The Forgotten Children of Iraq
by Mel Lehman
At least 500,000 Iraqi children have died
because of U.N. sanctions against Iraq. Dr.
Basim Al Abdili hopes his young patient Wassan Ali won't join that number, but
he is not optimistic.
Wassan has leukemia. Although Dr. Abdili knows how to treat Wassan so she would have a good chance of recovery, he doesn't have the medicine and equipment to do so.
"The percentage of cure of leukemia in the United States is from 60 percent to 80 percent," Dr. Abdili said. "But in Iraq, we have no cure rate of leukemia."
Dr. Abdili attributed the lack of medicine to sanctions imposed on his country for the past decade by the United Nations with the active support of the United States. The oil-for-food program, designed to bring food and medicine to Iraq, is empty promises, he said.
Wassan Ali, age 7, was born three years after the sanctions were imposed on Iraq. She knows little about why they continue. She came many miles from her hometown of Tikrit to Baghdad for treatment. Her father recently died in a hospital, so she was glad her mother and younger brother came with her. She hopes she'll get better, but as she looks around the leukemia ward at the Baghdad hospital, she sees are other children like her, sick with leukemia.
"It is very difficult for us as doctors here," Dr. Abdili said. "We know there is a cure rate of leukemia outside of Iraq, but inside Iraq, we can't help our patients. They die in front of our eyes. We can't do anything for them."
Hussein versus children
The plight of children like Wassan Ali has been largely overlooked by the world in the past 10 years. Instead of talking about Wassan and the many other sick children in Iraq, most discussion has been about Sadaam Hussein, President of Iraq, and whether or not he has destroyed all of the weapons of mass destruction Iraq possessed.
That is an important, complicated question. Iraq claims it has destroyed all of its biological and chemical weapons. U.N. and U.S. officials claim more inspections need to be done to verify that.
While that debate continues, sanctions on Iraq -- the most severe ever imposed on any country -- are hurting ordinary Iraqis, not the ruling elite of Iraq who are the targets of the sanctions.
Denis J. Halliday resigned as head of U.N. humanitarian relief efforts in Iraq after a 34-year career with the United Nations to protest the sanctions.
"The member states of the U.N. Security Council -- Britain and the United States in particular -- are sustaining an economic policy on Iraq with deliberation knowing full well of the horrible impact on the innocent people and children of Iraq," Mr. Halliday said. "They know full well that economic sanctions are killing thousands and have killed thousands of Iraqi people."
Child mortality rates
Earlier this year, Anupama Rao Singh, the UNICEF representative in Iraq talked about the status of Iraqi children from her modest office on the banks of the historic Tigris River. On her wall is artwork by Iraqi children, a sign of hope in a future when the children of Iraq like Wassan Ali will be healthy again and be able to paint and sing and laugh and dance. She discussed UNICEF’s August 1999 report on the number of deaths of Iraqi children.
"Basically what we found was that mortality rates in the south and center of Iraq for children under 5 years of age had more than doubled," she said. "For instance, the under 5 mortality rate had increased to 131 deaths per 1,000 live births which puts Iraq on the same plane as Haiti or Pakistan to give you some kind of a comparison. Infant mortality rates were 108 deaths per 1,000 live births, which means in practical terms one in 10 children do not survive beyond their first birthday.
"We think this constitutes a humanitarian crisis. If we extrapolate from these findings, we estimate that at least a half million children under 5 years old have died in the last 10 years who would not have died if the decline in mortality prevalent in the 1970s and 1980s had continued throughout the 1990s."
Ms. Singh attributed increased deaths to a complex set of factors including the relationship between malnutrition and frequent illness.
"Whereas a child under 5 in the early 1990s suffered from an average of about four episodes of diarrhea per year, by 1996-1997, we found that children were getting about 14 episodes of diarrhea in a year," she said.
"That's almost a fourfold increase. Every time a child gets diarrhea, it affects the nutrition status. Every time the child's nutrition status declines, the child becomes more vulnerable to disease. It continues this way until in unfortunate cases, it can lead to death."
Impoverishment of the Iraqi people stems from factors including a previous emphasis in the health system on cure rather than prevention and malnutrition, and compulsory use of infant formula rather than breast feeding.
"A typical Iraqi child now has a one in 10 chance of not surviving beyond the first year of life," she said. "If she or he does not die within the first year, the child stands a one in four chance of suffering from chronic malnutrition. Chronic malnutrition, once it sets in, is extremely difficult to reverse, if not irreversible. There's enough scientific data to show that chronic malnutrition in the early years of life can have permanent implications for the child's cognitive development."
Fewer going to school
Education is becoming a privilege of fewer Iraqi children. Though education is compulsory and free, there has been an attendance decline for 6-year-olds from almost 100 percent to 68 percent.
"Only two out of three 6-year-olds in Iraq presently enroll in school," Ms. Singh said. "If a child does enroll in school, there is a one in two chance the child will go to a school that is inadequate for decent education to take place. Surveys that we have done show that about 55 percent of the schools in Iraq are physically inadequate for schooling."
The number of children with psychological problems appears to be increasing, Ms. Singh said.
It's difficult to quantify and do research, but qualitative research has shown that from the early 1990s to the late 1990s, there has been a 125 percent increase in the number of children 9 to 15 years old who have been approaching the health system for mental-health care.
"These tend to be depression, anxiety, behavioral disorders and so on," Ms. Singh said. "We find an increasing level of working children, especially children in the informal sector in urban areas -- street children begging, cleaning cars, involved in petty trade.
Youth and young adults show a lack of hope despair that the situation is not going to improve, Ms. Singh said.
"Because there's been a fairly extensive de-professionalization of the middle classes, you find engineers working as taxi drivers or selling cigarettes or doing whatever it takes to earn a basic livelihood. Young people seem to get a message or feel that education is no longer valid or important."
Dealing with a chronic and complex humanitarian crisis situation as exists in Iraq requires the very definition of humanitarian needs to move beyond physical survival.
"We must address all needs of children and all rights of children to adequate growth, protection and development to their fullest potential," she said.
United Methodist Women respond
United Methodist Women is making a significant contribution to the plight of Iraqi children through their support of the Middle East Council of Churches. This effort is noteworthy since U.S. response to the children through other agencies has been minimal.
The Middle East Council of Churches provides:
Mike Nahhal, a native of Lebanon, who headed the council’s humanitarian response in Iraq during the past decade explained the situation:
"Iraqis are very bitter. The suffering of the people is great. What Iraq needs today is a compassionate approach, a sincere attitude and understanding. To achieve this, great effort should be invested to bring long-lasting peace to an area that has endured a lot of suffering and pain. This peace can be achieved only if it is based on respect and understanding."
Mel Lehman is writing a book about the effects of sanctions on Iraq. He lives in New York City.