Leukemia in Iraq

It is the sight of the parents that strikes you first when you enter the leukemia ward at the Saddam Central Hospital for Children in Baghdad. Sitting next to each bed, their taut, bleak faces tell the story before you even look at the child curled up beside them. These mothers and fathers know that once their children are admitted here, there is almost no chance they will leave alive.

“We call this ward the ‘ward of death,'” said Dr. Basim Al Abdali, almost matter-of-factly, as he inspected a patient’s notes at the end of a bed. A four-year-old boy had died just hours before this journalist’s visit. “Every day we lose one patient, maybe more than one patient, just in this ward. The mortality rate for leukemia and other cancers here in this ward is 100 percent.”

There are no exact figures for the number of deaths from leukemia in Iraq. But the World Health Organization (WHO) office in Baghdad does not question the Iraqi Health Ministry’s estimate that since 1990 there has been a fourfold increase in the incidence of the disease.

In the West, many leukemia patients can be treated for the disease and survive. Not in Iraq. Dr. Al Abdali blames the U.N. embargo on the country, which will be 10 years old in August. Because, he said, it means his hospital cannot provide the right treatment at the right time. One problem, according to Dr. Al Abdali, is that the Saddam hospital cannot get the chemotherapy drugs it needs in sufficient quantities. “We request them,” he said, “but either they’re put on hold or they don’t turn up for months.”

What the hospital needs most of all, said staff members, is a specialist facility for carrying out bone marrow transplant operations. “No Iraqi child with leukemia has the chance to have this kind of operation, but in your country every patient with leukemia can have this operation,” said Dr. Al Abdali.

At the moment, no Iraqi hospital is equipped to do bone marrow transplants and, needless to say, few Iraqis have the option of traveling to have the operation abroad. At Saddam Children’s Hospital, they can barely afford basic facilities for their patients.

The leukemia ward is a dingy, rundown place, with paint peeling off the walls. It is divided into six rooms, with six beds in each, but children are not isolated from each other. This means any infections pass rapidly among them.

The doctors admit that the children’s relatives often carry out basic nursing tasks because the hospital is so short-staffed. Since 1990, many of Iraq’s best medical specialists have left the country.

Nine-year-old Mohanad Adnan was one of the in-patients in the leukemia ward when this reporter toured the hospital. But he had lost so much weight that his body looked like that of a six-year-old. A large blood blister had developed over his right eye, forcing it shut. His other eye was expressionless and empty and his mother Hanna could do little but try to make him comfortable.

Mohanad was no longer responding to the chemotherapy available in the hospital, said Dr. Al Abdali, who was blunt about his prospects. “We expect the death of this patient in a few days because of the continuous bleeding.”

Mohanad Adnan’s mother, Hanna, now expected the worst. She had been at his bedside for the past four weeks. Speaking through a translator, she said she had no doubt what had caused her son’s illness. “The cause is known, by all people inside and outside Iraq. The cause is the contamination of our land during the war.”

What she was referring to is the widespread conviction among Iraqis that the increased incidence of leukemia over the past few years is caused by residues from munitions tipped with depleted uranium (DU) fired by U.S. and British forces during the 1991 Gulf war. As the result of the explosion of these munitions, DU particles are believed to have found their way into the food chain and the water supply.

The reality is that there has been no independent confirmation, so far, of a link between DU munitions and leukemia. But anecdotal evidence strongly suggests that it is a possibility.

Most leukemia cases are turning up in southern Iraq, where military activity was most intense. Even in Baghdad, in central Iraq, the majority of the patients in the leukemia ward at Saddam Children’s Hospital are referred from towns and cities in the south, such as Basra, Nasiriyah, Kerbala and Najaf.

The Baghdad representative of the World Health Organization, Dr. Ghulam Popal, said WHO intends to launch a detailed study of the issue later this year. But he said in an interview that already “I suspect that this depleted uranium is one of the causes of this leukemia.”

There also is suspicion in the U.S. and Britain that DU munitions may be among the causes of the so-called Gulf war syndrome, the debilitating condition that has afflicted so many Gulf veterans. An official at Britain’s Foreign Office in London said “we are skeptical about Iraqi claims” of a link between DU munitions and leukemia. Yet, significantly, he added, “We would welcome a comprehensive investigation to look into the issue, covering all the possible factors. There is a genuine concern over the issue of depleted uranium munitions in Iraq.”

Yet for many Iraqis talk of a study is, well, academic. In their view, the two countries they blame for spreading the leukemia in the first place are compounding the problem now by denying people the necessary treatment they need through continuing the embargo.

In Washington and London’s view, it is President Saddam Hussain who bears most of the responsibility, because he refuses to comply with U.N. demands on disarmament which, in theory, should lead to the lifting of the embargo. The U.S. has also made repeated allegations that the Iraqi leader is spending money on palaces and weapons which could go toward Iraq’s health needs.

However, aid officials with experience of Iraq’s health system argue that, even if true, claims like this are missing the point. After 10 years of sanctions and under-funding, the Iraqi health-care system has deteriorated to a point where it cannot meet the country’s needs, they say. The country hasn’t built a new hospital since 1990, and yet in the same period the population has grown by an estimated six million. “It’s not just the embargo that makes things difficult,” said one doctor at Saddam Children’s Hospital. “We’re very isolated. We don’t get scientific journals and information on new treatments. And many good doctors have left.”

In fact, the Iraqi Health Ministry has recently initiated plans to set up a bone marrow transplant facility at Baghdad’s Mansour Hospital. Iraqi specialists have been to Cairo to get expert advice from Egyptian doctors. And the ministry plans to request the necessary equipment from the U.N. sanctions committee.

But Khalid Jamil Mohammed Al Hayat, under-secretary at the Health Ministry, was not hopeful. “I expect again the Americans will suspend this equipment” because, he said, they are likely to claim that it could have a dual use, meaning that it could be employed for military purposes. “They say it even about the tires that we require for our garbage trucks, that these could be dual use.” He gave a weary laugh.

There was also a sense of weariness on the leukemia ward at Saddam Children’s Hospital, except that here it did not come with a smile. The mothers and fathers watching their dying children don’t seem angry or bitter, just confused and tired.

“It’s God’s will,” one mother said, when asked how she feels about the plight of her son. There is a sense that after nearly 11 years of sanctions, with no apparent end in sight, anger has simply given way to exhaustion.

Andrew North is a British journalist.

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