In Iraq, a Canadian-led team gauges the human cost of another Gulf war
Nutt and her colleagues found shortages at the pediatric hospitals they visited
CANADIAN DOCTORS Eric Hoskins and Samantha Nutt have worked extensively in war zones. The married couple recently joined the 10-member International Study Team, funded by more than 20 Canadian non-governmental organizations, to comprehensively assess the humanitarian impact a new war may have on Iraqi children. For Hoskins, who worked in Iraq immediately after the 1991 Gulf War, this was his 25 th trip to that country. Nutt has been there three times. Their diary account of the visit:
JANUARY 19: Tonight we board the Royal Jordanian flight from Amman to Baghdad. Flights were impossible three years ago and a rarity two years ago. Now they leave almost daily from Damascus and Amman. UN
Security Council Resolution 661 states that flights to Baghdad are only allowed for humanitarian purposes. Tonight, our flight is oversold. A quick glimpse at the other passengers suggests that “humanitarian” is now broadly defined: journalists looking like adventure guides; aid workers in white button-downs; human shields in handmade sweaters; and row upon row of men with briefcases, blue suits, silk ties and gold cufflinks. Looks like 300 people on business.
At Saddam International Airport, we jockey for position at customs. The question isn’t whether we will be turned away, but whether we will be forced to take the manda-
tory AIDS test. We have a medical letter, but we don’t need to use it—we are quickly approved. At the baggage area we are greeted by the minder appointed to “facilitate” our work. Cellular and satellite phones are seized but computers and cameras are allowed. Phones are returned in sealed bags on condition that when we return to the airport the bags are still intact.
We arrive at the Al-Rasheed hotel at 2 a.m. It is congested with journalists. Peter Jennings, sporting a perfect tan, breezes toward the elevators with five crew members. Tom Kennedy from CTV rushes by, exhausted. Peter Mansbridge is also on his way. Now all we need is Hockey Night in Canada and some beer.
JANUARY 20: Our team’s two Norwegian
Baghdad Diary | >
psychologists, Magne Raundalen and Atle Dyregrov, are among the world’s foremost experts on the psychological impact of war on children. We map out a comprehensive plan for the assessment, and make a wish list of meetings. While we wait, some of us visit the Saddam Pediatric Hospital. However, we arrive late in the afternoon and the hospital’s administrator has already gone home. We are instead invited to drink tea with the security guards. One guard asks, through hand gestures, if we can take a picture of his children and motions for us to walk with him behind the hospital. We hesitate—it is dangerous for Iraqis to be seen with foreigners. But he reassures us.
His home is one of many 10-by-eight-foot portables in an impoverished community behind the hospital. We meet the family, including five children ages 4 to 16. There is one small window, a couch, a stained mattress and a photo of Saddam Hussein. Only some of the kids are wearing shoes—this is what it means to be middle class in Iraq. We take photos of the children; they view the results on the digital camera, with squeals of laughter. They serve us yellow juice, made from crystals. We drink, although we know the water may be contaminated.
Our host insists on paying for our cab back to the Al-Rasheed. We refuse, but at the hotel, the cab driver will not accept our money—our host slipped him 500 dinars (about 25 cents, close to a day’s wage) while we were arguing with him. A matter of pride.
Later, we attend a meeting with the minister of electricity to learn about the poor state of the water and sanitation systems, both electricity-dependent. But Iraq’s electrical infrastructure was destroyed during the Gulf War, and is currently functioning at less than 60 per cent of its 1990 capacity. With so little clean water, according to UNICEF data, Iraqi children experience an average of 14 days of diarrhea a month. In the event of war, the minister says, “We have one plan. Faith in God Almighty, faith in our leadership, and whatever the leadership plans, we will go forth with it, until bloodshed.” JANUARY 21: At our morning team meeting, our psychologists are euphoric. They received approval to enter homes and carry out interviews without supervision. The team works at a furious pace, gathering data, attending meetings and searching for documents. In the late afternoon, we attempt to return to Saddam Pediatric Hospital, which
our minder has arranged for us to visit unaccompanied. We climb into the nearest taxi and make our way. When we arrive, the director is waiting to greet us, but we have been brought to a different Saddam Hospital—a specialized care facility for children with cancer. We undertake the assessment, but cautiously: claims about increases in childhood cancer since the Gulf War have become highly propagandized and are difficult, if not impossible, to verify.
The hospital is overcrowded, and few patients are receiving proper treatment. Bureaucratic delays, inefficiency and breakdowns in drug supply have led to a reduction in available medication. Regimens for treating patients are not adhered to, as drugs will arrive in the wrong order and in insufficient quantities.
JANUARY 22: Several Canadian journalists have learned that we have permission to visit Karbala tomorrow, an hour and a half south of Baghdad, and ask to accompany the team. For journalists, getting travel permission can be complicated. We discuss authorization for them with our minder. It is quickly approved.
By the hotel elevator, a blond woman in her early 20s approaches us. “Are you Canadian journalists?” she asks. “No,” we reply. “Are you human shields? ” We explain about our team’s mission. She is very animated, introducing herself as Marla and explaining that she was in Afghanistan last year and
“there are a lot of traumatized people there.” She doesn’t appear to be in Iraq for any specific purpose. We later learn that there are “war groupies” who follow journalists from one hot spot to the next, passing time in hotels and taking in events.
Today we make it to the right Saddam Pediatric Hospital, and enjoy another round of tea with the security guards before undertaking our assessments.
JANUARY 23: Karbala was at the heart of the Shiite uprising in 1991, which was quickly quashed by government forces shortly after the Gulf War ended. Our departure is delayed more than an hour due to a difference of opinion between our minder and the journalists’ minder regarding jurisdiction. When we finally arrive, we are once again taken to the wrong pediatric hospital. (Apparently, we don’t have proper permission to travel to the intended facility, one that we visited in 1996 and 2001.) As we stand next to the cars, negotiating with the district official, explosions can be heard in the distance. This is the southern no-fly zone, and British and American planes have increased their bombing in recent weeks.
We agree to do an assessment, pending approval of our visit to the other pediatric hospital. In one room, 18-month-old Mustafa is dying of kala azar, a parasitic infection, caused by sand flies, that attacks vital organs. The disease can be cured by a $25 course of pentamidine, but there is not
enough medication to treat him. His mother travelled 275 km from An Nasiriyah after hearing that Karbala still had stocks of pentamidine. She stands by his bedside, crying, pleading with us to provide medication, but there is nothing we can do.
When we get approval to visit the other hospital, it is the same story. Children are dying of kala azar, gastroenteritis, pneumonia and other treatable infections. There is only a few weeks’ supply of most medications, and doctors report feeling anxious and depressed. Yet there are some obvious improvements—marginal gains under the Oilfor-Food Program that allows Iraq, still subject to sanctions, to buy essentials with oil money. Beds have mattresses, incubators and fridges are working, children are receiving intravenous fluids, there is an adequate supply of blood products, and more doctors and nurses than before. But no one seems prepared for war.
JANUARY 24: We are all exhausted. Days are filled with evaluations and nights with writing reports. Journalists drop in to our office at all hours to fact-check stories. Meals are once a day. And whatever else was in that yellow drink the children served us has now fully declared itself.
On our way back to the room, we meet an Iraqi friend who has stopped by the hotel. Ahmed helped coordinate logistics during a previous visit two years ago. It had been the 10th anniversary of the Gulf War, and
he had recounted the horror of being in his house with his children in 1991 while bombs fell around them. Now, he says, it may begin all over again. His face is flushed as he whispers: “We hear there are more than 230,000 troops in the neighbouring countries! What could they possibly be planning to need that many? I don’t know what we will do.” JANUARY 25: The psychological impact of waiting for war may be incomprehensible to an outsider. We have worked in war zones in Africa, Asia, Latin America and the Middle East. But nothing has prepared us for the reality of being in Iraq right now, knowing with relative certainty that, within weeks, many of the Iraqis we are meeting, including children whose stories form the basis of the team’s report, will likely experience, and perhaps die from, war.
As physicians, and “experts” on the impact of war on children, we are the ones normally sent in after a conflict has either erupted or run its course. It is one thing to feel, as we sometimes do, like an international apology: “Send in the aid workers!” Too little, too late. It is another thing to stand on the precipice as another tragedy gets ready to unfold. This does not excuse or diminish the responsibility of Saddam Hussein in this humanitarian crisis; it is merely an observation of the heart-wrenching reality that confronts anyone now visiting or living in Iraq.
The team’s psychologists have learned, through their survey of more than 300 chil-
dren, that the public displays of Iraqi resilience (flag-burning, warmongering and such) mask intense fear and sadness. “They have guns and bombs and the air will be hot and we will burn very much,” said fiveyear-old Assem. “I think every hour that something bad will happen to me,” Hadeel, 13, told the psychologists. “They will come from above, from the air, and will kill us and destroy us. We fear this very much,” said Sheima, 5.
JANUARY 26: We hold a news conference to present our preliminary findings. Despite our concerns that the media is doing a poor job of examining the potential humanitarian fallout of a possible war, we have an outstanding turnout. Now it is time to return home, to submit our findings to the UN Security Council, non-governmental organizations and Ottawa.
On the way to the airport the team is quiet, deeply conflicted about having the luxury of leaving while the Iraqis who accompany us can’t. But crises also breed dark humour. Mike, our Lebanese logistics officer who lived through the bloodshed in his home country, has a case in point: a wartime series of jokes about an average man called Abu Abed and his wife, Urn Abed. One, Mike says, revolves around an explosion in Abu Abed’s apartment building. The building collapses; Urn Abed, who has been elsewhere, asks officials if she can look for her husband among those whose lives were lost. “You will not be able to identify him—their faces are indiscernible,” the official says. “That’s fine,” Urn Abed replies, “I can identify Abu Abed from ... below.” Mike describes how she passes the deceased men one by one, inspecting their manhood. One after the other, Urn Abed says, “This is not Abu Abed, this is not Abu Abed.” Then she stops in front of one and exclaims, “This man is not even from our building!” We all break out in laughter. For a brief moment, we forget where we are. But it doesn’t last.
At the airport, we are told the flight is, once again, oversold. We manage to find a seat and the plane departs.
JANUARY 27: While we wait during a stopover at Heathrow Airport, we search for newspapers and catch an Associated Press headline: “Report predicts massive civilian child death toll in Iraq. Canadians led, paid for study.” II1!
View the International Study Team’s report at www.warchild.ca
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