IPPNW Interview: Andrew Pinto

Dr. Andrew Pinto is a family physician and a member of Physicians for Global Survival (IPPNW-Canada). He is currently pursuing speciality training in public health at the University of Toronto.  This interview relates to his paper that was recently published in Medicine, Conflict and Survival titled “Engaging Health Professionals in Advocacy Against Gun Violence,” as well as his own involvement in violence prevention activities.

IPPNW: Was there something specific that happened that prompted you to become involved in joining IPPNW and working for peace?

AP: I was incredibly fortunate to complete my undergraduate degree at McMaster University, where I met Joanna Santa Barbara, Vic Neufeld, Neil Arya and others who were engaged in “peace through health”. These people became my mentors and continue to advise me today. I had always known that health was influenced by social, economic and political factors, but began to see how to frame problems like war from a public health perspective. Further, I came to understand the links between armed conflict, poverty, underdevelopment and the spread of diseases such as HIV. In my third year, the attacks of September 11, 2001 occurred. I witnessed an outpouring of hatred and a desire for vengeance amongst my fellow students, and the world community blindly joining the “War on Terror”. This was juxtaposed against the 2001 Peace Through Health Conference at McMaster. It was here that I met Dr. Olupot-Olupot, a Ugandan physician. This led to my first research on gun violence and was the beginning of my involvement in advocacy on this issue. I should emphasize that I am still a novice in many ways, and have a great deal more to learn from others about working for peace.

IPPNW: Health professionals have long been involved with advocacy around the social determinants of health, including poverty. Can you tell us what special expertise health professionals bring to the work of preventing violence?

AP: Health professionals witness the impact of violence directly through the care they provide patients. Whether it is a gunshot wound, a stabbing, or a woman who has been assaulted by her partner, health professionals see violence right before their eyes. They also see the harm that is caused to people by how we’ve set up society, what we call “structural violence”. The special expertise of health professionals is in their ability to bear witness through speaking out, to analyse and measure, to look “upstream” to root causes, and to communicate to the general public.

IPPNW: What historical role have health professionals played in speaking out against war and militarism?

AP: Many health professionals throughout history have highlighted the impact of war on health. In the modern era, the founding of the International Committee of the Red Cross in 1863 was a major milestone. It began the provision of humanitarian assistance to all parties in a conflict, and advocacy around the rights of civilians and prisoners of war. Rules of engagement were developed and there was an agreement to outlaw certain weapons that were simply too destructive. In the aftermath of World War II, physicians were part of discussions around preventing war. The atrocities committed by Nazi physicians promoted the development of global ethical codes, and a need for a Universal Declaration of Human Rights. During the Cold War, IPPNW and other organizations spoke out about the risk of nuclear war, emphasizing the lack of a medical response. Physicians and nurses also contributed to advocacy against the proxy wars fought by the USA and the Soviet Union in Korea, Vietnam, El Salvador, southern Africa and elsewhere. In more recent times, health professionals have spoken out about the terrible impact of war on civilians in Iraq and Afghanistan. More and more scholarship and activism is apparent, for example, in the recent publication of a full issue of the Lancet on health in the Occupied Palestinian Territories.

IPPNW: Why should health professionals be more concerned with small arms than with other weapons?

AP: Although chemical, biological and radiological weapons get a lot of attention, small arms cause the vast majority of injuries and deaths during armed conflict. They are simple to manufacture and most of the countries in the world engage in exporting and importing them. Hence they are easily obtained in almost all countries, sometimes at incredibly cheap prices. They are small and easy to use, enabling even children to become soldiers. They are durable and can last for years, often being recycled from one conflict to another. The great tragedy is that major exporting countries, such as the USA and Russia, not only profit from the suffering of the victims of war, but also control the UN Security Council, formed to prevent war.

IPPNW: You say that calculating the cost of gun violence can be powerful information in advocacy. Can you give us some examples of your work and others in this area?

AP: If we could calculate the cost to individuals, families and society of acts of gun violence, I think this would be powerful information. It would encourage civil society to say “no more”, and also motivate politicians to look at gun control as cost effective, as well as the morally right course of action. This happened with the movement around car safety and other public health campaigns. I have had the chance to work on this in Uganda with Dr. Peter Olupot-Olupot and in El Salvador with Dr. Emperatriz Crespin. Others have attempted to calculate these costs as well, notably researchers in South Africa and Brazil, two countries with an extraordinary burden of gun violence. All research indicates that gun violence is an incredibly costly burden to society.

IPPNW: What are the major challenges to health professionals in undertaking advocacy on limiting gun violence?

AP: A number of challenges face health professionals in this area. The evidence base is quite underdeveloped, given the logistics, costs and risk of doing such research. A great deal remains to be investigated. Many countries that are experiencing armed violence are low-income and do not have the resources to collect much information about incidents of gun violence. In addition, with advocacy work, one does not want to undermine local voices. One has to be very careful when speaking on behalf of those who have experience gun violence. Finally, as with other examples of peace activism, one must address complex and political and economic forces that drive the arms trade.  I think its important to respond to the rhetoric of the gun lobby, which attempts to promote arming citizens as an “individual right”. However, those who have spoken out have often faced personal attacks and harsh criticism by this lobby.