Watson Institute for International and Public Affairs
Costs of War

Refugees & Health

The U.S. post-9/11 wars have displaced at least 38 million people in and from eight countries: Afghanistan, Iraq, Pakistan, Yemen, Somalia, the Philippines, Libya, and Syria

The insecurity that refugees and internally displaced people (IDPs) face extends far beyond the guns and blasts of the war. It includes lack of access to food, health care, housing, employment, and clean water and sanitation, as well as loss of community and homes.

Over 38 million people in the war zones of Afghanistan, Iraq, Pakistan, Yemen, Somalia, the Philippines, Libya, and Syria have been displaced, either abroad or within their own countries, and are living in grossly inadequate conditions. This is a very conservative estimate and the figure could be as high as 49-60 million.

Many displaced persons, usually poorer migrants who lack the finances necessary to travel abroad, have had to relocate within their countries. Internal displacement is associated with some of the worst health outcomes, increasing people’s vulnerability to the negative impacts of loss of employment, inability to access public services such as clean drinking water, environmental contamination, and reverberating trauma and violence. In Afghanistan as of March 2022, there were approximately four million internally displaced people, almost 60% of whom were children under age 18. These IDPs experience malnutrition and mental health challenges and lack access to healthcare, with particularly serious consequences for maternal and infant mortality.

Refugees also face difficulties in renewing visas, the denial of civil rights and services, the fear of deportation, and anxiety about the future. Some who managed to escape the wars Afghanistan and Iraq fled to nearby states including Pakistan, Jordan, Syria, Lebanon, Egypt, Turkey, and Iran. The refugee influx into these countries has strained their resources and the livelihoods of their urban working classes.

Key Findings

  • The number of war refugees and displaced persons from the U.S.-led post-9/11 wars in Afghanistan, Iraq, Pakistan, Yemen, Somalia, the Philippines, Libya, and Syria is estimated at over 38 million.
  • Refugees and IDPs face food insecurity, unemployment, homelessness, lack of adequate health care, water, electricity, and sanitation, among other issues.


  • The Congressional Research Service should submit an annual report to Congress on displacement and refugees in regions where the U.S. is at war.
  • U.S. officials must discuss how to repair some of the damage inflicted on those displaced.

(Page updated as of May 2023)