Death in Darfur: 20% violence, 80% diarrhea

The latest Lancet is a special issue on Violent Conflict and Health, and includes articles on the connections between political violence and domestic violence, surgery in conflict settings, and a review of mortality surveys from the Darfur conflict.

Darfur has produced more numbers than most conflicts of its nature. Numbers of the dead are at the core of the debate between so-called Darfur advocacy groups (SaveDarfur being the largest) and skeptics who have argued that claims of genocide are grossly oversold and get in the way of facilitating lasting solutions (Mahmood Mamdani being the most prominent of these). The article in the Lancet, by epidemiologists at the Catholic University of Louvain (that’s in Belgium), takes the 12 biggest studies of deaths in Darfur, statistically smushes them together, divides their findings into six time periods between February 2003 and December 2008 according to political events, and then divides deaths into those directly attributable to violence and those attributable to illness.

Although I usually find epidemiology to be a profoundly boring enterprise (although a nonetheless critical one), the data here are remarkably illuminating. The period September 2003 to March 2004 represented the height of violence with a mortality rates due to violence of 2.5 per 10,000, but following this time these rates fell dramatically to 0.3 (April to December of 2004) and then to less than 0.1 since then. Deaths in Darfur continued during this time of course, but the majority were due to diarrhea, not violence. The authors estimate that between 2003 and 2008, a full 80% of all deaths were due to illness among those displaced by the conflict. In other words, this crisis has been 20% violence, the the vast majority of which was done by mid-2004. For the past six years (or really five years in the data reviewed), the problem has been diarrhea.

As stark as these numbers are, this ultimately means that Darfur followed the common pattern of violent internal conflicts: Initial massacres were followed by massive displacement and the loss of protective health systems, and the problems of displacement ultimately affected the well-being of the population more than the direct experiences of violence.

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5 Responses to “Death in Darfur: 20% violence, 80% diarrhea”


  1. 1 Ken January 26, 2010 at 7:46 am

    Outstanding post, Andy.

    • 2 andyrasmussen January 26, 2010 at 10:30 am

      Thanks, Ken. You know, upon reflection the 20-80 balance here may actually place the Darfur crisis on the low end in terms of recurring waves of violence. Although I’m running on empty in stats terms here, my impression of conflicts like Bosnia the in 1990s or DRC (related to Rwanda) in the last decade, I think of waves of violence that followed displaced populations into safe zones and camps. If you (or anyone) knows of studies comparable to this study, I’d love to hear about them.

  2. 3 oliveridley January 29, 2010 at 3:25 pm

    Excellent post. The 20-80 balance is surely not static, but depends on the baseline health and health infrastructure present before the conflict, and also on the severity and temporal extent of the violence.

    Diarrhea does not make for a poster, but unless the violence is stopped, public health infrastructure cannot improve, which is why the initial focus is on stopping the genocide caused by violence.


  1. 1 Darfur Death Rate: 20% Violence, 80% Diarrhea | Free Market Mojo Trackback on January 30, 2010 at 6:56 am
  2. 2 Domestic 20violence | CftcStx Trackback on March 5, 2011 at 6:34 pm

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