Increased child deaths in Iraq, from sanctions?

By Sarah Boseley

LONDON: Deaths among babies and children in Iraq have more than doubled in the past 10 years because of the deprivation and malnutrition caused by UN sanctions, according to reports in the Lancet medical journal published May 26.

These soaring child-mortality rates will present the defenders of sanctions with a difficult case to answer, and an editorial in the journal spells out a dire warning.

"The courageous policy is to suspend (not abandon) sanctions, lest upcoming generations of Iraqis, out of resentment, suffering and isolation, grow up to be as aggressive as their current leader," it says.

The study, carried out by Mohammed M Ali from the London School of Hygiene and Tropical Medicine and Iqbal Shah from the World Health Organization, provides the first accurate data on child mortality in Iraq since 1991.

The fieldwork was carried out by the United Nations children's organization Unicef, with the permission of the Iraqi government.

The researchers compared the death rates among babies and children under five years old in the autonomous northern Kurdish region with those in the rest of the country.

They found a marked difference between the Kurdish area, which is benefiting from the oil-for-food program, and the rest of Iraq, which is not.

In the Kurdish area, child mortality rates have improved; between 1994 and 1999, infant mortality declined from 64 to 59 per 1,000 live births and the under-five mortality ratio fell from 80 to 72 per 1,000.

In the rest of Iraq, child mortality more than doubled during the sanctions period, rising from 47 per 1,000 live births during 1984-1989 to 108 per 1,000 in 1994-1999; under-five mortality rose from 56 to 131 per 1,000.

The reports point to many critical factors undermining the health of the Iraqi population -- particularly for those who live in rural areas.

Hospitals and health clinics have had little or no maintenance since 1991 and their work has been hampered by shortages of power and water.

Before sanctions, 90 percent of urban families and 70 percent of those in rural areas had access to safe water supplies. Now, that can be said of only half those living in towns and a third of those in the countryside.

Ali said last Friday that he and his fellow researcher were not trying to draw conclusions from their work. "We have showed that the increase in child mortality coincides with the start of sanctions," he said.

Since sanctions were imposed, there has also been an increase in malnutrition for mothers and babies -- from 3 percent to 11 percent of the population -- and a rise in endemic diseases such as measles and diarrhoeal diseases. Malaria, eradicated from Iraq in the 1970s, has returned.

Children of educated women traditionally fare better than those from illiterate families -- but literacy is not helping in Iraq. "Clearly, education of the mother, suggested to be a determinant of infant-child mortality, has a limited effect in deteriorating socio-economic and health conditions, as seen in the south (and) center of Iraq," write the authors.

Peter Kandela, a doctor who has just returned from the country, writes of what he calls the tragedy of Iraq in another Lancet article.

"Children who should be at school are scouring rubbish heaps and keeping cool in cesspits, and when they get ill there will be no treatment for them," he writes.

"These are the next generation; and who will blame those who survive to adulthood if they react with bitterness and fury against those they deem responsible?"

Two surveys were carried out for the study on child mortality and maternal mortality, the second of which is yet to be published.

Between February and March 1999, researchers interviewed 23,105 married women aged 15-49 living in the center and south of Iraq. Between April and May, 14,035 married women of the same age were interviewed in the autonomous Kurdish region.

One paper notes that Iraq had "spectacular social and economic development" between 1970 and 1990, followed by dramatic decline in the past 10 years. All progress stopped with the start of the Gulf war, the report says.

-- Guardian News Service