Estimating the Number of Civilian Casualties in Modern Armed Conflicts–A Systematic Review

Abstract

Objective: To examine the possibility of estimating the number of civilian casualties in modern armed conflicts.Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using PubMed, Scopus, and Web of Science search engines. The outcome was analyzed using a qualitative inductive thematic analysis. The scientific evidence of selected article was assessed, using the Health Evidence Quality Assessment Tool.Findings: The review of 66 included articles in this study indicates that with an increasing number of public health emergencies and the lack of vital elements of life such as water and food, emerging armed conflicts seem to be inevitable. In contrast to military-led cross-border traditional wars, modern armed conflicts affect internally on local communities and take civilian lives. Consequently, the measures and tools used in traditional military-led cross-border wars to adequately tally wounded and dead for many decades under the mandates of the International Humanitarian Law, is insufficient for modern warfare. While casualty counting during modern conflicts is deficient due to organizational, political or strategic reasons, the international organizations responsible for collecting such data (the International Federation of Red Cross and Red Crescent and International Institute of Humanitarian Law) face difficulties to access the conflict scene, resulting in under-reported, unreliable or no-reported data.Conclusion: There are challenges in estimating and counting the number of civilian casualties in modern warfare. Although the global need for such data is evident, the risks and barriers to obtaining such data should be recognized, and the need for new international involvement in future armed conflicts should be emphasized.

Differences in Ethical Viewpoints among Civilian–Military Populations: A Survey among Practitioners in Two European Countries, Based on a Systematic Literature Review

“…Although controversial, scenario four was included because drone attacks endure and will be part of impending wars and armed conflicts [14,32]. This scenario increases the awareness of the military staff of the challenges they may face as well as the knowledge of civilians about military ethical challenges.…”

“…However, it also emphasizes the significance of multiagency assistance, particularly within the healthcare systems, and according to the existing international laws. Furthermore, it shows a change in the response of combatants in recent armed conflicts and the behavior of civilians during disasters, both natural and political [14,32]. Additionally, the COVID-19 pandemic has necessitated a shift in crisis standards of care from an individual to a population-based strategy [33].…”

“…In the management of disasters and public health emergencies, civilian-military healthcare collaboration (CMC) has emerged as one of the most reliable interagency collaborations, due to the similarity in skills and assets, to address all necessary elements of surge capacity, i.e., staff, stuff, structure (space), and systems [13,14]. Therefore, recognizing any conflict in ethical viewpoints between these two organizations necessitates a careful synchronization in values and moral perceptions since individuals in each organization will inevitably confront situations where there are competing obligations, tempting them to forsake moral and ethical analysis to escape from conflicting ethical tension [15][16][17].…”

“…However, although there are publications dealing with ethical viewpoints of both populations, there is a lack of direct comparison between military and civilian healthcare providers. Hypothetically, recent armed conflicts using new technologies (e.g., drones), public health emergencies, and the way affected populations may behave both in nature, medically and politically, can influence the significance of civilian military collaboration and any multiagency assistance, particularly within the healthcare systems [14,[32][33][34][35][36][37].…”

Bastardizing Peacekeeping and the Birth of Hybrid Warfare

“…Russia initiated a "hybrid war" that has slowly created a new cold war, affecting the life of millions of civilians and military, not only in the border of two countries but globally. 7,8 This new warfare has already caused a large number of deaths and injuries and is taking more lives day by day; 8 Russia uses all components of a hybrid war, including "political, diplomatic, economic, and financial warfare, legal (lawfare), as well as socio-cultural efforts, with infrastructure, intelligence, and criminal groups widely used." 9 In contrast to traditional wars, modern armed conflicts involve networks of state and non-state participants with various means of military and militia influences and strategies.…”