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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.”
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