### Editorial

850 www.thelancet.com Vol 378 September 3, 2011 

# War and peace

The cover of this week’s theme issue reproduces the War
and Peace panels of Brazilian artist, Cândido Portinari (1903–62). The home of these murals, when they are not on tour as they are currently, is the UN headquarters in New York City. They are a moving and appropriate symbol of the events that took place in that city 10 years ago, together with many of the global consequences that have happened since.

The best description of the meaning of War
and Peace came from former Brazilian President Luiz Inàcio Lula da Silva: “The suff ering seen in the mural that portrays war reminds us of the United Nations’ tremendous responsibility to prevent the threat of armed
confl ict. The second mural shows that peace is much more than the absence of war. It presupposes well-being, health, and a harmonious relationship with nature. It presupposes social justice, freedom, and overcoming the scourges of hunger and poverty. It is not by chance that

the mural War is positioned to face those arriving, and the

mural Peace those leaving. The artist’s message is simple, but powerful: to transform affl iction into hope, war into peace, is the essence of the United Nation’s mission.” These words reveal the importance of the artist’s symbolism for contemporary notions of health and wellbeing. The past decade has not been easy for those who believe it best to address human predicaments through nations working together. Too often the UN has been undermined or marginalised by countries preferring to ignore the wisdom of fellow nations—the violence perpetrated by the Syrian Government against its civilian population (a country led, in cruel irony, by a medical doctor) is a brutal recent example.

One lesson of 9/11 is the importance of the UN system— its values and procedures—for bringing countries together to solve global crises. WHO is part of that system, and it too is suff ering chronic degradation by nations indiff erent to its future. On this anniversary of 9/11, nations might think about how to strengthen an indispensable organisation that owes its existence to war and its future to peace—perhaps Portinari’s fi nal poignant message.

■ The LancetReutersUN Photo/Lois Conner As Americans on the East Coast survey the damage caused by Hurricane Irene and mourn those who lost their lives in the storm, one small, but signifi cant, piece of good news has emerged. The National September 11 Memorial, with its two huge refl ecting pools and waterfalls where the twin towers stood, remains intact with, remarkably, no damage done to the 400 swamp white oak trees planted in the Memorial plaza. Due to open to the public next week, the bronze panels that surround the twin pools have the names inscribed of all the 3000 people who died on 9/11 and those of the six killed in the World Trade Center bombing in February, 1993.

This issue of The Lancet allows refl ections on the events of 9/11, and particularly explores some of the research,review, and opinion pieces on the short-term and longterm physical, mental, and public health consequences of the terrorist attacks. The research papers report not only US
domestic health eff ects but also some of the international consequences. Respiratory illnesses and post-traumatic

stress disorder are known to be increased in those who survived the World Trade Center disaster, but data reported in this issue show that 9 years after the attacks, rescue and recovery workers continue to have substantial physical and mental health problems. No excess overall mortality is shown, although high levels of exposure to injury or
to the dust cloud are linked to increased risk of all-cause and heart-disease-related mortality. An excess of cancer cases is reported in fi refi ghters who survived the disaster, which could have implications for policy on eligibility for compensation. New data on battlefi eld ethics and casualties in civilians and coalition soldiers in Iraq are presented, while Arab-Muslim refugee health in the USA and public health preparedness are reviewed.

Personal accounts from doctors working in the health systems of Baghdad and New York City provide insights into what it is like to work in Iraq now, and what it was like in New York on 9/11. Practising medicine in extreme, dangerous conditions is beyond the experience of most doctors. But there is a message for all: fi nd time somehow amid the chaos to think about how you and those health-care workers around you feel. Medicine is about so much more than “just work”. ■ The Lancet 

# 9/11—new data, reviews, and refl ections

See Comment pages 851, 852, 854, 855, and 857

See Special Report page 863

See Perspectives pages 867, 868, 869, 870, and 872

See Articles pages 879, 888, 898, 906, and 915

See Review pages 925, 935, and 944

See Viewpoint pages 953 and 957