Public health crisis in Iraq

from the Gulf Times

Published: Wednesday, 5 December, 2007, 02:39 AM Doha Time

By Cesar Chelala
IT is the kind of news that everybody had been dreading. An outbreak of cholera in Iraq, which started in two Northern provinces, has already reached Baghdad and has become Iraq’s biggest cholera outbreak in recent memory. “This frightening and dangerous situation,” as stated by Bahktiyar Ahmed, a Unicef emergency health facilitator, serves to underscore the unrelenting threat to their lives of people already affected by a devastated health care system.

Statistics from the WHO indicate that there have already been more than 3,300 cases of cholera in the country, and more than 33,000 cases of watery diarrhoea –which could be a milder form of the disease. The cholera epidemic aggravates what is, under any measure, a most serious humanitarian and public health emergency.

According to Jeremy Hobbs, director of Oxfam International, “The terrible violence in Iraq has masked the ongoing humanitarian crisis. Malnutrition amongst children has dramatically increased and basic services, ruined by years of wars and sanctions, cannot meet the needs of the Iraqi people. Millions of Iraqis have been forced to flee the violence, either to another part of Iraq or abroad. Many of those are living in dire poverty.”

It is estimated that 28% of children are malnourished, compared with 19 percent before the 2003 invasion. In 2006, more than 11% of newborn babies were born underweight, compared with 4% in 2003. Malnutrition contributes to death from other conditions such as intestinal and respiratory infections, malaria and typhoid.

The lack of food is affecting not only children. It is estimated that 4mn Iraqis - 15% of the total population- regularly cannot buy enough to eat, and are now dependent on food assistance.

Children’s suffering doesn’t end there. Last year, the Association of Psychologists of Iraq (API) released a report which states that the US-led invasion has greatly affected the psychological development of Iraqi children. The Association’s spokesman, Maruan Abdullah, stated, “It was incredible how strong the results were.

The only things they [the children] have in their minds are guns, bullets, death and a fear of the US occupation.” What can one say to those that are responsible for the destruction of children’s lives and hopes?

Those unable to resist the situation any longer have fled in terror to other parts of the country or to neighboring countries, which have seen their health and social services totally overwhelmed by the sudden influx of millions of refugees.

Presently, 70% of the population in Iraq is without adequate water supplies and 80% lacks adequate sanitation. Dr Abdul-Rahman Adil Ali of the Baghdad Health Directorate has warned about the serious consequences of a defective sewage system. “In some of Baghdad’s poor neighbourhoods,” he said, “people drink water which is mixed with sewage.”

Hospitals are unable to respond to people’s needs. 90% of hospitals lack essential resources such as basic medical and surgical supplies. Most international aid agencies have left the country, a situation compounded by the emigration of qualified personnel, particularly medical personnel. Of 34,000 doctors living in the country in 2003, 12,000 have emigrated and over 2,000 have been murdered.

The war is not only affecting Iraqis. The nonpartisan Congressional Budget Office has issued a report to lawmakers stating that the war could ultimately cost the US government well over a trillion dollars –at least double of what has already been spent. That will happen even under the best conditions –an immediate and substantial reduction of troops- and impact American taxpayers for at least the next following decade.

U.S. soldiers have psychological wounds to last for a lifetime. A 2004 study of 1,300 Fort Bragg paratroopers who participated in the war showed that 17.4% had Post Traumatic Stress Syndrome. In addition, may soldiers have suffered so many injuries that the term “polytrauma” is being increasingly used by military doctors.

To adequately respond to this emergency situation facing most of the country’s population, it is crucial to improve the mechanism of distribution of food and medicines, and to support the work of non-governmental agencies that continue working in Iraq. The Association of Psychologists of Iraq has urged the international community to help establish centers specialised in child psychology and programs devoted to children’s mental health, which is a most urgent need.

It is imperative to lower the climate of hatred and distrust now reigning in Iraq. Improving Iraqis’ health at all levels could indicate to them that they have not been forgotten and disregarded. Because of their reputation for their devotion to improving people’s health throughout the world, a task force should be constituted with both Unicef and World Health Organisation officials to address Iraqis’ most pressing health needs and plan future actions. Improving people’s health can be the key to breaking a vicious circle of negativity and distrust and give Iraqis a renewed sense of hope.

* Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award for an article on human rights. He is the foreign correspondent for Middle East Times International (Australia).