Starving Iraq:
one humanitarian disaster we can stop

Campaign Against Sanctions on Iraq

March, 1999

"the toughest, most comprehensive sanctions in history"
James Rubin, US Department of State spokesman, daily press briefing, December 1, 1997

"We are in the process of destroying an entire society. It is as simple and terrifying as that. It is illegal and immoral."
Denis Halliday, former UN Assistant Secretary-General and Humanitarian Coordinator in Iraq, The Independent, October 15, 1998

The Campaign Against Sanctions on Iraq (CASI) is registered society at the University of Cambridge whose sole aim is to work on humanitarian grounds towards the removal of economic sanctions imposed on Iraq in 1990. CASI is not opposed to Iraqi disarmament or to a weapons embargo on Iraq; CASI does not support Saddam Hussein's government. CASI was established in 1997, and holds speaker meetings, raises funds for charities operating in Iraq, and lobbies UK politicians and civil servants. CASI maintains an e-mail discussion list and a website containing a complete archive of the discussion list; join the former by sending an e-mail to Visit the latter at All CASI members are volunteers; CASI's income comes entirely from private donations, entrance fees to events and the like. CASI can be reached at (e-mail), (phone) 0845 330 4520 or Campaign Against Sanctions on Iraq, c/o CUSU, 11-12 Trumpington Street, Cambridge CB2 1QA, UK. [contact details updated April 2002]


On 6 August, 1990 the United Nations Security Council imposed comprehensive economic sanctions on Iraq in response to its invastion of Kuwait. After Kuwait's occupation ended the Security Council extended the sanctions, hoping to pressure Iraq to end its atomic, biological and chemical weapons programmes and to destroy its ballistic missiles. Since then between a half million and 1.8 million more Iraqis have died than would have without sanctions. They have died of hunger. With their water systems bombed, without spare parts or electricity, they have drunk water from the rivers into which their sewage discharge; they then die of diarrhoea and other diseases that would have been easily prevented in the Iraqi medical system prior to the sanctions. Most of those dying have been children. The only biological weapons they know about are those killing them: typhoid, gastro-enteritis, brucellis, malaria and cholera. Between a third and a quarter of the children not dead are malnourished, often chronically, stunting them for life.

They are poor. In the first year of sanctions the economy shrank by 75%. Ordinary Iraqis have sold everything they could over the past years in an attempt to put food on their plates. This once oil-rich society is returning to its fields; without proper irrigation - again dependent on electricity - these are being lost to waterlogging and salinisation.

And they are becoming angry. According to the former top UN official in Iraq, Denis Halliday, sanctions are creating "a new generation of Iraqis that don't know anything about the Western world, and are alienated against Europe, North America and the West generally. ... We're breeding a new type of Taleban in Iraq by forcing this alienation from what's going on in the world ... this is a very dangerous approach." [interview with Jeremy Rose, December 10, 1998]

This is, we are told, being done to prevent the authority of the United Nations, the organisation responsible for the Universal Declaration of Human Rights, from being undermined. It is being done to enforce a Security Council Resolution concerned with the humanitarian needs of the people of Iraq, with regional security and with Iraqi disarmament.

We believe that the sanctions have failed in all three of these concerns. Eight years of mounting bodies make a mockery of government expressions of concern for the people of Iraq. The anger and hatred growing in Iraqis against the West, its institutions and its allies risk further inflaming an already tense and unstable region. And eight years on, the weapons inspectors are still looking.

We will quote the words of Madeleine Albright, the US Secretary of State, telling us that a price of half a million children has been a price worth paying for this accomplishment. We disagree that what has been achieved in Iraq is worth this many children; we also believe that starving a civilian population to force a brutal dictator to bend is akin to shooting down a hijacked airplane to get at the hiajcker.

These are the colours that we are flying. Over the rest of this paper we hope to convince you that these paragraphs are not overstated but that what is happening in Iraq has been a disaster for eight years and risks sowing the seeds of longer term instability in the Middle East. We will do so in much more muted terms, though. While the facts that we present inevitably reflect our underlying beliefs we have tried to present as fair a case as possible. This stems in part from a desire to be intellectually honest but also from a desire to provide information on a situation whose history has been spread out over eight years. As we think that the current tragedy owes in part to the lack of understanding of it we can think of no better way to counter it than to try to inform.

In what follows we track through half a dozen United Nations reports the decline of Iraqi life since the imposition of sanctions. We then introduce the United Nations Security Council and its resolutions on Iraq, including the oil-for-food programme. The next section attempts to evaluate the success of the existing sanctions, Unscom and oil-for-food projects. Finally, while aware that more information is required to form policy than we possess, we offer some suggestions as to components of a sensible policy. These suggestions are founded on the belief that stable peace in the Middle East requires just institutions.

We do not spend much time on the military and political aspects of this story. For a history of the 1990 - 1991 conflict Lawrence Freedman and Efraim Karsh's The Gulf Conflict is recommended; in The Fire This Time former US Attorney-General Ramsey Clark, a member of the US delegation to the Nuremberg trials at the outset of his career, has catalogued what he regards as the US war crimes of this period. We may also, I fear, have added to the pain of Iraqis by burying its human aspects beneath a pile of percentage signs. This may reflect a belief that these sorts of neutral data provide the mind with its most reliable fuel. Readers, though, may find shards of this pain in The Economist, The Independent and The Guardian, which have all had the courage to cover this unpopular story as if it was one about human beings and not just demons. Maggie O'Kane's December 21, 1998 article in The Guardian is an important corrective to what might be the most chilling element that we have omitted from this document, the possibility that the "depleted uranium" warheads used by the Allies during the 1991 bombings is responsible for the horrors of Iraq's jump in birth defects and childhood leukaemia.

To prevent the document from becoming bogged down with footnotes as well as percentage signs we have placed our references at the end of paragraphs. When we are referring to documents that we have received electronically we do not usually include page numbers as these depend on the document formatting.

The contributions of Dr Lamia al-Gailani, Scheherazade Haward, Prof. Nicholas Postgate, Milan Rai, Glen Rangwala, Vicky Russell and Sebastian Wills have all helped to make this document what it is. As their contributions were often very focused the statements contained in this document should not be taken to reflect their own beliefs.

Colin Rowat, editor

393 King's College
Cambridge CB2 1ST

February 25, 1999

The humanitarian disaster
This section provides an overview of a number of aspects of Iraqi life from 1990 to the present. Important events during this period are the imposition of sanctions in August 1990, Iraq's first UN-approved oil exports under the oil for food programme in December 1996 and the start of the enhanced oil-for-food programme in May 1998. Between August 1990 and December 1996 Iraq received almost no external assistance, with the exception of some foreign donations for Iraqi Kurdistan, the northern three of Iraq's 18 governorates; against the will of the Iraqi government in Baghdad these have been administratively separated from the rest of Iraq since 1991.

The organisations collecting the data that we present in what follows are United Nations agencies, with the following exceptions. In April and May 1991 a Harvard Study Team (HST), an independent organisation of ten public health specialists, physicians and lawyers, travelled to Iraq to, "report on the effect of the Gulf crisis on the health and health care of Iraqi civilians". Part of their report was published in the New England Journal of Medicine. The sites visited by Team were chosen independently of the Iraqi government; they travelled with independent interpreters. The HST later became the non-governmental organisation, the Center for Economic and Social Rights. In 1996 the CESR sent a 24 person delegation of doctors, public health experts, economists, lawyers, and health surveyors from eight countries to Iraq. [HST; NEJM 1991, Lancet 1997]

The other exception is an International Study Team (IST) of 87 researchers in agriculture, electrical engineering, environmental science, medicine, economics, child psychology, sociology and public health. They visited Iraq's thirty largest cities in all 18 governorates and rural areas throughout the country in August 1991. They worked with neither Iraqi government supervision nor funding; they were were supported by Unicef, the US MacArthur Foundation, the John Merck Foundation and Oxfam-UK. The IST study is cited as a source by later UN documents.

Life before sanctions
Prior to 1990, when sanctions were imposed, "Iraq had one of the highest per caput food availabilities in the region, due to its relative prosperity and capacity to import large quantities of food"; The Economist's Economic Intelligence Unit actually puts Iraq at the top of this list by the end of the 1980s. With an estimated minimum requirement of 2,100 calories a day Iraqis were, on average, eating about 3,372 calories a day over 1984 to 1989; except for 1989 these were years of war with Iran. [FAO/WFP 1997; EIU 95/96, p.6 ]

Oil had moved Iraq away from its traditional mainstay, agriculture. By 1989 oil accounted for 61% of Iraq's GDP and agriculture for only 5%. Consequently, about two thirds of Iraq's food was imported before the war, even in years of good harvests. In bad years like 1989 domestic cereal production could fall to as low as 15% of needs. This amounted to imports of 3 million tons of cereals per year, or 8,220 tons per day (out of an estimated consumption of 10,000 tons), costing between $2 billion and $3 billion a year. [FAO/WFP 1997; WD 1992, p. 923-24]

Iraq's prosperity had not stopped at eating well. Adult literacy was reported to be 95% and Iraq boasted 22 Universities and Institutes of Higher Education [FAO 1995]. This well educated public built the Iraq described by John Field, a member of a 1991 Tufts University - Unicef mission to Iraq:


By the end of the 1980s, 92% of the population had access to safe water, somewhat less enjoyed modern sanitation, and an impressive 93% lived in the catchment areas served by modern health facilities. The government's network of health centers and hospitals was well disseminated, well supplied, well staffed, and effectively - if rather clinically - engaged with the populations in their jurisdiction. ... Iraq had converted oil wealth into enhanced social well-being with considerable success. ... Education expanded, child mortality declined, and life expectancy increased all quite impressively. [in Unicef 1998, p.2]

Iraq's public hospitals were free, attracting patients from throughout the Arab world. Many of Iraq's 9,000 physicians (one in 2,200 Iraqis) had trained in the UK; about a quarter were certified specialists. "Iraqi biomedical specialists provided some of the most sophisticated medical care in the Arab region. ... [but] relied heavily on import-dependent, high-technology curative biomedicine". While medical specialists tended to be male, female pharmacists and dentists outnumbered their male counterparts in hospitals so that women actually formed the majority in the group of doctors, dentists, pharmacists and specialists. Throughout Iraq, according to 1994 government figures, women slightly outnumbered men as specialists and technicians, partly in response to men's involvement in the war with Iran. [Unicef 1998, p.10]

Iraq's medical sector was not unusual in its reliance upon technology. Urbanisation had left Iraq dependent upon electricity for clean water and sewage treatment as well. [NEJM 1991] Unicef explains that,


South/Centre Iraq had an advanced system of 210 fixed water treatment plants which served urban and major rural areas and 1,200 compact mobile plants for mainly rural areas, with an extensive system of distribution pipes. Almost all water comes from the Tigris, the Euphrates, their branches and tributaries. Being surface water, most of the water systems require liquid chlorine gas and alum for treatment. [Unicef 1998 p.31]

Summing up its accomplishments, The Economist's Economic Intelligence Unit stated that, "the Iraqi welfare state was, until recently, among the most comprehensive and generous in the Arab World". [EIU 95/96, p.6]

Life and death since sanctions
On August 6, 1990, four days after Iraq's invasion of Kuwait, United Nations Security Council Resolution 661 responded by stopping Iraq's imports and exports. There were a few technical exemptions to this: "supplies intended strictly for medical purposes, and, in humanitarian circumstances, foodstuffs". In practice, the United Nations Security Council, whose responsibility it was declare when "humanitarian circumstances" had arisen, did not do so until April, eight months later. During this time an "effective embargo" also applied to medical supplies, whose import, according to Dr Eric Hoskins, may have fallen to 3% of their usual levels during the bombing that occurred in early 1991. [SCR 661; Hoskins cited in WD 1992, p. 924].

In March UN Under-Secretary-General Martti Ahtisaari travelled to Iraq to report on conditions there and make recommendations for future policies. Civil uprisings against Saddam Hussein's regime by Iraqis across the country, verbally encouraged by the United States, were now, without any external support, being brutally suppressed by the government; by April, stability had been restored. Two million Iraqis, ten percent of the population, had been displaced in this unrest. In the midst of it, the Ahtisaari report explained that, "[n]othing we had seen or read could have prepared us for this particular devastation, a country reduced to a pre-industrial age for a considerable time to come." It went on to warn that:


the Iraqi people may soon face a further imminent catastrophe, which could include epidemics and famine, if massive life-supporting needs are not rapidly met. [MA 1991, p.13]

It went on to recommend that Iraq be allowed to import food and supplies to help it rebuild its water supply and sanitation systems. These had been badly damaged by the Gulf war.

Indeed, The Economist's Economic Intelligence Unit reported a 75% drop in Iraqi GDP from 1990 to 1991 alone, knocking it back to a similar level as in the 1940s. [EIU 96/97, p.13]

Iraq ran on electricity. In the low-lying lands in the south of Iraq electricity irrigated and drained fields, preventing waterlogging and salinisation. Throughout, it powered hospitals and water purification and sewage treatment plants. Its failure would not only interrupt the activities of these plants but, by reducing pressure, would allow untreated water to backwash through the system. [IST 1991]

Thirteen of Iraq's 20 power stations had been damaged or destroyed during the first days of allied bombing. The two that were still in operation by the end of the bombing only managed to produce 4% of Iraq's pre-war output. By May 1990, repairs undertaken by cannibalising spare parts from other plants had brought generation back up to about a quarter of pre-war levels. By August the system was back to two thirds of its 1990 peak output but, without the imported supplies required for proper repairs, these were expected to be temporary and to pose increased safety risks. [NEJM 1991; IST 1991]

Water purification and treatment
By April and May, 1991 the loss of electricity had badly damaged Iraq's water purification and distribution infrastructure. The Harvard Study Team observed, "people collecting water from broken pipes surrounded by pools of murky water or even directly from drainage ditches". Loss of electricity had also caused Baghdad's two sewage treatment plants to stop working; one was later destroyed by bombs, spilling raw sewage into the Tigris River. Blockages in the system meant that even when electricity was restored raw sewage


leaked into drainage ditches, formed open pools in residential neighbourhoods, and contaminated water supplies. In neighborhoods in both [the southern port city of] Basra and Baghdad, whole streets were blocked by pools of foul-smelling water. [NEJM 1991]

In August, 1991 only one of the 18 water plants inspected by the International Study Team was working at full capacity. This was the result, not so much of the bombing and subsequent civil uprisings, of "lack of spare parts and chlorine". Raw sewage flowed through streets, where garbage was also accumulating. An estimated half of the public drinking water supply suffered fecal contamination. [IST 1991]

For Basra's million inhabitants the sanitation in 1995 was probably the worst in the country with, "huge areas of sewage water, sometimes green with algae and sometimes showing visible faecal material. These areas were grossly unhygienic and much of the city smelled badly as a result of these overflows". While there were increases in infectious diseases as a result the FAO Mission was surprised that the city, faced with such bad conditions, had managed to avoid major epidemics. [FAO 1995 p.8]

By 1997, every day saw over 100 tons of raw sewage being pumped into Iraq's major rivers, especially in the south, whose flat terrain required more expensive treatment plants with lifting stations. [Unicef 1998, p. 34]

The water supply system, a higher priority than the sewage system, was not much better off. Per capita water use had halved over 1989 to 1997 and less than half the rural population now had access to potable water in 1996, down from over 70% before sanctions. Iraq's water supply standards are based, ironically, on the US standards adopted by the UN World Health Organisation (WHO); by 1997 70% of Iraq's civilian water supply greatly exceeded acceptable levels. [Unicef 1998, pp. 27 - 34] The system had broken down:


Water treatment plants lack spare parts, equipment, treatment chemicals, proper maintenance and adequate, qualified staff. Loss of electrical power supply is a crucial factor, where extended power cuts limit efficiency. Further, plants often act solely as pumping stations without any treatment, due to the high demand for water. The distribution network on which most of the population relies has destroyed, blocked or leaky pipes. Further, there have been no new projects to serve the expected population increase over the past seven years.

Local supplies of chlorine and alum [for purification] are minimal. The major manufacturing plant for chlorine is unable to produce even one-tenth of the required 500 metric tons per month due to frequent breakdowns. Locally produced alum sulphate is impure, which ruins the water treatment equipment. Importation has not been possible. [p.32]

Impoverished Iraqis, unable to afford bottled water, were turning to the polluted rivers, spawning a host of communicable diseases, malnutrition and excess child deaths. [Unicef 1998, p. 27]

Medical system

"But the sanctions regime does not prevent medicines or food from getting to the Iraqi people. Imports of food and medicine have never been banned. In fact the reverse is true." [Robin Cook, The Guardian, February 20, 1998]

"Although the sanctions did not directly preclude health commodities, the indirect effects of the trade embargo and reduced government revenues greatly constrained production and importation. ... Although [oil-for-food] is meant to provide US$210 million for each six month period of Phase I and II, only US$80 million (i.e. 20%) has been received as of November 15, 1997" [Unicef 1998, pp.39-40]

In 1991 water-borne diseases like cholera, typhoid and gastro-enteritis reached epidemic levels. The exact scale of the problem was unknown then as the equipment required to make clinical diagnoses was often lacking and overloaded physicians had to decide between treating patients and keeping proper records. Children began to suffer from severe forms of malnutrition, such as marasmus and kwashiorkor, unknown to younger Iraqi physicians.[NEJM 1991]

At hospitals where records were available comparisons between 1990 and 1991 revealed a consistent pattern:


a reduction in admissions, an increase in the total number of deaths, and a two- or threefold rise in the hospital mortality rate. The decline in admissions was thought to be due to extreme transportation difficulties caused by lack of fuel. ... Iraqi physicians reported that death rates among children in the community were as high or higher than those seen in hospitals. [NEJM 1991]

Functioning at a fraction of pre-crisis levels, most hospitals lacked, "even basic medical supplies such as vaccines, antibiotics, anaesthetics and syringes". Without power, Iraqi physicians performed caesarean section deliveries by lamplight. Fecal contamination was found in 30% of hospital water supplies where the absence of detergent only worsened matters. Loss of refrigeration left them without vaccines, leading to a resurgence of preventable childhood diseases such as measles and polio. By late 1991 hepatitis was on the rise, increasing up to 100 times in some areas; southern Iraq suffered from widespread meningitis. Typhoid, cholera and gastro-enteritis were also working their way through Iraq. [NEJM 1991; IST 1991]

The Ministry of Health had reduced diarrhoea related deaths in children under five by 80% from 1985 to 1987, helping rural children and infants particularly. Their initiative, involving the General Federation of Iraqi women, primary school teachers and religious leaders, distributed freely an Iraqi rehydration salt which, by 1989 entirely satisfied Iraqi domestic demand entirely. "This programme was severely interrupted by the Gulf War". [Unicef 1998, p.45]

For older patients it was not diarrhoea but an increased risk of heart attack as the supply of anti-angina medication has stopped; for teenage diabetics death came for want of insulin; for children with treatable leukaemia, "anti-cancer drugs are largely non-existent". The "most significant problem", though in the 29 hospitals and 17 community health centres throughout Iraq visited by the IST's three medical doctors and two public health specialists was child and infant mortality. [IST 1991]

Matters were not much improved five years later, as indicated by the figures in Table 1.
Table 1: Medical services in Iraq: (Source: Unicef 1998)
  Major surgical operations Laboratory tests Drugs and supplies budget Ambulances (Baghdad)
1989 15,125 1.49 million $500 million 350 (1990)
1996 4,417 0.50 million $25-$50 million 21

Iraqi hospitals had only one disposable syringe for every 20 they had before sanctions, resulting in, "epidemics of viral hepatitis, muscle abscesses and other infections, due to inadequate boiling or inoperative sterilizers"; disposable syringes cost ID 150, about 10p, each. Only one hospital in 24 had sheets for some patients, the monthly cleaning budget, often fallen to ID 1500 ($1.60), could not afford soap. Post-operative and post-partum infections had risen to 25% from 5%. Post-operative care and pain management in some hospitals was limited to aspirin. Shortages of blood bags (ID 30,000, $32) meant that haemorrhaging during surgery led to death. Asthmatics and epileptics died due to lack of supplies; hypertensive had more heart attacks, diabetics more comas and amputations. Records, once computerised, were now tracked on paper, itself in limited supply. Baghdad's ambulance fleet had been decimated by a tyre shortage. [cited in Unicef 1998, p. 41]

Young graduates from Iraq's 10 medical schools were leaving the country and studies of medical service providers who remained, "revealed the sizeable gap in the knowledge and practices ... reflecting the depleted health infrastructure status". Low birth weight rates, though, had jumped from 5% prior to 1990 (similar to industrialised countries) to 22% in 1996; 60% of pregnant mothers in primary health centres were anaemic. [Unicef 1998, pp. 41, 54, 57]

With the exception of tuberculosis, eight times worse in 1996 than in 1992 for women and three times for men, the Ministry of Health seemed to be winning the battle against vaccine-preventable communicable diseases. Not only is it developing national plans to control diarrhoea, eliminate polio, reduce under-five mortality, etc., it has learned not to rely on high-tech medicine: it is much more aware of the importance of preventative health and of the role of nutrition and works with much closer community involvement. The desire for better integration between the formal health care system and community groups is, in fact. the goal of the "long track" developed in the 1996 National Nutrition Conference's strategy on malnutrition. [Unicef 1998, pp. 48,74]

In 1995 the FAO estimated Iraq's 1994/95 cereal production at 2.5 million tons (6,800 tons per day), of which only 80% (5,500 tons per day) is edible due to the presence of "non-grain impurities". This fall from previous years had not been expected as the Iraqi government had given the agricultural sector a high priority, rainfall gave a "good performance" and cooperation between the Iraqi government and international organisations was good. Nevertheless


severe constraints relating to agricultural machinery, particularly nonavailability of essential replacements and spare parts, good seeds, fertilizers, pesticides, and herbicides has resulted in a decline in output. Livestock, poultry and fish subsectors also suffer from severe setbacks because of shortages of machinery, equipment, spare parts and essential drugs. [FAO 1995]

Especially in the marshy lowlands of the south damage to the electrical and irrigation systems means that "much land area, even that previously reclaimed, is presently being lost to waterlogging and increasing salinity". [FAO 1995]

1997 was the worst year since 1991. Equipment shortages meant that, "even in the fertile northern governorates, there was a drop of 30% in crop production for 1996", Perversely, while the decline of 1994 and 1995, "is due to unfavourable climate, the drastic decline in 1996 is probably the result of a conscious decision on the part of farmers not to cultivate wheat. With publicity about the Oil-for-Food plan, a price reduction of locally produced wheat was expected". [Unicef 1998, p.28]

In 1992, "when the situation was not as bad as now", Unicef and the Iraqi Ministry of Education conducted a survey in response to their concerns about increases in the female drop-out rate from primary education. They found that this was largely occurring as families had become unable to meet educational expenses, a growing number of family problems and a loss of interest in and belief in the importance of education by the girls dropping out. Fewer girls are continuing to secondary school. [Unicef 1998, pp. 81, 86]

On the other hand, total school attendance has continued to grow more quickly than population growth in all areas except teacher training, which has declined, and higher education generally, which has levelled off. School failures have increased, though. Unicef is more concerned about declines in quality:


These include lack of the most basic school supplies such as blackboards, chalks, pencils, notebooks and paper, inaccessibility to any water and absent or defunct sanitation. Some children deprive themselves from water and food before going to school so as not to develop the need to use a toilet. Other have to return home if the need arises. Due to shortage, up to four children may be assigned to each desk. If children have to sit on the ground, some parents do not send their children to school on the day when it is their turn.
There is no public budget for school maintenance. Broken windows, leaky roofs, and defunct latrine [sic] and washbasins remain in disrepair. Even when electric power is available, children "learn" in an atmosphere of dim light, poor ventilation and water leakage from classroom ceilings. Health and safety hazards on school grounds and in the vicinity include naked electric wires, garbage, insects and rats, and stagnant water resulting from the blockage and discharge of sewage pipes. Most schools do not have a first aid kit. [Unicef, 1998; p. 88-89]

In the North of Iraq these problems are compounded by armed conflict and cold. Unicef's report cites a CESR report which notes that government budgetary limitations are worsened by the actions of the UN Sanctions Committee, which has designated pencils and textbooks as "non-essential". [CESR 1996, p.6]

Unicef estimates that oil-for-food is only able to provide about 10% of the basic requirements of Iraq's educational system. The economic austerity enforced upon the Iraqi government makes it unable to enforce its compulsory education laws.

Food, rationing and income
Research into famines by Amartya Sen (Nobel Laureate in Economics and Master of Trinity College, Cambridge) and his co-author Jean Dreze has found that their occurrence does not necessarily represent insufficient quantities of food, but a failure in its distribution. This failure occurs when individuals have insufficient funds to purchase food or are otherwise not "entitled" to food, possibly not eligible for a formal distribution programme. Instead of focusing on agricultural production the famines are often identified by, "drastic reduction of food intake; exorbitant food prices; consumption of wild plants and other 'famine foods'; large-scale depletion of household assets; and even the emergence of open conflicts between family members (sometimes leading to physical fights) over the allocation of food". To the extent that famines are symptoms of broader economic failures they are more directly combated by restoring economies to health rather than merely distributing food. [WD 1992, p. 933-34]

Dreze and Gazdar, surveying consumption in August and September, 1991 with the IST found that the only "famine indicator" not present during the bombing was "mass migration in search of food". While, "[v]ery few of the households we interviewed reporting eating normally during the war" they "could not have expected to gain much from migrating, since no public relief was available anywhere. Their best bet was to remain in place and hope for a prompt resumption of public distribution through normal channels.. ... It is, in sum, not an exaggeration to say that famine conditions prevailed during the war". [WD 1992, p.933-34]

The month after sanctions were imposed, September 1990, the Iraqi government began to supply food rations in all 18 governorates. After the civil uprisings following the bombing the government in Baghdad withdrew from the northern Kurdish governorates, ceasing to have any influence there and ending rations in September, 1992. Since then, the north has relied on external donations and rations purchased by the Iraqi government under oil-for-food. [Unicef 1998, p. 12]

Under the rationing system the government distributed ration books to every member of the population; officially, "every resident household in Iraq is entitled to a ration card. The rations are identical for everyone throughout the country, irrespective of age, sex, region, nationality or any other criterion". Authorised agents, mostly ordinary grocers, collect coupons every month from these ration books which they present to the Ministry of Trade in return for food. When the food arrives it is paid for at nationally uniform subsidised prices, with 10% of the proceeds being retained as a commission by the agent. By August 1991 the Ministry of Trade recorded 48,000 registered agents, about one for every 500 Iraqis. In theory, the government food ration for a family of six was, in monetary terms, "considerably larger than the monthly salary of, for example, a soldier or unskilled worker". [WD 1992, p. 929-30]

Table 2: Government ration and caloric intake in Iraq (estimated minimum requirement: 2,100 calories per day)
Date Source Population Caloric Value Remarks
1984 - 1989 FAO/WFP 1997 Iraq 3,372 estimated average daily consumption
1990 FAO/WFP 1997 Iraq 3,150 estimated average daily consumption
1991 (bombing) WD 1992 Iraq 750 - 1,000 estimated average daily consumption
8/1991 WD 1992 Iraq 1,400 supplied by government ration; possibly supplemented
1991 - 1995 FAO/WFP 1997 Baghdad 2,250 estimated average daily consumption; widespread malnutrition
1991 - 1995 FAO/WFP 1997 Iraq 2,268 estimated average daily consumption; widespread malnutrition
8/1995 Lancet 1995 Baghdad 1,000 supplied by government ration; possibly supplemented
1997 pre-986 FAO/WFP 1997 Iraq 1,295 supplied by goverment ration; possibly supplemented
1997 post-986 FAO/WFP 1997 Iraq 2,030 supplied by SCR 986 ration; possibly supplemented
      2,300 expected by late 1999 under enhanced oil-for-food; not yet achieved

Well aware of the difference between theory and practice Dreze and Gazdar deliberately sought to visit, "remote villages, impoverished neighborhoods, displaced households, ethnic minorities and areas where tensions between the local population and the government were known to be rife". They were unable to find either a household without a ration card or anyone who had heard of such a household. Of the 58 households formally surveyed 70% reported that there had never been delivery failures, 28% reporting them during the bombing and ensuing civil uprisings; six of these 15 households report that they were compensated the next month. Supplies were close to the official ration (an average of 7.93 kg of flour against the official 8 kg per person); the most commonly stated concern regarded food quality. The selling price was also higher than the official price (.141 dinars instead of .115 per kilo of flour), suggesting some corruption on the part of agents. With exclusion from the rationing system being the official punishment for attempting to obtain a second ration card corruption seems to be treated seriously. Aware that Iraqis may have feared complaining openly Dreze and Gazdar report that one man attacked Saddam Hussein as eloquently as he defended the public distribution system. [WD 1992, pp. 930, 943]

Dreze and Gazdar try to explain the apparent anomaly that "a regime as repressive and intolerant as that of Saddam Hussein should turn out to be so considerate and impartial in matters of food distribution" by observing that autocrats around the world have used food hand-outs to buy support: "Nor has the potential of food as a political weapon been lost sight of by either side in the Gulf conflict" [WD 1992, p.931].

According to the World Bank's World Development Indicators the average Iraqi received $256 per month in 1990 (when measured in 1995 dollars); by 1995 this had fallen to between $2.50 and $5.00 for public sector employees. At the same time Iraqis were trying to buy wheat costing 11,667 times its July 1990 price (33 times its June 1993 price). For other food items the price increases were similar. Consequently, many sold possessions to buy food: "People in collective villages in the north were seen selling bricks and other material by pulling down their own homes. ... As a consequence the number of beggars and street children have increased enormously". By September 1995 about four million Iraqis, a fifth of the population, were living in extreme poverty. [FAO 1995; Unicef 1998, p. 9]

The FAO claimed that the "efficient public rationing system" that had been preventing "catastrophe" was in danger of collapse. Donors were not giving to Iraq, preventing the WFP from providing its food assistance programme and requiring the country to go it alone. The strain was showing: in September 1994 the ration's caloric value was cut from 53% of the 1987-89 level to 34%. [FAO 1995]

As well as providing fewer calories than before the ration was deficient in minerals and vitamins, including iron, vitamins A and C and animal protein. Coupled with the broader erosion of Iraq's public health infrastructure, including the electrical, sanitation and medical systems, these deficiencies had given rise to a series of childhood nutritional diseases, such as marasmus and kwashiorkor. Iraqi government figures suggested that the occurrence of these had increased 50 times since 1989 and that, more generally, 109,720 people had died annually since August 1990 as a result of sanctions. The FAO mission could not confirm these figures. [FAO 1995]

In May, 1996 the government of Iraq finally accepted that it could not continue without help; it signed the Memorandum of Understanding to implement Security Council Resolution 986, "oil-for-food". A year later UN Under Secretary-General for Humanitarian Affairs, Yasushi Akashi, conducted a fact-finding tour to assess the consequences of SCR 986. He found that, by the end of May, this centrally planned system had allocated less than a third of the food commodities due to arrive over the December - June period; delays in non-food imports were even worse, with health, water/sanitation and educational supplies only beginning to arrive later in 1997. The "time to process contracts, approval by the SCC [Sanctions Committee] and clearance of disbursement from the Banque de Paris" were cited as reasons for these delays. [Unicef 1998, p. 18]

While the situation had improved after two years of oil-for-food the 1997 FAO/WFP mission's October report raised a number of concerns. First and foremost, the ration provided under SCR 986 was inadequate on all fronts. Its theoretical daily supply of 2,030 calories was not only less than the estimated minimum requirement (2,100) but was also less than the 1991 - 95 consumption level of 2,250 calories that had been insufficient to reduce malnutrition. Further, the ration is "unbalanced and deficient" in nutrients with vitamins A and C almost absent. No animal proteins are included. As the Iraqi livestock population had fallen to 60% by 1997 of what it was before the sanctions the prices of meat made it unaffordable to the majority of Iraqis. As displayed in Table 3 Unicef's 1998 report detailed the consequences of these imbalances. None of these had been a problem in 1990; anaemia was the most prevalent in 1997. [FAO/WFP 1997]

Table 3: Micronutrient deficiencies (Source: Unicef 1998)
Micronutrient deficiency Consequences Remedy Plan Result
iodine stillbirth, reduced IQ, deafness, reduced animal growth iodised salt include salt in ration and produce it locally SCR 986 rations to include salt but erratic delivery has left situation unchanged in South/Centre. In North smuggling and plants provide more salt
vitamin A night blindness, diarrhoea, respiratory infections, increased mortality dairy products, meat, eggs diet supplements since 1995 supplements reaching needy. Rations fortified vitamin A would be better.
iron anaemia, maternal mortality, reduce cognitive development animal protein increase iron uptake from other sources. Fortified wheat flour.   women especially vulnerable, affects half of pregnant mothers. No animal proteins yet in diet. Supplements during pregnancy has had limited effect.
vitamin D rickets (bone growth) dairy products   "the only effective solution is improvement in the diet for mothers and young children"

Second, the practice of SCR 986 fell short of its theory from the outset: "Of the expected quantities of wheat flour and rice in the first six months of the agreement, for example, only 43 percent and 20 percent respectively had been received by 22 June, whilst some other foods and salt, had not arrived" in Iraq. The two month gap between the beginning of the second six month phase of the SCR and the approval of its distribution plan again meant "breaks in the food supply" and "reduced rations". [FAO/WFP 1997]

Third, the Mission feared that the international community would consider the situation in Iraq solved, a concern echoed by Unicef. This could lead to a reduction in the donations that the World Food Programme depended upon for the emergency feeding programmes that the Iraqi government had asked them to run since 1991. The Mission was especially concerned about the prospects for vulnerable groups such as "malnourished children under five, hospital inpatients, orphanages and social institutions, IDPs [internally displaced persons] and refugees". Donor response to WFP requests for food in central and southern Iraq has always been less stable, and often entirely lacking, than in the northern Kurdish governorates. [FAO/WFP 1997; Unicef 1998, p.75]

Fourth, the Memorandum of Understanding signed on May 20, 1996 by the Iraqi government and the United Nations for the implementation of SCR 986 had allowed Iraqi families with infants to choose between an infant formula ration or an adult ration; the latter could be eaten by the mother, who could then breast-feed. While three in four families chose the adult ration only the infant formula was being offered as of May, 1997. In combination with Iraq's contaminated water this could lead, warned the Mission, to worsened infant health. [FAO/WFP 1997]

Fifth, as in previous reports, the Mission noted that Iraq needed to be rebuilt if its people were to be healthy again. Agriculture had continued to collapse; the imports allowed it were "grossly inadequate". In spite of government attempts to promote agriculture land continued to be lost to water-logging and salinity as irrigation and drainage equipment continued to fail. Water treatment and sanitation also continued to deteriorate. [FAO/WFP 1997]

There are three crude types of malnutrition in children, each with its own measure. Those whose height is low for their age are called "stunted" and said to be suffering from chronic malnutrition. If weight is low for age they are "underweight" and suffering from general malnutrition. Finally, if their weight is low for their height they are "wasted" and suffering from acute malnutrition. Wasting is a measure of "severe food deprivation or deficient utilization" associated with "a significantly increased risk of dying". [IST 1991]

A child is classified as mildly malnourished if she or he has a ratio one standard deviation or more below what the World Health Organization considers to be average; the child is malnourished if the ratio is less than two standard deviations below average and severely malnourished if the ratio is below three standard deviations below average. Standard deviations are defined such that, in a "normally distributed" population roughly 16% will fall below one standard deviation, 2.3% below two standard deviations and .1% below three standard deviations. As the normal distribution is a simply defined mathematical distribution no real population is exactly normally distributed.

Childhood malnutrition

Chronic malnutrition (or stunting) results in poor physical child growth, often accompanied by sub-standard capacity for development and education. It reflects the cumulated detrimental effect on child growth by adverse economic conditions, poor health, feeding and care. Chronic malnutrition is difficult to reverse after the child reaches 2-3 years of age. Often stunted children grow up to be stunted adults, with a continuation of the same detrimental process on their children. [Stunting is the preferred indicator for longer-term changes as it is the most stable.]
Acute malnutrition (or wasting) reflects more recent onset adversities, such as diarrhoea and acute respiratory infections compounded by inadequate feeding. It is most easily reversed, but often recurs due to repetition of this cycle. This type of malnutrition is the most readily recognized by mothers, due to a child appearing thin.
Underweight implies a composite of chronic and acute malnutrition - either or both of these can result in underweight. It is the most widely understood indicator for nutritional status and is used in UNICEF's Progress of Nations report to monitor nutrition.

Source: Unicef, 1998. p. 59, 64

Table 4 displays the results of the childhood malnutrition surveys most frequently cited in UN documents. The horizontal dotted lines indicate the dates at which the oil-for-food programmes came into force: December, 1996 for oil-for-food and May, 1998 for the enhanced oil-for-food.

Table 4: Child Malnutrition in Iraq
Date Source Location Sample Method Low height-for-age / stunted / chronic malnutrition Low weight-for-age / underweight / general malnutrition Low weight-for-height / wasted / acute malnutrition Remarks
8/91 IST all Iraq 2,902 U5 2,902 U5 25% 14% 3.6% 900,000 children malnourished, 118,000 at increased risk of death. One and two year olds at highest risk
8/95 FAO / NRI Baghdad 594 U5 house-holds 28% (mild: 56% severe: 10%) 29% (mild: 65% severe: 7%) 12% (mild: 39% severe: 3%) Wasting worse in one to three year olds. Children with illiterate mothers more wasted.
8-9/96 Unicef / CSO




6,392 U5
1,799 U5

8,191 U5








No urban/rural difference in South/Centre but big increase; North started high, rural areas even worse off. No sex differences. Malnutrition peaks at age two.
4/97 Unicef /
South/Centre 15,466 U5
PHC 27.5%
National Polio Immunisation Day. Only children scheduled for immunisation sampled to prevent bias due to children brought for food screening.
6-7/97 FAO /
900 U5
158 U5
house-holds 15.7%
Malnutrition most severe from one to two years; college or university educated mothers reduce risk. Diarrhoea doubles risk of wasting or underweight in Kerbala. Boys twice as underweight as girls (22.7% v. 12.5%).
10-11/97 Unicef / NRI South/Centre 3,153 U1 PHC 12.2% 14.6% 7.5% Routine immunisation session.
11-12/97 Unicef / RMHSW North 2,328 U5 house-holds 30.3% 15.9% 3.1% stunting levels "compared with the poorest countries in the world"; stunting takes longer to reverse than wasting
3/98 Unicef /



15,804 U5
PHC 26.7%
10/98 Unicef /
South/Centre U1   11.7% 14.7% 8.3%  

United Nations agencies cited in Table 4 are Unicef (the United Nations Children's Fund), the FAO (Food and Agriculture Organisation) and the WFP (World Food Programme). The Iraqi government agencies cited in Table 4 are the CSO (Central Statistical Office), the MOH (Ministry of Health) and its NRI (Nutrition Research Institute). Its counterpart in the northern three governorates is the RMHSW (Regional Ministry of Health and Social Welfare).

U5 refers to children under five years of age; U1 to children under one year old (infants). The MICS (Multiple Indicator Cluster Survey) collects health, nutrition, education, water and sanitation information on children in randomly selected clusters. While the 1996 MICS collected information from households later studies tended to collect data during immunisation days in PHCs (Primary Health Centres). Iraqi children have immunisation cards with a schedule of dates for them to appear at PHCs for immunisation. The World Food Programme notes that one should be cautious about extending PHC data to a whole population but conclude that, "they are believed to present a reasonably accurate picture of the general situation" [WFP 1998, p.4].

The IST public health team interviewed all women between 15 and 49 years old in 9,034 randomly selected households throughout Iraq. Less than 50 women declined to participate in the interviews, producing a sample of 16,076 children. As a large proportion of the Iraqi population had been displaced as a result of the civil uprisings they used information on these groups provided by the United Nations High Commissioner for Refugees to ensure that their sample was representative. The children used for the malnutrition calculations were a random sub-sample of this 9,034 household sample.

The 1995 FAO team was led by British-born nutritionist, Dr Peter Pellett, Professor of Nutrition at the University of Massachusetts in Amherst. The team worked with other UN teams working in Iraq, such as Unicef, the United Nations Development Project (UNDP), the World Food Programme (WFP) and the World Health Organisation (WHO). Their interaction with the Iraqi NRI is explained:


[FAO] Mission members were responsible for the methodology, including the selection of the sample. In the field, interviews were conducted by NRI staff supervised by FAO Mission members, a UNICEF member and physicians from the NRI. Data were inputed... primarily by NRI staff with assistance from Mission members. Once data entry was completed the data were checked by Mission members. [FAO 1995]

The areas surveyed in Baghdad were drawn from the same survey "clusters" that the 1991 International Study Team had used. The report compares these findings to malnutrition in other countries:


For Baghdad, a highly advanced urban society, the prevalence of underweight children (29%) has increased to a level comparable with children from Ghana (27%) and Mali (31%). For stunting, prevalence rates are similar to estimates from Sri Lanka (28%) and the Congo (27%). Furthermore, the prevalence of wasting in Baghdad is comparable with estimates from Madagascar (12%) and Myanmar [Burma] (11%). The prevalence of severe wasting is comparable to data from northern Sudan (2.3%). In contrast, 1991 estimates of malnutrition from Baghdad were comparable with estimates from Kuwait (12% for stunting, 6% for underweight, and 3% for wasting). [FAO 1995]

As Baghdad is better off than other parts of the country the report adds the cautionary note that, "the nutritional status of children in southern and northern Iraq is likely to be even worse than reported in Baghdad".

Reporting on its 1996 MICS survey Unicef states that


Based on these criteria, Iraq has moved from a country in 1991 having a low prevalence of all three indicators (wasting, stunting and underweight), with malnutrition not an important problem, to high prevalence rates in 1996, matching the serious extent encountered in the very needy countries of the world. It should be noted that the 1991 survey was done one year after the start of sanctions, when the adverse effects on nutrition had already begun. [Unicef 1998, p.63]

In December, 1996, Iraq was allowed to make its first oil sales under UN Security Council Resolution (SCR) 986, the so-called "oil-for-food" programme. Studies could now ask whether this had led to any sort of nutritional improvement in Iraq.

In June and July, 1997 a joint FAO/WFP Mission was also in Iraq, assessing its "food supply and nutrition situation". Children were selected randomly in both Baghdad and Kerbala, a Shia holy city south west of Baghdad. The Mission suspected, on the basis of observations outside the capital, that the Kerbala figures are more representative of the country than the Baghdad figures.

Adult nutritional status was also surveyed. The standard measure for this is the body mass index (BMI), calculated by dividing one's weight by the square of one's height. Comparing measurements of Iraqi men and women to FAO international reference levels and to Tunisian levels, it was found that, "the number with low BMI in Iraq was considerably greater than in the reference population, illustrating the considerable presence of under-nutrition in this sample of the Iraqi adult population". See Table 5.

Table 5: Adult Malnutrition in Iraq
Date Agencies Location Population Body Mass Index (BMI) less than 18.5 Remarks
6-7/97 FAO Baghdad and
870 men 25% in men under 26 years chronically energy deficient; reduced food availability, leading to weight loss and poor weight gain, "probably the cause". SCR 986 should help but, "many may remain undersized due to deprivation in childhood".
408 women 16% in women under 26 years

The FAO/WFP team reported that, "[a]lthough there has been some improvement in the overall food situation following the implementation of SCR 986, malnutrition still remains a serious problem throughout the country". [FAO/WFP 1997]

Unicef concluded that the 1997 PHC surveys after the 1996 MICS do not show signs of improvement for children under five or infants. In fact, Unicef found that the whole population had slid so even those who were not malnourished were not as well as they had been. Commenting on the October-November results Unicef explains that:


Results for infant general [underweight] and chronic [stunting] malnutrition are at least 10% less than would be expected for children aged under five years, based on data analysis comparing the two age groups from the two prior surveys (August 1996 and April 1997) in the South/Centre governorates. ... This is because the process for these types of malnutrition is cumulative over time; i.e. increases with the child's age. On the other hand the prevalence of wasting tends to peak at 6-23 months of age and then declines, so the results for infants... tends to be of similar magnitude as that for the under fives. [Unicef 1998, p.66]

It consequently concluded that by 1997 one million children under five years old were malnourished; in the Kurdish north, stunting levels were on par with those in the world's poorest. By 1998 it seemed that two years of oil-for-food had only managed to stabilise the high levels of childhood malnutrition in South/Centre Iraq; in the North there was some hope that it may be declining. [Unicef 1998, pp. 23,67; WFP 1998] Unicef therefore concluded its review of malnutrition with the familiar recommendation:


To address malnutrition effectively, attention must be directed to all causal levels - direct (diet and health); underlying (household food security, care, water/sanitation, health services) and basic (education, resources - material, financial, human and organizational). [Unicef 1998, p. 74]

Mortality rates
Mortality figures are usually stated as a certain number per 1,000 live births. In the UK, the infant mortality rate (IMR) is 6 (children under one year of age, U1) and the under five mortality rate (U5MR) is 7; in Sweden both the IMR and the U5MR are 4 / 1,000; in Nigeria, at the other end of the spectrum, they are 114 and 191. Infant mortality rates cannot be higher than U5 rates as the latter include the former. (For other Unicef figures see

Mortality rates may be estimated in one of two ways. Direct techniques (also known as "direct recall" or "birth history") simply poll mothers, asking women about children that had been born, when they had been born, whether they were still alive and, if not, when they had died. The direct recall birth history method, "is the standard method for obtaining accurate data on infant and child mortality". [IST 1991]

According to the US Bureau of the Census indirect techniques, such as the Brass technique, use information, such as a mother's age, to attempt to statistically correct for the possible bias in direct techniques of under-reported deaths (e.g. if they have been forgotten); indirect techniques typically yield higher mortality estimates. Statistical correction, though, requires that assumptions be made; a common one is that the population is "stable", e.g. that birth and death rates have been constant and that there has not been net migration. []

When a mortality rate has been established for some time period more recent rates allow estimates of deaths prevented (if the mortality has fallen) excess deaths if, as in Iraq's case, the mortality rate has increased.

Table 6 presents various mortality estimates for Iraq. Those above the horizontal dotted line are baseline measures taken before the imposition of sanctions.

Table 6: Infant (IMR) and child (U5MR) mortality rate estimates
Date Source Population Sample Method Mortality Rate
( / 1000)
1985-89 IST in NEJM 1992   U1 direct 32.5  
      U5 direct 43.2  
1987 Unicef [in NEJM 1992]   U1 direct 25  
      U1 Brass 41  
      U5 ? 52 Method not reported in NEJM
1988 GCHS [in NEJM 1992]   U1 direct 29  
      U1 Brass 36  
      U5 ? 46 Method not reported in NEJM
1 - 8 / 90 IST 1991   U1 direct 22.7  
      U5 direct 27.8  
1 - 8 / 91 IST 1991   U1 direct 80.0  
      U5 direct 104.4 NEJM estimate: 46,900 excess deaths over their baseline
8 / 1990 - 8 / 95 FAO 1995 [in Lancet 1995] Baghdad U1 direct 160.7  
      U5 direct 198.2 Lancet estimate: 567,000 excess deaths over their baseline
mid-1990s MOH [in FAO 1995]   U1   92.7 possibly just applicable to South/Centre
4- 5 / 1996 CESR 1996 [in Lancet 1997] Baghdad U1 direct 33.0  

The NEJM (New England Journal of Medicine) 1992 article was published by the ten members of the IST public health team, along with Dr Alberto Ascherio, who assisted with data analysis. For about two thirds of the children discussed, living or dead, birth certificates or immunisation cards were also available to verify birth dates. Their interviews established, by the direct technique, both a baseline mortality rate and a post-sanctions estimate. [NEJM 1992; Zaidi 1999]

The NEJM authors consider the possibility that, "interviewers and respondents may have worked more diligently to report and document 1991 deaths than they did for earlier deaths. This explanation, however, fails to account plausibly for the magnitude of the differences in mortality before and after the war". They attribute the increase in mortality to "a complex interaction of factors. There are acute shortages of food and essential medicines throughout Iraq. Lack of clean drinking water and poor sanitation have greatly increased water-borne diseases, such as cholera, typhoid, dysentery, and gastroenteritis." From this they conclude that, contrary to the perception that use of "high-precision weapons" during the war largely spared Iraq's civilian population, "that the casualties of war extend far beyond those caused directly by warfare". [NEJM 1992; IST 1991]

This is consistent with the findings of the IST economists, Dreze and Gazdar, who report:


civilian casualties from bombing were reported to be very low in all the areas we visited. Most of the babies who lost their lives during the war period must have died from diseases related to poor nutrition, lack of clean water and related deprivations. [WD 1992, p.934]

Noting that excess mortality was particularly high in the south, north and Kurdish-controlled regions of the country, Dr Arthur Bierman wondered in a later letter to the New England Journal of Medicine whether the excess mortality estimate of 46,700 should be corrected by "removing" the civil war effect. Recalculating, he found "an excess of about 21,000 pediatric deaths from January through August, 1991". The response of Dr Alberto Ascherio and Sarah Zaidi, two of the original authors at the Harvard School of Public Health, was that attributing all of the excess mortality to the civil war, when "[p]overty, scarcity of food, lack of access to health care, and cold are among the factors that may have contributed to regional differences in the increase in mortality after the war", was a questionable correction without further data. [NEJM 1993a, NEJM 1993b]

In addition to collecting data on malnutrition the FAO 1995 Mission also collected child mortality information in Baghdad. After their report's submission, two mission members, Sarah Zaidi and Dr Mary C Smith-Fawzi wrote to the British medical journal, The Lancet. Ms Zaidi had also been a member of the 1991 Harvard Study Team; Dr Smith-Fawzi had planned the FAO nutritional survey. Summarising the FAO nutritional findings they concluded with a calculation:


The moral, financial, and political standing of an international community intent on maintaining economic sanctions is challenged by the estimate that since August, 1990, 567 000 children in Iraq have died as a consequence. [Lancet 1995]

This figure is the most famous mortality estimate to come out of Iraq. It is associated with an equally famous quote. On May 12, 1996 Lesley Stahl's guest on the US television news programme 60 Minutes was Madeleine Albright, then the US ambassador to the United Nations; she is now their Secretary of State and a key figure in their Iraq policy. Part of their exchange was:


Stahl: "We have heard that a half a million children have died. I mean, that's more children than died in Hiroshima. Is the price worth it?"


Albright: "I think this is a very hard choice, but the price -- we think the price is worth it."

Ms Albright did not question the figure. Ironically, data collected in 1996 by Ms Zaidi did. Her Center for Economic and Social Rights (CESR) team repeated the methodology of the 1995 FAO study but with a larger sample mothers, including some repeats. Their results, displayed in Table 6, were almost back to pre-crisis levels. Among the 406 mothers interviewed by Zaidi in both 1995 and 1996 96% of the births reported in both interviews matched by at least name and sex. Only nine deaths, though, were reported consistently in both periods; 65 of the deaths mentioned in 1995 were not mentioned in 1996 and nine deaths mentioned in the 1996 interview had not been mentioned in 1995. [Lancet 1997]

Therefore, while in Baghdad with the 1997 FAO/WFP Mission Zaidi also interviewed, for the third time, 26 women who reported a death in the 1995 interview, but not the 1996 interview. Nine of them now confirmed the deaths mentioned in 1995, thirteen of them did not and four were found to be miscarriages or stillbirths rather than live births. Zaidi concluded that the true estimate probably lay between the 1995 and 1996 figures. Recognising the limitations inherent to emergency estimates of mortality, based on memory, Zaidi suggests that indicators such as "weight-for-age", which can be directly measured, might be better estimators of the effects of sanctions. [Lancet 1997]

In internal discussions the CESR team has subsequently put forward a number of hypotheses as to why the 1996 CESR survey results yielded such dramatically lower figures than the 1995 FAO survey. First, in response to a concern about over-reporting of first day births in 1995, interviewers may compensated by recording some of these as still- births in 1996. As the 1995 mortality levels were higher in all categories than the 1996 levels, this hypothesis is not sufficient. Statistical analysis of the 1995 and 1996 data by individuals not connected to either survey did not show signs of individual interviewer bias; as each team included a Jordanian interpreter in 1996 it is felt unlikely that the Iraqi NRI interviewers could have systematically biased the 1996 survey. In 1995, the survey was introduced to women as a UN effort to assess the impact of sanctions, which may have led mothers to over-report deaths, emphasising their suffering. In 1996, as the CESR is unknown in Iraq, Iraqi interviewers "sometimes identified themselves are part of the Iraqi MOH", possibly leading to under-reporting out of fear of being considered discontent. As mothers in both surveys seemed eager and forthcoming this explanation is not entirely satisfactory either. The favoured explanation relates to the change in Iraq's prospects between 1995 and 1996:


Conditions throughout Iraq in August 1995 were desperate and deteriorating and mothers interviewed expressed high levels of despair. The Iraqi dinar, valued at US $3 before the imposition of sanctions, was selling at 3,000 dinars to the dollar, and prices for consumer goods, including staple food items, were beyond the reach of most Iraqis. By April 1996, the economic landscape had changed considerably. Public optimism concerning negotiations between Iraq and the UN over the food-for-oil deal, and the government's decision to release its stores of staple foods from warehouses into the market, combined to drive the Iraqi dinar up to 1,000 per US dollar, increasing the ability of households to meet their basic needs. These contrasting socio-economic conditions may have led mothers to over-report deaths in 1995 and/or under-report them in 1996. [CESR 1997]

This explanation seems consistent with Dreze and Gazdar's observation that, at the unofficial exchange rate, staple food prices were not significantly different in Iraq from those in its largest trading partner, Jordan. They interpret this to reflect the smuggling of food across the Iraqi-Jordanian border, implying that, "nutritional deprivation in Iraq is not a question of deficient food supply, but one of inadequate purchasing power" [WD 1992, p.928]. Indeed, this is the core of Sen-Dreze thinking on famines.

When asked in December 1997 about The Lancet estimate based on the data collected during the 1995 FAO mission that he led Prof. Pellett responded that


at the time I felt that the estimate was probably not too far from the mark and agreed in order of magnitude with other estimates that could be made from infant mortality data published by Unicef and others. It also reflected the degree of malnutrition that we saw in hospitals in 1995. The situation in the hospitals is no better in 1997, as we observed in [the 1997 FAO mission in] June and July. Irrespective of the actual numbers who have died the numbers are excessive and that point has become obscured by concentration on the rights and wrongs of the actual numbers. [Pellett 1997]

Table 7: Excess death estimates
Date Source Population Number Remarks
1 - 8 /91 NEJM 1992 U5 46,900 over 1 - 8 1991  
  NEJM 1993   21,000 over 1 - 8 1991 Bierman's regional correction; possibly questionable assumption.
1991 HST [in WD 1992] U5 170,000 in 1991  
9/90 - 3/94 MOH all 109,720 annually cited in FAO 1995; FAO has "no way of confirming this figure"
1995 Lancet 1995 U5 567,000 to date based on 1995 FAO data for Baghdad
1997 MOH U5
40,000 annually
50,000 annually
based on hospital data; cited in Unicef 1998, p.42. Causes of death for children: diarrhoea, pneumonia and malnutrition. As under five's are only 1/6 of the population they are suffering the most.
2/98 MOH U5 1,211,285 to date "Showdown with Iraq' doesn't deserve to be called a war", Rick Salutin, Globe & Mail (Canada), February 20, 1998;
9/98 MOH all less than 1,500,000 to date "a senior official in Iraq's health ministry"; claims "mostly young children". "Iraqis call West's bluff", Ian Black, The Guardian, September 30, 1998
1/1999 MOH



428,920 to date
1,444,544 to date


Iraqi Minister of Health, Oumid Medhat Mubarak; also claimed that IMR had risen from 24/1000 in 1990 to 98/1000 currently and that there were an additional 7,000 child deaths monthly. (Arabic News Service, January 18, 1999)

Health Minister Mubarak's estimate that some 7,000 extra child deaths are occurring every month is consistent with April Unicef figures and the WHO figures of 5,000 to 6,000 monthly deaths cited by Denis Halliday, UN Assistant-Secretary-General and Humanitarian Coordinator for Iraq until his resignation last September.

The Security Council

The United Nations at a glance

The United Nations is divided into six principal bodies. The General Assembly is the main deliberative body. In it the 185 Member States of the United Nations debate and cast their votes. Simple majorities are sufficient to approve ordinary matters while more important questions require a two-thirds majority.

The Security Council is a smaller body of 15 members, of which China, France, the Russian Federation, the United Kingdom and the United States are permanent members. The rest are elected by the General Assembly for two year terms. Policy decisions in the Security Council require nine votes but each of the five permanent members holds a veto.

The UN Charter, an international treaty, requires that "States to settle their disputes by peaceful means. They are to refrain from the threat or use of force against other States, and may bring any dispute before the Security Council".

UN documents emphasise that the Security Council has occasionally "authorized coalitions of Member States to use military action to deal with conflict, as it did in response to Iraq's invasion of Kuwait" but only "as a last resort, when peaceful means of settling a dispute have been exhausted".

Source: United Nations (

On August 2, 1990 Iraqi forces invaded Kuwait. Later that day the United Nations Security Council passed Resolution 660, condemning the invasion and calling for it to be reversed. Four days later the Security Council passed another resolution, SCR 661, imposing an almost total blockade on trade with Iraq with the exception of, "supplies intended strictly for medical purposes, and, in humanitarian circumstances, foodstuffs" [italics added]. All Iraqi assets abroad were frozen and all contracts over-ridden.

With its foreign assets frozen and prevented from exporting the exemptions on Iraq's imports were initially irrelevant as Iraq could not pay for imports. SCR 666 (13 Sept.) explained that Iraq could only accept donations of food through the Red Cross or other appropriate humanitarian agencies and even then only once the Security Council decided that the "humanitarian circumstances" mentioned in SCR 661 had arisen.

A committee, the "661 Committee" or "Sanctions Committee", was established to monitor the implementation of the sanctions. Its 15 members are the same as those of the Security Council; the same voting procedure also applies, including the permanent members' veto. The 661 Committee is not required to make its decisions available to public scrutiny.

On April 3, 1991, after the Gulf War had forced Iraq out of Kuwait, Security Council Resolution 687 extended the sanctions; this SCR is the one that maintains sanctions today. SCR 687 began by "[a]ffirming the commitment of all Member States to the sovereignty, territorial integrity and political independence of Kuwait and Iraq". It then expressed its concern about a number of Iraqi actions, including its unprovoked missile attacks (against Israel) during the bombing, its attempts to build a nuclear weapons programme, and its previous use of chemical weapons. The Resolution supported the "establishment of a nuclear-weapons-free zone in the region of the Middle East", the need to "work towards the establishment in the Middle East of a zone free of [weapons of mass destruction] and was aware of the "objective of achieving balanced and comprehensive control of armaments in the region". It was also conscious of "the necessity to meet urgently the humanitarian needs in Kuwait and Iraq".

Its resolutions established the UN Special Commission, Unscom, whose role it was to oversee the destruction of all of Iraq's chemical, nuclear and biological weapons, as well as all missiles with a range greater than 150 km. The International Atomic Energy Agency would oversee the nuclear component of Unscom's work. When the Security Council was satisfied that Iraq no longer had any of the weapons mentioned above, and had no plans to develop any of them, the prohibition against Iraqi exports would be lifted; paragraph 21 seems to tie the lifting of Iraq's import restrictions to a more vaguely defined Security Council review, to be held every 60 days. The time table laid out in SCR 687 was that disarmament plans should be approved within 45 days and then carried out in another 45, roughly July, 1991.

SCR 687 also, eight months after sanctions were imposed, decided that foodstuffs and other essential civilian materials could be imported into Iraq if approved by the 661 Committee. The Committee was also given the authority to allow limited exports from Iraq to pay for its imports. It remained to be decided how much Iraq would be allowed to export.

A July UN mission to Iraq, led by Prince Sadruddin Aga Khan, provided some possible figures. Its report, written with the aim of, "addressing immediate requirements of humanitarian scope and nature, but also with averting a crisis in the next six to twelve months" estimated Iraq's needs to be about $22 billion annually, of which food, health care, sanitation and water required some $3.6 billion. If pressed, it said, Iraq could obtain "greatly reduced services" for $6.85 billion, $2.4 billion of which would be required for food, health care, sanitation and water; prior to the sanctions Iraq had spent $2 to $3 billion on food imports alone. The Aga Khan report also recommended that Iraq be allowed to make controlled oil sales to fund the imports that Iraq needed to rebuild its damaged food, health, water, sanitation, power, oil and telecommunications sectors. [AK]

In partial response to the Aga Khan report UN SCR 706 was passed on August 15. This agreed to a six month period of Iraqi oil sales. The value of oil to be sold would be determined after a report by the Secretary-General but could not exceed $1.6 billion. The remainder could be used to purchase imports approved by the 661 Committee; the resolution required that these be "labelled to the extent possible as being supplied under this scheme".

The Secretary-General's report, submitted on September 4, concluded that a minimum of $1.73 billion was necessary to maintain the basic humanitarian needs of the country. As the deductions specified in SCR 706 were calculated by the Secretary-General to sum to $666 million a total sale of $2.4 billion would be necessary to meet Iraq's basic needs. The Secretary-General suggested that the Security Council might review its stated cap of $1.6 billion.

Two weeks later the Security Council approved the Secretary-General's distribution plan but not his suggested change in the oil sales cap in SCR 712.

In the end, these debates were irrelevant as the Iraqi government refused to implement SCR 706. It regarded the handing over of the reins of its economy to the UN as overly intrusive and as compromising the sovereignty that Security Council Resolutions on Iraq had vowed to uphold. The Security Council's response to this was to wash its hands of responsibility for the fate of the Iraqi population. In February the President of the Security Council claimed that, "by acting in this way [the Iraqi government] is forgoing the possibility of meeting the essential needs of its civilian population and therefore bears the full responsibility for their humanitarian problems". [UN 1996, p. 391]

For the next three years the Security Council took no new initiatives; we are not aware of any Security Council attempts to monitor the humanitarian situation within Iraq during this period. As evidence of suffering mounted Iraq's government realised that it would not be able to weather the storm on its own. They were met part way by the Security Council which, in passing SCR 986, "oil-for-food", on April 14, 1995, acknowledged some of Iraq's concerns about the previous oil-for-food resolutions 706 (1991), reaffirming "the commitment of all Member States to the sovereignty and territorial integrity of Iraq" and describing the oil-for-food programme as "temporary". [UN 1996, p. 103]

While Iraq initially rejected the terms of SCR 986 in May 1996 a Memorandum of Understanding (MOU) was signed, setting out the plan for its implementation. The Iraqi government would implement 986 in the 15 governorates of South/Centre Iraq and the UN in the three northern Kurdish governorates.

SCR 1153, approved on February 20, 1998, increased the cap on Iraqi oil exports to $5.206 billion every six months. This was adopted after the Secretary-General's assessment of the first three phases concluded that "the deteriorated state of health, sanitation and other essential infrastructure has had a growing negative impact on the well- being of the Iraqi people".

Most recently, in the wake of the US and British bombing, Iraq has announced that Unscom will not be allowed back in Iraq. On January 30, 1999 the Security Council established three panels to review Iraq's relationship to the United Nations. They are to report back in April with proposals on disarmament, Kuwaiti claims and humanitarian concerns. Their proposals will not be binding. The Economist predicts that, "America and Britain are likely to veto any proposal that involves easing sanctions on Iraq, a policy that the other three permanent members of the council have called for". The US has proposed removing the cap on oil sales and automatically approving food and medicine contracts but maintaining the same export and import controls. The Economist magazine has commented that this, "gesture is meaningless": the low price of oil and Iraq's collapsing oil industry (even with a trickle of spare parts now being allowed in) mean that lifting the cap, "will do no more than stem the decline". The US proposal came in response to a French proposal that the escrow account and import controls be abandoned entirely be replaced with a simple ban on arms and "dual use" equipment sales. [S/1999/100; The Economist, February 6, 1999; The Times, 15 January, 1999; New York Times, January 15, 1999]

Throughout all of the humanitarian resolutions have been a series condemning Iraqi obstruction of Unscom. Without attempting to address these in detail we do make some comments. First, there is now a widespread acknowledgement that Unscom shared information with governments hostile to Iraq in return for their assistance in tracking Iraq's weapons. Scott Ritter, the former Unscom chief weapons inspector, discusses this in his interview in The New Yorker (November 9, 1998). He also explains the reasons for his resignation: as Unscom was closing in on Iraq's weapons programme the US administration began to fear another confrontation with Iraq and so ordered Unscom to call off the inspections; Unscom is officially under UN, not US, control but the inspections were stopped. When Mr Ritter realised that the US was not interested in Iraqi disarmament he resigned. Responding to charges that Unscom teams also included under cover MI6 officers Liberal Democrat MP Norman Baker claimed that, "I would be very, very angry if the independence and integrity of the Unscom was compromised in this way. To include MI6 and Ministry of Defence intelligence staff deliberately in the UN teams is to undermine the UN itself." [The Independent, January 25, 1999]

Second, the International Atomic Energy Agency (IAEA) has consistently reported more cooperation from Iraq than has Unscom proper. While it is likely that Iraq has been less protective of its nuclear programme, which the IAEA is satisfied has been dismantled, than its chemical and biological programme, some responsibility for this difference has been attributed to the personality of Richard Butler, Unscom's chief, and the perception that he has reported to Washington rather than to the UN. On February 6, 1999 The Times announced that Mr Butler would be retiring when his contract expired at the end of June. [S/1998/1172]


The British and American governments often defend their actions towards Iraq by appeal to Security Council Resolutions. Recently, actions without basis in Security Council Resolutions have been defended this way. Their December, 1998 decision to bomb Iraq was defended by claiming that Iraq's continued obstruction of Unscom placed it in violation of SCR 687, authorising their response. In fact, as the Security Council was only beginning to discuss the December Unscom report when the bombing began, it is impossible that the Security Council could have evaluated its contents.

Security Council support has also been claimed for the "air exclusion" or "no-fly" zones over Iraq which have been used to prevent Iraqi air traffic over these parts of their country. Northern and southern "no-fly" zones were established by the US, the UK and France in 1991, ostensibly to protect Iraq's Kurds (in the north) and its majority Arab Shias (in the south and centre) from the government in Baghdad (primarily drawn from Iraq's Arab Sunnis). In September 1996 the United States unilaterally extended the southern zone northwards to the outskirts of Baghdad. In December 1996 France stopped patrolling the northern zone. Security Council Resolutions make no mention of either of these no-fly zones; on the contrary, they repeated affirm Iraq's political sovereignty and territorial integrity.

The "Oil for Food" programme
The first "oil for food" proposal was contained in Security Council Resolution (SCR) 706, adopted on August 15, 1991. The Iraqi government's refusal to implement it led to a long pause until April 14, 1995, when the Security Council passed SCR 986. This allowed Iraq to sell $2 billion worth of oil every six months. All proceeds from Iraqi exports would be paid directly into a UN-controlled escrow account at the Banque Nationale de Paris; the Iraqi government never touches the money. The income thus raised was split according to Table 8.

Table 8: Proposed allocation of oil-for-food funds (Source: UN Office of the Iraq Programme
  SCR 986 (14/4/95)
food, medicine and humanitarian supplies: Centre/South ("ESB account") 53% = $1,060 million
food, medicine and humanitarian supplies: North ("ESC account") 13% = $260 million
UN Compensation Fund 30% = $600 million
UN administration costs 2.2% = $44 million
Unscom costs 0.8% = $16 million
escrow account costs 1% = $20 million
total $2 billion / 180 days

The government of Iraq signs contracts with suppliers for the 53% of the oil-for-food revenue to which it is entitled. Those contracts are then submitted, by the UN Office of the Iraq Programme, to the 661 Sanctions Committee, which decides whether to accept or reject them. If accepted, funds are released directly from the ESB account to the contractor. The goods' arrival in Iraq and subsequent delivery is monitored by the United Nations.

Oil sales under oil for food take place in six month periods (called "Phases") after which renewal is required if Iraq is to be allowed to export more oil. The programme has been consistently renewed since its inception. On February 20, 1998, during Phase III, SCR 1153 raised the cap on Iraqi oil sales to $5.206 billion every six months. In response, the government of Iraq submitted an "enhanced distribution plan" detailing its proposed use of these extra funds. Following rapid approval by the Security Council the plan was implemented in Phase IV, which began on May 30, 1998. DP IV, the enhanced distribution plan, was designed to rehabilitate sectors like water supply and sanitation whose damaged infrastructure presented "major obstacles to improved health and nutrition". It would also provide, in theory, for a ration of 2,300 calories daily, meeting minimum requirements; this would include for the first time milk and cheese (in alternating months) and weaning cereal for infants. [WFP 1998]

SCR 1175, adopted on June 19, 1998, recognised the damage done to Iraq's oil exportation capabilities and allowed spare parts for the oil industry as well as food and medical supplies to be considered for import.

Table 9: Oil for Food Distribution (Sources: Unicef 1998, UN Office of the Iraq Programme, S/1998/1100, WFP 1998)
SCR Phase Duration Comments
986 I 10/12/96 - 7/6/97 Oil exports start 15/12/96; first contracts approved 1/97; first food arrives 3/97; first medicine arrives 5/97
Less than one-third of food distributed by end of May. Most electrical supplies for north expected to arrive by 12/98.
1111 II 8/6/97 - 4/12/97 Same distribution plan as Phase I; UK and US demand more stringent monitoring of distribution; as of 3/98 only 75% (50%) of health imports had arrived in Iraq for South/Centre (North), 59% (27%) for water/sanitation, 37% (45%) for education, and 48% (10%) for electricity/power (expected in North early 1999).
1143 III 5/12/97 - Similar distribution plan to Phases I and II; proposed ration 2,030 calories/day.
Agricultural pesticides arrived too late for season due to slow rate of approval and contracting. Electrical supplies expected in north mid-1999.
1153 IV 30/5/98 - 12/98 ration recommended by Secretary-General: 2,463 calories; ration accepted by Government: 2,300 calories; ration distributed due to falling oil price: 2,030 calories; therapeutic milk, high-protein biscuits and vitamin supplements delayed (being purchased for first time), expected in early 1999
1210 V 26/11/98 - 25/5/99  

At the end of each Phase the Secretary-General of the United Nations submits a report on the progress of oil-for-food. The latest six month report was submitted on November 19, 1998. The following is largely drawn from that report. From its start in December, 1996 to October 31, 1998 a total of $8.4 billion in oil revenues has been deposited into the escrow account. Total expenditures to date approved by the 661 Sanctions Committee are displayed in Table 10.

Table 10: Total imports received and delivered under oil-for- food: December 10, 1996 to October 31, 1998 (millions of $) (Source: S/1998/1100)
Commodity Value arrived in Iraq Value received by users
  South/Centre North South/Centre North
foodstuffs 2,483.4 2,128.1 327.2
medicine 444.7 183.7 19.1
water and sanitation 37.2 28.1 16.0 21.7
agriculture inputs 56.9 40.3 23.6 24.6
electricity equipment 44.3 11.9 43.8 2.8
education equipment 19.5 13.8 5.6 10.6
  3.7   1.9
demining   1.5   1.5
totals 3,185.2 2,400.8 409.4

As the northern governorates are separately administered (drawing funds from the 13% "ESC" account) most of their purchases are separate as well. Foodstuffs and medicines are the exceptions as the northern governorates and the Government of Iraq have bulk purchasing agreements for these.

Table 10 shows that some $2.5 billion in food has been imported by Iraq over the first two years of oil for food. This is roughly 40% of the $3 billion of food that Iraq had imported prior to sanctions in years of bad harvest. Iraqi agriculture has since been consistently worse than even the bad pre-1991 years. [FAO/WFP 1997]

In Phase IV, for the first time since the beginning of oil-for-food, in South/Centre Iraq


full rations have been distributed for three consecutive months. In 97 percent of households consulted, the food baskets were received on time. However, household visits by WFP observers in the south and centre of Iraq show nearly two thirds of households reporting that the food basket lasts only 20 days or less. [para 22]

Food prices offer a sign of the affordability, and therefore the availability, of foodstuffs in the market. Following an overall decline in food prices throughout 1997, food prices have begun to rise in 1998, suggesting a reversal in the trend towards greater affordability of food. [S/1998/1100, para 23]

In the Northern governorates only three quarters of households received their rations on time. As there are more possibilities for supplementing the ration in the north it plays a less important role in nutrition.

Of the medical supplies imported under oil-for-food slightly less than half, $203 million, has actually reached Iraqis, an annual amount of about $5 per person. In the south and centre the Secretary-General explains this poor distribution in terms of a sudden surge of deliveries, poor transportation, congested warehouses without proper handling equipment and the failure of some suppliers to provide "testing methodology and standard solutions". The effect of all of this has been to tax Iraq's infrastructure further and extend average processing time from two to three and a half weeks, enough for much of the medicine to lose its potency. The report regrets that no applications for "targeted nutrition supplies" such as high-protein biscuits and therapeutic milk have been received, although approved for inclusion in the enhanced distribution plan. [S/1998/1100]

In northern Iraq, where the WHO and local authorities have an efficient distribution system, medicines are more available, with few health centres rationing them. [S/1998/1100]

In South/Centre Iraq the imports for water and sanitation have, "slowed the pace of deterioration but the equipment does not address all the needs of the plants, nor do the funds suffice to significantly reverse the present deterioration. In 12 of these governorates water quality has improved slightly. Water quality in all three northern governorates has improved substantially, with Unicef replacing broken pumps and pipes and installing chlorinators. [S/1998/1100]

The Secretary-General reports that the agricultural inputs, while being more efficiently delivered, "do not adequately meet the needs of farmers" in South/Centre Iraq. Only 2.5% of the estimated tractors needed have been ordered and the deterioration of pumps has increased the threat of waterlogging and salinisation of farmland. In the north, however, Iraq's traditional breadbasket has recovered to the point where it is exporting wheat to South/Centre Iraq. Improvements in livestock have dropped the price of meat by about 40%. As agriculture in northern Iraq does not depend on irrigation it has not been as affected by the damage suffered in the south. [S/1998/1100]

In South/Centre Iraq electrical deterioration continues; power plants operate at less than half installed capacity, with oil-for-food imports increasing this by about 2 to 3%. Similar figures are not available for the north but receipt of imports has been notably poor. [S/1998/1100]

In South/Centre Iraq low implementation rates for educational materials, "are partially explained by the delay in receiving inputs for the printing of textbooks, the rehabilitation of schools and the production of school furniture"; further, the Ministry of Education has not had the vehicles to transport materials. Only 14% of the estimated funds required for school rehabilitation are forthcoming. Primary enrolment levels are cited as falling from 94% in 1991 to 84% in 1996, with no sign of improvement. Again, the situation in the north is better. Unesco and Unicef programmes have helped to restore supplies and to train teachers. Primary net enrolment rates have climbed from 81% (1996) to 91%. [S/1998/1100]

From the start of oil-for-food to the reporting date Turkey has received $371 million to pipe some of Iraq's oil. This is almost half again as much as the $257 million that all of Iraq has paid for electrical, water/sanitation, agricultural, education, settlement rehabilitation and demining work; it is three times the $152 million of these supplies that have actually been delivered to their end-users. [S/1998/1100, Office of the Iraq Programme]

Is the current approach working?
To ask whether an approach is working requires a sense of goals. We believe in the goals of SCR 687: that Iraq's sovereignty and territorial integrity should be respected; that a Middle East free of weapons of mass destruction is desirable; and that the humanitarian needs of Iraq's people are a concern. We also agree with Robin Cook's belief in the authority of the United Nations, for the reasons that he states:


... we must uphold the sanctity of international law and the United Nations. If we abandon them, we lose the only objective standard by which a country can steer its course. The rule of the strongest would be substituted for the rule of law. Conversely, if we stand by them, we will find they grow in strength and authority. That way we build a world that is safe from the Saddams of the future. [Daily Telegraph, November 18, 1998]

We do not believe that oil-for-food is accomplishing these goals. Whether the oil-for-food programme respects the sovereignty of Iraq is a debatable case; it is intrusive and humiliating but has Iraq's consent. As, eight years into a planned 90 day mission, Unscom has yet to file a satisfactory report on Iraqi disarmament, the sanctions do not seem to have successfully accomplished this goal either. This should not surprise: if the Iraqi regime truly does not care about the suffering of the Iraqi people then the sanctions, which hurt ordinary Iraqis more than the elite, will not exert much pressure on them. The sanctions might "work" if Iraqis felt that their regime did not care for their welfare and overthrew their government. Robin Cook dismisses this possibility in his Daily Telegraph article, explaining that, "We cannot ask for a popular uprising. If Iraqis put their hands up to disagree, they are literally cut off ." [November 18, 1998]

What follows seeks to raise questions about oil-for-food's ability to address the humanitarian needs of Iraqis.

A concern expressed from the outset of the sanctions has been the potential for permanent members of the 661 Sanctions Committee to abuse their ability to veto proposed imports. Denis Halliday, former UN Humanitarian Coordinator for Iraq, claims that the US has held back food and medical contracts in the Committee; "I think that's improved now, but they are still holding up some oil parts". As 661 Committee decisions are not subject to public scrutiny it is difficult to provide more detail. [Middle East International, November 13, 1998]

Innocent victims made to suffer for the sins of Saddam
Robert Fisk, The Independent, March 7, 1998

THE DISNEY PARK is empty and the government has banned the export of school textbooks - because not a single Iraqi schoolbook has been printed since 1990. Nor has a single school been built anywhere in Iraq since Saddam Hussein invaded Kuwait. Lack of funds, is the reason it seems (though not enough to stop Saddam building more palaces).

The Internet is a mystery to Iraqi children. New computers are banned under UN sanctions; they may have a dual military purpose. So, it appears, may cotton - because there are no more cotton sheets for hospital wards - and paper, too. Exercise books have run out; in Baghdad, one young mother admitted that she tells her children only to write in pencil, so that she can erase their work and give them back their exercise books to use again. Always supposing the children have pencils, which are subject to UN restrictions because they contain graphite, which could be used for military purposes.

The idea of Saddam's legions stripping the wood off school pencils to get at the graphite would be funny if the effect of UN sanctions was not so immoral. In the Basra General Hospital, children are suffering from typhoid, almost certainly from drinking water contaminated by sewage.

And who is to blame? Well, once we have gone through the Saddam routine - it is he, we are told, who is really being punished for his wickedness - we find that Iraqi water treatment plants are not being repaired. And why not? Because each individual item of machinery has to be manufactured specifically for the plants.

Technology that was up-to-date in 1990 is now obsolete. It is becoming ever more difficult to obtain spare parts. Iraq used to build its water plants with machinery from Spain, Italy and France. And UN sanctions committee approval is needed for each spare part. So the tap water is polluted.

When I ask a doctor at the Basra General Hospital why there are no children in the Disney Park, he replies: "Because they are all sent out to work by their families." On every street, children sell cigarettes, nuts, matches; or just beg. Others claw through rubbish tips for resaleable goods. They are being punished, you see, because of a man called Saddam Hussein.

Even without abuse of vetoes oil-for-food represents an attempt to centrally plan an economy of 20 million people. Charges of inefficiency and delayed arrivals (see, for example, SCR 1143 of December 4, 1997) should not surprise. The UN has tried to address this concern by creating an Office of the Iraq Programme (OIP) in October 1997 to coodinate oil-for-food's management. Its Executive Director is Benon Sevan. His second in command is the Humanitarian Coordinator in Iraq. For the OIP's first thirteen months this was Denis Halliday. When he resigned in September, 1998 Hans von Sponeck replaced him. The Secretary-General's November report makes it clear that the efficiency problem has not been entirely resolved by concluding with the hope that the 661 Committee, "will expedite the approval of applications essential for the increase of oil production and exports". [S/1998/1100]

Denis Halliday on his resignation

The sanctions were failing in the purposes they were set up for back in 1990-91. They weren't leading to disarmament and, second, the cost of the sanctions was unacceptable - killing 6 - 7,000 children a month. Sustaining a level of malnutrition of about 30 per cent for children under five leads to physical and mental problems. It's incompatible with the UN Charter, with the Convention on Human Rights and probably with many other international agreements. I just found that impossible to accept as the head of the UN in Iraq.
... if you've got a leadership which you can't communicate or have a dialogue with and that doesn't seem to want to conform to the standards that the UN is trying to establish, does that empower the Security Council to kill a refugee, or to sustain malnutrition? I don't think so. Killing 6,000 kids a month is like a declaration of war. I don't think the Security Council is empowered to do that just because they don't like Saddam. ... just because he is a son of a bitch does not mean that we have to be the same.[Middle East International, November 13, 1998]

A third explanation given for the continued suffering under oil-for-food is that the programme is deliberately abused by the Iraqi regime. In November, the Foreign Secretary claimed that, "we doubled the amount of oil that Iraq can sell to buy [food, medicine] and other humanitarian goods. But Saddam chooses not to. He spends his money on new palaces and weapons." [Daily Telegraph, November 18, 1998] Similar charges of attempts to import liposuction machines have been made.

The meaning of these statements is often unclear but may refer to at least three possibilities: first, that oil-for-food funds are being used to purchase "new palaces and weapons". Directly, this is impossible as purchases under oil-for-food funds must be approved by the Sanctions Committee of the Security Council. It could also be that purchases under oil-for-food are being diverted, possibly re-sold for revenue to purchase "new palaces and weapons". This claim is addressed by Mr Michael Stone in a letter to the editor of The Independent on December 28,1998:




I have recently returned from Baghdad, where for one-and-a-half years it was my job to report the progress of the humanitarian Oil for Food programme. Ministers and senior members of the Opposition frequently state that the Iraqi leadership have diverted supplies under this programme. This is a serious error. Some 150 international observers, travelling throughout Iraq, reported to the United Nations Multidisciplinary Observer Unit, of which I was the head. At no time was any diversion recorded. I made this clear in our reports to the UN Secretary General, and he reported in writing to the Security Council accordingly. In the case of private donations outside the Oil for Food programme, those which arrived by air were observed by us, and no diversion was recorded. Humanitarian supplies arriving by road were not within our remit, although my contact with the Iraq Red Crescent, which has a co-ordination role, would suggest no diversion. With regard to private medical donations, again nothing directly to do with the Oil for Food programme, there has sometimes been confusion. All supplies, in accordance with international practice, should have been vetted before distribution by the testing authority, Kimadia. (Some suppliers, in ignorance, tried to avoid this). I know of more than one occasion when outdated medicines arrived, and Kimadia was naturally reluctant for them to be distributed.

UN Under-Secretary-General for Humanitarian Affairs Akashi confirmed in mid-1997 that UN World Food Programme observers had access to every Iraqi governorate and village. He concluded that, "on a prima facie basis, one could say that the government was making a good effort to distribute food on an equitable basis." [Unicef 1998, p. 18]

Of course, given the sophistication of Iraqi arms concealment mechanisms, it is possible that oil-for-food resource diversion is equally subtle. We have yet to see report of this.

Another possible point of diversion is in the contract approval mechanism itself. Nabeel Musawi, recently exiled from Iraq and a director of the London-based Iraqi opposition group, the Iraqi National Congress, has claimed that contracts have been submitted to the OIP containing prices above market rates; the contractor that would receive the inflated price out of oil-for-food revenues might then launder the excess back to Baghdad, which could then make non-approved purchases. Responding to this claim, Denis Halliday has suggested that some of this may be simple graft: all over the world kickbacks are added to contracts; the Iraqi government may be no more honest. [Cambridge 1999]

A third interpretation of statements like Mr Cook's is that the Iraqi government is "choosing not to" spend money on humanitarian goods by not spending. The Secretary- General's November report gives no hint of this, explaining instead that the falling price of oil and Iraq's damaged oil infrastructure were only capable of raising $3.15 billion of the $5.2 billion allowed in Phase IV. Of this, only $1.98 billion will be available for humanitarian supplies, which "falls far short of the $3.1 billion required to implement fully the enhanced distribution plan". An expert committee had warned in April, 1998 of this shortfall unless spare parts were immediately ordered for Iraq's oil industry. [S/1998/1100] Similarly, the most recent World Food Programme report claims that


Unfortunately, the combination of low oil prices and inadequate pumping capacity means that, in practice, the Iraqi population is unlikely to see the fruits of the Enhanced Distribution Plan until well in 1999. In the food sector, it is probable that Iraqis will continue to receive a basket closer to the earlier, lower level of 2,030 calories. [WFP 1998, p.5]

They attribute the continued high rates malnutrition in Iraq not to government abuse but to inadequate water and sanitation infrastructure, an insufficient diet, Iraq's traditional focus on high-tech medicine, to the detriment of primary health care and basic health education, and "Inappropriate infant and child care practices", particularly low rates of breast-feeding. Unicef suggests that this last may be the result of "false perceptions of 'progress'". [WFP 1998; Unicef 1998, p.71]

There are hints contained within the Secretary-General's November report which may point to another form of Iraqi abuse of oil-for-food. It urges the Iraqi government to "further prioritize its request for spare parts and equipment with a view to enhancing its oil export capacity" and regretted that there had been no application for "targeted nutrition supplies". Without further information it is not clear whether these are suggestions of deliberate abuse or simply difficulties inherent to any centrally planned economy. This seems to be the most convincing way in which oil-for-food's failure to return Iraqi life to an acceptable state could even be partially attributed to the regime.

Another concern about the ability of sanctions and oil-for-food to meet the humanitarian needs of Iraqis is that their brunt seems to be borne by the weaker members of the population, rather than the regime. We have already documented how children and those too poor to supplement their rations are at greatest risk under the current arrangements. Mr Musawi claims that, "the regime has flourished under the current [sanctions] regime" while weakening the people of Iraq; he supports a lifting of the ceiling on oil-for-food as long as the money can be kept from the regime. [Cambridge, 1999]

One way in which the regime has flourished is through the smuggling industry generated by scarcity. Abbas Janabi, the personal secretary of Saddam's son, Uday, until his defection in the spring of 1998, claims that


Uday is the biggest winner from the sanctions. ... the profit from these operations go [sic] to him personally, to his pocket. I estimate that he has made at least hundreds of millions of dollars.

It is in Uday's interest that the sanctions remain. He also controls all the aid that pours in from the emirates. He stores them now in the warehouse of the [Iraqi] Olympic Committee after distributing a small portion of it for the media to take pictures. [Los Angeles Times, October 21, 1998; excerpting from London's al-Hayat of the same week]

The Los Angeles Times article contains no mention of oil-for-food resources being diverted. In February 1998 Robin Cook did not believe the claims that the sanctions were punishing ordinary Iraqis while leaving the elite largely untouched: "Britain has led efforts to ensure that the impact on the Iraqi people was minimized, and that the impact on the regime maximized." [The Guardian, February 20, 1998].

Writing in The Independent Richard Downes suggested that the sanctions might not just enrich those strong enough to be involved in smuggling but might also help the regime suppress dissent by allowing it to threaten to withdraw rations from dissenters. [December 12, 1998]

The sanctions may also target those in the South/Centre of Iraq disproportionately. In spite of Security Council concerns about an "equitable distribution" of resources within Iraq Unicef reported that Iraqis in South/Centre Iraq received about $60 annually under SCR 986, roughly two thirds of the $87 received by Iraqis in the northern three governorates. While not denying the brutality of Saddam Hussein's regime Mr Cook's February 1998 comments that, "it is no accident that the people [in northern Iraq] are hugely better off .. The contrast with the rest of the country could not be starker" should be seen in this light. [Unicef 1998, p.17; The Guardian, February 20, 1998]

Even were oil-for-food not subject to abuse or otherwise inefficient it fails to alleviate the suffering of Iraqis because it is underfunded. Recent needs estimates for Iraq include an estimated $2.7 billion of food annually for South/Centre Iraq in 1996-97, $4 billion if medicine is also considered or $22 billion if public works infrastructure is included; this last estimate is based on a 1991 calculation. The 1997 FAO/WFP mission concluded that, "Perhaps the most far-reaching recommendation for both agriculture and nutrition concerns the need for economic rehabilitation and development throughout the whole country"; Unicef echoed this in 1998: "The necessary cash assistance, at least in the South/Centre governorates, is lacking". [Unicef 1998, pp. 17, 95; FAO/WFP 1997]

... we continue to impose genocidal sanctions on Iraq, sanctions that are killing innocent Iraqis and - by the admission of Mr Cook and Mrs Albright - not harming Saddam at all... Mrs Albright rages at Saddam's ability to go on building palaces, and Mr Cook is obsessed with a report of the regime's purchase of liposuction equipment which, if true, merely proves that sanctions are a total failure. ... [Robert Fisk, The Independent, December 18, 1998]

Ending the disaster
We hope here to suggest possible elements of a saner policy on Iraq. Without more information than we have available to us in the public domain it would be foolish to claim that these would not require further discussion and refinement. We also make note of some steps that might worsen the situation, with the same caveat.

Possible steps forward
First, there seems to be a consensus in favour of removing the cap on oil sales: with the existing applications procedure the prospects for Iraqi acquisition of weapons is likely quite low. One argument that might be mounted against this proposal is that, as Iraq's oil industry is currently unable even to pump the $10 billion that it is allowed annually, a lifting of the cap may be a meaningless gesture, designed more to score political points than to alleviate the suffering in Iraq. Denis Halliday has offered a suggestion as to how more revenue could be received by Iraq in the short term, suggesting that the revenues generated by oil sales be temporarily re-allocated, with the Compensation Fund's 30% being used for Iraq's humanitarian needs. Once Iraq's more pressing needs had been met, it could repay the Compensation Fund. [Cambridge 1999]
The benefit of a removed cap and a temporary redirection of the Compensation Fund will not help if obstruction continues in the 661 Sanctions Committee. Its workings should be reviewed. A more transparent approvals process requiring public disclosure of deliberation could reduce the potential for valid Iraqi contracts to be delayed by veto- wielding permanent members whose interests do not coincide with the expressed aims of the Security Council.

While aiding in the meeting of Iraq's humanitarian and respecting no less its sovereignty these proposals do not seem to increase the risk of Iraqi aggression. Neither are they technically difficult steps to take: new Security Council Resolutions may supersede previous ones.

Neither of these proposals, though, address the concerns of regional stability or the creation of a Middle East free of weapons of mass destruction, stated concerns of Security Council Resolutions. Therefore, we propose that steps be taken to reduce the antagonism of the parties involved in the Iraq crisis. This is not to suggest that Saddam Hussein's regime has not committed atrocities, merely to recognise that seeking to destroy it may produce yet more and that Iraq, once one of the three pillars of US Gulf policy, must be a part of any stable peace in the Middle East. From this point of view the morally charged language used by the British government is inappropriate both given its own role in assisting in those atrocities and in raising the stakes to the point where British foreign policy is only left with "grim necessities", reminiscent of the US's inability to reduce its involvement in Vietnam.

Bombs are not the way to peace
Robert Fisk, The Independent, February 12, 1998

I have been reminded of some familiar odours these past few days. The first is the terrible, nauseous stench I endured for hours on the overnight train from Ahwaz to Tehran back in the Eighties, as I shared a carriage with dozens of young Iranian soldiers. All of them were coughing up Saddam Hussein's poisons from their lungs into blood-red swabs and bandages. And the mustard gas that was slowly killing them permeated the whole great 20-carriage train as it thundered up from the desert battlefields of the first Gulf War, through the mountains to the city where almost all these men would soon die and be buried. After only an hour into the journey, I was forced to throw open the carriage window to avoid vomiting.

No sooner had I filed a series of reports to London on this new and terrible war crime of Saddam Hussein than a British diplomat, lunching with one of my editors in London, remarked that "Bob doesn't seem to understand the situation." True, he said, gas was a terrible weapon. But Saddam was fighting the West's war against Iranian fundamentalism - a danger which might set the whole Middle East ablaze and which could threaten the entire world. Wasn't The Times - the paper for which I then worked - putting a little too much emphasis on Saddam's sins?

So the other smell I recall this week is the stink of hypocrisy when - in 1990 - the world's statesmen began to whip their people into line for war against the man they had supported in his conflict against Iran. The French had sold Saddam Mirage jets. The Germans had provided him with the gas that had me almost retching on the train from Ahwaz. The Americans had sold him helicopters for spraying crops with pesticide (the "crops", of course, being human beings). The British gave Saddam bailey bridges. And I later met the Cologne arms dealer who flew from the Pentagon to Baghdad with US satellite photos of the Iranian front lines - to help Saddam kill more Iranians.

For Iraq to believe in a security plan its own needs must be considered. This suggests an approach that Simon Jenkins, writing in The Times, called "waging peace":


To proffer economic sanctions as a "clean" alternative to military aggression is hypocrisy... Sanctions are targeted at people, not governments. That is supposedly their power. It is the essence of their immorality.

...Yet if [Robin Cook] will not wage war, then he must wage peace. This involves the full panoply of "constructive engagement". It implies targeted aid, trade, finance, tourism, educational, political and cultural exchange. It buys goods, welcomes students and sends teachers. It supports local media and promotes contact. It spends $160 million building bridges, not bombing them...

...It may lack the videos, the bombs, the headlines and the "feel-good" factor of the West's Iraq policy but engagement makes sense. It is based on sound 19th-century liberalism. It holds that human contact and commercial intercourse are politically constructive. Trade broadens the base of economic power within a country. Education extends an awareness of freedom. Both pluralise the avenues for diversity and even dissent. They are preconditions for liberty.

For some reason this argument does not apply to Iraq. Indeed its opposite applies. According to the British Government, what Iraq has most needed in the eight years since the Gulf War is abuse, sanctions, impoverishment, ostracism, and an occasional monsoon of fragmentation bombs. Not surprisingly, this has led to no rush of prosperity or freedom. [August 5, 1998]

The details of this approach would need to be worked out carefully. Perhaps Saddam should be isolated, perhaps even indicted for war crimes and other members of the regime cultivated. In the UK Labour MP Ann Clwyd's organisation, Indict, has been campaigning for the first of these and has now received US funding to assist it. In order to ensure that this legal approach was not regarded as another example of victors' justice it would be important that the courts involved be respected as independent. A complete lifting of all non-military sanctions, possibly even allowing some "legitimate" military purchases, would almost certainly be welcomed by Iraqis and would likely do much to regain their sympathy, abused for eight years. Less rigid border control does increase the likelihood that military supplies will be imported.

A stable security plan should also strengthen institutions for dispute resolution, such as the United Nations Security Council. If the United Nations wishes to be able to play this role it must be seen as enforcing its Resolutions evenly. This is particularly difficult in the Middle East where there is a widespread perception that this is not so. To pick a standard example, the Security Council Resolution 425, adopted on March 19, 1978, calling for, "Israel immediately to cease its military action against Lebanese territorial integrity and withdraw forthwith its forces from all Lebanese territory" has yet to be enforced twenty years later. Against this, SCR 660's demand "that Iraq withdraw immediately and unconditionally all its forces to the positions in which they were located on 1 August 1990", was punitively enforced within months. Above all, this is a choice for the United States, whose support for the United Nations does not even extend to paying its membership dues. As long as the United States prefers to use the UN in a partisan way it is unlikely that the Middle East will see stability.

Dangerous steps
We are currently increasingly committed to taking two steps that should not be taken. Both the bombing of Iraq has continued since December, 1998 and the arming of Iraqi opposition groups may have a variety of detrimental consequences. This latter step is largely being carried out under the US Congress' 1998 Iraqi Liberation Act, which has provided $97 million to arm seven Iraqi opposition groups, including the Iraqi National Congress in London. The two main Kurdish factions in northern Iraq, the Kurdish Democratic Party (KDP) and the Patriotic Union of Kurdistan (PUK) have also been named as recipients by Congress. The KDP, which has remained in dialogue with Baghdad, has declined the offer, stating that, "We do not intend to receive this kind of aid", and expressing concern that an unstable regime in Baghdad was likely to act unpredictably. [The Guardian, January 25, 1999]

First, both actions run contrary to UN Security Council Resolutions. By enforcing the impression that the Security Council is a tool for the exercise of power, not justice, these actions undermine the authority of the UN. They are unlikely to encourage Iraq to cooperate with the United Nations in fulfilling its obligations to the UN.

Second, both weaken the institutional fabric of Iraq unless rapidly "successful" in effecting a desirable regime change. The comments of General Anthony Zinni, the commander of US forces in the Gulf, on the likelihood of this occurring as a result of the Iraqi Liberation Act may also apply to the hope the bombing will cause a more desirable regime in Iraq: "I don't see an opposition group that has the viability to overthrow Saddam at this point". Of the 91 fragmented opposition groups, which include the Supreme Council for the Islamic Revolution in Iraq and the Iraqi Communist Party as well as Kurds and the INC, he claimed that, "their ability is questionable" and that, without a united coalition to take Saddam's place, the region would be destabilised. Listing Somalia, Afghanistan and Iran he added that, "I've seen the effect of regime changes that didn't quite come about the way we would have liked ... And the last thing we need is another rogue state. The last thing we need is a disintegrating, fragmented Iraq because the effects on the region would be greater in my judgement than [those of a] contained Saddam". [Agence France Presse, January 30, 1999; The Independent, February 20, 1999]

Third, the Iraqi government, with a demonstrated record of political brutality, can be expected to defend its hold on power brutally. Murders like that of the Iraqi Shia leader, Ayatollah Mohammed Sadeq al-Sadr, and his sons can be expected to become more frequent: the Iraqi regime is accused of ordering the assassinations out of fear of the Ayatollah's growing influence; it responds with claims that the assassinations were designed to discredit it. Shia Islam is adhered to by the majority of Iraqis; Sunni Islam, the larger branch of Islam, is the predominant religion of the Kurds. [Roula Khalaf, Financial Times, February 22, 1999]

While the current regime may attempt to retain power brutally Denis Halliday cautions against a further danger:


People like to think [Saddam Hussein] runs the place alone. He doesn't. The Ba'ath Party is changing. There's a new generation of people coming up who are no longer content to sit back and talk to the UN. They're angry, they want action, maybe they want violence, and they're frustrated. As far as they're concerned, the present leadership of Iraq, crazy as it may sound, is moderate. [Middle East International, November 13, 1998]

Fourth, bombing and prolonged attempts at insurrection will inevitably causing civilian casualties and harden Iraqi antagonism to the US and UK. Dr Audrey Stevenson's December 22, 1998 letter to The Independent seems instructive:


Sir: The hope that the bombing of Iraq will provoke the Iraqis to rise against their leader seems to me to be ludicrous.

My experience of being bombed during the Second World War (I was stationed in London during the Blitz and the attacks by V1 and V2 missiles) did not make me want to throw out Winston Churchill - quite the opposite. But it did give me a profound and increasing dislike of the perpetrators of the bombings, namely the Nazis.

Why should the Iraqis be different?

Fifth, in weakening Iraq as a nation regional instability is increased. Will there be calls in Iran for a Shia uprising against Sunni oppression in Iraq, as there were just before the Iran-Iraq War? Will Turkey, which has repeatedly invaded Iraq's northern governorates to attack Turkish Kurds (q.v. The Times, February 18, 1999), feel sufficiently threatened by the possibility of independent Iraqi Kurds that it decides to declare its own "security zone" in northern Iraq, counting on its membership in NATO to prevent it from punishment?

The sixth danger associated with these steps is that they seem to be taken more out of short term frustration than any long term plan. Buelent Ecevit, Turkey's prime minister, has allowed the US to use bases in Turkey to attack Iraq but claims that, "I don't understand what the United States wants to achieve. ... They have tactics, but no policy or strategy." [The New York Times, January 13, 1999]

They have forgotten what life is
Lamia al-Gailani

Dr al-Gailani is a Cambridge-educated archaeologist. She is involved with the London-based registered charity Help the Children of Iraq (# 1056486). It uses its members' first-hand knowledge of needs within Iraq to import food, clothing and medicines to Iraq. It can be reached at P. O. Box 6083, London, SW19 5XE.

I am going to write a few observations on my visits to Baghdad since 1991. What have the sanctions done to my friends and colleagues? Iraq had some of the best-educated government officials, and university and school teachers in the Middle East. As they are paid by government salary, they have been particularly hard hit by the loss in value of the Iraqi Dinar: the average salary is now around ID 4000 ($3).

In my last visit, one of the archaeologists came and sat next to me during one of the lectures. He is worried about how to feed his daughters. What worried me, is the way he was talking. He was not able to finish one complete sentence. I felt his behaviour was suicidal. I was later told, that out of desperation, he was nearly caught trying to defraud the department. I know he is an honest man.

Another friend is a PhD and so is her husband, who was a bank manager. She was famous for her colourful dresses, the numerous number of gold bracelets she wore, earrings and rings. Last time I was in Baghdad, she was wearing a dress that was ten years old, and not only that, the hem of her skirt was torn; all the gold has gone, sold to survive. I felt very humbled, when she told me that she was grateful to the friends who have been sending her cash from Europe.

Many of the Iraqis survive because they have relatives outside Iraq who send them dollars. But at the same time, this has fragmented many families. Another friend, I was told, was left by his wife, who went to Abu Dhabi. I enquired from him what happened: "No, we are not separated, but we cannot survive on our salaries; she has gone to work there so I can survive and my children".

The people I have mentioned were relatively affluent before the sanctions. The situation has affected all types of people, and the result there is a complete break in the law, and morality. There are no limits to the type of crimes that are happening in Baghdad now. Before the War, Baghdad was one of the safest places. For example, the gate of a friend's house was broken in the 1960s; it was open all the time until recently. Now when I go and visit them, the door is padlocked day and night.

Every family would tell you a tragedy, either of a relative or a friend who had been killed as a result of a robbery. Last August, a lawyer sold a house he has, so that his son could get married. One night burglars broke in (they knew about the sale), demanding the money. When there was none, they killed him, his wife and his son.

I can tell more stories like that, and they are all people I know.

I do not want to talk about the health situation, because all the newspapers talk about it, and there are those who dispute the authenticity of the figures. But from the incidents I know, I don't think it is an exaggeration. Definitely cancer is on the increase; in fact, nearly all the deaths I know of since 1991 have been from cancer. One of my best friends, Dr. Walid al-Jadir, died of cancer two years ago. I had visited an archaeological site south of Baghdad (Sippar) with Walid. When we were on top of the mound I noticed a mushroom cloud in the horizon. "What's this?", I asked. "Oh, UN destroying weapons".

What got me is casualness of his reply, a resignation to what is happening. It is the feeling of doom.

Baghdad as a city is crumbling, with effects on the health of the inhabitants. Because of lack of spare parts the sewers are full, spilling into the streets in some parts of the city, and that is not only in the slums. My cousin has contracted a cleaner to drain the street outside his house every week of the overflowing, smelly water.

It has even affected the animals. I want to tell this story; being an animal lover, it has haunted me. After the bombing in 91, a cat with her two kittens adopted my niece. The mother disappeared, presumed dead. Then one of the kittens was run over by a car. The one left, was very loving and loved to be cuddled, but she did not know how to play with a string or ball (have you seen a kitten who doesn't go at your finger?). That is what is happening to the Iraqis, they have forgotten what life is.

[AK] United Nations. "Report to the Secretary-General on Humanitarian Needs in Iraq by a Mission led by Sadruddin Aga Khan, Executive Delegate of the Secretary-General, dated 15 July, 1991". Mimeo. Geneva: Office of the Executive Delegate of the Secretary-General for a United Nations inter-Agency Humanitarian Programme for Iraq, Kuwait and the Iraq/Turkey and Iraq/Iran border areas. July 15, 1991.
[C] Clark, Ramsey. The Fire This Time: U.S. War Crimes in the Gulf. Thunder's Mouth Press. 1994.
[Cambridge 1999] Galloway, George, Denis Halliday, Nabeel Musawi and John Sweeney. Panel discussion on the effectiveness of sanctions on Iraq hosted by the Campaign Against Sanctions on Iraq and the Cambridge Union Society. January 27, 1999.
[CESR 1996] Center for Economic and Social Rights. "UNsanctioned Suffering". 1996.
[CESR 1997] Zaidi, Sarah. untitled draft sent for internal team comments. March 7, 1997.
[EIU 95/96] The Economist's Economic Intelligence Unit. Iraq: Country Report 1995-96.
[EIU 96/97] The Economist's Economic Intelligence Unit. Iraq: Country Report 1996-97.
[FAO 1995] UN Food and Agriculture Organization. Technical Cooperation Programme: Evaluation of Food and Nutrition Situation in Iraq. 1995 (also available from
[FAO/WFP 1997] Food and Agriculture Organisation / World Food Programme. FAO/WFP Food supply and nutrition assessment mission to Iraq. October 3, 1997.
[FK] Freedman, Lawrence and Efraim Karsh. The Gulf Conflict: 1990-91. Princeton University Press. 1993.
[HST] Harvard Study Team. "Harvard Study Team Report: Public Health in Iraq after the Gulf War." Mimeo. Cambridge, MA: Harvard University. May 1991.
[IST 1991] International Study Team. "Health and Welfare in Iraq after the Gulf Crisis: An In-Depth Assessment from August, 1991". 1991. (summary at
[Lancet 1995] Zaidi, Sarah and Mary C. Smith-Fawzi. "Health of Baghdad's children", The Lancet, 346, p.1485. December 2, 1995.
[Lancet 1997] Zaidi, Sarah. "Child mortality in Iraq", The Lancet, 350, p.1105. October 11, 1997.
[MA 1991] United Nations. "Report to the Secretary-General on humanitarian needs in Kuwait and Iraq in the immediate post-crisis environment by a mission to the area led by Mr. Martti Ahtisaari, Under-Secretary-General for Administration and Management, dated 20 March, 1991". Mimeo. New York: Document S/22366, United Nations, March 20, 1991.
[NEJM 1991] The Harvard Study Team. "The effect of the Gulf crisis on the children of Iraq", New England Journal of Medicine, 325 pp. 977 - 980. 1991.
[NEJM 1992] Asherio, A., R. Chase, T. CotJ et al. "Effect of the Gulf war on infant and child mortality in Iraq", New England Journal of Medicine, 327 pp. 931-36. 1992. [n.b. page 1768 of the same volume corrects Tim CotJ's institutional affiliation: although an employee of the U.S. National Institutes of Health he was on a year's leave at the time; the U.S. government did not support their report]
[NEJM 1993a] Bierman, Arthur. "The Gulf war and infant and child mortality in Iraq", New England Journal of Medicine, 328. 1993.
[NEJM 1993b] Ascherio, Alberto and Sarah Zaidi. "The authors reply". New England Journal of Medicine, 328. 1993.
[Pellett 1997] Pellett, Peter. Personal correspondence with Colin Rowat. December 1, 1997.
[S/1998/1100] United Nations, Secretary-General. "Report of the Secretary-General pursuant to paragraph 10 of Security Council Resolution 1153 (1998)". November 19, 1998. (
[S/1998/1172] United Nations, Secretary-General, "Letter dated 15 December 1998 from the Secretary-General addressed to the President of the Security Council", December 15, 1998. (
[S/1999/100] United Nations, President of the Security Council. "Note by the President of the Security Council". January 30, 1999. (
[Unicef 1998] Unicef. Situation Analysis of Children and Women in Iraq - 1997. April 1998. (
[UN 1996] United Nations, Department of Public Information. The United Nations and the Iraq-Kuwait Conflict, 1990-1996. 1996.
[WD 1992] Jean Dreze and Haris Gazdar, "Hunger and Poverty in Iraq, 1991", World Development, 20(7) pp. 921-945. 1992.
[WFP 1998] UN World Food Programme. "Protracted Relief and Recovery Operation - Iraq 6085.00". 21 December, 1998. (available from or off
[Zaidi 1999] Zaidi, Sarah. Personal correspondence with Colin Rowat. February 19, 1999.

Other campaigning groups in the UK
Some of the groups campaigning in the UK for a just treatment of Iraq are listed below. While members of these groups often exchange information and may seek to coordinate activities with each other (e.g. most are participants in the February 27, 1999 "Day of Action", marking the eighth anniversary of the formal end of hostilities against Iraq; many hosted Denis Halliday during his January 1999 tour of the UK) each is quite autonomous and has its own distinct concerns. Consequently, their inclusion here does not necessarily indicate their support for the contents of this document.

Campaign Against Depleted Uranium (CADU)
c/o GMD CND, One World Centre, 6 Mount Street, Manchester M2 5NS

Campaign Against Sanctions on Iraq (CASI)
Campaign Against Sanctions on Iraq, c/o CUSU, 11-12 Trumpington Street, Cambridge CB2 1QA, UK

Campaign Against War and Sanctions on Iraq (CASWI)
Hugh Stevens, BM 2966, London WC1N 3XX

Emergency Committee on Iraq (ECI)
George Galloway, MP, Room 501, 7 Millbank, Westminster, London SW1A 0AA

Gulf Crisis Group - Milton Keynes
Bushra Connors, 5a San Remo Road, Aspley Guise MK17 8JY

Iraqi People First
Sylvia Boyes, 7 Greenhill Road, Moseley, Birmingham B13 9SR

Manchester Coalition Against Sanctions and War on Iraq (MCASWI)
Rae Street, Calder Cottage, 97 Hare Hill Road, Littleborough, Lancs. OL15 9HG

Sheffield Committee Against War in the Gulf
Sheila Abdullah, 6 Bedford Road, Oughtbridge, Sheffield S35 0FB

Sussex Campaign Against Sanctions on Iraq
Neda Daghir,

Voices in the Wilderness UK
Milan Rai, 12 Trinity Road, London N2 8JJ

Women in Black
Nadje al-Ali. 83 Bartholomew Road, London NW5 2AH