Andre Medici
Adriana Correa Alves (1)
Introduction
In the last twenty years armed conflicts intensified in many of the poorest areas in the world, with severe consequences in mortality, human displacement, famine, destruction of public infrastructure and losses of physical and social capital. Armed conflicts reverse the benefits of the development process. Their devastating economic and social consequences are deep, remaining for years after the end of the conflict.
Many armed conflicts are associated with demographic imbalances. In fact, the persistency of high fertility rates, the rise of youth population, chaotic urbanization and migration processes, beside the scarcity of natural resources as cropland and freshwater supply, are frequently associated with the origins of civil wars in low income regions.
Armed conflicts generate direct consequences in mortality due war violence. All the three demographic dynamic components – mortality, fertility and migration – could be affected by armed conflicts and civil wars. Mortality in all age groups increases due direct human losses by the conflicts. Even affecting all age-groups, direct mortality in the conflicts is higher among adolescents and young adult male population. As consequence, armed conflicts multiply the number of orphans and widows, creating life disruption and increasing poverty among the survivors, especially women and children.
On the other hand, armed conflicts have also indirect impacts in mortality and morbidity accelerated by the increasing malnutrition, the disruption of family structures and family support to youth and children and the destruction of farmlands and public infrastructure. Health services, water supply and epidemiological surveillance generally don’t work properly during armed conflicts times. Increasing morbidity is one of the biggest consequences of civil wars and it is associated with the higher incidence of transmissible diseases such as AIDS and malaria during the conflicts and in post-conflicts contexts. The burden of diseases increases as consequence of the rising of physical disabilities and chronic diseases, especially those associated with stress and mental disorders.
Fertility generally increases as result of lack of access to family planning and other factors as rape and sexual violence against women. Some authors associate increases in fertility during and post-conflict with the women’s will to compensate the loss of children due to the war, but this argument still needs evidence to be proved.
International and internal migration intensifies due the generation of large waves of war refugees affecting family arrangements and family composition. In areas where displaced population is accommodated in refugees’ camps, family structure is disrupted because these camps are organized according gender and age groups. Family members are separated and children are not allowed to live with their parents. Age structure and gender ratios also change and turn imbalanced, due to disproportionately mortality of men and youth/adults. Men and women also may be differentially affected by the challenges and opportunity to reorganize their lives, to find households and to reinsert themselves into social networks and economic activities in the aftermath of armed conflicts.
Women and children suffer the most. Gender specific consequences include increased gender ratios, female-headed households, changes on the fertility patterns and unmet needs of reproductive health programs due the disruption of health systems and destruction of health facilities. Women often become caregivers for injured combatants and find themselves, as a result of conflict, unexpectedly cast as sole manager of a household, sole parent, and caretaker of elderly relatives. Children, especially the orphans, miss opportunities to attend school and health programs. Women and children are easy targets to sexual and gender-based violence and exploitation to the point of depression, mental illness and suicide. Women are disproportionately vulnerable to war associated risks such as human trafficking, forced labor or slavery, HIV/AIDS and other SDT and lack of access to education and health care. The violent environment during the conflict and post-conflict contexts reduces access or eliminate health information and health services, especially in outlying areas.
Demographic transition: balance and trends
Although the demographic transition is accelerating in most developing contexts, in low income regions, such as Sub-Saharan Africa, fertility and mortality are still high. Since the 1960s, population programs, especially those financed by international organizations or bilateral technical cooperation, have played a significant role in enabling couples to choose smaller families and to reduce fertility. However, armed conflicts could stop the spectrum of collaboration between these programs and the governments, slowing the gains in fertility reduction. In addition, two thirds of children in many Sub-Saharan African countries are projected to have HIV infection by the time they have reached age 50 (or die from HIV before).
The demographic transition is a generic concept associated with demographic changes from a context of high mortality and fertility rates to another of low mortality and fertility rates. Historically, the first classic demographic transition refers to the declines in mortality and fertility, as witnessed from the XVIII Century onward in several European populations, and continuing at present in most developing countries. The final stage of the first demographic transition was supposed to be an older stationary and stable population corresponding with replacement fertility (i.e. just over 2 children on average), zero population growth, and life expectancies higher than 70 years. The European demographic transition process was accelerated by the immigration. European countries intensively exported population to the Americas and other regions between the second half of XIX century and the first half of the XX century.
A new concept introduced by R. Lesthaeghe (2002) and others (2) in developed countries is the second demographic transition (SDT). The traditional concept implies that, at the end of the first demographic transition process, would be in place an ultimate balance between deaths and births and no “demographic” need for sustained immigration. The second demographic transition, on the other hand, sees no such equilibrium as the end-point. New social behaviors and changes in cultural norms bring new patterns such as a multitude of living arrangements other than marriage and the disconnection between marriage and procreation. These new social behaviors lead the fertility to sub-replacement levels and consequently to a no stationary population.
Instead, populations would face declining sizes if not complemented by new migrants (i.e. “replacement migration”), and they will also be much older than envisaged by the first demographic transition as a result of lower fertility and additional gains in longevity. Migration streams will not be capable of stemming aging, but only stabilize population sizes. Nonetheless, the outcome is still the further growth of “multicultural societies.” On the other hand, the SDT brings new social challenges, including those associated with further aging, integration of immigrants, less stability in family arrangements and high levels of poverty or exclusion among certain household types (e.g. single persons of all ages, lone mothers and illegal immigrants).
The demographic transition process tends to be much faster in developing countries. In Latin America, improvements in preventive health and medical care in recent decades lead to a fast to infant mortality reduction and increased life expectancy. Fertility has also declined faster, resulting in a quick transition from unprecedented population growth to low birth rates. Migration (both national and international) also affects the demographic transition in Latin American Countries. Colombian migrants, expulsed by the guerrillas, went to Amazon areas of Brazil and Salvadorians went to Guatemala, Honduras and Belize as consequence of armed conflicts.
One of the principal criticisms of the demographic transition concept is the questionable applicability to developing regions such as Africa, where the prerequisites for wealth, governance and information access to reduce both mortality and fertility are limited, especially in war and post-conflict contexts. The creation of good governance and sustainable economic growth, with increased provision of social rights as health, education, good jobs and social welfare, could pave the road to a stable process of demographic transition in these regions.
Armed conflicts and Demographic Dynamics: a brief literature review
The empirical literature on conflict and demography is scarce. Despite the relevance of the impact of armed conflicts on demography dynamic in poorest countries, especially due high mortality and forced migration, this subject is a new field of study (3). There is little structured analysis about the consequences of armed conflicts in the demographic patterns and most of the conclusions are anecdotic and could not be generalized. In most cases it is hard to found general patterns. Most of the consequences depend on the interaction between economic, social, cultural and political variables existing before, during and after the conflicts.
Conflict and violence have been referred as one of the principal causes for the erosion of physical, social and human capital in many countries. In a recent search for evidence about the demographic consequences of armed conflicts, Randall (4) analyzing the post-conflict demography of the Malaian-Tuareg, found mixed evidence of the effects of war on reproduction, mortality and family arrangements in three different stages: disorder, limbo and new order. Each one of the three phases has particular complexities and the armed conflicts could work as a catalyst to generate demographic change or to accelerate previously established demographic trends. The different escalation processes presented by the author’s framework serve to identify the related degrees of a conflict’s development and the peculiar forms of involvement by those experiencing the conflict.
The disorder takes place at the beginning of the conflict and may include violence and displacement according different environments. In the disorder phase could be observed biological and psychological impacts of the conflicts such as nutritional crisis, emergence of diseases, social stress, increased infant mortality and curtailed breast-feeding. The fertility and nuptiality tend to fall as a result of spousal separation, lack of privacy, abortion and reduced fertility due to under nutrition. The risk of rape also tends to increase.
During the limbo stage, that happens when conflict is established, people have no clear direction for the future. The population has few opportunities for sustainable self-reliance and generally suffers economic restriction and basic logistic problems associated with food distribution, security, health care and sanitation. This phase can last for several years and entire generations can grow up and matured under these uncertain conditions. In the third stage named new order, which take place during the post-conflict reconstruction, the main characteristic is the re-establishment of social and political order and the restoring of the semblance of normal life. The new order does not represent necessarily a return to the past patterns but generates an entirely new social, economic and demography dynamic.
Verwimp and Van Bavel (5) explain the cumulated fertility of Rwanda women and the survival of their children during and after the conflict through the theory of risk insurance or old-age security approach of reproductive behavior. This theory implies that fertility rises among refugee women as a response to lower chances of surviving. The refugees compensate the loss of children by having more children. Such behavior was particularly observed among the Palestinian population under armed conflicts by decades, where fertility is substantially higher than would be expected from their level of socio-economic development, according DellaPergola (6).
Girls’ survival in the first life-year is naturally bigger than boys’ survival in regular demographic contexts, but in armed conflicts areas the newborn boys have more chances of surviving than girls due family behavior and social norms. During armed conflicts boys are valued because they are early incorporated to fight as soldiers. Other social norms could also explain the over-value of boys by families. In many African countries, as Rwanda, only boys are heirs of land property. Families composed by girls have the risk to lose land property and access to food and water sources in the future.
Avogo and Agadjanian (7) explore the influence of the end of war and the postwar rebound in Angola’s fertility patterns. They show that the impact depends on the degree of exposure to the war and also the women’s socio-economic status. Ghobarah, Huth and Russett (8) analyzed several cross national World Health Organization dataset on 23 major diseases in population distinguished by gender and age groups and they found evidences that civil war increases the risk of death and disability through the breakdown of norms and practices of social order. The study also found that if a neighboring country recently experienced a civil war, women and girls are disproportionately affected by disability and death from AIDS.
In Latin America, where societies count on higher income and governance levels among other development regions, the existing literature shows that armed conflicts have impacted less the demographic trends and women and girls than in Africa. In Central-American Countries as Guatemala, Honduras and El Salvador, armed conflicts triggered intense migration flows and had demographic impacts such as delays in the reduction of fertility rates. For example, in the wake of the ensuing Honduran agrarian reform, in which only native Hondurans were allowed to own land, as many as 130,000 Salvadorans were forced to give up whatever jobs or land they had acquired and return to El Salvador. The exodus of Salvadorans from Honduras contributed to the so-called "Football War" between these two countries, in 1969, and the large number of returning Salvadorans worsened social and economic tensions within El Salvador itself.
In the next edition of this blog we will discuss some examples about how armed conflicts had affected demographic and health trends in some developing countries.
Notes
(1) Adriana Correa Alves is a Consultant of the Inter-American Development Bank and hold a PhD in Humans Right in Salamanca University (Spain).
(2) Lesthaegue, R., (2002) Second Demographic Transition, Vrije Universiteit Brussel (VUB).
(3) Brunborg, H., and E. Tabeau, (2005), Demography of Conflict and Violence: An Emerging Field, European Journal of Population, 21: 131–144.
(4) Randall S. (2005), Demographic Consequences of Conflict, Exile and Repatriation: a Case Study of Malian Tuareg. European Journal of Population 21: 291-320.
(5) Verwimp P. and Van Bavel J V (2005), Child Survival and Fertility on Refugees in Rwanda after the Genocide. European Journal of Population (2005) 21:271-290.
(6) DellaPergola, S. (2001). Demography in Israel/Palestine: Trends, Prospects, Policy Implications. Paper presented at IUSSP General Conference. Salvador, Brazil.
(7) Avogo W. and Agadjanian V. (2007). Reproduction in crisis: war, migration and fertility in Angola. A paper presented at the Population Association of America 2007 Annual Meeting Program. March 29-31, 2007, New York.
(8) Ghobarah, H. P. Huth and B. Russett (2003). Civil war kill and main people – Long term after the shooting stops. American Political Science review, 97(2), 189-202
