Persistent guerrilla warfare in much of Iraq and the punishing fight for Baghdad are stalling the Bush administration's ambitious relief operations even as they make humanitarian successes more critical to the larger U.S. mission of overhauling the Iraqi state, according to U.S. officials and analysts.
U.S. and international aid agencies remain largely stranded outside Iraq's borders while fighting continues for control of Baghdad and other key areas of the country. Food stocks, while adequate in most places, will run out in weeks. Across the country, water is running short.
Perhaps the greatest immediate need is for medical assistance -- especially in the Iraqi capital, where deaths are now in the thousands and hospitals are overwhelmed.
"The situation in the city is extremely critical," International Committee of the Red Cross spokeswoman Amanda Williams said yesterday. Red Cross workers took supplies to the Medical City Hospital, which she said had no water or power, and where only six of 27 operating theaters were functioning.
Fighting blocked Red Cross efforts to reach another hospital, she said. Meanwhile, the World Health Organization reported that trauma kits for 6,400 patients, as well as 38 tons of medical supplies, were stranded in Jordan because of the fighting.
The worsening casualty figures and the increasing damage are complicating relief operations that the administration considers central to winning support from Iraqis for the difficult postwar challenges ahead, according to government officials and aid specialists.
"Every day this drags on, the more significant the human needs will be. There's bound to be a lot of hard feelings," said George Devendorf, director of emergency operations for Mercy Corps, a U.S.-based aid group. "The bitterness is going to be tough."
The military imperative to defeat Iraqi President Saddam Hussein's forces is colliding with the political demands to win Iraqi hearts and minds, analysts said. The war is only three weeks old and could end soon, but the more death and disruption it causes, the more difficult the challenge for the Bush administration.
"You're going to find people saying, 'We're much worse off than we were before,' and there's going to be resentment against the liberators," said Roberta Cohen, a Brookings Institution specialist in displaced persons.
"We said we were going to bring water and medical aid and food," Cohen said. "We were going to flood areas of the country with aid. None of that seems to be happening."
No one is more impatient than the relief workers who are poised to deliver electrical generators, water and jobs to Iraq, and who say that Iraqis will benefit after hostilities end.
"The frustration level is going up. We feel like we're a bunch of pigeons perched on the boundaries," one U.S. relief staffer said. "We are ready to do stuff, but we need a secure environment in which to do it."
The only significant international relief presence in Iraq thus far has been that of the Red Cross. In recent days, U.S. government aid workers have made their first tentative moves into the country. A two-person disaster assessment team from the U.S. Agency for International Development has inspected Basra and its airport, while USAID workers and members of the Pentagon's relief and reconstruction staff have moved into the southern port of Umm Qasr.
Trucks have entered Iraq carrying Kuwaiti medical supplies, and USAID, United Nations and Pentagon-led teams hope to set up shop in Kurdish-controlled territory in the coming days.
Although trucks carrying U.N. cargo have begun moving into northern Iraq from Turkey, independent aid groups reported that Turkish authorities have been slow to approve shipments and have blocked relief workers from entering the north. Aid groups asked Secretary of State Colin L. Powell to press the Turks to allow freer movement into Iraq during his visit to Ankara, Turkey, last week, but one worker said: "[W]e're no closer than we were a week ago."
"There are no good ways to get into northern Iraq right now," the worker said. He added that continuing bombardment and fighting in parts of the north make things "a little prickly" for humanitarian organizations.
The U.N. World Food Program reported yesterday that food stocks in northern Iraq would last 15 to 25 days. The United Nations identified 266,000 people in the north who have fled from the cities for rural areas that they consider safer. Ninety percent are staying with families, and nearly 10 percent are in public buildings, limiting the humanitarian need.
Supplies of food have been stored in countries that share borders with Iraq, and thousands of tons of wheat should arrive from Texas in two to three weeks. Two Australian ships, each holding 50,000 tons of wheat, have been unable to dock in Umm Qasr because they are too large for the port's silted channel and narrow berths.
The U.N. official in charge of Iraq's oil-for-food program warned the Security Council yesterday that emergency goods have yet to be ordered. Benon V. Savan said the Iraqi pipeline, consisting of goods sought by Hussein's government before the war, lacks crucial supplies.
Savan also said that the United Nations does not have the capacity to deliver all the goods in the pipeline before the world body's control over Iraq's finances expires. He called on members, who have been bickering over the Iraqi program, to contribute to an emergency appeal.
"I appeal to all concerned to put aside political considerations and concentrate on the emergency humanitarian needs of the Iraqi people," said Savan, director of the United Nations' Iraqi Program.
When U.S. workers enter the country in force, they intend to focus on water, sanitation, food and the health care system, said Michael Marx, leader of USAID's disaster response team. He told reporters in Amman, Jordan, that the relief workers are pleased that the war in Iraq has not yet generated a humanitarian crisis.
"We are seeing pockets of need," Marx said. "We are seeing some displacement, which is absolutely normal in this type of situation, but the displacement is in the thousands instead of the millions, which is what we had planned for."
Security will rule the next steps, Marx said.
"It's frustrating," Marx added, "but this is not time- or calendar-driven. We have to wait until the combat operations have ceased."