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Last Updated

08 Feb 2003

Source: The Lancet 361(9356), February 8, 2003


Humanitarian groups unprepared for Iraq war

Health survey of Iraqi children reveals shocking state of health system

While the world stands poised at the precipice of a war on Iraq, roughly 13 million already-vulnerable Iraqi children face "grave risk of starvation, disease, death, and psychological trauma", a blue-ribbon panel of humanitarian non-governmental organisations (NGOs) says.

In the event of war, the likely outcome will be a humanitarian "disaster" in which casualties among children could reach the hundreds of thousands, a ten-member team of health researchers, psychologists, and children's rights activists warned on Jan 30.

The team published their bleak conclusions in a report entitled Our Common Responsibility: The impact of a new war on Iraqi children after a fact-finding mission to Iraq from Jan 19-26. The report argues that young Iraqis are now particularly imperiled because of a weakened health system ensuing from the ongoing deterioration of the nation's social infrastructure, including its health-care, water, sanitation, and food supply systems.

As a consequence, "the population is far less prepared, physically and emotionally, to withstand a war than they were the last time around", Eric Hoskins, head of the international study team sponsored by 20 NGOs from Canada, the USA, and Norway, said in an interview.

The team concludes that the fallout from the 1991 Gulf War, along with 12 years of economic sanctions imposed on Iraq for failing to comply with the United Nations Security Council resolution mandating the elimination of nuclear, biological, and chemical weapons programmes, have combined to leave most Iraqi children living in conditions of destitute poverty.

Iraq's food distribution system and public-health infrastructure are in tatters. Some 16 million Iraqis are already entirely reliant on food rations and there is a scant 1-month food supply in the country, leaving 500,000 children malnourished or underweight. Hospitals and medical clinics only have a 3-4 week supply of medicines, while the safety of the nation's water and sanitation systems has been severely compromised. Around 40% of people in Iraq do not have access to fresh water.

"The death rate of children under 5 years of age is already 2.5 times greater than it was in 1990. Most children [70%] die of diarrhoeal and respiratory diseases. This greater vulnerability means greater illness and death under conflict circumstances", the report says.

The researchers also found a "startling" level of psychological harm among Iraqi children as a result of the threat of war. A survey of 85 families and questionnaires collected from 232 schoolchildren indicates that youths are already "fearful, anxious, and depressed. Many have nightmares. And 40% do not think that life is worth living."

Although the authors are careful to say they "take no position" as to whether disarmament of Iraq is best achieved through political or military means, they leave little doubt of their preference. War, the report says, "must be considered as an option of last resort and an indictment to the failure of diplomatic and all other means to resolve dispute".

It also urges Saddam Hussein's regime to end its weapons programmes. "Iraqi sovereignty means not only independence, it means responsibility."

"We tried to separate the political from the humanitarian", says Hoskins, president of War Child Canada and one-time senior policy adviser to former Canadian Foreign Affairs minister Lloyd Axworthy.

What was also apparent from the mission is that the international humanitarian aid effort is woefully unprepared for war, Hoskins adds.

"If a war does break out, we have to think about how we can minimise the amount of humanitarian casualties and that gets into things like pre-positioning food and stuff. But the answer to that is, we are, thus far, completely unprepared and that's by the admission of the UN and other officials that we met with in Baghdad. We just aren't ready for this."

On Feb 4 UN aid officials warned that they did not have enough resources to deal with the aftermath of a war in Iraq. One of the biggest problems after the war will be handling the refugees, which UNHCR estimate could number 600 000 people.

Wayne Kondro