The Hidden Casualties of Drone Warfare – Global Governance Futures 2025

By Abdul El-Sayed - 05 September 2014
The Hidden Casualties of Drone Warfare – Global Governance Futures 2025

This opinion piece is part of the ‘The Global Governance Futures 2025’ programme which brings together young professionals to look ahead and recommend ways to address global challenges.

Conflict is, by its nature, a human tragedy—leaving destruction, devastation, and disarray in its path. But for as long as humans have been destroying one another, each has had to bare the risk of that decision facing his enemy in war. This has, throughout history, forced a very human sense of empathy into what is the most inhumane of endeavors.

Increasingly, however, warriors are no longer forced to face their enemies. Rather, unmanned aerial vehicles (UAV, also known as ‘drones’) technologies allow them to carry out their missions in secluded office buildings thousands of miles away. And that is why the continued development and deployment of UAVs in conflict is ominous for the human welfare consequences of war.

Why is drone warfare worse than its conventional counterpart?

These technologies enable conflict that would not otherwise occur. This was the conclusion of a non-partisan panel of former high-level officials at the CIA and the Department of Defense: “we are concerned that the availability of lethal UAV technologies has enabled US policies that likely would not have been adopted in the absence of UAVs. In particular, UAVs have enabled the United States to engage in cross-border use of lethal force against targeted individuals in an unprecedented and expanding way…”

How does UAV technology create conflict that would never otherwise occur? It decreases the necessary political investment in armed conflict that governments must otherwise front. In particular, UAV technologies decrease the ‘boots on the ground’ commitment governments must make if they choose to engage, increasing the potentiality and likelihood of conflict.

As case in point, the US has engaged in drone campaigns in Yemen, Somalia, and Pakistan, all waged without congressional authorization. Hence, the military and Central Intelligence Agency, who are overseeing these efforts, have not been beholden to electoral pressure, and therefore, less accountable to the taxpayers who fund them. Because they are less costly than conventional wars, Congress has turned a blind eye to the follies of these unofficial wars, setting a troubling precedent.

The resulting casualty counts have been high. The Bureau of Investigative Journalism estimates that US drone strikes have killed nearly 2400 civilians in Pakistan alone. The use of drones by US forces has also claimed civilian lives in Somalia and Afghanistan, as well as in Yemen where a drone strike mistakenly targeted and destroyed a wedding convoy, killing 14 civilians and injuring 22 in December, 2013.

But beyond the direct casualties of drone strikes, the health literature recounts devastating implications for human welfare more broadly—resulting in casualties that we don’t see.

The destruction of infrastructure leaves populations susceptible to infectious disease epidemics that can occur when water sanitation systems are compromised, or when the loss of housing results in overcrowding. These promote epidemics of cholera, tuberculosis, and other deadly diarrheal and respiratory diseases.

Furthermore, the mental health consequences are far-reaching. One study of 944 Gazan children estimated that the prevalence of post-traumatic stress disorder symptomatology was 42% in this population. And mental health has clear, long-term consequences for physical health—increasing lifetime risk of obesity and cardiovascular disease, the world’s primary killer.

Drone warfare may be particularly damaging to mental health: The “Living Under Drones” report, details the ‘anticipatory anxiety’—the stress caused by anticipating a traumatic event—that drones cause as they are heard constantly dinning overhead. One psychiatrist who has treated patients in Waziristan following drone strikes recounts a debilitating preoccupation with drone strikes in the region—the belief among civilians that “they could be attacked at any time.”

Worse, the health implications of these conflicts extend for decades after the final bullet has been fired. In fact, the effects of armed conflict are intergenerational, increasing the risk of mental illness and chronic disease in future generations not yet born. This occurs because the maternal illness that results from conflict can influence the health of unborn fetuses in utero by conditioning the womb. Experienced conflict also influences parenting in negative ways.

Already, the use of drones has had profound human welfare consequences in casualties alone. A recent study by a US military advisor suggested that drone strikes resulted in up to 10 times as many casualties as conventional aerial strikes.

As the literature about the long-term consequences of armed conflict suggests, an iceberg of disease and disability—including pneumonia, tuberculosis, cholera, post-traumatic stress disorder, and depression—underlies these startling casualty statistics at its tip. And despite precious little data systematically collected to document it, the human suffering resulting from the use of these weapons will continue long after the final missile has been fired.

Jean-Paul Sartre remarked “when the rich wage war, it’s the poor who die.” UAVs leverage wealth to enable unregulated warfare—the political costs of which would be prohibitive without these technologies. And those who suffer are society’s poor—the thousands of casualties to the US drone war, and the millions more yet living who will suffer the long-term effects of mental and physical illness.

These human costs, they should drive our collective pursuit for effective global governance that forces governments to bear the full political costs of these heretofore unregulated conflicts and limits the development and deployment of these technologies. Because in the end, underlying all of the death and destruction these technologies may wreak, it is our collective humanity that will have suffered most of all.


Abdul El-Sayed, MD, DPhil is Assistant Professor of Epidemiology at Columbia University’s Mailman School of Public Health. His research explores the social determinants of population health. He is a Fellow of the Global Governance Futures (GGF 2025) program. The views presented are his own and do not represent those of Columbia University.

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