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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: http://www.iraqfoundation.org/hr/1998/Mar_20_halabja.html. The document is published at: http://www.washingtonpost.com/wp-srv/WPlate/1999-03/10/063l-031099-idx.h tml ******************** 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 necessities. 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 conditions. 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 possible. 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 channels. 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 Hospital. c Copyright 1999 The Washington Post Company -- ----------------------------------------------------------------------------- This is a discussion list run by Campaign Against Sanctions on Iraq. To be removed/added, email email@example.com, NOT the whole list. Archived at http://linux.clare.cam.ac.uk/~saw27/casi/discuss.html