My Twitter feed tells me Canada has just recalled its ambassador from Moscow (that'll teach smartypants Putin a thing or two!), but apart from our government's adolescent readiness to do the dramatic thing rather than the right thing, the Ukraine crisis seems to have intensified very rapidly this weekend.
By coincidence, I've already published a piece on The Tyee about the political implications of "dromocracy," street power, when mass demonstrations topple governments. In the case of Ukraine, the dromocrats have driven out an elected but very unsavoury president, while providing a pretext for a still more unsavoury president to move his troops into the Crimea and perhaps the Russian-speaking region of eastern Ukraine.
This brings back unpleasant memories of the weekend in October 1962 when I was glued to Los Angeles' first all-news radio station (stone age Twitter), listening to reports of President Kennedy cancelling engagements because of a cold, followed by reports of movements of Marines from Camp Pendleton to unknown destinations. That was how the Cuban missile crisis began.
By another coincidence, I'm also reading Margaret MacMillan's impressive book The War That Ended Peace: The Road to 1914. She has a gift for quick, devastating personality sketches that leave no one unscathed, from Kaiser Wilhelm on down. In the cruel light of hindsight, the authors of World War I (and II) look like badly tailored nincompoops who worry more about helmet chinstraps than about the fate of nations.
At the time, of course, they were nothing of the sort—just hard-working generals, aristocrats, and politicians trying to do their best for their countries' interest. How could they have foreseen the 1918-19 pandemic that the war exacerbated? But they were nincompoops just the same...like the better-tailored nincompoops who brought us Vietnam, Iraq, and a host of other miseries since October 1962.
On the face of it, Ukraine's 45 million people (many of them Russian speakers) are no match for Russia's 143 million. But even a short armed conflict, however it ends, will likely end with a public health disaster not that much different from Syria's.
According to Quandl, a very useful source of statistics, Ukraine's population is not as healthy as those of most western industrial nations. Life expectancy at birth in 2011 was 70.8 years (only 66 years for males). Ukraine spends US$527 per year on health, compared to US$8,600 for the US and US$1,316 for Russia.
In many respects, Ukraine is just another advanced country with virtually universal literacy, good sanitation, and improved drinking water. Its infant immunization rates are high.
But Ukrainians have a tuberculosis prevalence rate of 132 per 100,000 (US: 4.8; Russia: 136). Their HIV rate of 1.1% is close to Russia's 1%.
Even a moderately disruptive armed conflict between Ukraine and Russia will cause an instant test of Ukrainian hospitals' surge capacity as wards fill with physical trauma cases. Patients with infectious or chronic diseases will lose whatever care they now have. Patients dependent on pharmaceuticals will lose their supplies.
We can also expect a challenge for hospitals in bordering nations like Poland, Slovakia, Hungary and Romania, as refugees pour in. The World Health Organization, already stretched very thin, will face still more demands on its resources.
Rudolf Virchow, the German pathologist and politician who gave me the subhead for this blog, would be furious but vindicated to see his observation confirmed: "Medicine is a social science, and politics is nothing else but medicine on a large scale."