The battle to save Iraq's children

Doctors issue plea to Tony Blair to end the scandal of medical shortages in the war zone

Friday, January 19, 2007

By Colin Brown

They are backed by a group of international lawyers, who say the conditions in hospitals revealed in their letter amount to a breach of the Geneva conventions that require Britain and the US as occupying forces to protect human life.

In a direct appeal to Tony Blair, the doctors describe desperate shortages causing "hundreds" of children to die in hospitals. The signatories include Iraqi doctors, British doctors who have worked in Iraqi hospitals, and leading UK consultants and GPs.

"Sick or injured children who could otherwise be treated by simple means are left to die in hundreds because they do not have access to basic medicines or other resources," the doctors say. "Children who have lost hands, feet and limbs are left without prostheses. Children with grave psychological distress are left untreated," they add.

They say babies are being ventilated with a plastic tube in their noses and dying for want of an oxygen mask, while other babies are dying because of the lack of a phial of vitamin K or sterile needles, all costing about 95p. Hospitals have little hope of stopping fatal infections spreading from baby to baby because of the lack of surgical gloves, which cost about 3.5p a pair.

Among those who have signed the letter are Chris Burns-Cox, a consultant physician at Gloucester Royal Hospital; Dr Maggie Wright, the director of intensive care at James Page University Hospital; Professor Debbie Lawlor, professor of epidemiology and public health at University College London; Professor George Davey Smith, professor of clinical epidemiology at Bristol university; Dr Philip Wilson, senior clinical research fellow at Glasgow University; and Dr Heba al-Naseri, who has experienced the conditions in Iraqi hospitals. Dr al-Naseri, who has worked at Diwaniyah Maternity Hospital and the Diwaniyah University Hospital, describes in harrowing detail what the conditions were like for a newborn baby - one of the lucky ones who survived - called Amin.

"Amin had to be fed powdered milk, diluted with tap water. There wasn't enough money to buy expensive formula milk or bottled water - their price had risen above the increase in wages since 2003. The problems with the intermittent electricity and gas supply meant regular boiled water could not be guaranteed. With the dormant waste and sewage disposal systems, drinking-water is more likely to be contaminated," he said.

Cases the doctors highlight include a child who died because the doctor only had a sterile needle for an adult and could not find a needle small enough to fit the vein, and another child who died because the doctors had no oxygen mask that fitted.

The doctors say the UK, as one of the occupying powers under UN resolution 1483, has to comply with the Geneva and Hague conventions that require the UK and the US to "maintain order and to look after the medical needs of the population". But, the doctors say: "This they failed to do and the knock-on effect of this failure is affecting Iraqi children's hospitals with increasing ferocity."

They call on the UK to account properly for the $33bn (£16.7bn) in the development fund for Iraq which should have supplied the means for hospitals to treat children properly. They say more than half of the money - $14bn - is believed to have vanished through corruption, theft and payments to mercenaries.

They say that all revenues from Iraq's oil exports should now pass directly to the Iraqi people and that illegal contracts entered into by the Coalition Provisional Authority be revoked.

Their letter was supported by experts in international law, including Harvey Goldstein, professor of social statistics at the University of Bristol, and Bill Bowring, a barrister and professor of law at Birkbeck College.

Nicholas Wood, an architect who helped to organise the protest, said they had evidence on film of dead babies being dumped in cardboard boxes. " In one hospital, there were three babies to an incubator. The incubators are 36 years old and are held together by tape and a bit of wire. They are wrecks. They cost about £5,000 each, but that is nothing to compared to the cost of a missile," he said.

The letter was sent to Downing Street via Hilary Benn, the International Development Secretary, by his predecessor, Clare Short.

A system in meltdown

* Save the Children estimate that 59 in 1,000 newborn babies are dying in Iraq, one of the highest mortality rates in the world. Thousands of infants are dying because of the lack of basic cheap equipment. In Diwaniyah hospital, south of Baghdad, one doctor had to try to ventilate a baby with a plastic tube in its nose because he lacked an oxygen mask costing just 95p. The baby died.

* In the same hospital, a baby with a rare illness causing internal bleeding died due to lack of a phial of vitamin K, which would have cost less than £1.

* One doctor in a Baghdad hospital recently tried to save the life of a child with a drip, but he lacked a sterile needle for a child and the child died. The lack of rubber surgical gloves, which cost 3.5p a pair, has hugely increased the risk of infections.

* Premature babies are crammed three to an incubator, when an incubator can be found. An incubator costs about £5,000.

* Only 50 per cent of the pre-war total of doctors remain in Iraq. The US clearout of Ba'ath party members sympathetic to Saddam Hussein after the invasion has led to a breakdown of health administration.

* The British doctors are calling for guarantees of safety to be given to all medical staff in Iraq by the US and British forces. Above all there is a need to stop the militias killing doctors and nurses.

* Hospitals have been bombed and ambulances shot at. Helicopters could be laid on by the US and UK to ferry cases to Jordan, Syria, Iran and Saudi Arabia for treatment of acute trauma and disease.

* Doctors are calling on Britain and America to restore at least $2bn (£1bn) of $14bn that has gone missing since the invasion. Part of this sum, lost in corruption or to militias, was earmarked for hospitals.

* Up to 260,000 children may have died since the 2003 invasion of Iraq.