06/18/2000 - Sunday - Page A 7, Inside Iraq
Iraq's Sacrificial Lambs
Its babies are dying in squalor; is UN embargo to blame?By Matthew McAllester. MIDDLE EAST CORRESPONDENT
Baghdad, Iraq - From the corridor outside the crowded pediatric ward came the scream of a mother in the first seconds of mourning.
Looking from side to side, a woman in a black head scarf carried the limp body of her 1-year-old daughter Yousser out of the ward's examination room. Her tears fell on the scarlet fabric of the last dress Yousser would ever wear. As she stood cradling her dead daughter, the woman started to explain how she had first brought Yousser to the hospital 10 days ago after the little girl developed bloody diarrhea. Today she had brought her back, but it was too late.
Again the moan of a mother. This time from inside the examination room. It was 3:03 p.m.-seven minutes since Yousser had died.
"Another one," said Dr. Uldram Ahmed, chief resident of the pediatric section of Ibn Al-Baladi maternity and pediatric hospital in a poor part of Baghdad known as Saddam City.
Lying on his back inside the examination room was Ali Hussein. Facing him on a wall of the room was a photograph of two chubby, European-looking toddlers giggling as they fed long grass to a kid goat. Ali was not like those children.
He looked brittle. The right nostril of his nearly fleshless nose was crusted in blood. His minuscule hands were curled and motionless. He was 10 weeks old and looked like he'd lived through a century. His teenage mother leaned over him as Dr. Ghassam Rashid Al Baya pressed his stethoscope to the naked baby's gray chest.
"He died?" asked Ahmed, who was looking on.
"Yes," Al Baya replied, still listening to Ali's chest for a sound he knew he would never hear.
"Second one dead," Ahmed said. "Look at the bloody vomitus." Ali's last, crimson breath formed a tiny wet cloud next to his head on the orange wrap he lay on.
"He died," Al Baya confirmed, tucking his stethoscope away into the pocket of his white coat. "He passed." Ali's mother enclosed him in the stained orange blanket and glided out of the room in silence. He was the third that day. The first died at 8 a.m. The second was Yousser. And there was another, a 4-month-old girl, Rinda Satar, across the corridor gasping what Ahmed said would be her last breaths. Two of them, Ali Hussein and Rinda Satar, were from the same neighborhood, Hai Al Tarek.
The hospital didn't even keep a record of their mother's names or their addresses. The women walked out of the building with their babies in their arms. All around the hospital the old electric clocks were stopped at different times. 12:52. 4:11. 5:32. And 1:07 in the room where Ali Hussein died.
It was a perfectly average day at Ibn Al-Baladi.
"You see, they died of poor feeding, loss of weight," said Al Baya, who earns the equivalent of a dollar and a half per month. He's 30 years old and has been a doctor for six years. He has lost count of the number of babies who have died in his hands. Today's dead suffered from malnutrition, stomach infections, bacterial infections, chronic loss of weight, the doctors said. The usual. With proper nutrition, clean water, efficient sanitation and sufficient medical supplies, most of these babies would survive, the doctors said. It hasn't always been this way. Not that long ago Iraq had one of the best health care systems in the Middle East. Infant mortality rates were comparatively low.
But now this is normal at Ibn Al-Baladi.
"It is one of the results of the embargo," Al Baya said. "This is a crime on Iraq. What is wrong with these poor children? Are they soldiers that they have to be treated like this? They are not soldiers." Al Baya may have lost count but other people are trying to record the numbers of children who have died in Iraq since the UN Security Council imposed economic sanctions on the country in August 1990. While not the only way of judging the effect of the sanctions, the number of children who have died is perhaps the most stark indication of its impact on the Iraqi people. UNICEF, the United Nations' children's organization, last August put the number of children under age 5 who have died since the start of the sanctions at 500,000.
From 1994 to 1999, UNICEF says, more than one in 10 Iraqi children who live in the main part of the country under the control of President Saddam Hussein died before they reached the age of 5. A similar survey for the period from 1984 to 1989 had the death rate at less than half the current rate. Iraq blames the United Nations and the Western powers-mainly the United States and Britain-who insist on maintaining the embargo.
The United States insists that Hussein is to blame for refusing to allow arms inspectors free rein in Iraq, for refusing to spend government revenue on essential services, for mismanaging the medical supplies imported under the UN's Oil for Food Program and for exploiting the common people of Iraq for propaganda purposes.
"We've been pretty clear about not wanting to see babies dying," said a State Department official who spoke on condition of anonymity. "Those 500,000 babies died needlessly because of a government that doesn't care about them." "It has transcended the bounds of tragedy," said Riyadh Al Qaysi, Iraq's deputy minister of foreign affairs. "It's a concrete genocide." The apportioning of blame is highly politicized. Deciphering where that blame truly lies is difficult.
"There is a total lack of logic on either side, with the American government or the Iraqis," said a senior diplomat in Baghdad.
There may be no better place to look at the roots of Iraqi suffering than Hai Al Tarak, the neighborhood of little Ali Hussein and Rinda Satar. It is right on the edge of Baghdad, on the frontier of Saddam City, itself a vast slum of 2 million people.
Over and over, the water is named as the chief culprit behind the dying babies of Hai Al Tarek.
"The water is so dirty, cloudy," said Jassima Abed, 32, the mother of Rinda, the dying four-month old. "There are worms in the water and it has a bad odor." Rinda had similar symptoms to Ali Hussein: Bloody diarrhea, loss of weight, lethargy, vomiting. In the hospital, she lay on stained blankets, her breath rasped and the skin around her stomach was drum-tight. The doctors said the actual cause of death would be a bacterial infection.
Such tragedies are commonplace in Hai Al Tarek.
In the single-room hut of mud bricks she shares with her husband and two children, Samira Kassim, 23, flapped at the flies that buzzed around her and talked of how her 4-year-old son, Mazen Karim, died in February.
"He started to lose weight day after day and his skin started to stretch. I took him to the hospital on December 29th. They put oxygen on his nose but he was in a coma. He didn't want to eat. It's because of the water and the dirtiness around. I always told him not to use it or play in that water but I expect he did." Kassim lost another son two years ago. She is pregnant again. Her children bathe once a week in the dirty water, which they get from a neighbor's pipe and store in plastic containers in the room. Often, there's not enough water coming out of the taps. She throws the family's urine from a bucket into her front yard where it evaporates in the sunshine. Her children play in the street, which is covered in garbage and has an open sewage ditch running down the side.
Her husband works for the Baghdad sewage system and makes the equivalent of five dollars per month.
In 1990, fewer than a thousand people lived in Al Tarek. Now there are more than 30,000 living in sloppily built homes of bricks, mud and concrete blocks.
There is no sewage system. Trucks sometimes come and remove the solid waste from the homes. Ditches of urine and other liquid waste line nearly every street where barefoot children play. A huge disused canal full of toxic water and raw sewage sits between Al Tarek and Saddam City. The water in Al Tarek, residents said, is frequently smelly, cloudy and, as Abed said, full of worms.
It's so bad that sometimes Al Tarek people fetch water from the main parts of Saddam City, itself an impoverished mini-city where herds of goats chew at piles of garbage in the street.
"We are always sending requests to the mayor for new water pipes and the answer is always there are not enough pipes and pumps because of the embargo," said Jihad Nasser, 59, the mukhtar or unofficial head of the community. "The government promised a sewage system but when the war started none came." And so the people of Al Tarek drink whatever water they can find.
Saad Behnam Abdullah, at the end of another 16-hour day in his tatty office as director general of the Baghdad Water Supply Authority, said he was not at all surprised to hear about the deaths of the children in Al Tarek.
On his wall was a wistful poster of a large plan the authority had in the late 1980s-before the embargo-to build new reservoirs, pumping stations, treatment plants and pipelines around the city. None of that has been started even and the city's aging water and sewage pipes are cracking all over the place.
The problem with Baghdad's water is not its quality when it leaves the pumping stations, he said. It's that the water and sewage pipes have started to disintegrate and that means raw sewage is being sucked into the water supply en route to people's homes. Anupama Rao Singh, the UNICEF representative in Iraq, also said this is the main problem. With hardly any money to spend on the systems, Abdullah and his colleagues can't hope to repair the pipes.
A vicious cycle is going on underground in Baghdad. When the water and sewage pipes leak, the nearby ground shifts and settles, causing further cracks. And that causes more leaks. And then the ground shifts and settles again. It's getting worse all the time, Abdullah said.
When asked how much it would cost to repair the system, Abdullah erupted in bemused and tired laughter.
At Al Tarek, the problems are worse than for most of the city, he said. The supply of water there is low, he said. It's at the end of the line and the water pressure is at its weakest, and as Al Tarek continues to grow, the demand for water is pushing people to tamper with the pipes.
"The lack of quantity is forcing people to find other ways to get water and it's not good for their health," he said. "They're bursting pipes, getting that water mixed up with polluted water and sewage, pumping water on their own from the mains pipes. That creates a negative pressure, which can suck in sewage.
They are causing this pollution but they're obliged to do it. They don't have water. This has caused so many cases in the hospital." Who's to blame for this? "America," said Kassim without hesitation.
American officials say that such responses are the result of fear of Hussein's regime and lack of understanding of the situation. If Kassim had blamed the Iraqi government while speaking in front of a government official, the consequences for the family might have been dire. Foreign reporters in Iraq have government minders with them at all times except in meetings with diplomats and aid workers.
In one of the few moments that a reporter had away from the minder, a medical worker departed from the party line. "The people can't say what they really feel," the medical worker said. "It's the political regime that's the problem. Of course they blame the government." American officials say the Hussein regime mishandles the supplies that come into Iraq under the Oil For Food program. Established in late 1996, the UN-administered program allows Iraq to sell large quantities of its oil. The UN handles the profits. The Iraqi government requests supplies, a UN committee reviews the requests and, if approved, the goods are shipped to Iraq. In Northern Iraq, which is currently run by two Kurdish parties, the UN directly administers the distribution of aid. In the south and central parts of Iraq, still under Hussein's control, the Iraqi government runs the aid program.
UN officials in the south dismiss the American government's claims about widespread and manipulative Iraqi mismanagement.
"Not one of the observer mechanisms has reported any major problems in humanitarian supplies being diverted, switched or in any way misused," said George Somerwill, spokesman for the UN in Iraq. Rather, aid workers said, the program is clunky, bureaucratic and operates in a country whose infrastructure has been devastated.
"Not all contracts are approved in time," said Dr. Hussien Zakar, officer in charge of the World Health Organization in Iraq, which monitors the distribution of medicine and the Iraqi health care system. "Not all shipments arrive in sequence. They're not always efficiently distributed. There's a lack of transport and funds for that." These same problems with the embargo make it difficult to do anything about the water and sewage mess, UN officials say. The sanctions committee has repeatedly withheld approval for engineering equipment the Iraqi government says it needs for the water or sewage systems because, the committee says, the equipment could also be used for the Iraqi military. UN officials in Baghdad say most of these objections, especially those raised by the United States and Britain, are not valid.
Iraqi government officials also say they have no money to spend on the new trucks for distributing medication, partly because the Oil for Food program allows them no cash allowance, only materials.
"Saddam finds money to spend on trucks for his army," the State Department official said. "Why doesn't he spend it on distributing medication?" Another point American officials like to make about the Iraqi government's expenditure choices is the comparatively healthy state of Iraq's private hospitals. Newsday made an unscheduled visit to one private hospital in Baghdad and conditions there were markedly better than in the public hospitals visited.
"There are very obvious disparities within the country," said Singh, of UNICEF.
A simple car journey testifies to that. Drive from central Baghdad, past some of the city's new private hospitals with expensive German cars parked outside, then through the boulevards of Saddam City and into Al Tarek and you see that disparity.
In Al Tarek, in Kassim's room, her neighbor Aria Rishak Ghelan told how she too had lost a child.
It was April 21 of last year, she said, when she noticed that her 5-year-old boy Sajad Abbas had started to suffer from the same symptom that all the sick children from Al Tarek seem to have-diarrhea.
"I took him to Al Qadissiya hospital and the next day I lost him," she said. "At 9 a.m. he died. Nobody explained why.
"I was married twelve years ago," said Ghelan, 29, who wore a black head scarf and was barefoot. "Life was good then and we were living with my husband's parents." That was before the embargo. Three years ago, with a growing family, they had to find their own home and the only place they could find was Al Tarek, which is where people in Baghdad go when they have no other option. Most people there build their own homes out of whatever they can find on any patch of land they can find. They have no legal right to live there.
"There are many things here," Ghelan said. "We don't usually get enough to eat, the water is bad and there is sewage outside." "It is a horrible life," said Ghelan, who has four surviving children. "If the conditions continue like this it will just get worse."