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North vs. South: Professor Garfield's comments on the UNICEF survey and the State Department

Professor Richard Garfield, an epidemiologist at Columbia University and a
specialist on the health effects of sanctions, has written the following
letter to the New York Times regarding UNICEF's "Child and Maternal
Mortality Survey".  Since there's no assurance the Times will publish, I've
gotten Dr. Garfield's permission to circulate independently.  In addition,
several additional comments from Dr. Garfield are noted below.

<Dr. Garfield's Letter to the Editor of the New York Times>


Letters to the Editor
The New York Times
229 West 43rd Street
NY NY 10036

To the Editor:

The State Department claims that lower child mortality in Iraqi Kurdistan is
proof that problems are caused by Saddam Hussein, not sanctions [Children's
Death Rates Rising in Iraqi Lands...8/13/99, page A6].  But the embargo in
the North is not the "same embargo" as they claim.  The North enjoys porous
borders with Turkey, Syria, and Iran, and thus is effectively less embargoed
than the rest of the country.  It benefits from the aid of 34 Non-Government
Organizations, while in the whole rest of the country there are only 11.  It
receives 22% more per capita from the Oil for Food program, and gets about
10% of all UN-controlled assistance in currency, while the rest of the
country receives only commodities.  Food, medicine, and water pumps are now
helping reduce mortality throughout Iraq, but the pumps do less for
sanitation where authorities cannot buy sand, hire day laborers, or find
many other minor inputs to make filtration plants work.   

Goods have been approved by the UN and distributed to the North far faster
than in the Center or South. The UN Security Council treats people in that
part of the country like innocents.  Close to 20 million civilians in the
Center and South of the country deserve the same treatment.  Spokesman James
P. Rubin said that "We can't solve a
problem that is the result of tyrannical behavior."  He probably was
referring to Saddam Hussein.  As one involved in providing assistance
throughout Iraq, I must admit that the arbitrary, ineffective, or
destructive control sometimes exercised by the Security Council over Iraqi
funds for food and medicine seem no less tyrannical. A good faith effort to
meet basic needs in Iraq would create a better basis to negotiate an end to
the Iraq conflict.  Instead, every problem is blamed on Saddam.  This
politicization of the Oil for Food program only delays and weakens our
ability to address the urgent humanitarian needs created by this most
comprehensive embargo of the 20th century. 


Richard Garfield
Columbia University
617 West 168th Street
New York, NY 10032

<End of letter>

In phone conversation, Dr. Garfield said that the UNICEF survey[1] was
methodologically sound and that its results (based upon the first
large-scale field data collected since 1991) made his purposefully
conservative analysis of historical mortality data[2] 'look extremely,
*extremely* conservative.'

Based on the survey, UNICEF's Executive Director notes "if the substantial
reduction in child mortality throughout Iraq during the 1980s had continued
through the 1990s, there would have been half a million fewer deaths of
children under-five in the country as a whole during the eight year period
1991 to 1998."  I asked Dr. Garfield about this assumption -- that is, is it
safe to assume a relatively linear rate of decline in child mortality
through the 90's?  He replied that, yes, it's probably the best estimate
available and may, in fact, be conservative given that the rate of mortality
decline had been increasing just before sanctions began.

Thanks again to Dr. Garfield for sharing this information.

Drew Hamre
Golden Valley, Minnesota USA


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