14 NOVEMBER 1991, 
NOTES COMPILED BY JULIE HACKING, GRAPHIC NEWS ©

THE CHILDREN WHO LOST THE WAR

According to reports by an international study team, child mortality in Iraq has almost quadrupled since the Gulf War. Before the war, the mortality rate for children under five was 27.8 deaths per thousand live births. The figure has now increased to 104.4 deaths per thousand live births. The figure is highest in the age group between one and two years, children who have lived most of their lives under the effect of either conflict, sanctions or both. Children who survive are in many cases severely malnourished. Again, those aged between one and two years are twice as likely to be malnourished as those between three and five.

The mortality rate increase is smallest in Baghdad, which, while still suffering from damaged facilities and severe shortages, has seen improvements over recent months. The highest increase in the death rate occurs in the North, taking account of the devastating conditions experienced by the Kurds earlier in the year.

A complex interaction of factors is thought to be responsible. 
There are acute shortages of food, including infant formula and powdered milk. What little infant formula is available costs 2-3000 % more than in August 1990, before the invasion of Kuwait. 

Essential medicines are in extremely short supply throughout Iraq. Lack of clean drinking water and poor sanitation have greatly increased waterborne diseases, such as cholera, typhoid, dysentery and gastroenteritis. Hepatitis and meningitis are widespread. Preventable diseases such as measles, polio and tetanus are reappearing as Iraq’s vaccination programme, efficient before the war, is now almost non-existent. Disruption to the country’s electrical supply destroyed most stores of vaccines, which must be refrigerated. Until full electrical facilities are restored, supplies of vaccines and other temperature sensitive drugs will remain extremely limited. Many medical instruments will not function for the same reason.

Hospitals lack other basic medical supplies such as antibiotics, anaesthetics and syringes. Health workers re-sterilize and re-use disposable syringes, needles and other supplies intended for single use. Laboratories, X-ray units, neonatal units and operating theatres can provide only very limited services, or none at all. Soap and detergent are almost non-existent, and consequently so is the hospital laundry service. In cities affected by civil disturbances following the war, laboratory equipment was often stolen or damaged. An acute shortage of specialized nursing staff worsens an already appalling situation.

Regional differences are apparent. Baghdad has benefited from improvements to its water supply and so infectious diseases within the city have diminished whereas in southern Iraq disease and death remain at epidemic levels. 30% of hospital water sources were found to be polluted with fecal contamination. Lavatories are clogged and in several hospitalsinspected by the team, raw sewage had backed up into the wards.

Damage to electrical plants during the bombing has been only partially repaired, Waste water treatment, water purification and delivery are also severely impaired by the lack of electrical power. Shortage of spare parts and chlorine pose even greater problems than bomb damage. Over 60% of the population surveyed no longer have tap water available in their homes.The entire public health infrastucture remains at risk.

Psychological effects are also taking a profound toll, particularly amongst the young. Nearly two thirds of children interviewed by the team believed that they would not survive to become adults, and nearly 80% feared losing family members through death or separation.  

Sources: International Study Team, UNICEF