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From The Washington Post, 11/21/04:
http://www.washingtonpost.com/wp-dyn/articles/A809-2004Nov20.html
Children Pay Cost of Iraq's Chaos
Malnutrition Nearly Double What It Was Before Invasion
By Karl Vick
Washington Post Foreign Service
Sunday, November 21, 2004; Page A01
BAGHDAD --
Acute malnutrition among young children in Iraq has nearly doubled
since the United States led an invasion of the country 20 months ago,
according to surveys by the United Nations, aid agencies and the
interim Iraqi government.
After the rate of acute malnutrition among children younger than 5
steadily declined to 4 percent two years ago, it shot up to 7.7
percent this year, according to a study conducted by Iraq's Health
Ministry in cooperation with Norway's Institute for Applied
International Studies and the U.N. Development Program.
The new figure translates to roughly 400,000 Iraqi children suffering
from "wasting," a condition characterized by chronic diarrhea and
dangerous deficiencies of protein.
"These figures clearly indicate the downward trend," said Alexander
Malyavin, a child health specialist with the UNICEF mission to Iraq.
The surveys suggest the silent human cost being paid across a country
convulsed by instability and mismanagement.
While attacks by insurgents have grown more violent and more frequent,
deteriorating basic services take lives that many Iraqis said they had
expected to improve under American stewardship.
Iraq's child malnutrition rate now roughly equals that of Burundi, a
central African nation torn by more than a decade of war.
It is far higher than rates in Uganda and Haiti.
"The people are astonished," said Khalil M. Mehdi, who directs the
Nutrition Research Institute at the Health Ministry.
The institute has been involved with nutrition surveys for more than a
decade; the latest one was conducted in April and May but has not been
publicly released.
Mehdi and other analysts attributed the increase in malnutrition to
dirty water and to unreliable supplies of the electricity needed to
make it safe by boiling.
In poorer areas, where people rely on kerosene to fuel their stoves,
high prices and an economy crippled by unemployment aggravate poor
health.
"Things have been worse for me since the war," said Kasim Said, a day
laborer who was at Baghdad's main children's hospital to visit his
ailing year-old son, Abdullah.
The child, lying on a pillow with a Winnie the Pooh washcloth to keep
the flies off his head, weighs just 11 pounds.
"During the previous regime, I used to work on the government
projects. Now there are no projects," his father said.
When he finds work, he added, he can bring home $10 to $14 a day.
If his wife is fortunate enough to find a can of Isomil, the
nutritional supplement that doctors recommend, she pays $7 for it.
"But the lady in the next bed said she just paid $10," said Suad
Ahmed, who sat cross-legged on a bed in the same ward, trying to
console her skeletal 4-month-old granddaughter, Hiba, who suffers from
chronic diarrhea.
Iraqi health officials like to surprise visitors by pointing out that
the nutrition issue facing young Iraqis a generation ago was obesity.
Malnutrition, they say, appeared in the early 1990s with U.N. trade
sanctions championed by Washington to punish the government led by
President Saddam Hussein for invading Kuwait in 1990.
International aid efforts and the U.N. oil-for-food program helped
reduce the ruinous impact of sanctions, and the rate of acute
malnutrition among the youngest Iraqis gradually dropped from a peak
of 11 percent in 1996 to 4 percent in 2002.
But the invasion in March 2003 and the widespread looting in its
aftermath severely damaged the basic structures of governance in Iraq,
and persistent violence across the country slowed the pace of
reconstruction almost to a halt.
In its most recent assessment of five sectors of Iraq's
reconstruction, the Center for Strategic and International Studies, a
Washington research group, said health care was worsening at the
quickest pace.
"Believe me, we thought a magic thing would happen" with the fall of
Hussein and the start of the U.S.-led occupation, said an
administrator at Baghdad's Central Teaching Hospital for Pediatrics.
"So we're surprised that nothing has been done. And people talk now
about how the days of Saddam were very nice," the official said.
The administrator, who would not give his full name for publication,
cited security concerns faced by Iraqi doctors, who are widely
perceived as rich and well-connected and thus easy targets for
thieves, extortionists and the merely envious or vengeful.
So many have been assassinated, he said, that the Health Ministry
recently mailed out offers to expedite weapon permits for doctors.
Violence has also driven away international aid agencies that brought
expertise to Iraq following the U.S. invasion.
Since a truck bombing at the U.N. headquarters in Baghdad killed more
than 20 people last year, U.N. programs for Iraq have operated from
neighboring Jordan.
Doctors Without Borders, a group known for its high tolerance for risk
and one of several that helped revive Iraq's Health Ministry in the
weeks after the invasion, evacuated this fall.
CARE International closed down in October after the director of its
large Iraq operation, Margaret Hassan, was kidnapped.
She is now presumed to be dead.
The huge Atlanta-based charity had remained active in Iraq through
three wars, providing hospitals with supplies and sponsoring scores of
projects to offer Iraqis clean drinking water.
By one count, 60 percent of rural residents and 20 percent of urban
dwellers have access only to contaminated water.
The country's sewer systems are in disarray.
"Even myself, I suffer from the quality of water," said Zina Yahya,
22, a nurse in a Baghdad maternity hospital.
"If you put it in a glass, you can see it's turbid. I've heard of
typhoid cases."
The nutrition surveys indicated that conditions are worst in Iraq's
largely poor, overwhelmingly Shiite Muslim south, an area alternately
subject to neglect and persecution during Hussein's rule.
But doctors say malnutrition occurs wherever water is dirty, parents
are poor and mothers have not been taught how to avoid disease.
"I don't eat well," said Yusra Jabbar, 20, clutching her swollen
abdomen in a fly-specked ward of Baghdad's maternity hospital.
Her mother said the water in their part of Sadr City, a Shiite slum on
the capital's east side, is often contaminated.
Her brother contracted jaundice.
"They tell me I have anemia," Jabbar said.
Doctors said almost all the pregnant women in the hospital do.
"This is not surprising because since the war, there is lots of
unemployment," Yahya said.
"And without work, they don't have the money to obtain proper food.''
Iraqis say such conditions carry political implications.
Baghdad residents often point out to reporters that after the 1991
Persian Gulf War left much of the capital a shambles, Hussein's
government restored electricity and kerosene supplies in two months.
"Yes, there is a price for every war," said the official at the
teaching hospital.
"Yes, there are victims. But after that?
"Oh God, help us build Iraq again. For our children, not for us. For
our kids," the official said.
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