At the Consortium of Universities for Global Health (CUGH), I will be presenting my research on using attacks on health-care infrastructure as an indicator of violence in conflict; the case of Syria. The fundamental indicator of the human cost of conflict has consistently been the number of casualties over a specific period of time. Although the best proxy to measure intensity of conflict, the mortality rate is difficult to enumerate. In the case of Syria, estimated mortality rates range from 250,000 to 470,000, highlighting the difficulty in obtaining accurate death tolls in a violence context.
Our study utilizes open-source data to document health-care facilities attacked per month in Syria, and compare to the trends in the civilian casualty rate. We find that while the trends in civilian casualties and attacks on health-care facilities show similar patterns in the early stages of the Syrian conflict, the civilian casualty rate stabilized whilst the number of attacks on health-care infrastructure increased. Our findings reveal that only using civilian casualty rates to measure the level of violence would belie the true cost of war, and that attacks on health-care infrastructure are a valuable indicator to include in measuring the intensity of an armed conflict. In the case of Syria, this information could provide a more nuanced understanding of the consequences caused by the destruction of health-care infrastructure, and could expose the nature of indirect deaths in conflict.