Laka Foundation, May 1999
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The health of the Iraqi people
Felicity Arbuthnot, journalist
United Nations sanctions imposed on Iraq since August 1990 are described even by UN officials as unique in ferocity. Prior to 1990, according to World Health Organization figures, the population had 92% access to high quality free health care in some of the finest hospitals in the Middle East, 93% access to clean water, high nutritional status and a free education system described as unique by UNESCO, since of standard such that a child born into abjects poverty could leave graduate school as a doctor, engineer or architect. Nine years on, the human toll taken by the sanctions is on a unparallelled scale. "We have a new phenomenon", remarked one doctor. "People are just dying, they are not ill, they just give up - especially young men between the ages of about 30 to 35, their youth has been sacrificed to the sanctions, and they see middle age approaching with no hope, dreams, aspirations or ability to provide for those they love."
I had telephoned Mustafa from Jordan, old friend, gentle academic, whose childlike joy of life illuminated every experience. During the December 1998 bombing his voice broke as he described the destruction of some of the most ancient buildings - world heritage sites - in his beloved Baghdad. Mustafa always celebrated my arrival with an aubergine dish to dream of. Surprisingly the call connected immediately and Doha, his daughter, answered: "I'm on my way, get the aubergine ready...". There was a silence, then: "We have had a catastrophe, Mustafa is dead." He had died five minutes earlier. A month before he had undergone a full medical and been told he had 'the heart of lion'. "He was haunted by the thought we would be bombed again after the Ramadan and he had no way to protect us" said Nasra, his wife. He died on 17th January, the anniversary of the start of the Gulf War.
He was buried within twelve hours in accordance with Islam. Since the bus from Amman took 20 hours (flights are vetoed by the UN Sanctions Committee), I could only attend the mourning - a four day grieving of an intensity defying description. Friends, relatives colleagues called, shared the pain. When Nasra, feisty, gutsy, witty, beautiful and beloved friend entered, she was unrecognisable: 'the weight of grief' encapsulated. "It is killing us all, one by one', she gasped, "we lost five friends this year." All were under forty, all had 'just died'.
Bashir. Where ever one looked was the manifestation of his statement. Six month old Yacoub Yusif, with his small hand twisted at the right angle, with no thumb on his small foreshortened right arm, was comparitively lucky. Six year old Mustafa Ahmed with his bright, intelligent face and great dark eyes had gross deformities of all his stick like limbs, of his facial bones, his hands pathetically turned. Sitting on the examination table like a frail broken doll he said: "I van write." Hunched over, a tiny piece of pencil (pencils are vetoed by the Sanctions Committee, since they contain graphite) and minute square of paper (also vetoed) he wrote, the stub clutched between his knucles, in beautiful Arabic, laughing with triumph at his achievement.
Ali Samir, seven, shuffled in like a tiny, bird like old man, the expression in his eyes was of one who has seen all the trials of the world. He was covered with head to toe ulcerations which as they healed tightened his skin - or ruptured. His fingers were turned inwards, seared in to his palms, he had no toes. When his gay 'Route 97' top was liften up, the terrible, searing ulcerations on his back brought tears to the eyes. "Surgery is counter indicated, since he won't heal - this is a genetic malformation caused by environmental changes in pregnancy' said Consultant, Dr. Harith. The Zafaranya district of Baghdad where he lives was bombed relentlessly in the Gulf War and a nuclear reactor reportedly hit. It was bombed again in 1993 and Ali was still recovering from this terror in the December bombings when the district was hit again. He too could write and did so with pride - but he was unable to tell us - he had no tongue.
In the southern, beautiful, relentlessly bombarded city of Basrah where the biblical Tigris and Euphrates rivers meet the Shat Al Arab, the state of health takes another dimension again. One doctor has completed a thesis comparing the congenital abnormalities, cancers and malignancies since the Gulf War with Hiroshima. Dr. Jenan Ali has been keeping a record of 'mysterious' congenital anomalies. Her photographs for 1998 were chilling. Full term babies undeveloped, the so-called 'bunch of grapes' babies reminiscent of the nuclear testing areas of the South Pacific. A baby with no face, another with no eyes, twisted limbs, or no limbs. A tiny mite with a huge head - and no brain. Page after page of tragedy. "All young parents, with no history of abnormalities in the family as far as we can tell - since we have few laboratory facilities now" further, many she felt "not recorded in the text books - but we cannot be sure since we have had no text books since 1990." (Text books and medical journals are vetoed by the UN Sanctions Committee.)
There were haunting human tales of the December bombing. Jameel, father of Zena a teenager who has severe psychological problems linked to her terror in the Gulf War, when she was six, recountered another tragedy. Zena was inseperable from her cat Sudar (Sugar). It slept by her, ate with her, followed her every move. Sudar shared her most intimate secrets, quietly purring with pleasure at every contact. When the bombing started, Sudar lost her mind, tearing around the garden, attacking, defying all attempts to catch and comfort, tearing and scratching at Zena in her terror. Sudar is still mindless and Zena inconsolable.
"There is something else, which I hope won't affend you", said Jameel. "We had seven children in out house during the bombing, the youngest 6 months, the oldest 7 years. Their terror was such that when the bombs stopped, we were left in the dark (the electricity sub-station was reportedly hit again) with great pools of urine and faeces."
At the Saddam Paediatric Hospital Sahara, aged 3, was dying. She had acute myeloid leukaemia and was bleeding internally from the nose and gums. She needed 10-15 units of platelets a day - the doctors could obtain just one. "In the UK and US leukaemia is a treatable disease, yet due to a lack of chemotherapy we have not achieved one cure - only some remissions - in the last eight years" said Dr. Rad Aljanabi, Chief Resident. "In '94, '95 and '96, we had no treatment at all, so every single patient died." Iraq's cancer, leukaemia and malignancy rate has risen up to sevenfold since the Gulf War, a rise associated with the depleted uranium weapons used primarily by the US and UK, which left a residue of radioactive dust throughout the country, which according to studies, including by John Hopkins University in the US has entered the food chain via the water table and soil.
Leukaemias were a rarity prior to 1991: "This is my first residency" said one doctor. "I saw 39 new cases in three months. I admitted eight in the last month, I remember all their names. We are suffering, the patients are suffering - I cry so often." He wrote down their names: Hussein, Tuness, Mahmood, Tabarik - 11 months old - Lara, Hussan and Sahira. The oldest was 4 years. There were other horrors. Heider Latif, 5 years old, weighing just 13 kgs. Starvation, multiple congenital abnormalities, cancers, heart defects, leprosy, water borne diseases: death stalks Iraq's children from the moment of birth.
Cases at the Centre for Reconstructive Surgery would break a heart of stone. "We are seeing an astonishing rise in even the rarest of abnormalities' said British trained plastic surgeon Professor Ala. "I can show you a baby born one hour ago if you are strong and not prone to fainting" said Dr. Janeen.
A nurse brought in a small bundle wrapped in cloth - sterile wrappings, baby clothing is just a memory in another formerly internationally renowned hospital. Unwrapped the tiny being, making a little bleating noises, had no eyes, no nose, a sweet little mouth, but no tongue or osophegus, no hands or genitalia. Hopelessly twisted small legs were joined together from the knees upwards by a thick 'web' of flesh. "We see many similar" commented Dr. Janeen.
In the maternity unit, midwife Bushra Nasser said: "My colleague delivered the baby you saw, I am frightened of what I might deliver." With no ultra sound or scanning facilities (vetoed) there is no knowledge until birth. "Sometimes the mothers attack us in their agony." In the event, the baby we watched born was a healthy eight pounds - but the conditions so insanitary, without hot water, with cockroaches crawling over the metal of the delivery bed - disinfectant is vetoed, electricity and thus water heating off eighteen hours a day - odds were stacked against him from the moment of birth. When mothers ask: "Is it alright?" there is terror in the question. Some soil samples in areas of Basrah show 84 times (sic) background radiation from uranium elements.
Twentyfive percent (sic) of babies are now born prematurely or of premature weight due to malnutrition and/or environmental factors. There is no oxygen, no incubators working at optimum capacity, no rehydration, no gastronasal nutrition. As we stood in the premature unit, containing 17 babies the doctor remarked: "We have not had one premature weight birth survive since 1994." I looked round the ward at each small life, at twins sharing an incubator, noted each face and tiny form. Each is by now almost certainly now another statistic in embargo-related deaths.
There are three unforgettable incidents. A doctor running up and saying: "Do any of you" (photographer Karen Robinson, myself and our interpreter) "have O-negative blood?" A newly born baby, bright yellow, with acute jaundice would die without an exchange transfusion. There was no blood. I thought I might have the blood type, but then was unsure if it was positive or negative. "Test me" I said. There were no laboratory facilities to do so. If I was wrong, the baby would die anyway.
The 23 day old baby which died two minutes before we reached the ward. His mother had run, inconsolable, screaming, from the hospital. The grandmother, upright, proud, Shia, in her black abaya, tears streaming down her face, stood by his cot, as I vainly stroked his small, perfect head and face, so warm, feeling somehow he could be brought back. All he had needed was oxygen. There was none.
The two doctors and the soldier who screamed at us as we left: "You want a story, you want pictures: there is a two year old baby dead on the sixth floor - the doctors did everything they could, all he needed was oxygen - two years old. What more do you want of us?"
As we left, Dr. Ali - Glasgow trained, world renowned surgeon: "I still have a bank account in the Bank of Scotland, but it is frozen under sanctions", shook hands. "You have seen the state of our hospitals, what will we do if they bombed again?" The hospital, founded by British General Maude, had been hit in the Iran/Iraq War and two doctors killed. In the Gulf War, it was pounded so relentlessly people often were unable to col-lect the dead said Dr. Ali: "Dogs were eating bodies in the street." I said it was impossible to believe it could happen again. For what? We left Basra and returned to Baghdad. The following morning Basra was bombed.
There is a monument in Basra to Iraqi Airways. It reads: "Iraqi Airways, 1947 - 1990." It could be a metaphor for Iraq.
Contact: Felicity Arbuthnot, c/o CADU, Greater Manchester & District CND, One World Center, 6 Mount Street, Manchester M2 5NS, United Kingdom.
Tel: +44-161-8348301; Fax: +44-161-8348187
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