Tanisha Fazal has an important article in the latest International Security: ‘Dead wrong? Battle deaths, military medicine and exaggerated reports of war’s demise.’

It is, in part, an artful response to what must surely seem the increasingly astonishing claim that we live in a time of unprecedented peace.  It depends, in part, on who ‘we’ are, of course, but the general thesis has been shouted from the rooftops by (for example) Joshua Goldstein‘s Winning the war on war (2011) and Steven Pinker‘s The better angels of our nature (2011).  Pinker’s thesis is the more general, to be sure: he claims a decline in ‘violence’ in general, not only in military and paramilitary violence.

Tanisha’s argument hinges on the reliance on ‘battle deaths’ as an index of the incidence of war; these statistics are a minefield of their own, though they are used by most of the major databases, but Tanisha argues that many contemporary wars have been distinguished by a diminution in battle deaths and a marked increase in the numbers of wounded who now survive injuries that would previously have killed them.

She identifies four key changes.  The first two are pre-emptive: soldiers in advanced militaries are now healthier, and so they  can survive disease and injury much better than in the past, and they are equipped with protective equipment that reduces their vulnerability (she’s thinking here not only of MRAPs but more particularly of personal equipment that affords the head and trunk some protection against blast injuries).

The second two are reactive, and their emphasis on military medicine and evacuation chains intersects directly with my present research on combat casualty care 1914-2014 (see here and here).  From Tanisha’s summary over at Political violence @ a Glance:

‘… battlefield medicine itself has improved via the availability of anesthetics and antibiotics, which make for more effective surgeries as well as a greater likelihood of avoiding or surviving post-operative infections. Similarly, the return of the tourniquet as part of a general focus on hemostatics appears to have dramatically reduced the percentage of soldiers dying from preventable blood loss.

‘… military evacuation practices have gone from soldiers laying on the ground for weeks waiting for transport by stretchers to mechanized ambulances to medevac helicopters. States invest heavily in military transport for this purpose today; NGOs like the ICRC, however, were at the vanguard of this particular shift.’

That last sentence raises a series of other, crucial questions that I’m also trying to address in my own project: not only the involvement of civilian/humanitarian organisations (and here I’m presently exploring the role of the Friends Ambulance Service on the Western Front in the First World War and in the Western Desert in the Second) but also the part played by militaries in caring for civilian casualties.  How far have they enjoyed the benefits of improved military medicine and trauma care, and how far down the evacuation chain do they move before they are diverted to (often less advanced) civilian hospitals and clinics?