War is the great threat to medical and public health. The tragedies that take place on a daily basis in the Gaza Strip and West Bank are testament to this fact.

Palestinian children are facing a major mental health crisis that is directly related to their living in a war zone. In The Lancet, the British medical journal, researchers looked at children exposed to home bombardment and demolition. The study, which also looked at political violence that is associated with such assaults, found that it “was the strongest socioeconomic predictor of post-traumatic stress reactions.”

The study also found that children who were not directly exposed to the direct assaults, seeing the events on television or on radio reported anticipatory anxiety and strong expressions of distress.

The study was also concerned with the health care professionals who are not sufficiently trained to diagnose these children. “In communities affected by war and other forms of political violence, children’s emotional problems can be detected early by professionals and volunteers working in health care, and relief operations and education, rather than by specialists in mental health.”

Clearly, the bombing, military violence and bulldozing of people’s homes by the Israeli military has brought major public health and mental health problems to everyone in its path of destruction, but children are bearing a higher cost than most.

International public health agencies, working with the Palestinian Authority, must be dispatched to administer to these children in need and, by doing so, stop the reckless anti-people activities of the Sharon government.

The damage caused by the Israeli siege on the Palestinian people is beginning to have a human face. Children’s mental health is being damaged. On a more clearly brutal side, the use of rubber and plastic bullets paints another picture.

Rubber bullets have become a common form of crowd control. The bullets are intended to inflict superficial injuries, but are often seen as acceptable since they don’t kill. However, a study in The Lancet makes it clear that rubber bullets are very dangerous and must be eliminated as a weapon of crowd control.

“Rubber bullets were used for the first time by British forces in Northern Ireland in 1970,” the study said. Between 1970 and 1975, over 55,000 rubber bullets were fired in Northern Ireland. Plastic bullets were used by South African security forces before the end of apartheid. The Israeli military used plastic and rubber bullets between 1987 and 1993 against Palestinians.

The scientific study shows photos of the penetration of the skin by these bullets. They are very dramatic and clearly show that while the death rates from the bullets are not high – only when the bullet hits the skull or neck – the damage is very extensive.

The researchers concluded their study by saying that while there is a need for crowd control, rubber bullets are too dangerous. “We found a substantial number of severe injuries and fatalities inflicted by use of rubber bullets when vulnerable upper-body regions such as the head, neck and upper torso were struck. This type of ammunition should therefore not be considered a safe method of crowd control.”

The author can be reached at pww@pww.org