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Subj: Articles Sanctions/Cuba and Iraq Date: 03/31/2000 12:36:34 AM Central Standard Time From: Hammondc To: email@example.com There were some articles published in the January 18, 2000 Annals of Internal medicine concerning sanctions. Perhaps a letter to the editor commending the American College of Physicians-Society of Internal Medicine and answering the Madeleine Albright editorial would be in order. I have lifted the high points and summarized below. If you would like me to fax the entire text of the articles, please let me know. Karine Morin and Steven H Miles for the Ethics and Human Rights Committee of the American College of Physicians-American Society of Internal Medicine reviewed the impact of sanctions on civilians. They state, "In contrast to war's easily observable casualties, the apparently nonviolent consequences of economic intervention seem like an acceptable alternative. However, recent reports suggest that economic can seriously harm the health of persons who live in targeted nations." In a paragraph that clearly alludes to Iraq (the references are articles about Iraq), they state that in countries where broad economic sanctions are applied, malnutrition caused by the high cost and shortage of food is often a leading cause of morbidity and death among children. Even in instances where humanitarian good, such as food and medicine, are exempt from sanctions, there is often little practical effect if foreign currency is not available to import such goods, foreign bank accounts are frozen, or borders are closed. Other types of trade restrictions, such as strict requirements for export licenses and/or restrictions on transportation, may make the terms of trade "virtually unattainable." The American Public Health Association has already developed a policy addressing economic sanctions. The recommendations of the Ethics and Human Rights Committee (supported by the AMA) include: 1. Excluding from sanctions humanitarian goods, such as food- and health-related materials or medical supplies, that are deemed likely to reduce the morbidity or mortality of civilians. 2. Empowering qualified and neutral agencies to publicly and expeditiously address humanitarian appeals for exemptions, to conduct and disseminate analyses of the health effects of economic sanctions, and to monitor and report the effects of the sanctions on an ongoing basis. 3. Providing medical and health-related supplies and services to offset any increased morbidity caused by sanction. 4. Monitoring and reporting the effective delivery of medical and health-related materials. Michele Barry published "Effect of the U.S. Embargo and Economic Decline on Health in Cuba." She travels to Cuba as a member of a working group for the Social Science Research Council. She writes about the health care system of Cuba which in the late 1980s and 1990s was far better than in other Latin American countries. However, the fall of the Soviet Union and mergers of U.S. pharmaceutical and biotechnology companies have created a "progressive lack of critically needed medicines, diagnostic tools, vaccines, and medical machinery that had previously been available or affordable. She documented food shortages and stated that the median weight of children and adults has decreased dramatically because the amount of food supplied at workplaces and schools has been substantially reduced. Several public health catastrophes on the island have been directly attributed to the U.S. embargo. In 1992 and 1993, more than 50,000 cases of optic and peripheral neuropathy occurred. This epidemic was attributed to reduced nutrient intake, which was caused by food shortages, and local tobacco use, which increased the risk for blindness. Use of costly multivitamin supplements dramatically decreased the incidence of blindness. An additional epidemic of esophageal stenosis in toddlers who inadvertently drank liquid lye is believed to be the result of a soap shortage that caused Cubans to use lye as a substitute. A 1994 outbreak of the Guillain-Barre syndrome in Havana was caused by water that had been contaminated with Campylobacter species because chlorination chemicals were not available for purification. Serious shortages of insulin, other medications, and vaccines have also taken their toll, especially on the health of children. The article discusses the more recent developments in the ambulatory treatment of HIV-positive individuals which both has reformed the previous system, provided excellent care, and resulted in the lowest reported prevalence of HIV in the hemisphere. The SSRC has initiated requests for proposals for academic collaboration between scholars in Cuba and North America (Http://www.acls.org/pro-cuba.htm, and U.S. medical student rotations and residency rotations will be permitted in rural Cuba under the sponsorship of a nonprofit US organization, Medical Education Cooperation with Cuba (MEDICC) (http://www.medicc.org/body_index.html. She states, "The U.S. embargo against Cuba, one of the few that includes both food and medicine, has been described as a war against public health with high human costs." She recommended that medicine, food, and water purification materials should be made available or, preferably, should be exempt from sanctions. Official monitoring of the effects of economic sanctions on civilian populations should become a high priority. In an Addendum: In August 1999, the US Senate voted 70 to 28 in favor of eliminating unilateral export bans in an amendment to next year's agricultural appropriations bill. This would have effectively ended the embargo on exporting food to Cuba. The U.S. House of Representatives subsequently deleted this amendment in a House-Senate closed committee session. The US. Senate leaders are planning yet another vote on legislation (Dodd/Serrano legislation S. 926/H.R. 1644) that would permit the sale of food and medicine to Cuba. The date for this vote was not available at the time this article went to press. Finally, the Madeleine K. Albright editorial: She cites "overwhelming evidence" of the need for continuing sanctions as a means of pressure against Saddam Hussein. She states the U.S. took the lead in offering the "oil-for-food program, but that "Saddam long resisted this plan because he wanted to use his people's suffering to mobilize public opposition to sanctions." She states that Iraq is now importing as much food and exporting almost as much oil as it did before the Gulf War. She cites the disparity between the situation in Northern Iraq compared to the area controlled by Saddam Hussein's government as further evidence that Saddam Hussein is causing the suffering of the Iraqi people. According to the UN, the Iraqi government has spent only $9.5 million of the $25 million that has been set aside for nutrition supplies for vulnerable children, pregnant women, and nursing mothers. Other charges include $300 million in undistributed medical supplies, ordering of expensive equipment when primary care needs are unmet, and diversion of food and medicine purchased under the oil-for-food program. She stated that they also have evidence that the Iraqi military bulldozed 160 homes in the town of Almasha in June 1999 after local citizens protested the governments failure to distribute food and medicine. She also states that the regime is squandering money on palaces, etc..... She also says that Cuba is another government that blames its failures on the sanctions. Within the limits of the 1992 Cuban Democracy Act, the Department of Commerce licensed approximately $45 million in medical sales in 1998 and the first half of 1999 and more than $100 million in humanitarian donations of medicine and medical equipment. Any help that you could provide in finding credible sources to quote in answer to the Albright editorial would be appreciated, or better if you know of a physician who could quickly respond, please let me know. Connie Hammond Columbus, Ohio -- ----------------------------------------------------------------------- This is a discussion list run by the Campaign Against Sanctions on Iraq For removal from list, email firstname.lastname@example.org Full details of CASI's various lists can be found on the CASI website: http://welcome.to/casi