Prior
to the Gulf War in 1990, Iraq had one of the highest standards of living in
the Middle East. According to UNICEF's Donor Update of 31 August 2000, a UN
report in 1991 described Iraq in the early mid-l980s as a state rapidly
approaching the standards of developed countries. The country had an
elaborate health care system, a modern telecommunication network, 24
electrical power generation stations, sophisticated water treatment plants
and potable water for the large majority of the population, including an
elaborate health care system.”
Effect
of economic sanctions
On
August 6th 1990 and under the influence of the United States, the UN
Security Council imposed economic sanctions on Iraq to force its withdrawal
from Kuwait. The implementation of these sanctions was maintained after the
withdrawal in 1991 allegedly as a means of pressuring Iraq into ending its
weapons’ development program.
These
sanctions being the most comprehensive in modern history have had a
devastating effect on the Iraqi people. The current health situation is
abhorrent. The ten years following the implementation of the sanctions have
seen a sharp rise in morbidity and mortality among the Iraqi people.
According to some estimates, over half a million children have died as a
direct result of these sanctions, an additional 200 children die each
passing day and at least 6000 people die each month.
According
to information from the Iraqi Health Department, the primary causes of death
among children under the age of five are: respiratory infections, diarrhea,
gastro-enteritis and malnutrition. The primary causes of death in those
above 5 years are: cardiac diseases, hypertension, diabetes mellitus, renal
diseases, liver diseases and malignant neoplasms.
Prior
to the sanctions, the most common problem faced by pediatricians was
childhood obesity. Diseases as kwashiorkor (pot-belly syndrome), marasmus
and other forms of malnutrition were practically unheard of; however these
syndromes are now common and malnutrition has become endemic. The lack of
adequate vitamins and nutrients in the daily diet has lead to an increase in
susceptibility to opportunistic infections.
In
the "Assessment of Food & Nutrition Situation in Iraq" report
of May-June 2000, the FAO/WFP/WHO confirmed that about 800,000 children
under 5 are chronically malnourished. The report also indicated a high
prevalence of anemia in school children, and stated that numerous cases of
rickets (Vitamin D deficiency) still occur. The report also confirmed that
diarrhea was an important contributing factor to the malnutrition cycle in
Iraq. Wasting (low weight for height) in children under 5 was reported to be
over 10% in Baghdad, Kerbala and Diyala governorates (WHO).
A
UNICEF report states: “In marked contrast to the prevailing situation
prior to the events of 1990-1991, the infant mortality rates in Iraq today
are among the highest in the world, low infant birth weight affects at least
23 percent of all births, chronic malnutrition affects every fourth child
under five years of age, and only 41% of the population have regular access
to clean water. The ICRC states that the Iraqi health-care system is today
in a decrepit state.”
Another
huge problem is the lack of safe water supplies due to the damage of water
and sewage plants, having either been struck during the war or lacking in
spare parts and necessary equipment. Although the Iraqi population has
increased in the last ten years, there is a lack of new projects needed to
secure the increased need for safe water supplies. Water disinfectants as
chlorine have been banned under the ‘dual use’ rule and the locally
produced chlorine is in no way sufficient. This has lead to the spread of
water-born illnesses such as typhoid, dysentery, cholera and polio, the
latter reemerging after nearly being eradicated prior to the sanctions.
According to UNICEF, access to safe water in urban areas, has fallen from
100% to 94% whereas in rural areas there has been a dramatic fall from 71%
to a mere 41%. The quality of water has also deteriorated, according to
reports from the World Health Organization and the Ministry of Health. Up to
250-300 tons of solid untreated raw sewerage is discharged directly into
rivers each day. Only 25% of the population is served by piped sewerage
systems.
The
health risks of depleted uranium
The
use of weapons coated with depleted uranium (nuclear waste) during the Gulf
war and the subsequent prevention of the necessary equipment needed by the
Iraqi government to clean up its battlefields, has lead to a six-fold
increase in cancer cases. The DU dust can enter the body by inhalation or by
the ingestion of contaminated food or drink. According to former US
Attorney General, 900 tons of radioactive waste was spread over Iraq during
the Gulf War. In a press release of 4 August 1998, the US Department of
Defense stated: “The Gulf War was the arena for the first battlefield use
of armor-piercing munitions and reinforced tank armor incorporating depleted
uranium.”
According
to the World Health Organization, the health risks of depleted uranium
include: damage to kidney functions (chemical toxicity), possible higher
risk of lung cancer and bone cancer (radiological toxicity), and the need
for more information regarding the incidence of leukemia. As far as
chemotherapy is concerned, there are insufficient drugs available (even if
people could afford them) or the hospital receives only partial components
of a chemotherapy protocol, which renders it useless (Europa). Although the
incidence of cancer has risen sharply following the war the most effective
painkiller, morphine, used to ease the pain of cancer patients has been
banned by the Security Council.
Deterioration
of the health care system
The
deterioration has affected all branches of the health care system. Health
care institutions and hospitals that were once well equipped, well supplied
and easily accessed by patients, have now become overcrowded, unhygienic and
foul smelling.
Doctors
and nurses are exhausted and underpaid, lacking in the most basic of
equipment. Some of the items banned under the ‘dual use’ rule include
medical equipment as heart and lung machines, incubators, X-ray machines and
even ambulances. Medication such as analgesics, chemotherapeutics and
vaccines have also been banned by the Security Council claiming they could
be transformed into biological or chemical weapons. The poor supply of
electricity and lack of generators (which have also been banned) have
greatly affected hospital care, including of course surgical operations
which have experienced a 70% drop from an average of 15,000 operations per
month in 1989 to less than 4,500. Laboratory investigations have also
experienced a drop of 65.4%. According to Dr. Mubarak, the Iraqi Minister of
Health, the government health spending has been reduced from an annual
US$550 million to US$26 million that Iraq receives under the Jordan-Iraq
protocol (Europa). Sterilization of equipment and refrigeration have
similarly been adversely affected.
Who
is responsible for this tragedy?
In
August 1999, a delegation of 10 Congressional staff members visited Iraq and
reported on the devastating effect these sanctions have had on the Iraqi
people. U.S. Representative David Bonior described the sanctions as
“infanticide masquerading as policy.” The US Government continues to
demand the maintenance of sanctions on Iraq because it continues to possess
weapons of mass destruction. However, this contrasts with what Scott Ritter,
the former senior weapons inspector in Iraq, said which is, “The reality
is that from a qualitative stand point when you judge Iraq's current weapons
of mass destruction capabilities today - they have none."
The
former United Nations Humanitarian Coordinator, Dennis Halliday, started the
oil-for-food program in Iraq. He resigned from his post of Assistant
Secretary-General in protest of the sanctions. His successor Hans Von
Sponeck also resigned. On 29 November 2001 they wrote an article in which
they noted: “The most recent report of the UN secretary-general, in
October 2001, says that the US and UK governments' blocking of $4 billions
of humanitarian supplies is by far the greatest constraint on the
implementation of the oil-for-food program. The report says that, in
contrast, the Iraqi government's distribution of humanitarian supplies is
fully satisfactory (as it was when we headed this program). The death of
some 5-6,000 children a month is mostly due to contaminated water, lack of
medicines and malnutrition. The US and UK governments' delayed clearance of
equipment and materials is responsible for this tragedy, not Baghdad.”
Sources:
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Also:
Dr. Aisha El-Awady
is an Instructor of Parasitology, Faculty of Medicine, Cairo University
