Iraq is not only on the brink of war. Its people are on the brink of a humanitarian disaster. Rates of child mortality have soared since UN sanctions were imposed in 1990. With or without war, this crisis must be addressed. With war, there would be the very grave danger that civilian suffering would immeasurably increase.
Iraqis depend on a modern infrastructure for their food, water, and sanitation, but this is in a desperate state of repair. Any military attack is likely to cause even greater harm. In a society where people were adequately nourished, and where diarrhoea was not so prevalent, this might not lead to humanitarian disaster. But in Iraq, which has suffered the greatest increase in child mortality in the world over the past ten years, there is every danger that it could.
On the brink
More than one in ten Iraqi children die before their fifth birthday (131 out of every 1000 live births)1. Iraq has suffered a faster increase in the rate of child mortality than any other country in the world (160 per cent in the decade to 2000)2. Seven out of ten infant deaths result from diarrhoea or acute respiratory infection linked to polluted water or malnutrition 3. Although the rate of child malnutrition actually improved in 2001, UNICEF's latest survey in February 2002 revealed that close to one million children under five - nearly one-quarter of all children - still suffer from chronic malnutrition4.
Polluted water, poor sanitation
That so many children die from diarrhoea is not hard to understand. The country's main source of water, the Tigris, receives half a million tonnes of raw or partially-treated sewage each day. Half of all sewage treatment plants do not work5. Of those that do, one-quarter do not meet Iraq's own environmental standards.
Piped water still reaches most urban homes, but 65 per cent of it is not treated. In rural parts of central and southern Iraq, UNICEF now reports that only 45.7 per cent of homes have piped water, compared with 75 per cent before the 1991 Gulf War. Leaky pipes mean that some households get water only once in ten days6. In the towns, the system of tankers on which half the urban population depended, is crumbling without essential spares, tyres, and batteries.
|'Mains sewers don't work
because they need working pumps. Trucked systems - used to empty cesspits
and tanks - aren't working properly because there are no spares, no tyres,
no batteries. Sewage flows back into people's houses. People then put the
sewage in open storm drains, or just into the street. There are pools of
raw sewage in cities. Whichever way you look at it, it's a public-health
Paul Sherlock, Oxfam engineer, Baghdad, 28 October 2002
Iraq is a developed country. Its water and sanitation system depends on electrical supply. In 1991 air strikes destroyed much of the country's power supply, disrupting these basic civilian services as well as Saddam's command and control. Eleven years later, it is thought that one-third of the national power supply is still down. In the summer of 2002, the UN Development Program estimated that Iraq needed to generate 6200 MW of power. With an operating capacity of only 3800 MW, this means a deficit of 2400 MW7. Most water treatment plants have their own generators, but 70 per cent do not work. The net effect of power cuts is water cuts8.
Drought and ecological mismanagement have made Iraq's rivers more and more polluted. But UN sanctions have contributed to the current collapse of the water and sanitation system. Effectively, Iraq does not control the revenues from its oil exports and is not able to spend them as it chooses. In practise, it cannot purchase seven new pumping stations for its urban water supply. And at the time of writing it has not yet received the UN permission required under the sanctions regime for several hundred new compact units for rural areas. Even if it does, it is not clear that it could find the funds for these either.
Iraq's oil revenue is held in foreign bank accounts, controlled by the UN. In the five years to 2002, Iraq earned US$37.3bn. But the first call on those funds is not tackling the scourge of diarrhoea. It is paying for Iraq's war reparations, the UN's administrative costs, and the UN Oil-for-Food programme. The needs of the water and sanitation system and the electricity that powers it - let alone education - come a poor second.
In 2002, the scarcity of resources has got worse, not better. Falling oil prices means that Iraq earns less. The Iraqi government has also sometimes made matters worse. The latest phase of the Oil-for-Food programme earned US$4.3bn (to 1 November), compared with US$9.5bn during a similar period in 20009. Approximately US$7bn is estimated to be the minimum needed to cover the costs of Iraq's war reparations and the Oil-for-Food programme - an inadequate and inappropriate response which has become essential to the survival of nearly every Iraqi household.
Iraq does not produce enough to feed its people. The past three years have seen a major drought. An attempt to irrigate land using the Tigris and Euphrates has been frustrated by sanctions-related difficulties in getting spare parts to maintain the network. The 2002 wheat harvest of 1.6m tonnes is healthy, but will still run out in early 2003.
The result is that the great bulk of Iraq's people depend overwhelmingly on food rations. According to the UN Office for Humanitarian Coordination in Iraq, around 15 million people, out of a country of 22-24 million people, are completely dependent on food aid10.
In 1990, the average Iraqi had 3159 calories of food a day11. Though the Oil-for-Food programme imports around 475,000 tonnes a month, it still provides for only approximately 2200 daily calories. As Paul Sherlock saw in Mosul, 'The children are stunted, the mothers malnourished.'
'There's just not enough food to go around,' Sherlock reported. But this is exacerbated in some households. 'What appears to be happening is that fathers in many households get most. That's part of the reason why there's so much malnutrition among children, and why so many mothers die in childbirth. They're just not in good shape.'
But the greatest problem is not so much the amount of food. It is most Iraqis' dependency on an inflexible and bureaucratic ration system, agreed between the Iraqi government and the UN, and delivered almost entirely through the Government's distribution network.
Conclusion: A people vulnerable to attack
Rations provide food, however inadequately. But they also make Iraqis vulnerable to anything that disrupts their supply and distribution - whether government policy, or any kind of military action which, 'collaterally' or deliberately, affects roads, ports, or railways. As the UN Special Rapporteur on the Right to Food said recently, 'The right to food must be protected in times of peace - but also in times of war12.
But the Iraqi people are possibly even more vulnerable to the disruption of water and sanitation systems and the electricity infrastructure on which they depend. Air strikes of the kind that took place in 1991, which wiped out power supplies, could have a devastating impact.
|'I saw what the air strikes
did in 1991. In the town of Samawah, knocking out the power to pump the
main sewers meant that sewage was spilling out on the surface to form large
pools. People were fleeing the stench and danger of disease.'
Paul Sherlock, Baghdad, 28 October 2002
International humanitarian law prohibits attacks on 'objects indispensable to the survival of the civilian population'13. Iraqis depend on a modern infrastructure for their food, water, and sanitation. Any military attack could cause grave harm to that infrastructure, which is already in a desperate state of repair.
In a society where people were adequately nourished, and where diarrhoea was not so prevalent, this might not lead to a humanitarian catastrophe. But in Iraq, which has suffered the greatest increase in child mortality in the world14, it clearly could. It is not true to assume that the suffering of Iraqi civilians - from Iraqi Government policy and 12 years of inept sanctions - could not get any worse. A military attack now on Iraq could do just that. As always, it is for the advocates of military action to demonstrate that action will do more good than harm.
This briefing note is largely based on a recent assessment in Iraq by Oxfam's most experienced water engineer, Paul Sherlock, in co-operation with Caritas. Sherlock visited Baghdad, Najaf to the south, and Mosul and Kirkuk in northern Iraq. Between 1991-96 he worked regularly in Iraq on Oxfam's programmes. He will visit countries bordering Iraq later in December 2002 to assess the preparedness for potential flows of refugees from any military attack.
1 1999 figures are the most recent, reported by UNICEF's Iraq representative Carel de Rooy, quoted by Reuters, 21 November 2002. See also 'Sanctions and Child Mortality in Iraq', The Lancet 355, 27 May 2000, page 1851.
2 'The Situation of Children in Iraq: An Assessment Based on the United Nations Convention on the Rights of the Child', UNICEF Iraq, February 2002, page 19
3 Ibid, page 20
4 UNICEF Iraq representative Carel de Rooy, quoted by Reuters, 21 November 2002
5 Alleviating Poverty in Iraq, UNDP Iraq 2002
8 The Situation of Children in Iraq, page 7
9 Weekly Update, Office of the Iraq Programme, United Nations, New York, 5 Nov 2002
10 Quoted in 'On the brink of war: a recipe for a humanitarian disaster', Caritas International, November 2002, p4.
11 Alleviating Poverty in Iraq, UNDP Iraq 2002
12 The right to food: Report by the Special Rapporteur on the right to food, Mr Jean Ziegler, UN Commission on Human Rights, Geneva, 10 Jan 2002, ECN.4/2002/58, paragraph 72. See also "The right to food in situations of armed conflict", Jelena Pejic, International Review of the Red Cross 83 (844), 2001
13 1977 Additional Protocol I, Geneva Conventions, Article 54.
14 UNICEF Iraq representative Carel de Rooy, quoted by Reuters, 21 November 2002