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Violence poses a major threat to the Public Health in Bangladesh

Published 29.12.2009

High mortality rate, injury rate and pain complaints in the violence-prone areas of Bangladesh should be taken as a warning sign of deteriorating public health according to a recent epidemiological household survey made by RCT.

Organised crime and political violence (OPV) and human rights violations have marred Bangladesh history since 1971. The ruling parties have systematically used violence against political opponents and criminals. Little is known about the consequences for the oppressed population. A recent RCT study describes the patterns of OPV and human rights violations in a disturbed area of Bangladesh and assesses the physical, emotional and social functioning of victims.

This is the first epidemiological household survey to confirm the elevated prevalence of injury, lifetime experience of OPV-related injury and pain complaints in Bangladesh. Among other it estimates the Crude Mortality Rate (CMR) and the Under 5 Mortality Rate (U5MR) in relation to the level of exposure to OPV and human rights violations in a complex setting.

Findings show that the CMR (0.49 per 10,000 per day) in 2007 was similar to that of most African countries at civil war (0.5 per 10,000 per day), while the U5MR (2.1 per 10,000 per day) had reached the WHO emergency threshold (2.0 per 10,000 per day). The violence-related mortality rate in Meherpur district, where the study was conducted, was similar to the rate in a conflict zone in eastern Burma.

The study concludes that the level of violence and human rights violations is high with more than 80% of the population over 35 years old complaining of pain. The annual injury rate was 36%, and the lifetime experience of violence-related injury was 50%. Thus the affected population suffers from violence-related injuries and traumas, which could be a factor contributing to poverty.

In addition, there is considerable evidence that victimisation is not random. A combination of individual, relational, community and societal factors, including variables such as political party affiliation, conflict with other families, household income and residential area, affected the risk of victimisation in a household. When the politics of organized crime and the organised crime of politics are mingled, the victims are both economically and politically deprived.

Understanding multilevel factors may help identify prevention measures and various opportunities for effective health interventions.

The study has been published in two separate articles, focusing at different factors and levels:

Household exposure to violence and human rights violations in western Bangladesh (I): prevalence, risk factors and consequences
Shr-Jie Wang, Jens Modvig, Edith Montgomery
BMC International Health and Human Rights 2009 9:29
Download here

Household exposure to violence and human rights violations in western Bangladesh (II): history of torture and other traumatic experience of violence and functional assessment of victims
Shr-Jie Wang, Mohammad Akramul Haque, Saber-ud-Daula Masum, Shuvodwip Biswas, Jens Modvig
BMC International Health and Human Rights 2009 9:31
Download here

 

Written by Heidi K. Tokle

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