Many NGO's in international communities focus their efforts on aiding refugees. However, in this lecture, we will see that as the face of conflict and disaster has changed, more people are being displaced from their homes and communities, while still remaining in their countries of origin. These people are not technically refugees, but are internally displaced persons. IDPs are not only separated from their homes and families, but they also suffer many health risks, since they're not covered by many of the international covenants afforded refugees. >> Among the new taxonomies is how we're defining people that are exposed to conflict. And as I told you in the last slide, pretty much we were dealing just three decades ago with about 53 million refugees. The, today we have the lowest number of refugees. And this particular slide shows about close to 5 million. But, we have now in dealing with mostly internally displaced persons something that we've never even tallied before because they were such low numbers. [COUGH] but now we have the highest number of internally displaced people. So those are people who, who stay within the country of origin. They do not cross an international border. But among all populations, which we now call conflict-affected residents, about a 148 million people throughout the world. So these are people who are stressed in lots of different ways. But if you ask them individually, do you feel secure? Are, do you feel threatened? Yes, they would answer yes to that. So, where are these conflict affected residents? Well, the largest number of are in Pakistan and Nigeria, but the countries that have the largest numbers who are conflict-affected within their countries are Libya and Somalia. Probably something that you're not surprised at. But if we look at that internally-displaced populations within the, within all the countries, the IDP children are twice as likely to die than refugees due to disease, starvation poor immunization rates and little access to health. So, it's refugees that are actually covered and protected under the United Nations High Commissioner Refugees that had the lowest death and malnutrition rates. The highest level of immunizations against measles because once they cross a border, an international border and become a refugee, they're protected under international law. This quite honestly dictated in the initial 1945 post World War II era. This slide depicts something that you need to be aware of, and that is that when wars start. And i'm talking about, oh, the war in Somalia that caused about one and a half million deaths. The war between Eritrea and Erithea which caused over a million deaths. War in Sudan, the initial war that caused certainly over a million deaths. But it's important to know that in those wars and all wars that we've had, that [COUGH], the number of people who die from deliberate violence, so the war itself, rarely go above 11 to 14 %. And even striking to know that one, ones that I just mentioned, Somalia, Sudan and Eritrea, the people who die from violence are around 2 to 3%, so what are these other people dying from? They're dying from the fact that war does one thing very well, and that is that it destroys the public health infrastructure and the social protections that we provide our populations when there's governance. So it's water, sanitation, shelter. It's food. It's energy. It's also maternal and child health programs. It's immunization programs. It's food programs and things like that. One of the reasons why we, we study war, certainly the reason I have all the decades in my career, is to really try to mitigate those, what we call, indirect consequences. So, the direct consequences of the deliberate violence caused by weaponry and conflict. The indirect consequences are these public health consequences. But what you see here is that, of the total mortality, if you look at the second line, it's up to 60 to 90% of those who die that are actually dying from public health causes. And it's the lower level, even though it's sexy, it comes on the TV, that's what's reported, but we don't appreciate the majority of people that are dying, are dying from public health reasons. Current challenges [COUGH] as I mentioned the non-declared, unconventional wars have become the norm, especially since the turn of the century. The social media driven nation-state revolts, as you've been watching, occurred in, in Egypt, for example. The rise of non-state actors, like the Al Qaeda and the affiliates. Private groups and militaries, many of them claiming to be humanitarians. But [COUGH] with this we've never had not only in individual countries but in regions, but globally more problems with disappearing public health infrastructure and social protections. Part of it is economic, part of it is the fact that after we do have conflict, it's rare that the public health protections and the infrastructure come back to the baseline earlier than a decade, okay. So it takes a long time after the war is finished. Nongovernmental organizations leave, the UN and others leave, but that doesn't mean that the public health protections are restored or recovered.