PHA-Exchange> LTE in The Lancet

[Wim De Ceukelaire]

http://www.thelancet.com/journal/vol362/iss9399/full/llan.362.9399.correspon
denc
e.27950.1

Securing Iraq's health

Sir--Your Editorial (Oct 18, p 1249)1 expresses concerns we all have about
the
fate of Iraqis, but we cannot but be disappointed that it misses the
emphasis
on ending the occupation.

You rightly criticise the occupying forces for failure to restore health
services, yet you fail to highlight that their belligerence was responsible
for
Iraq's woes in the first place. Increasing international aid and the health
sector reforms you advocate are mere palliative measures that will not
address
the root cause of the problem. Emphasis on these measures will lead to
legitimising and prolonging the military invasion and occupation, which have
brought about the current situation. In fact, aid in the form of billions of
dollars of loans from the US government and other donors will make future
generations of Iraqis pay for the consequences of war and occupation that
they
had not invited. What Iraq needs today is an end to the occupation according
to
a tight timetable, and compensation--not aid or loans--for the grave damage
that it has suffered.

You also fail to emphasise the need to hold the occupying forces accountable
for their actions in front of international law. You might recall that in
the
run-up to the war on Iraq, millions of people worldwide, including many
health
professionals, demonstrated their opposition to this war because it was
unjust,
immoral and illegitimate.2 We must not forget this now that Iraq is under
military occupation. The US-led invading troops have shown disrespect for
international humanitarian law. They regularly failed to make a distinction
between combatants and civilians, and even targeted vital public utilities
and
health personnel on duty. Their use of depleted uranium ammunition and
cluster
bombs has alarmed the international public health and human rights
community.3
Their unwillingness to provide protection after the end of major combat
resulted in the looting and severe disruption of the Iraqi infrastructure,
including the health-care system.4 Months later, their inability to provide
a
suitable environment for people's wellbeing and public health can hardly be
questioned.5

The health community is beginning to mobilise against this great injustice.
An
international group of health professionals concerned about the public
health
consequences of war and military occupation has therefore launched an appeal
for an immediate end to the military occupation
(http://www.intal.be/html/intappeal.html, accessed Nov 10, 2003) This appeal
also supports the demand of holding the aggressors accountable for the
destruction of Iraq and suffering of the Iraqi people and bringing their
civilian and military authorities to court under international law.

We strongly believe that sovereignty and social justice are imperative for
public health, which cannot prosper under conditions of military occupation
and
continuing insecurity. The global public health community therefore has the
responsibility of showing its continuing opposition to military aggression,
including the occupation of Iraq. The time for rebuilding Iraq and the
equitable provision of health care is indeed long overdue; yet it will not
come
before the hostile military forces have left the country.
*Wim De Ceukelaire, Samer Jabbour, Carolyn Stephens



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*International Action for Liberation (intal), Haachtsesteenweg 53, 1210
Brussels, Belgium (WC); American University of Beirut, Van Dyck Hall,
Beirut,
Lebanon (SJ); and Public and Environmental Health Research Unit, Department
of
Public Health and Policy, London School of Hygiene and Tropical Medicine,
London, UK (CS) (e-mail:wimdc at skyinet.net)


1 Editorial. Act now to secure Iraq's health. Lancet 2003; 362: 1249.


2 Stephens C. Open letter to the Right Honourable Tony Blair, Prime Minister
of
the UK: public health and humanitarian effects of war on Iraq. Lancet 2003;
361: 345.


3 Amnesty International. Iraq: civilians under fire. AI Index:
MDE14/071/2003,
April 2003.


4 Editorial. Laws, war, and public health. Lancet 2003; 361: 1399.


5 Tayal U. Public health at risk as aid agencies pull out of Iraq. BMJ 2003;
327: 522.