Iraqi survivors face health-care collapse

by David Dodwell and Cesar Chelala

NEW YORK — In a letter addressed to British Prime Minister Tony Blair, 100 prestigious doctors have denounced the harm to children’s health and lives wrought by the war in Iraq. The signatories — British doctors who have worked in Iraq, Iraqi doctors, leading British consultants and general practitioners — state that conditions in Iraqi hospitals constitute a breach of the Geneva Convention.

They demand that the United States and Britain — Iraq’s “occupying powers” as recognized by the United Nations — address this situation, for which they are responsible.

“Sick or injured children,” they point out, “who could otherwise be treated by simple means are left to die in the hundreds because they don’t have access to basic medicines or other resources.

“Children who have lost hands, feet and limbs are left without prostheses. Children with grave psychological distress are left untreated.”

According to Save the Children, 59 of every 1,000 babies born in Iraq die — one of the highest infant-mortality rates in the region. When an incubator can be found, three premature babies occupy space meant for one. The number of premature babies in Iraq is soaring, due in part to the stress of war on mothers.

“There is a lack of everything,” Maria Fernandez, spokeswoman for Saving the Children from War, a Vienna-based aid agency, has observed. “Antibiotics, special milk for dehydrated children, and almost all medical material for emergency conditions aren’t available.”

Doctors at Basra’s Maternity and Child Hospital have noted that every month between 14 and 16 new cases of leukemia are reported but cannot be treated for lack of medication.

Deteriorating sanitation conditions combined with the heat during the summer months have led to a steep increase in cases of Kala Azar, a potentially fatal parasitic disease transmitted by the sand fly that preys on the internal organs of those affected. I was able to observe its devastating effects on patients in Nepal. Although the disease can be treated with Pentostam, the drug is practically unavailable in southern Iraq.

Security issues and corruption among government officials also play a role. Pharmaceuticals, possibly diverted from Iraqi warehouses, appear on the market in neighboring countries or in private pharmacies, leading to the suspicion that organized crime has become involved in drug distribution.

Lack of proper nutrition is also of concern. A U.N. Human Rights Commission report has indicated that malnutrition among Iraqi children under 5 has practically doubled since the U.S.-led invasion — to at least 8 percent. The situation is worsened by the widespread occurrence of intestinal infections due to lack of potable water and appropriate medicines.

The U.S.-led invasion of the country has greatly affected Iraqi children’s psychological development, according to a report of the Association of Psychologists of Iraq (API) released in 2006. One thousand children were interviewed for the report, which concluded that fear of kidnappings and explosions has led to severe stress among children.

“The only thing they have on their minds are guns, bullets, death and a fear of the U.S. occupation,” Maruan Abdullah, the API spokesman concludes. Ninety-two percent of the children examined had learning disabilities, in particular those whose parents are government employees or high-ranking professionals such as doctors.

The disastrous state of the health infrastructure and a shortage of doctors and nurses are complicating factors. Doctors are targets of violence and kidnappings. A report issued by the Brookings Institute in December 2006 states that 2,000 Iraqi doctors have been murdered and some 250 kidnapped since the invasion.

Fearing for their lives, many doctors and nurses refuse to work in hospitals. More than half of Iraq’s 34,000 doctors have left the country, in many cases after being targeted by criminal gangs. Stranded in neighboring countries, they lead economically strained lives.

Faced with this dismal picture, the natural question is: Can anything be done to improve the situation and increase Iraqi children’s chances to lead better and healthier lives? The answer is that small, stopgap measures will not significantly improve the situation.

As long as the conflict persists, it will continue to exact a disproportionate price on children’s well-being and their quality of life.