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Monday, November 22, 2004 - Page updated at 12:00 A.M.

Guest columnist
Another round of misery for the children of Iraq

By César Chelala
Special to The Times

Two Iraqi boys sell cigarettes in Baghdad. War and poverty push large numbers of Iraqi children out of school and into work to support their families.
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Before the Iraq war, Physicians for Human Rights had warned about the serious public-health and human-rights risks to the already vulnerable Iraqi population, should the war take place.

Its predictions have been recently, and sadly, confirmed by an article in the medical magazine The Lancet. According to the article, there have been in excess of 100,000 civilian deaths since the invasion of Iraq in 2003, including a substantial number of children. Carol Bellamy, UNICEF's executive director, has called the death of 34 children in recent bomb attacks "an unconscionable slaughter of innocents."

This is the third time that Iraqi children have been victims of war in that country's recent history. The two conflicts previous to the present one were the eight-year war with Iran in the 1980s and the Gulf War in 1991, which caused considerable damage to Iraq's infrastructure.

In addition, the country has suffered from over 12 years of comprehensive United Nations' sanctions and from Saddam Hussein's perverse policies to use funds for personal gain rather than to improve the basic-services infrastructure in the country.

Prior to the present conflict, Iraqi children were already highly vulnerable to disease and malnutrition. One in four children under 5 years of age was chronically malnourished, and one in eight children died before their fifth birthday. This was happening in a population with almost half the inhabitants under the age of 18.

A limited post-war nutritional assessment carried out by UNICEF in Baghdad found that acute malnutrition has nearly doubled compared with before the war. That assessment also found that seven out of 10 children suffered from various degrees of diarrhea, which leads to a loss of nutrients and often to death if not properly treated.

Hundreds of thousands of tons of raw sewage are still pumped into the Tigris and Euphrates rivers every day. Because water-cleaning chemicals have been looted or destroyed, the quality of water being pumped into homes is extremely poor and leads to more-frequent illness and malnutrition among children. The collapse of the water and sewage systems is probably the cause of an outbreak of a virulent form of hepatitis that is particularly lethal to pregnant women.

It is estimated that 270,000 children born after the war have had none of their required immunizations and routine immunization services were all but disrupted. In addition, the existing stock of vaccines became useless as a result of the destruction of the vaccines' refrigeration system.

Antibiotics of minimal cost in the international market are in short supply, increasing the population's risk of dying from common infections. Many hospitals go dark at night for lack of lighting fixtures.

As a consequence of all these public-health failures, Iraq has the distinction of being the country that has least progressed in reducing child mortality since 1990.

In the 1990s, the most significant increases in child mortality occurred in southern and central Iraq, where under-5-year-old child mortality rose from 56 to 131 per 1,000 live births. Due to lack of security, many babies are now delivered at home, and many mothers do not receive any prenatal care. There is a maternal mortality rate of over 300 per 100,000 live births, compared with a rate of 49.2 per 100,000 for neighboring Turkey.

Dr. César Chelala, a public-health consultant in New York City
In the main cities, every day children are killed or injured when in contact with unexploded ordnance, land mines and other kinds of live ammunition littering the country. In Baghdad alone, there are approximately 800 hazardous sites containing cluster bombs and dumped ammunition. Anti-personnel landmines have caused the deaths of both U.S. and allied soldiers and innocent Iraqi civilians.

The Iraq Education Survey, carried out by the Iraqi government with support from UNICEF, describes how children's educational opportunities have been affected by the war. In the most affected governorates, more than 70 percent of primary-school buildings lack water service. The survey shows that since March 2003, bombing has damaged over 700 primary schools, more than 200 have been burned and over 3,000 have been looted.

After a year and a half of hostilities, the suffering of civilians seems only to increase, affecting all sectors of the population.

Even more poignantly, that over half of the deaths caused by the occupation forces are women and children is a severe indictment against the war.

Dr. César Chelala, an international public-health consultant in New York City, writes extensively on public health and human-rights issues.

Copyright © 2004 The Seattle Times Company

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