We are on the verge of a U.S.-led pre-emptive war against Iraq.  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 massively harmed by war.

Death of Women Civilians

Throughout the 20th century a growing percent of those killed in war were civilians.  Bombs and weapons kill and maim civilian women in equal numbers with civilian men during armed conflict.   By the 1990s, 9 of 10 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.  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. 

Since World War II, the world has witnessed an acceleration of conflicts within countries and the intent to eliminate entire peoples.  The Nazis “final solution” against the Jews has been replicated in recent internal conflicts against Cambodians during the Pol Pot regime, Muslims in Yugoslavia, Tutsis in Rwanda, and Kurds in Iraq.  Men, women and children equally are victims of genocide; women, in addition, are sexually exploited and tortured as well as killed for their ethnicity.  In the central African country of Rwanda, in 1994, nearly 1 million people were killed in ethnic conflict during a three month period, the most rapid genocide in history.  An estimated 40 to 45 percent of those killed were women; and up to 500,000 women and girls were raped and sexually tortured.   After the war many rape survivors were isolated, suspected, and shunned by their community, consigned, in effect, to a social death.
 
Rape, Sexual Torture and Sexual Exploitation

A unique harm of war for women is the trauma inflicted when men wield their penises as weapons to demean, assault, and torture.  Military brothels, rape camps, and the growing sex trafficking for prostitution are fueled by the culture of war which relies on and licenses 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 always 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.  

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 1500 women, men and children 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 agencies (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 distributions 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 skill 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.

Death and Injury 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.

Widows of War

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.

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 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.”

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 girls and women 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 1 year of age died at twice the rate of boys, and girls over 5 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 women 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, they are also prey to sexual extortion for food and medicine.

Wars of the late 20th and early 21st centuries are fought with remotely guided weapons, at distances that shield the combatant from witnessing the death and maiming of his victims.  Even landmines, the sadistic toy-like objects planted in the path of civilians, are remote from those who seeded them aerially or scattered them manually and thousands of miles more removed from their manufacturers.  Military rape and sexual exploitation, on the other hand, are perpetrated male face to female face on the battlefields of women’s bodies.  Of all who suffer the trauma of war, women and girls pay the highest price for the military culture that prepares men to indiscriminately kill humans–no matter the age, gender, and civilian status, and that cordons off a zone of tolerance for male sexual aggression against women and girls around military bases, during armed conflict, and in post-conflict peacekeeping and occupation sites.

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 girls and women 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 will be the most intense in history, wrecking medical and social service systems; eliminating food, water, electrical systems and medicine; and causing the deaths of up to 500,000 during and after the bombing.  An estimated 2 million will become displaced and refugees.   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, a U.S.-led pre-emptive war against Iraq (even if approved by the Security Council) is unjust and a moral failure on the part of those who wage it.
 

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H. Patricia 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.  

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