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Washington Post article by Christine Gosden on the suffering of the
people of Halabja after 1988's chemical weapons attacks and the years of
sanctions. More information about Halabja can be found at:

The document is published at:

Halabja 11 Years Later
More deaths, little progress.

By Christine Gosden
Wednesday, March 10, 1999; Page A23 

It is now one year since I wrote an article for The Post and
appeared on "60 Minutes" to appeal for help in addressing the
terrible problems of the civilian population in Halabja, in
northern Iraq, who in 1988 had been bombarded by Saddam
Hussein with a devastating cocktail of chemical and possibly
biological weapons. The entire op-ed page was devoted to
pictures of victims and accounts of continuing medical problems
I documented. While concerned about media intrusions on
privacy, the people I saw were desperate for help and
completely lacking basic medicines and treatment. They wanted
me to be their advocate, and I wanted to help so that those
already affected, and future victims of weapons of mass
destruction, might have the hope of effective therapy.

What has happened in this intervening year? Many of the
people in the pictures, including a man with a huge jaw tumor
and another with colon cancer, have died without benefit of
painkillers, medicines or other assistance. One man committed
suicide, and another died of heart failure. None was older than
55. The people of Halabja had hoped that by revealing intimate
details of their medical conditions, they would, after 10 years of
suffering, receive some form of support. Day after day, events in Iraq
and the Middle East fill the media, yet sadly, the people in Halabja
and throughout northern Iraq continue to die as governments around the
world stand idly by.

Even considering the complexities of regional and international
politics, it is difficult to understand international indifference to
a humanitarian disaster with such clear relevance to worldwide threats
posed by weapons of mass destruction. Last November, a seminar titled
"Halabja: Healing a Community, Helping the World" was organized by the
Washington Kurdish Institute and sponsored by the U.S. State
Department. Doctors from the region detailed a lack of basic medicines
and diagnostic equipment and voiced frustration at not being able to
diagnose or treat cancers and other serious health problems. Childhood
malformations including heart defects, severe medical problems
including blindness, respiratory problems and neuropsychiatric
disorders remain untreatable without adequate medicines and equipment.
The doctors clearly have the ability to respond but lack the bare

The appalling consequences of chemical weapons threats are
understood largely as a result of this largest attack ever made
against civilians. Currently, various countries are pouring
resources into domestic preparedness programs. Emergency
action teams in safety suits stand ready to respond. Yet the
Halabja experience yields lessons that could undercut the
best-laid responses. First, very little is known about the
long-term effects of a chemical weapons attack, as no one has
ever systematically studied the aftermath of such an attack on
a civilian population. Furthermore, while we may know some of
the effects, we know almost nothing about how to treat them.
An example is blindness resulting from corneal scarring due to
mustard gas burns. In 1943 the distinguished ophthalmologist
Dame Ida Mann tried to develop medicated contact lenses for
World War II victims. Nothing further in this area has been
done in the last 56 years, and it is questionable whether
corneal transplants would restore sight, even if local doctors
had that capability.

At the dawn of the 21st century, governments manufacture,
stockpile or fail to destroy millions of tons of chemical weapons
despite international nonproliferation efforts. The sarin attack on
the Tokyo subway system illustrates the more pressing threat posed by
psychopaths and terrorists who can manufacture or procure deadly
compounds. A disconcerting feature of the Tokyo episode is that
emergency response crews and medical attendants breathed in fumes
exhaled by victims, and a significant number of the medical team, as
well as the victims, now show long-term neurological impairment.
Anyone involved in evaluation or treatment of exposed populations can
be at risk simply doing his job.

The implications of these disturbing events and terrible
fascination they hold lead me to question the reluctance by
governments and international institutions to address the
health effects on the population of northern Iraq. If easing the
suffering of this population is not motivation enough, one
might think self-interest alone would generate an international
response -- i.e., protecting ourselves against possible attacks
and trying to develop effective treatments. Implementing a
novel treatment and research program is difficult in ideal
conditions. In northern Iraq, restricted regional access,
unstable security conditions and complex international political
machinations compound these difficulties. Baghdad withholds
all but a minute fraction of medicines and medical equipment
designated for Iraq under the U.N. "oil for food" program.
Coupled with sanctions, this double embargo deprives the
population of the north of lifesaving assistance. Yet these
daunting obstacles can and must be overcome.

During the past year, I have worked with Kurdish doctors and
others to develop a sensitive and ethical treatment and
research program. The quarter-million victims of chemical
attacks in northern Iraq cannot be treated like guinea pigs. In
Halabja, residents still live in the rubble of homes destroyed 11
years ago. If self-interest ultimately leads to international
responses, a research program cannot be initiated unless a commitment
is made to help the people. Their medical problems require long-term,
holistic responses that address environmental as well as medical

We hoped to raise support for an international humanitarian
and medical collaborative effort to investigate long-term effects of
weapons of mass destruction throughout Iraqi Kurdistan. The effort
would yield important information about agents used and assist in
development of useful countermeasures. Working with local doctors, we
would evaluate clinical effectiveness of treatments and focus research
to develop novel treatment methods to help those exposed in conflicts,
accidents or terrorist attacks worldwide. At an initial level, medical
programs would be designed to treat as many people as effectively as

But there is also a need for higher level long-term aims, such
as research to study the effects of each type of weapon (in
causing problems such as cancer, congenital malformations,
infertility, neurological disorders or blindness, etc.). Funding for
such programs would be small in comparison with the cost of bombs and
missiles expended on Iraq, or with costs of domestic preparations for
hypothetical situations. At the very least, medicines and medical
equipment for palliative care of dying children and adults could be be
given priority status.

The program I envisioned planned for local, national and
international collaborations between academic hospital-based
centers and community-based programs that would facilitate
leading-edge research (for example, in the biology of tumors),
specialized conflict-situation epidemiology, neurotransmitter
studies and primary prevention strategies, such as nutritional
supplementation to prevent birth defects. The program also
involved partnerships with nongovernmental organizations to
provide effective humanitarian relief through established

Unfortunately, these plans have foundered on the rocks of
political expediency, bureaucratic malaise and institutional
rivalry. I now realize that although impassioned, I have been
ineffective and have failed to provide effective help and support for
the people of Halabja and other victims of weapons of mass
destruction. I had not realized my desperate pleas might be
interpreted as overenthusiastic advocacy unbecoming a humanitarian
scientist. While support has been voiced from many quarters, no major
assistance for a medical-humanitarian program has yet been made
possible. Compassion fatigue, cynicism and red tape abound, despite
sympathetic supporters in government and among nongovernmental
organizations keen to help.

Sometimes the human spirit soars out of the greatest
afflictions, but the pall of the toxic cloud over northern Iraq still
has profound effects. The people hoped there would be help for their
recurrent nightmares, relief from suicidal thoughts, reassurance about
their dread of developing rapidly growing tumors accompanied by
intense pain. They have fears about the survival of their children
because the new generation is threatened by cancer and leukemia, birth
defects and premature death. The entire population has suffered, and
the environment has been poisoned. Surely, as the 11th anniversary of
the attack approaches, we should be able to do something to help.

The writer is a professor of medical genetics at the University
of Liverpool and practices medicine at Liverpool Women's

       c Copyright 1999 The Washington Post Company

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