Disproportionate press attention has focused on the mental health of the Iraqi leader, Saddam Hussein, and not enough on the physical health of the Iraqi population who have borne the brunt of a debilitating embargo that has just entered its eighth year. UN Secretary-General, KofiAnnan, recently recommended a twoand-a-half fold increase in the amount of oil Iraq can sell to purchase vital food and medicines.
A few days after Iraq’s invasion of Kuwait in August 1990, the United Nations Security Council passed Resolution 661 imposing an embargo on Iraqi oil sales and trade, except the import of essential food and medicines. Shortly after an American-led alliance had successfully shielded and then stormed the desert to liberate Kuwait in February 1991, the Iraqi leader, Saddam Hussein, accepted a United Nations Special Commission (UNSCOM) to oversee the elimination of his nuclear, biological and ballistic missile programmes before sanctions could be lifted.
As Baghdad and UNSCOM played a ﬁve year hide-and-seek game, sanctions increased the suffering of ordinary Iraqis. In May 1996, an oil-for-food bazaar was arranged where Saddam ﬁnally struck a deal with the UN to alleviate the suffering of his citizens: Iraq would be allowed to sell $2 billion worth of oil every six months in exchange for the compulsory purchase of much-needed food, medicines and other supplies in the agriculture, education, electricity, and water and sanitation sectors.
Of the $2 billion received from oil sales, $1.32 billion would be used to purchase humanitarian items; $600 million would go to a compensation fund for individuals and ﬁrms affected by the occupation of Kuwait; $44 million would go towards the administrative costs of the UN’s humanitarian programme; and $15 million would cover the costs of the UN arms inspectors. Saddam reluctantly agreed to the deal to reduce the crippling burden of sanctions on his collapsed economy.
The UN recruited 150 observers to monitor the distribution of supplies to all of Iraq’s eighteen governorates and assess the adequacy, equitability and efﬁciency of the goods. They audit the records of health facilities, warehouses, mills, silos and food agents, as well as interviewing beneﬁciaries and medical personnel on the adequacy and quality of supplies.
Geographical observers monitor every area of the programme, a multi-disciplinary observation unit tracks goods and checks suspected discrepancies, while an alphabetic soup bowl of UN agencies deploy specialised sectoral observers: the WFP observes storage and food distribution; the FAO gathers data on agricultural production and markets; the United Nations Children’s Fund (UNICEF)conducts nutritional surveillance and immunisation programmes; UNESCO builds desks and distributes educational material; Habitat runs shelter and resettlement programmes; the UNDP monitors distribution and use of electricity genera t i o n and transmission equipment; and WHO tracks the distribution of medical supplies.
Food, glorious food
The UN is monitoring a ration distribution system that Baghdad had administered since 1990. Government-owned warehouses, silos and distribution centres supply 53,000 private retail agents with food and ﬂo u r. These agents
then distribute to beneﬁciaries monthly, with a nominal fee of 105 dinar (15 cents) imposed on each recipient to cover transportation and administrative costs. The food basket includes wheat ﬂour, rice, sugar, oil, pulses, tea, salt, soap, detergent and infant milk.
Food started arriving in Iraq at the end of March 1997, leading at ﬁrst to a drop in prices on the open market. But erratic distribution and shortages soon led to an increase in food prices and the distribution of the entire food basket only occurred in August 1997. Because of the shortages, Baghdad has supplemented some goods from its own buffer stocks. Food rations typically last for an average of 20 days a month and beneﬁciaries voice a myriad of complaints to UN observers about the quality of the basket: malodorous soap, sticky oil, dark ﬂour, light tea.
The frustration of the population is palpable during interviews in streets and markets. Many complain that the process is an exercise in futility that neither leads to an increase in the quantity nor an improvement in the quality of the food, and a few have refused to be interviewed, blaming the UN for their continued suffering.
Food agents constantly complain that frequent delays in receiving commodities lead to spiralling transport costs. Flour production at mills has often been disrupted by inadequate grain, lack of spare parts, poor maintenance and frequent power cuts.
The dire food situation is further exacerbated by Iraq’s neglect of its agricultural sector after an oil boom it assumed would last for ever. Before 1990, ninety ﬁve per cent of Iraq’s foreign exchange earnings came from oil and the country produced only one third of its food needs, importing food costing $2-3 billion every year. The country has lost an estimated $100 billion in earnings from oil sales as a result of the embargo. The highly-mechanised agricultural sector also lacks spare parts for tractors and combine harvesters as well as pesticides, insecticides, herbicides, and animal vaccines.
Iraq’s public health sector has 113 hospitals, 898 health care centres and 45 specialist facilities. The vast majority of these are in a chronic state of disrepair. Seventy ﬁve per cent of medical equipment in such facilities does not function.
Hospitals desperately need vaccines, medical and surgical supplies and dental and diagnostic equipment. Frequent power cuts affect sensitive equipment; sewage facilities are sometimes blocked or leaking; water is erratic; ambulances are practically non-existent; lifts are frequently out of order; hospital wards lack furniture and bed linen.
The situation has been exacerbated by the languid pace at which medicines and medical supplies have arrived: by 28 November 1997, only forty two per cent of allocated supplies for the ﬁrst distribution phase – which had ended six months earlier – had arrived in the country. Drugs often have to be rationed, denying patients their full dosage and weakening the efﬁcacy of treatment.
The hills of the north
The UN Inter-Agency Humanitarian Programme in the three Kurdish-controlled northern governorates of Erbil, Dohuk and Sulaimaniyah procures, stores, transports and distributes humanitarian supplies. While the UN monitors the process in the 15 central and southern governorates of Iraq, it runs the show in the north. Unlike the rest of the country which receives supplementary government stocks in cases of shortages, the three northern governorates have no such programme. The World Food Programme (WFP), however, runs a supplementary feeding programme for 328,000 vulnerable people in the north: refugees and internally displaced people, returnees from Iran, pregnant women, and malnourished children.
The north was cut off from the national electricity grid in 1992. The water level is low at the Dokan and Darbandikan hydro-electric power stations, and ﬁghting has often disrupted electricity supply, especially in Erbil. An estimated 10 million land mines lie scattered around the three governorates.
Fighting between the two Kurdish factions, the Kurdish Democratic Party (KDP) and the Patriotic Union of Kurdistan (PUK) has often adversely affected the distribution of humanitarian supplies and led to large displacements of population. There are 650,000 internally displaced people in northern Iraq, two thirds of them displaced since 1991.
UN agencies have had their vehicles commandeered by militias and relief convoys have been ﬁred upon, forcing the agencies to rely on a UN Guards Contingent to escort convoys to dangerous parts of the north. Baghdad has also been accused of pursuing an arabisation policy, by forcibly moving Kurds from strategic oil-rich Kirkuk to areas further north.
The military and political situation in the mountainous region of Iraqi Kurdistan is volatile and complex. In August 1996, the KDP invited Iraq to send troops to Erbil to help it recapture the governorate from its rival PUK faction. The KDP now controls Dohuk and much of Erbil, while the PUK has Sulaimaniyah. The PUK has insisted on a share in the $350,000 a day that the KDP gains from tax on trade with Turkey and Iran.
While Iran supports the PUK, and Turkey and Iraq back the KDP, both Ankara and Baghdad have recently sought a rapprochement with the PUK, and Teheran has held talks with the KDP in an intricate web of shifting alliances. In the mid-1980s, Baghdad had been negotiating with the PUK and the KDP was considered close to Teheran.
Turkish and Iranian Kurdish militias are based in northern Iraq, and both Ankara and Teheran have made military incursions into Iraqi Kurdistan in pursuit. A series of American-brokered peace talks since last October has resulted in cease-ﬁres and agreements to halt external support and share tax revenues, but these agreements have been broken before the ink has dried.
After earlier incursions in 1992 and 1995, 50,000 Turkish troops entered Iraqi Kurdistan last May in an effort to smash the Kurdish Workers’ Party (PKK), a Turkish militia allied to Syria and the PUK which seeks self-rule in southeast Turkey. At the end of last year an estimated 8,000 Turkish troops and 130 tanks were still in northern Iraq. Baghdad’s protests to the UN about Turkey’s infringement of its sovereignty have fallen on deaf ears.
When elephants fight…
Baghdad has accused Washington and London of cynically delaying and blocking the distribution of humanitarian goods in the UN Sanctions Committee. The Iraqis bitterly cite the examples of ambulances, tyres and vehicle batteries. By 31 August 1997, out of 786 export applications, 67 had been approved, 83 were on hold, 20 were blocked and 11 were pending. No equipment arrived in the agricultural, education, electricity and water and sanitation sectors till September.
Washington and London have explained the delays by citing fears that some of the exports could have ‘dual functions’ and criticised Baghdad for submitting incomplete or inaccurate contracts. France, Russia, China, and Egypt have urged greater ﬂexibility and a more expeditious processing of contracts.
Many analysts have noted that Saddam has cunningly created divisions between the ﬁve permanent members of the Security Council by offering lucrative, long-term oil deals to Russia, France and China to get them to push for the lifting of sanctions, while giving them a stake in the survival of his regime.
Moscow is owed US$8 billion by Baghdad, giving it more than a passing interest in the long-term health of the economy. In December 1996, the Russian Duma proposed that Moscow unilaterally end its participation in UN sanctions against Iraq and Russia’s permanent representative at the UN, Sergei Lavrov, has criticised the delays in approving exports to Iraq in the Sanctions Committee.
Last March, Moscow signed a $3.7 billion agreement with Baghdad to develop Iraq’s Qurna oilﬁeld. French oil ﬁrms, Total and Elf, were allocated the two giant Iraqi oilﬁelds of Nahr Umar and Majououn. The French President, Jacques Chirac, was regarded as the architect of close ties with Baghdad during his spell as premier between 1986 and 1988 when Paris delivered Mirage jets and other arms to Iraq.
Baghdad also signed an agreement with China in August 1996 to develop the Al-Ahdab oil-ﬁeld. All three Security Council members have called for an easing of sanctions and, in the current crisis, Beijing and Moscow have publicly opposed military action.
Relations between Washington and Baghdad have been further worsened by the frequent statements of senior American ofﬁcials that only a change of regime in Baghdad could bring an end to sanctions. Washington has accused Iraq of violating sanctions by smuggling oil through Iran: an allegation that Baghdad has denied. While Baghdad regards the oil-for-food deal as a ﬁrst step towards the lifting of sanctions, Washington has insisted that the humanitarian programme is a separate issue.
There appears to be little support in the Middle East for the tough American stance on Iraq. Many countries criticise the Clinton administration’s failure to apply pressure on the Israeli Prime Minister, Binyamin Netanyahu, whom they accuse of retarding the Middle East peace process.
They also point out that while Iraq is condemned for disobeying UN resolutions, Israel is violating resolutions 242 and 425 by its continued occupation of Golan, Gaza, south Lebanon and the West Bank without similar penalties being imposed. Many Arab states have called for an easing of sanctions to alleviate the suffering of the Iraqi people.
The UN programme in Iraq is unique and unprecedented. Never before has such complex humanitarian action been undertaken to relieve the effect of sanctions, and never before have the effects of sanctions on a population been so well documented.
Before the oil-for-food deal, UNICEF and WFP estimated that 4,500 Iraqi children were dying of a lack of food every month. More recent UN surveys reveal that a third of Iraqi children under the age of ﬁve and a quarter of adults under 26 are malnourished.
Diseases previously controlled like typhoid, cholera, tetanus, measles and kwashiorkor have all returned with a vengeance since 1990. The infant mortality rate doubled between 1990 and 1995, while the mortality rate for children under ﬁve increased six-fold in the same period. As a World Health Organization study on Iraq noted in March 1996: ‘The vast majority of the country’s population has been on a semi-starvation diet for years.’
Iraq’s Gross Domestic Product per capita income fell precipitously from $2,900 in 1990 to $60 today, and while 1 Iraqi dinar fetched $3 in 1989, 1,500 dinars are now required to obtain $1.
Iraq, once reputed to have one of the best-educated populations in the Middle East, is now faced with the bleak prospect of the de-education of an entire generation: twenty-ﬁve per cent of children are not enrolled in primary school and only sixty-eight per cent of six-year olds were on school lists in 1996.
Iraq’s 4.8 million students lack proper classrooms with desks, doors, educational materials, water and sanitation. Street urchins begging for money have become an increasingly common sight in Baghdad.
As the country’s infrastructure continues to crumble, power cuts frequently range from six hours a day in Baghdad to sixteen hours a day in other governorates, affecting water supplies and medical services. Many generation plants, water-puriﬁcation systems and sewage plants destroyed during the Gulf war have still not been repaired. Water systems work at less than ﬁfty per cent capacity and over forty per cent of water supplies in the two southern governorates of Basrah and Thi-Qar are thought to be contaminated.
Iraq’s plight is worsened by the fact that funds from previously sympathetic donors have dried up because the UN’s oil-for-food programme is erroneously thought to be meeting the country’s humanitarian needs. Iraq’s formerly oil-rich economy has become a shadow of its former self, reduced to doling out rations to a demoralised and impoverished population. As a critic of sanctions, Walid Khadduri put it: ‘UN sanctions…have become morally questionable, since they have shattered the social fabric of Iraqi society and caused much death, sickness, malnutrition and poverty… ’ .
The forceful UN Humanitarian Coordinator for Iraq, Denis Halliday, bluntly stated last November: ‘It is vital that politics be kept apart from humanitarian assistance, and that oil sales be increased so that the Government of Iraq can purchase animal proteins, vitamins and minerals that are currently missing from the food basket.’
With frequent reports from UN bodies about the inadequacy of the oil-for-food programme in meeting the needs of the Iraqi population, UN Secretary-General, KoﬁAnnan, felt obliged to act to alleviate the suffering. In his latest report published on 1 February, Annan recommended an additional $2 billion of oil sales every six months to allow Iraq to purchase more humanitarian goods. Cheese and powdered milk would be added to the food basket and the quantities of rice, pulses and vegetable oil would be increased to improve nutrition.
The Secretary-General also called for the accelerated processing of export contracts, requested more funds for electricity rehabilitation, agricultural production, water and sanitation, community childcare units, nutritional rehabilitation centres and primary health centres, and recommended a supplementary feeding programme for nearly two million vulnerable people.
There is now a clear recognition that the distribution of food and medicines is insufﬁcient to improve the situation, since nutritional security is also affected by such factors as diseases, bad water and sanitation, dilapidated health facilities, and low agricultural production.
In this modern-day Dickensian tragedy, as long-suffering Iraqis await their fate, the Americans and British continue to accuse Saddam of behaving like Oliver Twist in greedily asking to buy more food, while playing the Artful Dodger with arms inspectors. Saddam, on his part, continues to accuse the Anglo-Saxons of behaving like Ebenezer Scrooge in frugally refusing to lift sanctions or allowing him to sell more oil. As another desert storm erupts, the drama of the great oil-for-food bazaar continues.