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The Executive Director of UNICEF explains the differences in Iraqi mortality rates (North vs. South)



U.S. State Department spokesman James Rubin has cited UNICEF's mortality
report as illustrating that "in places where Saddam Hussein isn't
manipulating the medicines and the supplies, (the sanctions regime) works."
This statement figured prominently in today's New York Times report by
Barbara Crossette, which was heavily syndicated in the U.S.  

It's unfortunate the Times chose *not* to report UNICEF's own explanation of
the discrepancy of mortality rates.  Following is a key paragraph from an
Associated Press story, including comments from Carol Bellamy, the Executive
Director of UNICEF (see http://www.msnbc.com/news/300149.asp):

<begin snip>
UNICEF EXPLAINS THE NUMBERS
       Bellamy said she believes the difference in mortality rates is the
result of several factors: The Kurdish north has been receiving humanitarian
assistance for longer than central and southern areas; agriculture in the
north is somewhat better; and evading sanctions is a little bit easier in
the north.   
       Iraq's child mortality rate had been on the decline in the 1980s,
Bellamy noted.
       If that decline had continued in the 1990s, she said there would have
been half million fewer deaths of children under 5 during the period from
1991 to 1998.
       Bellamy said the findings cannot be easily dismissed as an effort by
Iraq to mobilize opposition to U.N. sanctions.
<end snip>

Ms. Bellamy's comments echo those of other humanitarian workers in Iraq.
Below, I've attached the comments of Hans von Sponeck (Dennis Halliday's
successor as administrator of oil-for-food) in conversation with Kathy Kelly
and others from Voices in the Wilderness; the full AP article is also
attached.  

Upon review, it appears that the NYTimes article - while damaging - was
virtually alone in its simplistic finger-pointing.  Crossette is one of 3
NYT reporters that covers Iraq regulary (Judith Miller and Steven Kinzer are
the others), and she consistently finds the sins of Saddam more newsworthy
than the plight of the Iraqi people.  Her analyses have been indifferent to
the fact that blame for this tragedy is shared, and that the functional
cause of the disaster remains the embargo.

Regards,
Drew Hamre
Golden Valey, MN USA

---
(First item from Kathy Kelly, VITW)
Here are a few more items from the April 5 transcript of the interview with
Hans von Sponeck.  Summarized, the main points are:  

The reasons for the difference between the North and rest of Iraq are: (1)
the North has more funding per capita, (2) the North has a more
non-monitored
goods flowing in, from Turkey, and (3) there is more private activity in the
North.
Here is the passage:

-------------------------------------------

If you talked to UNICEF, they gave you already some information [on
malnutrition]. I just want to say [that] malnutrition -- general
malnutrition, acute malnutrition, chronic malnutrition -- all three are in
better shape in the northern areas, in these three northern Kurdish areas,
than in the rest. That has many quite objective reasons. One of which is
that in the Kurdish part of Iraq, the per capita contribution from the
humanitarian program is much higher than in the rest of Iraq. That's one
reason. The other is that the Kurdish areas are adjacent to Turkey through
which a lot of illegal items are coming into Iraq. [Another reason is] the
market mechanisms are much better functioning in these parts. There's much
more private activity ... in this part of the country. That explains the
differential between the North and the Center-South. Having said that -- I'm
sure my UNICEF colleague did say to you -- that none of the figures, neither
the 23% for general malnutrition in the!
 South-Center nor the 14% in the North, are an acceptable figure. It's bad,
and one should try and do something about it.... The food basket isn't
adequate.

-------------------------------------------
(Second item from Kathy Kelly, VITW)
---
VITW Update Letter - May 25, 1999

The US government's readiness to starve and bomb both Iraqi and Yugoslavian
civilians shows a readiness to sacrifice whole populations by use of force
when nonviolent means could have been used and when it seems the US could
predict, in advance, the adverse effects of decisions to use threat and
force. It's maddening to watch the US government use moralistic arguments
about using force to protect innocent people, only to then pursue policies
that have the same effect as the one ostensibly being attacked, only ten
times worse.

An Iraqi teenager's frustrated and impassioned plea still rings in my ears:
"You come and you say, 'you will do, you will do,' but nothing changes! I
am sixteen. Can you tell me, what is the difference between me and a
sixteen year old in your country? Aren't we all human beings? But we watch
our children die,
every day, and we have no rights...my father heads the electric company in
this country and I study by candle light at night...and that is only to
mention one human right!" We must work very hard to become voices for the
young ones who struggle beneath weighty cruelty.


In your outreach efforts, you may encounter questions about recent concerns
over stockpiling of medicines and medical supplies within Iraq. UN
officials in Baghdad have helped us understand prevailing complexities
which affect these efforts. Special thanks to Chris Allen Doucot, Bert
Sacks and Joel Schorn for helping us summarize these observations (below).
Those of us who lack health insurance may have a special window of
understanding into what happens when people lack money to effectively
distribute medicines. Nine years ago, Iraqi health care professionals knew
how to distribute medicines and medical supplies with astonishing
efficiency. Now, they don't know how because they don't know
how to do it without money....and neither do underfunded health care
facilities in the US that attempt to serve uninsured patients!



In response to recent media stories in which U.N. Secretary General Koffi
Annan reported that $3 million of medical supplies are languishing
undistributed in Iraqi warehouses, and other press reports charging Iraqi
government with deliberately withholding the distribution of medical
supplies and overstocking the same supplies for military purposes, Voices
in the Wilderness would like to present the following information regarding
the stockpiling drawn from sources close to the humanitarian effort in Iraq.

In an April 5, 1999 meeting with a delegation of doctors, medical
personnel, and peace activists, Hans Von Sponeck, the U.N. Humanitarian
Coordinator for Iraq, warned of a great deal of misinformation about the
overstocking of medicines in hospitals and warehouses. "If you get from
someone a monocausal explanation, then start getting suspicious."

While the Iraqi government has at times ordered the overstocking of items,
Von Sponeck calls this act "one factor and not a major factor in our
opinion." He also disputes the military nature of the medicines.  "What the
military in a war situation needs in terms of medicine is not the kind of
medicine that we are
bringing in for normal diseases and illnesses into the warehouses," Von
Sponeck said. More important in explaining the overstocking are the
following factors: Low wages of Iraqi warehouses workers, insufficient
transport, and the poor condition of Iraqi warehouses in the provinces
hinders distribution of
medical supplies. A lack of cash in the hands of Iraqi authorities also
makes it difficult to insure shipments will be paid for and therefore go
through. The Iraqi government has to overcome numerous obstacles put up by
the sanctions to even find suppliers of medicines. 

In an interview, Dennis Halliday, the former U.N. Humanitarian Coordinator
for Iraq, indicated another problem regarding contracts: the Iraqi
government did not do a good job finding the right-sized companies to
distribute medicine. In addition, the U.N. Security Council has delayed for
months approving the distribution contracts.

The U.N. Security Council has not approved the refrigerator trucks required
to transport the medicine nor the computers necessary to run the inventory
system. Inefficiencies in the Iraqi Ministry of Health also hurt efforts to
distribute medicines.

In an April 22 1999 conversation with Hartford, Connecticut Catholic Worker
member Chris Doucet, the Deputy Director of the U.N. Humanitarian Program
in Iraq, Farid Zarif, cited not only the lack of refrigerated trucks but
also the roving electrical blackouts that spoil some of the medicine and
hamper its
distribution. Through U.N. Resolution #986, in which Iraq was allowed to
sell a limited amount of oil in order to raise cash to buy food, many items
arrived at the same time and could not be distributed because of lack of
trucks. Finally, Zarif said, technicians needed to install medical
equipment and devices needed to run the equipment have yet to arrive, and
thus the equipment continues to sit in the warehouse.

Dr. Hans Von Sponeck concluded: "The sanctions are an experiment that
failed. We must not do it again."

Sincerely,

Kathy Kelly
Voices in the Wilderness

---
(Full AP story with Bellamy comments)

Iraqi childhood deaths rise sharply 
   
Since Gulf War, sanctions, economic collapse have taken heavy toll 

UNITED NATIONS, Aug. 12 -  Death among infants and toddlers has nearly
doubled in much of Iraq in the last eight years, the United Nations
Children's (UNICEF) fund reported Thursday. The dramatic increase, measuring
the change since shortly after the 1991 Gulf War, will likely fuel the
furious debate over the continuing economic sanctions against Iraq.

        IN GOVERNMENT-CONTROLLED central and southern Iraq - home to 85
percent of the country's population - children under age 5 are dying at more
than twice the rate they were 10 years ago, according to UNICEF. By
contrast, in the autonomous northern region, the mortality rate of children
under 5 declined by over 20 percent in the last five years, the survey
found.
       UNICEF Executive Director Carol Bellamy said the findings show an
ongoing humanitarian emergency in Iraq, which UNICEF officials say is caused
by a host of factors including sanctions, two wars, a collapsed economy and
the response by the Baghdad government.
       
STIRRING DEBATE ON SANCTIONS 
       The survey will undoubtedly inflame the ongoing debate in the U.N.
Security Council over whether to ease sanctions imposed after Baghdad's 1990
invasion of Kuwait, regardless of whether Iraq has fully complied with U.N.
demands to eliminate its weapons of mass destruction.
       "We are not calling for a lifting of sanctions as such, because we
cannot. That is not in our jurisdiction," Bellamy said in an interview
Thursday.
       UNICEF recognizes that sanctions are used by the international
community to promote peace and security, she said, "but when they're used
they need to be implemented in a way to avoid serious human impact,"
especially on vulnerable children.

U.S. BLAMES SADDAM FOR HOARDING   
        The United States, which opposes lifting sanctions until Iraq is
disarmed, blamed the Iraqi leader for the malnutrition and deaths of Iraqi
children in government-controlled areas.
       "The bottom line is that if Saddam Hussein would not continue to
hoard medicines and capabilities to assist the children of Iraq, they
wouldn't have this problem," State Department spokesman James P. Rubin said
Thursday.
       In an effort to help ordinary Iraqis cope with sanctions, the United
Nations has allowed Iraq to sell limited amounts of oil to buy food,
medicine, and other humanitarian aid since 1996.
       While the United Nations runs the oil-for-food program in northern
Iraq, it relies on the Iraqi government to implement the program in the
central and southern regions.
       
AID WORKS BETTER BEYOND SADDAM'S REACH
       The UNICEF findings back a trend that U.N. officials identified in a
report in April on the oil-for-food program: U.N. humanitarian relief
operations were more effective in areas outside the control of President
Saddam Hussein.
       The survey found that in government-controlled central and southern
Iraq there were 56 deaths of children under 5 per 1,000 live births from
1984-1989 compared to 131 deaths per 1,000 live births from 1994-1999.
UNICEF said this puts the child mortality rate in most of Iraq on a par with
rates in Haiti and Pakistan.
       By contrast, in the autonomous northern region, the mortality rate of
children under 5 rose slightly from 80 deaths per 1,000 live births from
1984-89 to 90 deaths per 1,000 live births during the years 1989-94. But it
declined by over 20 percent from 1994-99 to 72 deaths per 1,000 live births.

UNICEF EXPLAINS THE NUMBERS
       Bellamy said she believes the difference in mortality rates is the
result of several factors: The Kurdish north has been receiving humanitarian
assistance for longer than central and southern areas; agriculture in the
north is somewhat better; and evading sanctions is a little bit easier in
the north.   
       Iraq's child mortality rate had been on the decline in the 1980s,
Bellamy noted.
       If that decline had continued in the 1990s, she said there would have
been half million fewer deaths of children under 5 during the period from
1991 to 1998.
       Bellamy said the findings cannot be easily dismissed as an effort by
Iraq to mobilize opposition to U.N. sanctions.
       
UNICEF CALLS FOR MORE FUNDING
       UNICEF urged the international community to provide additional
funding for humanitarian efforts in Iraq and called on the U.N. committee
overseeing sanctions and the Iraqi government to give priority to
humanitarian contracts.
       And the agency said the Iraqi government should urgently implement
programs to improve the nutrition of children suffering most, adopt a
national policy promoting breast feeding, and replace the baby formula in
the current food rations with additional food for nursing mothers.
       U.N. spokesman Fred Eckhard said nutrition programs for the needy
will help reduce infant mortality rates in government-controlled areas, just
as similar targeting has reduced child deaths in the north. 
       
        1999 Associated Press. 



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