Contents

1. Introduction
2. Carrying Medicines To Iraq
3. Baghdad
4. Al Mansour Teaching Hospital
5. Saddam Paediatric Hospital
6. Amiriya
7. Vigil Outside The UN
8. Fallujah
9. Going Home

1) INTRODUCION Return to top

In June of this year, Richard Butler, the UN Chief Weapons Inspector, announced after talks in Baghdad that, "The light at the end of the tunnel is today more visable than it has been for a very long time." He went on to say that under a new work schedule agreed with the Iraqi government, UNSCOM might be able to verify by August that Iraq has fulfilled its disarmament obligations.

With this in mind, Voices In the Wilderness UK decided to send a delegation to Baghdad to fast and vigil outside the UN during the August talks. We also organized a simultaneous fast and vigil opposite 10 Downing Street in London, whilst Voices In the Wilderness US fasted and vigiled outside the UN in New York for nearly three weeks. As it turned out, the talks were brought forward by a week and Richard Butler had left Iraq before we arrived, but world attention was still very much on the situation there. This is a brief report of the visit made by Milan Rai and myself to Iraq, the fourteenth Voices In the Wilderness delegation, and the first organized entirely by Voices In the Wilderness UK.

2) CARRYING MEDICINES TO IRAQ Return to top

Following a recent announcement from Iraq that it would no longer accept donations of humanitarian aid, we originally thought that we would not be able to take medicines on our visit. However, we heard shortly before we left that Voices In the Wilderness had been granted an exemption. At that stage it was too late to get hold of prescription medicines such as antibiotics, so instead we bought over-the-counter medicines - children's vitamins and painkillers. In addition, we took with us recent copies of the British Medical Journal and the Lancet. In 1994, copies of these medical journals destined for Iraq were impounded by British customs on the grounds that they constituted commercial mail and were therefore 'non essential' and a breach of the UN sanctions.

By carrying medicines and medical journals to Iraq without export licenses, we were in breach of the UN sanctions on Iraq. On the last UK delegation, in February this year, the medicines being carried by Milan Rai and Martin Thomas were seized from their luggage by Customs. This time, however, we were not stopped, even though we had announced our intentions publicly beforehand, and the medicines and journals made it to Iraq safely.

3) BAGHDAD Return to top

On Thursday, our first day in Baghdad, we went to the Iraqi Red Crescent, the organization sponsoring our visit. They were able to help us set up various hospital visits, as well as securing permission for us to hold the vigil outside the UN later in the week. We met Dr. Al Wash, the President of the Red Crescent, and presented him with the medical journals we had brought, to be distributed to hospitals in Baghdad. He was delighted with this small gift, telling us how difficult it was for Iraqi doctors to keep up to date with medical advances since the imposition of the sanctions which prevented such journals reaching the country.

4) AL MANSOUR TEACHING HOSPITAL Return to top

On Friday we made two hospital visits, accompanied by a guide from the Red Crescent. At the first, Al Mansour Paediatric hospital, we handed over the medicines we had bought with us. The chief resident, Dr. Essam, told us that conditions were continuing to deteriorate in the hospital, especially in terms of supply of medicines. Few antibiotics were available, so patients were not receiving the most appropriate one, and often supplies ran out before the course was completed - a recipe, as he pointed out, for build up of antibiotic resistance. There were also shortages of medical supplies such as syringes; although patients did not have to share, each child was given a single syringe and needle on admission, to be used throughout their stay. As a nurse, I did not need to be told that this was against all principles of infection control.

As we walked through the hospital, the extent of damage caused by the sanctions was evident. The corridors were half-lit, some in complete darkness, as a means of reducing the strain on the generator during the frequent power cuts. The place was almost deserted; doors leading off the main passage were marked 'ECG', 'baby welfare', 'dental unit', but there was no sign that any of these activities went on any longer. The air conditioning wasn't working so the whole building was incredibly hot as the outside temperature was over 50C; in all the wards, mothers were fanning their children in a vain attempt to cool them a little.

One of the first children we saw, Mohammed, was a te n year old boy suffering from leukaemia. His story was to become all too familiar to us; the necessary medicines were not available, or were only irregularly, with the result that his disease was not going into remission. With proper treatment, children with his type of leukaemia usually have a fair prognosis - the usual survival rate is 70-80%. For Mohammed, though, there was going to be no happy ending. His disease had spread to his brain, he was pitifully thin, and was suffering from bedsores. The glazed look in his eyes, and complete lack of interest in what was going on around him, was something I've seen many times in people close to death and I felt sure he wasn't going to live much longer.

We wanted to photograph all the children we saw, in order to be able to explain to people at home exactly what was going on in these hospitals. I felt awkward about this - it felt as if we were intruding on people's private grief - but all of the mothers seemed happy for us to photograph their children, many of them even holding the children up so we could get a better shot, as if to say to us, "Look what your sanctions are doing to my child." Mohammed's mother put a toy in his hand and urged him to look at the camera and smile; the child was barely strong enough to even turn his head, and his mother's desperate attempts to pretend - to herself? to us? - that everything was all right were simply heartbreaking.

Apart from leukaemia, the main disease we saw was gastroenteritis, leading to malnutrition, particularly amongst very young children. Bed after bed was filled with tiny babies with the wizened 'old men' faces characteristic of marasmus. Each time Dr. Essam recited more or less the same facts: the child had been suffering from diarrhoea, the proper treatment was unavailable, and the child now weighed less than half what it should. Lack of medicine was compounded by lack of food and clean drinking water.

5) SADDAM PAEDIATRIC HOSPITAL Return to top

From the Al Mansour hospital, we traveled a few miles to the Saddam Paediatric Hospital. Here, conditions were much the same. In casualty we met 18 month old Aptisam, who weighed only 6 kg; a child of her age should weigh around 11 kg. Dr. Al Janabi, the hospital director, explained to us that she had been prescribed a feeding programme but that her family couldn't afford to provide it. Even buying Aptisam the recommended three eggs a week would cost the family over a third of their monthly income, clearly impossible especially since they had several more children at home.

In the next bed was Abdul, two years old and still unable to sit up unaided. As well as being severly malnourished, Abdul suffered from repeated chest infections and was obviously having some difficulty breathing. Dr. Al Janabi suspected that he might have cystic fibrosis, but did not have the facilities necessary to carry out the simple test which would confirm this. Abdul's mother, a very young woman, turned away as we took his photograph. When she turned back, I could see that she was crying. I tried to convey from my expression how sorry I felt, but it felt such a useless gesture. She didn't need my sympathy; she needed proper medical care for her child, and as long as the sanctions remained in place, she wasn't going to get it.

Further on, in the blood diseases unit, seven year old Aptisam lay on the bed, too exhausted to even sit up. She had leukaemia; a remission had not lasted long and now she was once again in the clutches of the disease. Her illness was compounded by hepatitis B, which she'd contracted from a blood transfusion. Normally all blood would be screened for the hepatitis virus; under the sanctions regime, such niceties are no longer possible.

Everywhere we went, we saw the results of sanctions. There were no sheets on the beds; some families had provided their own whilst other children were lying on old clothes and the most unfortunate didn't even have that comfort and were simply lying on the plastic mattress in the searing heat. The children's medical notes were written on old scraps of paper. There was a terrible smell pervading most of the wards; the doctor explained that this was because they had no antiseptics or cleaning products, which further contributed to the spread of infection.

Prior to sanctions, Iraq had an advanced and efficient health care system, with over 90% of the population having access to primary health care. Many new hospitals were built in the 1970s and 80s, with excellent facilities for diagnosis, surgery and treatment. Studies showed that Iraqi children suffered more from overeating than malnutrition. Eight years of sanctions have destroyed virtually all the progress Iraq made in the health sector over several decades.

6) AMIRIYA Return to top

After visiting the two hospitals, we traveled to the Al Amiraya air raid shelter in a suburb of Baghdad. This was the shelter bombed by the USAF on February 13, 1991. They claimed they had evidence that it was a command post, and sent a missile straight down the air duct, causing a fireball which incinerated all but fourteen of the 1200 people - many of them children - sheltering inside. There was no apology from the US, the lost lives were simply dismissed as 'collateral damage', that coy military euphemism for dead civilians.

The shelter has been cleared out and now stands as a shrine, the walls lined by photographs of the dead. It has not been repaired, and the huge hole in the enourmously fortified roof illustrates the power of the missile. Visiting the shelter was chilling testimony to the real effects of the Gulf War - how [it] was presented by the military as a 'clean' war, complete with visual effects to rival any video game, was in fact a bloody and tragic experience for so many ordinary people in Iraq.

7) VIGIL OUTSIDE THE UN Return to top

On Sunday, we started our fast and vigil outside the UN. It was timed to coincide with the vigil outside Downing Street, running from Sunday until Wednesday. We held the vigil in conjunction with Bridges to Baghdad, an Italian NGO which has been working in Iraq for many years. Fasting outside the UN felt very appropriate; this was the organization which was putting so many Iraqis on an enforced fast. Unlike us, most Iraqis don't have the luxury of not eating for a few days out of choice; for many of them, particularly at the end of the month when their government food ration has run out, there may be many days of not eating until the next ration arrives.

On Tuesday, Mil and I were able to secure an interview with Dennis Halliday, the UN Humanitarian Co-ordinator for Iraq. He recently announced that he was to resign, reportedly because of differences with UN headquarters in New York over aid for Iraq. He has been very critical of the sanctions regime, pointing to the suffering it was causing to the ordinary people of Iraq. Mr. Halliday spoke to us very frankly, saying that 'as an instrument for change I find [the sanctions] to be a failure and a very tragic one'. In his estimation, it would take Iraq ten to twenty years to recover from the effects of the sanctions. Mr. Halliday talked also about the difficulty he had in reconciling his role as an official of an agency - the UN - whose remit was to improve human rights, with the requirements upon him to oversee a sanctions regime which he felt was causing untold suffering to millions of ordinary people.

8) FALLUJAH Return to top

On Wednesday morning we left the vigil for a while and headed for Fallujah, a large town forty miles west of Baghdad. First of all we went to the hospital, which was in an even more pitiful state than those we had visited in Baghdad. Dr. Rashid, the director, told us of the terrible shortages the hospital was experiencing. As we walked round the hospital, we could see that he was not exaggerating the dire situation.

The first ward we went into was coronary care - infact, the only coronary care element to it was the consultant, since the monitors were all broken, they had no diagnostic tests except ECGs, no heart medication, no facilities for more than the most basic surgery. The consultant talked to us about one of the men in the ward, a 45 year old - although he looked far older - called Saleh. He'd had a heart attack and a stroke, and needed monitoring, painkillers and heart medication. All the doctors could give him was valium, and as a result his prognosis was very poor. The doctor seemed to be in despair. "It's a horrible story, and a sad story and we're dealing with it every day," he told us. "You know what you have to do but you can't do it."

In the paediatric ward we encountered one year old Hayad and his mother Siham. Like so many of the children we saw, Hayad was suffering from marasmus, and weighed only 6 kg. Her mother too was desperately thin. She told us that often the family would swap the infant formula provided in the government food ration for food such as rice which the whole family - she had five more children - could eat. Her husband had no work, and the family had no house, living instead in a former flour mill which the government was using as a shelter for homeless families.

From the paediatric ward we went to casualty. Fallujah hospital, being on a main road, receives a lot of victims of road accidents. It was hard to see how the casualty unit would be able to do much for such unfortunates; their entire stock consisted of a bandage, a hank of cotton wool (which had to last the week) and a spool of ordinary sewing thread which in the absence of suture material was being used to stitch wounds. A few surgical surgical instruments were standing in a jug of foul-looking liquid: Dr. rashid explained that they had no antiseptics and the steriliser didn't work.

On our way around the hospital, Mil commented on the ambulance standing outside. It was new, and constituted one of the few improvements the hospital had seen over recent months. However, Dr. Rashid pointed out that whilst the ambulance was useful, it was the only one they had to cover a city of 40,000 plus a large outlying area and simply wasn't enough on its own to meet the need.

My final visit - as the only woman in the party I was the only one allowed to see this part of the hospital - was to the labour ward. Here, five women were in labour, or had just given birth, in one small room, each one lying on a narrow metal bed with no sheets. The floor was covered in blood which an elderly woman was busy sluicing away with buckets of water. There was a terrible smell, and the air was hot even though an elderly air conditioner laboured away in the corner.

As I stood talking to Dr. Naira, the obstetrician - the only one in the hospital - the power went out and we were plunged into total darkness. In Fallujah, power cuts total twelve hours a day, and the barely functioning hospital generator provides only an unreliable back up. Standing there in the hot foetid darkness, listening to the low moans of women giving birth - there were no painkillers of any kind available - I felt that I had arrived in the nearest place to hell I had seen on this trip.

I was told that many women died of post-partum haemorrhage due to lack of blood, and many more suffered from infections particularly after episiotomies, due to not having adequate sterile supplies. Sometimes they didn't have enough needles and were forced to share them between different women. Maternal complications were increased because most of the women giving birth were poor and malnourished. Dr. Naira told me that she had been an obstetrician for thirty years, and she had never before experienced such dire conditions.

From the hospital we went to the marketplace in Fallujah, hit by an RAF bomb in 1991. The bomb had been intended for one of the bridges but went off course, killing 137 people. We asked one of the stallholders about the bomb, and were immediately surrounded by a large crowd of men anxious to tell us their stories of that day. They pointed out the place where the missile had landed, now rebuilt as the 'Al Shouhda' - martyr - market. Abdullah, now thirteen years old, came forward on crutches and shyly lifted his robes to reveal that both his legs had been blown off in the attack, and he was now hopping around on one false leg. Another man, Falah, told us that his fourteen year old brother Hamed had been killed by a piece of metal which pierced his head. "The first time, we were killed with bombs," he said. "Now we are being killed slowly by sanctions. Thousands of our children are dying every day - what's their crime?"

9) GOING HOME Return to top

On Wednesday, after visiting Fallujah, we returned to the UN to complete our vigil. Early the next morning we set off on the drive back across the desert to Jordan, and on Friday flew back to London. We had vaguely wondered whether Customs might stop us on our way back but it seemed unlikely, and in the event we had no problems. From the airport, Mil and I went straight to 10 Downing Street where we delivered a letter to the Prime Minister to inform him that we had breached the UN sanctions on Iraq.