emergencies and refugee situations. Annual Review of Public Health, 18, 283-312.

United Nations. (2001). Gender perspectives on Landmines, Briefing Note 5: Department for Disarmament Affairs, Department of Peacekeeping Op erations - Mine Action Service in collaboration with the Office of the Special Adviser on Gender Issues and the Advancement of Women. http://disarmament.un.org/gender.htm.

United Nations Children's Fund. (2001). The state of the world's children 2001. New York: UNICEF. http://www.unicef.org/sowc01/.

United Nations Division for the Advancement of Women. (1998). Women 2000: Sexual violence and armed conflict: United Nations response. New York: United Nations.

United Nations Division for the Advancement of Women. (2001). Women 2000: Widowhood: Invisible women secluded or excluded. New York.

United Nations High Commissioner for Refugees, & Save the Children UK. (2002). Note for implementing and operational partners by UNHCR and Save the Children UK on sexual violence & exploitation: The experience of refugee children in Guinea, Liberia, and Sierra Leone. http://www.unhcr.ch.

H. Patricia Hynes is Professor of Environmental Health at Boston University School of Public Health where she is Director of the Urban Environmental Health Initiative and works on issues of urban environmental health, environmental justice and feminism.