PHA-Exchange> IRAQ- How the children are dying : A first hand report from Baghdad - (PART-1)

[UNNIKRISHNAN PV (Dr)]

Sent: Sunday, March 16, 2003 8:14 AM
Subject: IRAQ- How the children are dying : A first hand report from Baghdad 


How the children are dying : A first hand report from Baghdad

Dr P V Unnikrishnan & Prof S Parasuraman report first-hand from Baghdad 

http://www.newindpress.com/sunday/sundayitems.asp?id=SEH20030315041629&eTitle=Cover+Story&rLink=0 

   March 16,2003   THE NEW INDIAN EXPRESS - Cover Story-1

How the children are dying

Dr P V Unnikrishnan & Prof S Parasuraman report first-hand from Baghdad 

A severely malnourished child. UNICEF estimated that 32 percent of children under five (some 960,000 children) were chronically malnourished in 1997 - a result of the imposition of sanctions in 1991.

  Iraq today hurts the mind and wounds the soul. What a hoary past it had. As Mesopotamia, it was associated with the origins of civilisation. Baghdad's historical importance is unique as a city of continuous human habitation for centuries. Politically its place in the Arab world is unique too because it has always been the home of the Ba'ath party. 

  But today it is a sight that troubles anyone with a conscience. Saddam City on the outskirts of Baghdad is perhaps the world's largest slum with a population of 3 million. If someone disappears inside Saddam City, you may assume he is gone for ever. No questions asked, no clues available. Those with no visible and immediate business in the area is advised not to hang around. 

  Most experts who have studied the situation on the spot say that the people of Iraq face a grim future with or without a war. Since the American Sanctions began in 1991, the misery of the ordinary people has gone beyond bearable limits. Half a million children have died since 1991 due to sanctions-related causes, according to UNICEF. Twice as many children suffer from malnutrition in Iraq than in Jordan or Turkey. 

  If the war begins, the situation will of course go out of control. According to a UN report written in December and recently leaked, war will put at least 7.4 million people in Iraq in immediate need of humanitarian help. This figure represents only those that aid workers can reach. Millions of other needy but inaccessible civilians will simply have to be left to perish. 

  This horrible reality can be seen in one example. As many as 60 percent Iraqis today depend on food handouts rationed by the government (the food coming from the oil-for-food programme that is allowed outside the sanctions). The moment war breaks out the supply lines will be cut and government's distribution system will just disintegrate. 

  It is in the medical sector that the everyday misery of the people is most visible. This is also the sector that we studied most closely. Ours was not a medical mission. We went to Iraq to gather some direct information on the kind of international aid the Iraqi people might require. Such information used to come from UNICEF and other organisations. But their expatriate staff had left in recent weeks. Even the France-based Doctors Without Borders has only one representative who arrived in Baghdad recently. 

  As we went round some medical facilities, the cases we saw were most disturbing. We met Jihan Abbas, 3, and her mother Jebhe Shaalan at a cancer ward of the Saddam Paediatric Teaching Hospital in Baghdad. Jihan looked comfortable in her mother's arms. They come from Yathrib, a village 250 km north of Baghdad. Jihan has an elder brother aged 4 and a younger sister just a year old. Jihan had arrived just that day for yet another course of treatment, after several previous rounds. She had leukaemia. 

  Jihan's mother was worried about the safety of her one-year-old child left with their 36-member joint family back in Yathrib. Jihan had to remain hospitalised for 10 days. Then she would have to go back home for ten-days, then return to the hospital again. Doctors wished they could keep her in the hospital for a longer time, but there were more patients awaiting admission and treatment. ''We are trying to accommodate everyone. So the patients take turns. We know that the treatment is not enough, but that is what is realistically possible,'' said a doctor. 

  The 300-bed hospital had become home for several hundred children with leukaemia and other complications. Patients are treated on a rotational basis. The hospital had remained full over the past several years, and the caseload had been increasing. What complicated the situation of this under-equipped, understaffed hospital was a new set of symptoms and diseases that the doctors were not familiar with. And the sanctions completely shut out any access to advances in cancer treatment made elsewhere in the world. A large share of the leukaemia cases came from southern Iraq, a theatre of the 1991 war. 

  During that war, the US and its allies had dropped 88,000 tonnes of explosives, some of them laced with depleted uranium, in 110,000 air sorties over a period of six weeks. Experts link increased incidence of childhood leukaemia in south and central Iraq to the depleted uranium from radioactive shell material used; and the hospital doctors testified to the linkage. Northern Iraq was spared the intensity other areas had suffered, but Jihan's village was affected by the bombing. ''The Americans bombed indiscriminately and my father was killed in the bombing,'' remembered Jebhe, Jihan's mother. It was the beginning of their unending suffering. 

  Jihan's father was a farmer and the family was into small-time agriculture. They earned about 500,000 dinars a year, barely enough to support their 36-member household. In the 1980s one Iraqi dinar had fetched three US dollars. Now the exchange value for the ''paper'' (as some Iraqi's affectionately call the 250-dinar currency note) is very low with one US dollar fetching over 2,000 dinars. Jihan's family was already in debt by a couple of million dinars. 

  Theirs was not a case in isolation. The high cost of medicines plagued all. The hospital gave subsidised care and medicine, but patients still had to pay for some prescription medication, the market brands of which were very expensive. Under the ''oil for food'' programme, there was no embargo on medicine, but in practice bottlenecks in approval and actual delivery delays meant that needed medicines were either in acute short supply or just not available. 

  The situation in Iraq's only speciality cancer hospital -- Radiology and Nuclear Therapy Hospital -- is far more serious with patients all over the wards. The plight of the families of Delle Habib, 14, from Nasira, Southern Iraq (diagnosed with ovarian tumour), Jihan Ali, 17, (diagnosed with lymphoma) and Samir Fahri, 30 (a newly-married man, diagnosed with testicular cancer), and innumerable others coming to the hospital is not much different from Jihan's. They needed medicines, food and security. Instead, they are only going to get precision bombs. In the 1991 war less than 7.4 percent of the weapons used were so-called 'precision ordinance.' Innumerable bombs hit unintended targets, killing thousands of people. 

  The dismal health care scenario is made worse by the equally dismal situation on the food front. With an unemployment rate of over 60 percent, and average monthly government salary around US$3, most Iraqis depend on government rations for survival. Jebhe's family, like millions of others, is unable to provide nutritious food to her children. She learned from doctors that immunity levels depended on nutritious food. Such food would have made Jihan's life a little more bearable. ''We eat meat once a month. It is very expensive'' said Jebhe. ''We used to eat it everyday before the war.'' 

  Malnourishment, water-borne diseases, depleted uranium, psycho-social consequences and a crippled health care system have taken a heavy toll on ordinary families like that of Jihan's. In 2002, babies with low birth weight accounted for 24.7 percent of all births. And 23 per cent of the children aged under five are chronically malnourished. A quick glance through the neonatal ward of the hospital showed that there were too many underweight and premature babies kept in old incubators. 

  With all that, the situation in Baghdad was better compared to rural and interior Iraq. In Basra and other places in souther Iraq, water, power and health facilities destroyed in the 1991 bombing have not yet been restored. The sanctions imposed 12 years ago hit children the worst, though they had no role in the war. In fact, they were not even born then. Fewer children attend schools now as many of them have to work to make a little extra income for the family. Poverty has forced some of them to the street. Their future is uncertain. The playgrounds are empty, as few children use them. We check with shops selling toys and sports goods. ''Nobody buys them these days. There is no money,'' said an elderly man running a small makeshift shop. 

  The incidence of leukaemia among the children has been increasing over the years. In real time and space, this simply means immeasurable suffering to a large number of children. In three southern Iraqi governorates, namely Basrah, Misan and Deqar that were subjected to severest bombing, the number of cancer cases has increased by 2.8, 5.7 and 4.3 times respectively in 1997, compared to 1990. The national average increase in cancer cases in this time span has been 1.7 times. 

  People here feel that, whatever the UN and its weapons inspectors say, the US and UK will go to war. ''It is not going to be a war. It will be just bombing. In a war, there are two parties fighting each other. Here it is one powerful force bombing defenceless people,'' said the taxi driver who took us to the hospital. 

  People from all over the word oppose war but leaders of the world's two great democracies refuse to listen. How long will this nightmare last? It is already a funeral in slow motion. A war will only fast-forward it. 

  Dr P V Unnikrishnan is a medical doctor working on humanitarian issues with the People's Health Movement. Prof S Parasuraman is ActionAid Policy Coordinator in Bangkok. They visited Baghdad in February on a humanitarian mission on behalf of ActionAid, People's Health Movement and like-minded organisations. 


 

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