Months after armed combat against Iraq has ended, the devastating health and environmental effects of the conflict continue and may persist for generations, says a new report from Medact, the UK based charity of health professionals highlighting the health impacts of war and conflict.
The report, a follow up to the charity's 2002 document Collateral Damage (BMJ 2002 325:1134), contains the results of an eight month survey of publicly available health data and expert organisations in and outside Iraq. Medact estimates that as many as 55 000 people have died since the war in Iraq began, and thousands of combatants and civilians have received severe injuries and mental trauma. Many Iraqis live in poverty and have limited access to clean water and sanitation and health services, says the report. These conditions are expected to exacerbate the already poor health of the Iraqi people and to limit their ability to cope with the longer term health and social impacts during the post-conflict period.
The environmental costs of the conflict include extensive pollution of land, sea, and rivers; oil spills and toxic smoke resulting from oil well fires; and destruction of buildings, roads, power stations, and sewage plants as a result of bombing.
"The six months following the end of the war have been devastating to the Iraqi people, particularly to vulnerable groups such as women, children, and the elderly," said Dr Sabya Farooq, the lead author of the report. Official health surveillance data are patchy, said Dr Farooq, but researchers found "evidence of increasing maternal mortality because of restricted access to obstetric and antenatal care."
Although the reconstruction of Iraq to date has included emergency health relief, the Medact report emphasises the importance of restoring security and health services, and the revitalisation of the economy. Ongoing violence, insecurity, and lawlessness threaten successful reconstruction and the daily activities of aid agencies and health services, says the report.
Medact is calling on the occupying forces and UN agencies to investigate further the costs of the war, ensure that the reconstruction of public services in Iraq is fully funded, and carry out their obligations under the Geneva Convention to maintain law and order and to protect hospitals, health professionals, and aid workers. According to the report, the World Bank estimates that the cost of the reconstruction will exceed $55bn (£33bn; €48bn) over four years.
The report was simultaneously released by the affiliates of International Physicians for the Prevention of Nuclear War.
Continuing Collateral Damage: The Health and Environmental Costs of War on Iraq 2003 is available at medact.org