Long-Term Health Effects Of Iraq War Unknown

by Sanjay Suri

The number of deaths and injuries during the conflict and in its aftermath have been high, but "the full effects of war on health are felt through many other less direct but potentially equally or more deadly pathways," says the report released in London Nov. 11.

"The full impact of the war on health will not be known for years," the report adds.

Medact, which includes doctors and other health professionals, points to a death and injury toll that is far higher than many people imagined.

The group estimates a total of between 13,500 to 45,000 Iraqi military deaths from March 20 to May 1, with about three times as many injured. The number of Iraqi civilian deaths during this period is between 5,708 and 7,356, the report says. In the post-conflict phase, there have been between 2,049 and 2,209 deaths, the report says.

The U.S. and British toll was 172 killed during the conflict and 222 in the post-conflict period from May 2 to Oct. 20, the report says. In addition, the number of U.S. troops wounded is officially 1,927, half of them post-war, the report says, adding that the unofficial number is higher.

Besides, more than 6,000 U.S. soldiers have been evacuated due to physical or mental illness, the report says.

But unlike to coalition troops, "very few Iraqi combatants have access to adequate health or social care or long-term rehabilitation services," Medact says.

The legacy of the war continues to kill, injure and damage people in all sorts of ways, the report points out.

One direct consequence of the war is the masses of unexploded ordnance lying around. Cluster weapons, landmines and depleted uranium weapons "remain a potential health hazard for local populations years after the conflict," the report says. "Deaths and injuries from unexploded ordnance are likely to be under-reported."

The condition of a country's environment and physical infrastructure also has a significant and direct impact on its people's health, the report says. It points to the dangers from destruction of water and sanitation systems.

"Smoke from oil well fires and burning trenches caused air pollution and soil contamination," the report says. "Heavy bombing and troop movements degraded natural and agricultural ecosystems."

The study finds that "malnutrition, which results from low food intake or an unbalanced diet or both is a major determinant of poor health in Iraq."

Mental and physical health is being damaged further. "People suffering from the immediate impact of war are more susceptible to further health hazards and less able to mobilize their own resources for survival and reconstruction," the report says.

The study finds that shortages of clean water, adequate food and power lead to an increase in certain diseases that is likely to result in more deaths than caused directly by the conflict.

The short and long-term physical health effects feared include disability, infectious diseases, stillbirths, underweight newborns, diseases of malnutrition, and possibly more cancers.

The mental consequences include post-traumatic stress reaction, psychiatric illness, behavioural disturbance and developmental delays in children. "With unemployment above 60 percent, the vicious circle of ill health and poverty is reinforced," the report adds.

"Security remains the country's main health issue, both as an underlying reason for seeking medical care and in limiting access to services," Medact says in its report. "Since the war robbery, burglary, kidnapping and violence have been widespread. The U.S. has too few soldiers and only 150 of the 400 law courts are believed to be in operation."

There are a reported 15 to 20 daily attacks on coalition forces and 15 to 25 civilians shot dead in Baghdad every day, the report points out. "Since the end of the war the Baghdad morgue reports 500 excess deaths per month."

The study warns of the "less visible aspects such as disruption of individual and societal development."

The bombing tactics of "shock and awe" generated acute anxiety among Iraqi civilians and combatants "that will trigger a significant increase in common mental disorders of anxiety and mood disturbance," the report says.

"Long-term morbidity will include more suicides, greater disability, increased drug and alcohol abuse and more social and domestic violence -- major obstacles to the restoration of a stable society."

The incidence of behavioural and emotional disorders is likely to be high among children and adolescents, "interacting with broader issues of moral breakdown, violence and educational failures."

Medact calls on authorities to establish a health sector based on the principle that health and health care are basic social rights. It is asking for health information systems to monitor disease patterns, and an assessment of chemical risks and contamination.

Medact says the authorities in Iraq must give social and political reconstruction the same prominence as economic reconstruction.