War’s accountants have well-filled Excel spreadsheets: so many billions to rebuild the bridges, so many for the hospitals. But there are columns they often forget. Columns about brains going into exile, broken souls, land poisoned for generations.
Back to Syria and its 15,000 doctors out of the 30,000 it had before the war28. Surgeons who used to operate in Aleppo now serve coffee in Berlin or drive Ubers in Toronto, because their degrees aren’t recognised. Years of study, decades of experience, reduced to nothing by bureaucracy. For the host countries, it’s a monumental waste: according to several estimates, the average cost of requalifying runs to several tens of thousands of euros and often takes more than two years. Meanwhile, their hospitals are short-staffed.
And it isn’t just a question of numbers. Every doctor who leaves means hundreds of patients without care. A woman giving birth without an obstetrician. A diabetic child without an endocrinologist. War doesn’t only kill with bombs. It also kills through absence, through emptiness, through lack.
In Ukraine, the toll is of a different order but just as chilling: according to the WHO, 9.6M people have mental health needs linked to the conflict29. Nearly 10M scarred minds. A quarter of the population. A recent study shows that 68% of Ukrainians have seen their mental health deteriorate since the invasion. Acute stress, post-traumatic disorders, generalised anxiety: Ukraine’s overwhelmed psychiatrists speak of a traumatised generation.
Then there is the delayed bill. In the United States, the government will have to pay out $490bn to care for its Iraq veterans alone30. But that’s only the tip of the iceberg: the cumulative costs for all veterans of the post-9/11 wars are estimated at $2.5tn by 205031. Men and women who came back missing limbs, but above all with invisible wounds that will take years to heal. If they ever do.
The environment doesn’t negotiate. It takes the hits and keeps a tally. In Ukraine, the environmental damage is estimated at $60bn by the Ministry of Environment. But how do you really put a figure on 12,000 km² of forest gone up in smoke? How do you price land mined over 100,000 km², or 15% of the national territory?
UN deminers say it will take 25 to 30 years to clear the country, depending on the international funding available. Thirty years during which children won’t be able to play in the fields and farmers won’t be able to work their land. Thirty years of danger lurking under the grass.
And the invisible will remain: heavy metals seeping into groundwater, unexploded munitions contaminating the soil, depleted uranium that lingers for centuries. In Iraq, in some areas bombed with these munitions, notably Fallujah, local doctors are seeing a troubling correlation: soaring rates of cancer and birth defects. The direct link is still debated in the scientific community, but the correlation is documented.
Agriculture, for its part, has been devastated for generations: more than 20% of Ukraine’s farmland is now degraded or unusable because of the conflict32. Once-fertile land is becoming no man’s land. The contamination works its way up the food chain: from soil to plants, from plants to animals, from animals to humans. An invisible but relentless vicious circle.
In Vietnam, the ecological after-effects of the American war persist half a century after the fighting ended. Between 1961 and 1971, the US military sprayed more than 80M litres of herbicides over forests and rice paddies, including around 45M litres of Agent Orange, a powerful defoliant containing dioxin, one of the most toxic substances ever synthesised. The result: millions of hectares contaminated, land made barren, and a silent epidemic of cancers, neurological diseases and birth defects across several generations. According to the Vietnam Red Cross, up to 3M people are affected by this exposure today. And yet decontamination came late, was partial, and has been badly underfunded. The estimated cost of fully cleaning up the worst-hit areas, such as Da Nang or Bien Hoa, exceeds €500M, but only a few pilot projects have been carried out with American support. Meanwhile, residents still live close to poisoned soil, and dioxin keeps circulating through the food chain. On the roads from Ho Chi Minh City to the Củ Chi tunnels, or into the jungle, the guides say it every day: if they do this job, it’s so that nobody forgets what they lived through.