Apr 19, 2007

Iraq: Unfolding Humanitarian Catastrophe


Humanitarian conditions are becoming desperate, according to a report compiled by the World Health Organization, which cites lack of access to sanitation and clean water, and growing public health concerns.

Below is an article written by Elisabeth Rosenthal published by International Herald Tribune:

It goes without saying that war is bad for people's health. But a compendium of new public health statistics, released Tuesday [17 April 2007] by the World Health Organization, quantifies just how desperate the situation has become for ordinary Iraqis.

There are the obvious risks of car bombs and snipers, which kill an average of 100 people a day, said the report of the organization's Health Action in Crisis Group.

But beyond that, there are a host of more fundamental problems created by years of conflict: 80 percent of Iraqis lack access to sanitation, 70 percent lack regular access to clean water and 60 percent lack access to the public food distribution system, the report says.

As a result of these multiple public health failings, diarrhea and respiratory infections now account for two-thirds of the deaths of children under 5, the report said.

According to a 2006 national survey conducted by Unicef, 21 percent of Iraqi children are chronically malnourished, which puts them at risk for both stunted growth and mental development.

The statistics are being presented by the WHO on Tuesday [17 April 2007] and Wednesday [18 April 2007] at a meeting in Geneva of the United Nations High Commissioner for Refugees' international conference on displaced persons in Iraq and nearby countries.

"There been so much violence for so long that the result is inevitably this kind of complete social decay," said Les Roberts, a principal researcher in a series of public health surveys on mortality among Iraqis, whose controversial results have been published in the British journal Lancet.

Roberts said he believed that some of the new data vastly underestimated the humanitarian tragedy.

"The WHO has done a great job in walking a tightrope," said Roberts, who was formerly at Johns Hopkins School of Public Health and now heads the Program on Forced Migration and Health at Columbia University.

"They are telling the world that the Iraqi health situation is really bad and likely to get worse, but doing it within the political constraints of respecting government numbers not offending the host country in which they operate."

Roberts said, for example, that the report of 100 excess deaths a day was in his mind "a gross underestimate," placing the probable tally at several times higher.

According to UN reports on security, the Baghdad morgue alone has been receiving about 50 bodies a day for more than a year.

Roberts said that the morgue received only a fraction of dead in the city and that surveys by his group and others had suggested that Baghdad was less violent than other parts of the country.

Khalid Shibib, a member of the UN group, agreed that most of the public health figures were "better a few years ago" because "loss of electricity and displacement of people have led to a deterioration of our public services and lack of access."

The United Nations High Commissioner for Refugees says two million Iraqis have been "internally displaced" from their homes and another two million have left the country.

Shibib said that "if the environmental situation continued to deteriorate, there will be increased diarrheal diseases, such as cholera."

"Also, if there continues to be so many displaced people who are crowded together, maybe living with relatives, there will be a great rise in respiratory diseases, maybe even tuberculosis," he added.

But Shibib said that the United Nations had thus far not detected any such outbreaks and that the childhood malnutrition rate of 21 percent was better than average for the region.

Hundreds of doctors and nurses are fleeing the violence and chaos of Iraq, the Health Action in Crises Group said, although Shibib said there were no official numbers.

As a result, clinics and hospitals are understaffed and undersupplied. Also, with a huge number of wounded people arriving at emergency wards, the health system "is not able to cope with the burden," he said.

The report cites the Iraqi government as saying that almost 70 percent of critically wounded patients die in the hospital due to lack of staff, drugs and equipment.

To make matters worse, wounded, ill and pregnant people in central Iraq and in Baghdad are afraid to risk the trip to the hospital for medical help for security reasons, the report noted. Shibib said the problem was compounded by ethnic divisions between Shiites and Sunnis, creating fear that patients would not be treated at certain clinics because of their ethnicity.

"This is reminiscent of what happened to the people of Sarajevo after a year's siege," Roberts said.

"But for some reason, the world does not focus on the humanitarian consequences in Iraq. They're thinking about the military violence."