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Letter from Baghdad
By Charlie Clements
27 January, Monday
Dear friends:
Excuse the impersonal nature of the greeting. I am writing this from
Baghdad where access to e-mail is very unpredictable, so if I do get on
tomorrow I want to send this to as many people as possible rather than
risk writing individual letters and getting bumped.
I'm here with several public health experts that are attempting to
assess the consequences of a U.S. attack on Iraqi civilians. Civilians
don't seem to be part of the calculus of the decision makers in America.
I helped plan but didn't participate in a mission that assessed the
civilian casualties after the Gulf War the majority of which weren't
direct but where children who died of diarrheal diseases caused by
bombed water purification plants or pneumonia brought on by an immune
system undermined malnutrition. UNICEF research indicates there have at
least 50,000 excess child deaths per year over the last decade.
As we toured a water purification facility yesterday that has yet to
fully be repaired-the sanctions have kept them from having both spare
parts or sufficient chlorine for disinfection, I wondered "what possible
thought could military intelligence for that target except the
consequences to civilians?" Then later in the evening someone handed me
a Defense Department document declassified after the Gulf War which
said, "Failing to secure supplies will result in a shortage of pure
drinking water for much of the population, this could lead to increased
incidences, if not epidemics of disease"
Epidemics are numbers, of course. Just before visiting the water
treatment center I was in a very sparse children's hospital, where
doctors introduced me to a mother and her two-year old daughter, who is
diagnosed with leschmaniasis called 'kala azar' here. He said they had
insufficient medicine to offer her a full twenty-day course and that it
would be kinder to shoot her than let her face the slow wasting and
painful death that lies ahead. He said the wards are about to fill with
children like her because they don't have sufficient pesticides to
control the sand fly vector. I've seldom seen a pediatrician so bitter.
He said, "We are a proud and capable country used to providing these
things ourselves. Now we beg them from the 661 (sanctions) committee who
either deny them or delay them for years." I don't think I could contain
my rage, if that girl were my daughter, Jesse.
These investigations into the public health consequences of a U.S.
attack don't fully reveal the fear that people live with here. Fear from
the security and intelligence apparatus of Saddam Hussein, fear their
child may die for lack of medicine, fear that the food basket (2100
calorie/person/day which is defined by refugee experts say is the
minimal need to sustain human activity), which supports every family in
the world's largest feeding program, would be disrupted by a U.S.
attack, fear that the massive unemployment may never end and life return
to normal, if they can remember what that was like. Some actually say in
resignation, "If a U.S. attack would end all of this, then let's get it
over with"
Just as it is children and vulnerable populations like pregnant women
and the elderly, who have largely paid the consequences for Saddam's
invasion of Kuwait, it is they who will be asked to pay again. Only this
time there are no spare parts for the electrical generators that will be
the first targets, no spare chemicals for the water purification plants
that will be paralyzed without electricity even if they weren't targeted
again, no spare body fat for the malnourished children and no spare iron
stores for the anemic pregnant mothers, no spare food in anyone's
pantry, and one has to wonder about if there is any spare emotional
capacity to deal with more tragedy that looms on the horizon.
Sadly, none of our policy makers seem to be asking, if there are
alternatives other than war that could achieve America's objectives. I
suppose that Sept 11th has made it difficult to question or stand-up to
the tough talk of the President. So I am here with my colleagues to do
it with the only language we know the language of public health a
language sometimes so grounded in the human experience that we hope it
will break through the language of the DOD the language of "collateral
damage." Hopefully the report may cause us to ask, "Is there another
way, because I don't want this to be in my name?"
France, Germany, and Russia think there are other ways as do all of
Iraq's Arab neighbors who oppose this war. You would think that if
Saddam Hussein is a neighborhood bully-and he surely is-that his
neighbors would be most concerned. They fear that if a tough guy from
out of town comes into their neighborhood and beats up on him that it
will inflame the street for years. They think sanctions have humbled him
sufficiently to take the edge off and continue to do so.
The physicians at the pediatric hospital who were most eager to have
medical information were happy to know about SatelLife. When I asked for
their address, they said their e-mail was shut down by the government,
because the system was flooded with messages urging them to surrender
rather than resist when the U.S. attacks.
Hope I'll be able to send this. You are not allowed to use your own
computer here for access, so feel free to share this as I don't have my
e-mail address book.
Warmly,
Charlie Clements
P.S. The pediatrician taking care of the little girl with kala-azar
turned to me and said, "It would be kinder to shoot her than let her go
home and die the lingering death from kala-azar. He said it in English
and the interpreter, by instinct, translated it into Arabic. The mother
sitting there with the girl in her arms suddenly had eyes overflowing
with with tears.
Charlie Clements is a Distinguished Graduate of the U.S. Air Force
Academy and a Distinguished Alumnus of the University of Washington
School of Public Health. He is a Vietnam veteran and current CEO of
WaterWorks, a Santa Fe-based not-for-profit that assists American
communities that are without running water or sewer. He is a former
President of Physicians for Human Rights.
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