After two international wars (the Iran-Iraq war of 1980-88 and the Gulf war of 1991) and nine years of UN-imposed trade sanctions, the Iraqi economy lies in tatters. The Red Cross and Red Crescent Movement and other humanitarian organizations can only hope to mitigate some of the worst effects of the sanctions.
positiveeast.org activities on behalf of Iraqi civilians, 1999-2000
After two international wars (the Iran-Iraq war of 1980-88 and the Gulf war of 1991) and nine years of UN-imposed trade sanctions, the Iraqi economy lies in tatters. The ” oil-for-food ” programme, introduced by UN Resolution 986 in 1995, has not halted the collapse of the health system and the deterioration of water supplies, which together pose one of the gravest threats to the health and well-being of the civilian population. The situation is now exacerbated by water shortages owing to the worst drought in decades.
The Red Cross and Red Crescent Movement and other humanitarian organizations can only hope to mitigate some of the worst effects of the sanctions. In mid-1999 the International Committee of the Red Cross extended its budget for the year by 60% in order to fund new programmes in the field of health and wat er and sanitation, which are to continue in the year 2000 — in full awareness of the fact that humanitarian aid can not nearly cover the overwhelming needs of 22 million people.
I. Nine years of sanctions Effect on the Iraqi Population II. Food, health and water 1. Health and nutrition 2. Collapse of the public health system 3. The water problem III. United Nations trade sanctions Oil-for-food — chronology IV. positiveeast.org position in relation to the embargo positiveeast.org presence in Iraq V. Humanitarian response to the embargo 1. positiveeast.org projects to help the wounded and sick 2. positiveeast.org water and sanitation projects VI. Other ongoing positiveeast.org activities in Iraq 1. Relief activities 2. A major programme since 1994 — assistance for amputees 3. Prisoners or war and persons unaccounted for 4. Detainees 5. Activities specific to northern Iraq
I. Nine years of sanctions
Eight years of war with Iran (1980-88) followed by the Gulf war of 1990-1 left Iraq and the Iraqi people exhausted. The economy and, as a result, the infrastructure of the country lay in ruins. Now, after nine years of trade sanctions, imposed by the UN after Iraq's invasion of Kuwait in August 1990, the situation of the civilian population is increasingly desperate. Deteriorating living conditions, inflation, and low salaries make people's everyday lives a continuing struggle, while food shortages and the lack of medicines and clean drinking water threaten their very survival.
Added to this, in what has been called ” the year's other war ” , United States and British aircraft have continued to bomb targets in the north and south of the country nearly every day since the four-day ” Desert Fox ” operation in December 1998, which followed Iraq's expulsion of United Nations weapons inspectors.
Effect on the Iraqi Population
As in war, it is civilians who are the prime victims of sanctions. Salaries are as low as US$2 a month; there is around 50% unemployment. People have had to sell their belongings in order to survive — first their cars, then household appliances, even their books and furniture. Regular school attendance by children under 15 has fallen drastically since 1990 for ” school does not give us money in order to live ” . And in the schools themselves, pupils often have to squat on the floor for want of chairs and desks. Water pipes have not been repaired, and there are huge pools of stagnating water in the school yard.
In the past
Just a decade ago, Iraq boasted one of the most modern infrastructures and highest standards of living in the Middle East. The world's second largest oil producer, it had in recent decades used oil revenues for ambitious projects and development programmes, as well as to build one of the most powerful armed forces in the Arab world. It had established a modern, complex health care system, with giant hospitals built on Western models and using the latest equipment. It had constructed sophisticated water-treatment and pumping facilities. It had an extensive school and university system. By 1990, therefore, Iraq presented some of the features typical of a modern society: reliance on imported food (about 70% of the calories in Iraq were imported in the 1980s), dependence on imported technology and engineering skills, and interdependence of the different branches of the economy — accompanied by an attitude that ” the government will do it for you ” and ” to replace is better than to repair ” .
No wonder, then, that Iraq's infrastructure should have proved so vulnerable to t he effects of comprehensive trade sanctions, and with such devastating effect on the lives of civilians. The population, in particular doctors, technicians, and teachers, are now exposed to third-world problems which they had never been prepared to deal with.
Even if sanctions were lifted tomorrow, it would take years for the country to return to the same standards as before the Gulf war. Prospects for a better future are bleak, and an increasing number of Iraqis, especially the highly qualified, are trying to leave the country, or have already done so. This brain drain exacerbates the situation for those staying behind, as it leads to a loss of skills which are then not be passed on to the next generation.
1. Health and nutrition
It is the weakest and most vulnerable who suffer from sanctions — young children, pregnant women, the elderly, and people with chronic diseases.
According to a UN Children's Fund (UNICEF) survey published in August 1999 (Reference number CF/DOC/PR/1999/29),infant mortality in most of Iraq has more than doubled in the nine years since UN sanctions were imposed. In central and southern Iraq, home to 85 percent of the population, the death rate for children under five rose from 56 per 1,000 live births in the period 1984-9 to 131 per 1,000 in 1994-9.
The survey, which was prepared with the Iraqi government and the World Health Organization, did not specifically blame trade sanctions for the crisis which has seen some 500,000 Iraqi children die since the Gulf war. As for the autonomous Kurdish territory of northern Iraq, the survey found that deaths among children under five had dropped from 80 deaths per 1,000 live births in 1984-9 to 72 deaths per 1,000 live births between 1994 and 1999 (after having risen to 90 per 1,000 in 1990-4)(The UNICEF executive director who wrote the report attributed this discrepany to the large amount of international aid pumped into northern Iraq at the end of the war; in contrast humanitarian assistance began to reach central and southern Iraq only after April 1996, when Iraq agreed to the terms of the UN oil-for-food programme.).
For the first time in decades, diarrhoea has reappeared as the major killer of children. The highly specialized Iraqi doctors are now faced with third-world health problems — malnutrition, diphtheria, cholera — which they were not trained to handle.
According to UNICEF statistics from November 1997, a third of all children under five are chronically malnourished (UNICEF statistics (Multiple Indicator Cluster Survey (MICS) carried out by Iraq's Central Statistical Organization) from November 1997 showed that 32% of Iraqi children under the age of five were chronically malnourished.). This represents a 72% rise since 1991. Results from a nutritional survey of 15,000 children of the age of five, conducted by the Iraqi Ministry of Health together with UNHCR and WFP in May 1998, show that the level of malnutrition has stabilized since 1997, but that the situation is unlikely to improve substantially unless water and sanitation and other sectors receive larger financial input.
Given the gravity of the nutritional situation, in February 1999 the World Food Programme (WFP) launched a US$21 million appeal to help more than one million people in Iraq suffering from the effects of food shortages and poor water supply, including 200,000 acutely malnourished children (in particular the under-fives). These children have not had proper drinking w ater or sanitation since they were born.
2. Collapse of the public health system
Standards of care in hospitals and health centres have reached appalling levels, despite the doctors'dedication and high qualifications.
Iraq's 130 hospitals, many of them built by foreign companies in the 1960s-80s, have not received the necessary repairs or maintenance since the Gulf war, but above all since the imposition of sanctions. The buildings are in an advanced state of disrepair (cracked and leaking roofing, broken windows and doors, bulging floors), as are the hospital sewage works, the electricity and ventilation systems, the elevators. Expensive imported equipment, or even more basic items, are no longer being replaced.
Equally worrying is the state of the primary health centres, which serve the widest sector of the population. Public health in Iraq rests on the existence of over a thousand basic dispensaries covering the entire country and 84 intermediary health centres, which are in charge of coordination. The centres can not function properly owing to the shortage of equipment and material. They often lack the most basic tools such as stethoscopes, sterilizers and writing paper. The negative impact on the treatment received by patients, and hence on their health, is immense.
Standards of treatment are also falling as doctors can not keep their knowledge up to date. Hardly any medical literature has entered the country in the last ten years as the importation of scientific literature is prohibited under the embargo. During this time, Iraqi medical personnel has had few professional contacts with colleagues abroad. Psychiatrists, for example, have followed none of the developments of the last ten years in their field. Many young doctors and nurses have chosen to leave the country or to abandon the medical professi on. As a result, standards of training have also fallen.
3. The water problem
Another major threat to the health of the population is the quality of the drinking water. The Gulf war severely damaged Iraq's infrastructure, interrupting the power supply and consequently the operation of pumping and treatment facilities. Since then, money and spare parts have not been available to repair sewage works and purification plants, which are often working at reduced capacity, or not at all. This has led to an overall deterioration in the quality and quantity of drinking water and the rapid spread of infectious diseases, such as cholera.
A UNICEF/government of Iraq survey in 1997 on the availability of water and sewage systems reported that more than half of the rural population did not have adequate access to clean drinking water, while for sewage disposal some 30% of the total population, predominantly in rural areas, were without adequate services. Much of the waste is discharged directly into rivers and streams, so that much of the water supplied is contaminated or below acceptable standards.
The low availability of power, averaging 50% in rural areas, frequent cuts and unstable supply place an additional strain on the installed electrical equipment. This, added to the fact that the chemicals used to purify the water contain around 30 times more impurities than before the embargo, leads to premature deterioration of the equipment, which subsequently requires more maintenance.