The U.N. Children's Fund recently ranked 195 countries and territories by mortality rates of children under five; only 32 countries had rates higher than those for Iraq.
Living on Food Rations
Malnutrition, particularly among children and pregnant women became a serious problem in Iraq when the United Nations imposed economic sanctions in 1990.
Around 18 million people in a country of 24.5 million lack secure access to food, according to the United Nations' World Food Program (WFP), and 60 percent of the population depends solely on food distributed by the government.
"The Iraqi government established a highly efficient distribution system when the Oil for Food (OFF) was instituted in 1996," said McCally. "But the food rations are very basic refugee rations. It's wheat, rice, beans, some cooking oil, dried milk; that sort of thing. That'll let you get by for a while, but they're not nutritionally complete."
The Oil for Food program, which allowed Iraq to sell oil for food, medicine, and basic supplies, was suspended March 17 when the United Nations evacuated its personnel from Iraq.
A confidential memo prepared prior to the war by the U.N. Office for the Coordination of Humanitarian Affairs estimated that 30 percent of children under 5 would be at risk for death from malnutrition in a "medium-impact" war scenario. The report, which was obtained and released by humanitarian aid groups opposed to the war, went on to say that "all U.N. agencies have been facing severe funding constraints that are preventing them from reaching even minimum levels of preparedness."
Once again, security issues are a problem. Since the start of the conflict, only about 220 trucks carrying food and water have been allowed into Iraq from Turkey. WFP hopes to deliver around 1.6 million tons of food in the next six months.
"As soon as security permits, WFP will open humanitarian corridors into Iraq out of other neighboring countries, including Jordan and Iran," said WFP spokesperson Khaled Mansour. "WFP international staff are on standby in Cyprus ready to re-enter northern Iraq, pending clearance from a joint UN security assessment team."
The agency's Baghdad office has been looted and very little property remains, according to reports from two agency officers in the Iraqi capital.
Smoke, Dust, and Debris
Only a few oil wells have been torched, unlike the 1991 Gulf War, when fleeing Iraqi troops set fire to more than 600 Kuwaiti oil wells. Still, smoke from oil-filled trenches in Baghdad, bomb and looter-ignited fires, and the destruction of weapon caches found by coalition troops will inevitably lead to an increase in asthma and other respiratory problems, health experts say.
"Smoke inhalation is not good for you. We know that in this country where we think the air quality is pretty good," said McCally. "Do we know how many people will be damaged, how severely, and when? No. We do know more people will be going to hospitals. If you're old in Iraq and breathing smoke for a day or two, you're likely to wind up with complications of heart disease or exacerbated lung disease."
Smoke from oil fires contains a range of contaminants such as sulfur, mercury, dioxins, and furans. But particulate matter, small particles of dust or soot in the air, may pose an even greater problem. Chemicals that are very toxic can bind themselves to particulates, which can be inhaled quite deeply and trapped in the lungs.
"We are getting reports from a couple of people who stayed behind [in Iraq] that the bombing has been pretty targeted, but it still brought down a lot of houses," said Zaidi, who is based in New York. "Bringing a building down causes an incredible amount of dust. Just think of the devastation caused by the dust, debris, and environmental contaminants from 9/11, and replicating that many times over, in a city of 5.5 million."
Access to Medical Care
The medical system in Baghdad has virtually collapsed. The dead are left unattended, and the increasing summer heat and deteriorating water and electricity supplies create a high risk of epidemic disease, the Red Cross said in a release Monday.
Doctors and health care workers are staying home to protect their families. At the same time, hospitals are being stripped of beds, equipment, supplies, and medicines. In addition, the civil unrest is making it impossible to repair power stations, and few hospitals have back-up generators.
People with chronic illnesses, in addition to those who sustained injuries during the war are unable to receive needed treatment. Humanitarian agencies poised outside of Iraq are calling on coalition forces to establish order.
"It's tragic really, said McCally." Fourteen years ago, if you were an Arab or Muslim looking to advance yourself, Iraq is where you went to start a business, to go to school, or continue your medical education. Life there has just plummeted."
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