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Iraq Faces Health Crisis, Medical Group Reports

By Glenn Frankel
Washington Post Foreign Service
Wednesday, December 1, 2004; Page A15

LONDON, Nov. 30 -- Iraq is facing a public health disaster because of the U.S.-led invasion, ongoing conflict and mismanagement of the relief and reconstruction effort, a British-based medical monitoring group said in a report released Tuesday.

The group, Medact, which has opposed the war because of the potential health ramifications, called for an independent investigation of civilian casualties and for a renewed international effort to provide emergency relief and build a better health care system.

The war has "exacerbated the threats to health posed by the damage inflicted by previous wars, tyranny and sanctions," the report concluded. "It not only created the conditions for further health decline, but also damaged the ability of Iraqi society to reverse it."

The report endorsed a controversial study published by the Lancet medical journal here last month that estimated that 100,000 Iraqis had died as a result of the conflict. "No starker proof is required of the disastrous effects of war, even supposedly a short and contained one, on innocent people," the report stated.

The 100,000 figure is far above estimates from other groups. An independent Web site, Iraqbodycount.net, which compiles direct media reports of deaths, put its tally as of Tuesday at between 14,571 and 16,750, although it has stated that actual deaths may be far higher.

The Iraqi Health Ministry has put casualties from April 5 to Oct. 5 of this year at around 3,853 dead and 15,517 injured, based on hospital reports. The British government contends that these figures are the most reliable, but Washington and London have refused to release their own estimates.

The Medact report cited increases in child mortality rates, damage to water, sanitation and electricity facilities and inadequate food supplies as contributing factors in the breakdown of public health. It said the health system, which had been drained of money and personnel during the 1991 Persian Gulf War and the economic sanctions that followed, "was poorly prepared to cope with the impact of the 2003 war."

Since the U.S.-led invasion began in March 2003, hospitals and public health laboratories have been damaged or looted, child-care facilities shut down and vaccines either stolen or spoiled during power shortages, according to the report.

It criticized the Pentagon for maintaining a tight grip on post-invasion relief efforts and discarding plans by experienced humanitarian agencies to deal with the health crisis. Medact said its report was based on interviews its investigators conducted in Amman, the capital of Jordan, with 20 international nongovernmental organizations and individuals involved in medical relief work, as well as phone and e-mail conversations and other reports. Medact officials conceded that the issues involved were "complex and contentious" and needed more study.

Iraq's Health Ministry responded by acknowledging that serious public health problems exist but said no major epidemic or health crisis had occurred since the invasion.

"We are passing through a very difficult period for health because of the huge needs for rehabilitation and reconstruction after more than two decades of absolute neglect," the interim health minister, Alladin Alawan, told the BBC.

Alawan disputed Medact's endorsement of the Lancet casualty figures but welcomed its call for a large-scale international effort to aid public health. "We would actually welcome any collaboration from independent agencies," he said.

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