Conflict and war are ingrained in human history. Historically, groups have always fought against groups, cities against cities, and nations against nations. Most independent countries have had their fair share of war. In the first and second world wars, Canada was a crucial part of the western alliance, and was involved in the long Military Intervention against the Islamic State of Iraq and the Levant. Conflict and war arise for various reasons including money, power, territorial control, ideologies, and a combination of these reasons. Similar to several social factors, armed conflict is a pervasive man-made public health problem.

Regarding the current Russia-Ukraine war, it is important to give a brief background and back story. In February 2014, Russia’s annexation Crimea was followed by war in Donbas and subsequently, the declaration of Independence of separatist states (Luhansk, Donetsk). The fear of Russia losing control of countries formerly part of the Soviet Union, to the western alliance, combined with Ukraine’s desire for autonomy from Russia, made Russia place a ban on Ukraine from joining NATO. This deteriorated into a full blown war on 24th February, 2022 in an attempt to demilitarize Ukraine.

Modern warfare differs significantly from those of the past. A combination of multiple treaties, alliances and highly destructive nuclear weapons create horrific possibilities of another world war, and in extreme cases, an end to current civilization. Due to much more advanced weapons in modern warfare, damages can be terrible and unfathomable. The statistics for the Russo-Ukrainian war- in just a month are already alarming. The Office of the United Nations High Commissioner for Human Rights (OHCHR) has confirmed over a thousand deaths, and much more injured. It is challenging to precisely quantify the impact of this war, or any other war for that matter, because the long term destructive effects go way beyond bullets and bombs. The current war is especially worse considering that the world is still recovering from the Covid-19 pandemic.

An already existing public health challenge from this conflict was the removal of opioid substitution therapy on May 2014, after Russia annexed Crimea. This resulted in increased breakout of infections related to intravenous drug use. These infections, often called syndemics- as a result of common association with each other, include HIV and Tuberculosis. Concerns around the potential of biological warfare has led the World Health Organization (WHO) to advise Ukraine to destroy high-threat pathogens housed in the country’s public health laboratories. This would prevent any potential spills that may spread disease among the population. Anxiety, PTSD and other mental health problems are also expected to increase due to this war. If not for anything, the thought of escalation to nuclear warfare is enough to cause mental health anguish- just like the the nuclear attack on Hiroshima/Nagasaki which lasted for decades after the Second World War.
Armed conflict like this leads to increased incidence of traumatic injuries- not just among soldiers but also among civilians; men, women and children. News reports in the past weeks have captured gruesome scenes of the destruction of essential health facilities such as Mariupol Maternity hospital, and a psychiatric hospital in Izyuum. In a desperate effort to force the Ukrainian leaders to submission, these destructions by the Russian military have resulted in massive civilian casualties. Russia has inflicted significant damage on Ukraine since the war is fought on Ukrainian soil. Overwhelmed by the pressure from the Russian military, Ukrainian citizens continue to feel unsafe and anxious, this has led to increase in the number of refugees in neighbouring countries. The number of refugees are now as high as 3.16 million- mostly moving to Poland, creating a major public health crisis.

Citizens of other countries like Ghana, India, Zimbabwe,Nigeria have been trapped In Ukraine due to difficulties leaving the country.
Since the onset of the war, Russia has received multiple sanctions from western allied countries, international organizations like EU, council of Europe ,UN and many others. This has caused significant economic consequences for the country, in addition to the usual economic decline that come from war.
Notable economic outcomes of war include:
• Ban on Russia oil, gas and coal on March 8 by the US president
• Freezing of foreign exchange reserves worth over $1 trillion
• Suspension of Visa and MasterCard in Russia
• Inflation rates of about 9.15 percent
• Sanctioning of important Russian oligarchs

Other countries have also seen economic decline due to the nature of global economics today. Interest rates in US are now as high as 25%. In Canada,Inflation rates have risen to a 30 year high of around 6% leading to sharp increase in the prices of oil and other commodities.
Ukraine has attracted massive support from international organizations, national governments all over the world and NGOs. Canada, amongst other nations, continue to provide financial and humanitarian support, armed support and standby UNIFIER troops.
Whether the Russo-Ukrainian conflict is resolved by the ongoing war is left for the future to decide. What is known, however, is that the public health effects and resulting social change will be felt for many years to come.

Social change explains how the world changes overtime with respect to human behavior, interactions and relationships as well as social and cultural norms. Social change is a force that drives institutions, world views, opinions, standards and laws which ultimately transform the society. These changes can be positive or negative, they may take years, or even decades to become evident since they are usually subtle and observable only after long periods of time. Here, we focus specifically on positive social change- particularly how education and health determinants create social change. Significant outcomes of positive social change over the years include:
• Abolition of slave trade
• Civil rights and democracy
• Feminist movement- women being able to vote, attend university and gain employment
• The LGBTQ+ rights movement
The Social determinants of health are social factors that directly or indirectly impact health. These factors, such as education, income, housing and employment, are agents of social change. This is because they are able to significantly influence our lives, ways of thinking and reasoning. These internal changes in our thoughts and attitudes, in turn, influence our external actions that contribute to social change in societies. All forms of change usually begin when human beings are open minded, interactive and engage on ideological, political, and social levels. This also involves listening to other peoples opinions and potentially engaging in difficult conversations or dialogues. Open-mindedness means listening to other people’s views and perspectives on diverse issues, as well as agreeing to disagree.
Social change can be influenced by:
• Social order
• Technology
• Environment
• Social institutions
• Population
• War and conquest
• Diffusion
• Values and beliefs

As a social determinant of health, an agent of change and a major method of distributing information, education is an essential tool that drives positive social change. Parents and teachers impact wards with social, moral, and cultural values and skills needed to become agents of social change. These are done through activities, games and storytelling. Education gives us information about government, history, and our rights as citizens, as well as teaches us the roles and responsibilities of citizens. In fact, most forms of interaction, including dealing with disagreements, forming opinions, problem solving, exercising self control, relations with various personality types, are learned in school. Although these may not be true for all, another form of education called edutainment, is usually one we can all relate to. Edutainment uses entertainment to teach and inspire social change- this may be by role plays, fictions, revealing what’s happening in other parts of the world and learning about society in general.
Social change is an ongoing, inevitable and ever-present phenomenon that is often used as a marker of development. Most times, social change follows predictable patterns that can either be continuous or cyclic. Continuous forms of social change include changes that happen constantly , but on a smaller scale. These changes are always happening in our societies but may not be immediately observable. They become evident after a long period of time, particularly when we look back in time, historically. Patterns of social change are regarded as cyclic when everything follows a distinct cycle. This is similar to the annual cycle of seasons that come and go, as well as economic booms and dooms that are continuously experienced in the world. Other examples include fashion trends and social expectations. Some cycles are more predictable than others, while others can take decades to recur. Due to the natural ability of human beings to learn, adapt and grow, it is necessary to constantly change with the changing environment around us. We are able to continuously inspire social change, both personally and socially.