As the coalition forces dropped the first bombs in the war in Iraq, aid agencies and United Nations teams were working around the clock in bordering countries to prepare for a predicted influx of refugees.
Although estimates of the size of the likely population movements vary widely, the UN Office for the Coordination of Humanitarian Activities (UNOCHA) estimates that as the war escalates between 600000 and 1.1 million people may flee the country to neighbouring Iran, Turkey, Jordan, Syria, Saudi Arabia, and Kuwait.
As the BMJ went to press, the United Nations also warned of a potential humanitarian crisis in Iraq's second city, Basra. Secretary general Kofi Annan called for urgent measures to help the 1.5 million residents of Basra who were facing the threat of disease from a lack of clean water.
Fighting had continued in Basra for four days and 100000 children were now at risk. A UN official in Amman, Jordan, said many people were now taking water from the Shatt-al-Arab river where sewage was dumped, with the result that diarrhoea was likely and children were seriously at risk.
But no reports had yet been received of a major movement of people out of Iraq. A spokesperson for the Office of the UN High Commissioner for Refugees (UNHCR) said, “There have been some population movements from cities and towns in the north of Iraq but no pressure on the border, and it seems that people have basically moved into the countryside.”
More than a million refugees are known to have fled northern Iraq during the Gulf war in 1991. Numbers this time, say sources, will be influenced considerably by the course and length of the war, availability of food, water, and fuel, and potential retaliation against civilians by President Saddam Hussein's forces. A further 900000 people are likely to be displaced internally, says UNOCHA.
Relief agencies present in neighbouring countries are, however, bracing themselves for the worst. The UNHCR has this week intensified its efforts to help Iran and Jordan prepare camps for up to 300000 people. The World Food Programme, also a UN agency, says that it has enough supplies for two million refugees for one month.
Denis McClean, a spokesman for the International Federation of Red Cross and Red Crescent Societies, Geneva, said: “We are prepared to provide support to 350000 at present, but we can increase capacity quickly if necessary.” Other organisations, such as Oxfam, expressed similar sentiments.
This week Ruud Lubbers, the UN's high commissioner for refugees, called on all governments in border countries to keep their borders open to people in need of temporary protection and assistance. The call came as the Saudi and Syrian borders were officially declared closed by authorities worried about the mass influx. It seems that people fleeing Iraq will be housed in temporary camps at the borders.
“But our preparations for a possible influx of refugees have been severely hampered by lack of funding by donors, who had been hoping that war in Iraq could be avoided,” said Philippe Lavanchy, the federation's chief of mission in Iran. “Now it is upon us, we have had to move very quickly.”
A UNOCHA spokeswoman in Geneva told the BMJ this week that currently only $53.9m (£34m; €51m) of the $123m appealed for in February has so far been received from the international donor community. This was “not surprising,” however, given that the crisis had not yet started and that most were hoping to avert it. “We will launch a fresh appeal this week,” she added.
An Oxfam spokesperson said that “There is not yet enough funding coming into the UN” and that there were clear gaps in the relief effort currently under way. A joint statement issued by a group of leading UK aid agencies, including Oxfam, on 21 March called for the UK government to “massively scale up its funding to the UN” for the humanitarian effort.
Aid agencies also expressed concern this week over the UN's limited preparedness and provision for internally displaced people. By 25 March reports indicated that up to 30000 people, mainly ethnic Kurds fleeing Kirkuk and Baghdad, had poured into Iraq's autonomous Kurdish region.
Steve Priestly, who is from the UK based Mines Advisory Group and who is based in the area, said on the group's website: “These people have no assistance in terms of food, shelter or medical care … key agencies are either not represented here or have suspended their programmes.”
According to Geoffrey Keele, a Unicef spokesman, ensuring humanitarian assistance inside Iraq—particularly the provision of safe water supplies—was vital. Children made up half the popu-lation of Iraq, he noted, and “one of the lessons learned after 1991 was that disruption of water supplies was one of the key factors that led to the deaths of children through dehydration.”
Unicef fears that tens of thousands of children are already so weak that diarrhoea caused by drinking dirty water could kill them. Oxfam estimates that half the Iraqi population will have no access to drinking water if military action damages water and sanitation infrastructure, as occurred during the Gulf war in 1991. An Oxfam spokesperson said that this would most certainly lead to a “public health disaster,” with outbreaks of cholera, typhoid, and dysentery.
Kaye Stearman of Care International, which is still present in Baghdad, said: “The needs inside Iraq are enormous.”
Figure.
© REUTERS 2003/FALEH KHEIBER
An Iraqi man holds a picture of Saddam Hussein in Baghdad after coalition forces pounded the city in a night blitz