By Livia Leykauf, Caritas Switzerland
In Iraq the suffering continues The severest sanctions ever imposed by the United Nations were imposed on the Iraqi government 10 years ago. However, it's the average person on the street who is suffering most, as members of the recent Caritas Internationalis delegation to Iraq saw during their visit. Bebetto is seven years old, and undernourished. Filippa, four, is also undernourished. As is Nahla, who will soon be three. The list seems endless. Around one million Iraqi children are either malnourished or undernourished. That is one in three children. Things may be a bit better than they were, but the number of undernourished children is still much too high.
"It's harrowing. Even if people are doing their best to cope with the everyday difficulties, effectively it's crippling everybody."
In her work as a paediatrician Dr Salwa Al Dawaf, sees girls and boys everyday who are much too small for their age. When they arrive at the Caritas Centre in Baghdad, many of them are sick, underweight or emaciated. People receive nourishment almost exclusively from United Nation food parcels. As a result, many suffer from a deficiency of essential protein and vitamins.
As Dr Al Dawaf explains, "Most people simply don't have enough money to buy meat or fresh fruit." She takes little Rania up onto her arm. As they play together she explains how the child had already started regaining some weight from the supplements she's been receiving during the last few months. But she's still almost a year behind a healthy child in terms of development.
The effect of sanctions on everyday life - in what was once an affluent country - is not only reflected in the food shortage. The water supply has also suffered. The output of the water network has halved since the Gulf War. The water supply network reaches a good 90% of households in cities such as Baghdad, Mosul or Basra, but in rural areas it's only about 43%.
According to Dr Naim M. Noah, head of the Engineering Department at Caritas Iraq (which also deals with the water supply network) even the drinking water is not as pure as was ten years ago before sanctions. There are insufficient funds for repairs, it is extremely difficult to obtain replacement parts, and many qualified professionals have either left the country or switched to different sectors. Water and sewage treatment is frequently interrupted by power cuts and people in weak conditions already -- children, the sick, pregnant women and elderly people -- suffer most from the poor water quality. Caritas health centres and municipal hospitals have reported a sharp increase in the number of cases attributed to dirty water. Typhoid and severe cases of diarrhoea are escalating.
The quality of medical care has also plummeted over the past 10. Many hospitals are in disrepair. Incubators and x-ray machines are antiquated. Mattresses are shabby and threadbare. Doctors report that 99% of children with leukaemia die because they do not receive the right medication, despite the slight relaxation made recently to allow more importation of medicines.
A father visiting one of the Caritas Centres in the north of Baghdad reflects the mixture of desperation and anger: "What has my daughter done to deserve this? Why should she suffer?
Iraqi people hunger for peace
Cases of serious malnutrition among the people of Iraq have decreased during the past years. However, every third child under the age of five still suffers from malnutrition. Alla is one such child. She is four years old and physically and mentally disabled, which is why her mother took her to one of the eight health centres in Baghdad provided by Caritas and the Red Crescent Society. Dr. Salwa Al Dawaf found that Alla showed signs of malnutrition and included the little girl in the "well-baby programme". Now she visits the centre regularly with her mother. She is no longer frightened when the nurses measure her height or place her on the scales to be weighed.
Alla's mother takes part in an education programme with other women to learn about hygiene and nutrition in order to care for their weak and ailing children. They learn, for example, what a balanced diet consists of, what dangers lurk in unclean water, and what symptoms indicate that a child needs to see a doctor. The fact that infant mortality is over 10% in Iraq shows just how desperate the situation is. "Practically all the children participating in our programme suffer from malnutrition, which is why here they are given additional food, particularly proteins because these are not contained in the UN food packages. For children, pregnant women, and nursing mothers above all, a balanced diet is vital for life and survival," explains Dr. Al Dawaf.
A great concern
Two in three families are completely dependent on UN food packages, which are distributed as part of the "Oil-for-Food" programme. Dr. Al Dawaf is very concerned about the food situation in Iraq, "Many of the children come from big families, the fathers can't find work, and they lack the bare essentials. It isn't about not having luxury items, but about not having the basic items necessary for life."
One mother explains, "In the past meat was part of the daily diet in Iraq. It's part of typical Iraqi cooking and found even in very simple dishes. Nowadays at the very most we can afford to buy one small piece of chicken or lamb once a month."
A father accompanying his wife to the "well-baby" surgery says, "Although I have a permanent job and I earn reasonably well, we are not able to give our little Massara the food she needs to grow and thrive."
Between recovery and setback
In the year 2001 alone, 22,000 women and children took part in the "well-baby programme", 95% of whom were in better health and had gained strength by the end of the programme.
But many return soon after. They often develop bad cases of diarrhoea from dirty water, for example, and the health and strength they worked so hard to gain have been lost. "The situation is already desperate. The people are doing their best to come to terms with it. But one must remember that the Iraqi people have already been weakened. All it needs for the situation of the people to get even worse would be for a catastrophe to happen," Dr. Al Dawaf says. "An unimaginable catastrophe," she adds quietly.