Two new reports conclude that the health costs of war are unaffordable



Desmond Avery




A war on Iraq could cause half a million deaths and devastate the lives, health and environment of the combatants, Iraqi civilians, and people in neighbouring countries and beyond. The details are examined in an independent report entitled Collateral damage: the health and environmental costs of war on Iraq, prepared by health researchers under the aegis of Medact, a British nongovernmental organization.

The report's estimates of the total possible deaths on all sides during the conflict and the following three months range from 48 000 to over 260 000. Civil war could kill another 20 000 people, while deaths occurring later caused by adverse health effects could reach 200 000. The number of wounded could range from 120 000 to 650 000. In all scenarios the majority of casualties are civilians.

The research team is from the London School of Hygiene and Tropical Medicine, the Albert Einstein College of Medicine in New York, and other institutions. They based their calculations on the 74 most reliable sources available, consisting of reports from UN agencies, aid agencies active in Iraq, and government and academic publications. They studied the health status of Iraqis before and after the Gulf War of 1990–91, the environmental impact of that war, strategic and military war scenarios available in the public domain, and morbidity and mortality data from comparable conflict areas.

The author of the report, Jane Salvage, told the Bulletin: "I concluded that even a contained, short war could trigger famine and epidemics, displacement of millions of people, catastrophic effects on children's health and development, and economic collapse. Any new conflict will probably be much more intense and destructive than the 1990–91 Gulf War, involve more deadly weapons developed in the interim, and be likely to take place in densely populated urban areas."

The report also points out that the mental and physical health of ordinary Iraqis is far worse than it was in 1991. This makes them more vulnerable than before, and less able to muster the resources needed for recovery and reconstruction. Iraq before 1991 had become a middle-income country with a modern social infrastructure and public services. It now occupies 126th place out of 174 countries on the UN Human Development Index.

The second report, Our common responsibility: the impact of a new war on Iraqi children, concludes that the vast majority of Iraq's 13 million children would be adversely affected if the war went ahead. It was released on 30 January by a Canadian-led team of health experts, and is based on data they gathered on a humanitarian fact-finding mission to Iraq earlier in January, visiting more than 100 families (parents and children) in their homes in Baghdad, Basra, and Kerbela.

They found that the health and nutritional status of Iraqi children were still in a significantly worse state than they had been before the Gulf War in 1991. Most of them are still dependent on food distributed by the Government of Iraq. War would disrupt that system and expose them in large numbers to severe malnutrition.

The researchers, two of whom are leading child psychiatrists, also found that children suffer significant psychological harm from the ambient fear of war. "The first and foremost message from the children was about their fear", the report states. "Except for some boys who denied any fear at all and 14-year-old Ahkmed who in a breaking voice stated 'Right now I think more about my exams', they all report strong daily fear. A majority specify this fear to be thoughts about the death of family members and the fear for their own lives."

Other facts and findings in Our common responsibility: 16 million Iraqi civilians are entirely dependent for food on government-distributed rations; there is only an estimated one-month supply of food in Iraq; 500 000 Iraqi children are acutely malnourished and underweight; only 60% of Iraqis have access to clean drinking-water; the UN estimates that hospitals and clinics will run out of medicines within three to four weeks of a conflict.

Collateral damage: the health and environmental costs of war on Iraq can be found at . Our common responsibility: the impact of a new war on Iraqi children is available at

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