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Director-General to develop public health activities to deal with the problem. The resulting World Report on Violence and Health, published by WHO in 2002, was the first comprehensive report by WHO on violence as a public health problem (Krug et al., 2002). The WHO report presents a typology of “violence” that defines three broad categories based on characteristics of those committing the violent acts: self-directed violence, interpersonal violence, and collective violence. This paper deals with elements of the third category, collective violence, with a primary focus on collective violence that involves “armed conflict.”

The three forms of violence in some ways overlap. Those engaged in collective violence may engage in self-directed violence as a symptom of posttraumatic stress syndrome or as a result of self-hatred because of acts committed in war. Collective violence may also be associated with interpersonal violence. For example, individuals and groups engaged in armed conflict may commit interpersonal violence, sometimes fueled by ethnic tensions or in the military by conflict with superior officers or with fellow servicemembers in the midst of war. Soldiers may return from war with a battlefield mindset in which they commit interpersonal violence to address interpersonal conflicts that might have been addressed in nonviolent ways. And children raised in the midst of war may come to believe that violence is an appropriate way to settle interpersonal conflicts.

Collective violence has been characterized as “the instrumental use of violence by people who identify themselves as members of a group—whether this group is transitory or has a more permanent identity—against another group or set of individuals, in order to achieve political, economic, ideological, or social objectives” (Zwi et al., 2002). The WHO report gives, as examples of collective violence, “violent conflicts between nations and groups, state and group terrorism, rape as a weapon of war, the movement of large numbers of people displaced from their homes and gang warfare.” As noted in the report, “all of these occur on a daily basis in many parts if the world” and “the effects of these different types of events on health in terms of deaths, physical illness, disabilities and mental anguish, are vast.” This paper includes extensive discussion of war and other military activities and brief discussion of “terrorism” and the “war on terror” (Levy and Sidel, 2008a).

Definition of “Armed Conflict”

Conflict is a common characteristic of most societies but rarely escalates into the use of physical force and even more rarely into the use of weapons. When weapons are used in “collective violence,” they are usually termed “arms.” This paper concentrates on collective violence in which weapons are used, for which we use the term “armed conflict.” These weapons range



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