Tomgram

Letter from Iraq — biological warfare

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Dr. David Hilfiker is part of a delegation from the peace group Voices in the Wilderness that has put itself directly in the target zone of a future war in Iraq. I’ve known him for many years. For the last two decades, he has worked as a doctor with the poor and homeless ill in Washington DC. He is a thoughtful man of deep conviction as well as a fine writer. He has written two books on doctoring: Healing the Wounds about being a small town doctor in Minnesota — possibly the first book by a doctor to explore seriously the issue of doctor’s errors — and Not All of Us Are Saints, which described what it was like for a middle class doctor to work (and sometimes live) with the poor and sick. More recently, he has produced a short, exceedingly useful primer, Urban Injustice, How Ghettos Happen, on the nature of inner city poverty and what can be done about it. (The answer: lots if only we as a society were willing.)

He wrote me this letter/report on the devastation he’s seen in Iraq part way through his stay there. The title of the piece — which is his — is a reminder that elsewhere in the world “biological warfare” may have quite a different meaning. Nothing speaks more strikingly of the long-term bankruptcy of American policy in Iraq than to imagine that its history stretches from support for Saddam Hussein in the 1980s, when he was practicing biological warfare against his Kurdish minority and the Iranian enemy, to what has functionally become an economic form of biological warfare against a whole society, and especially its children — all to unsuccessfully overthrow one man. Tom

BIOLOGICAL WARFARE
By Dr. David Hilfiker

As part of a small peace delegation visiting Iraq, I recently went to the village of Qurnah, which lies at the confluence of the Tigris and Euphrates Rivers, the “birthplace of civilization,” if I remember high school world history. By the time they reach Qurnah, the Tigris and the Euphrates have run through most of the populated regions in Iraq. Twelve years after the Gulf War and the imposition of economic sanctions, sewage treatment facilities are in such a state of disrepair that 500,000 tons of raw sewage are dumped into the waterways of Iraq everyday. Much of that passes by Qurnah.

The intake for the small water treatment plant in Qurnah lies in the Tigris River, just above the confluence. When the contaminated water is brought into the holding tanks, it is first mixed with aluminum sulfate, which helps agglutinate the particulate matter so that it can settle out into a sludge at the bottom of the tank. Unlike at similar plants we visited, there usually is enough aluminum sulfate for this first step. When there isn’t, the local engineer just hopes enough particulate matter will settle out anyway. The machine that cleans the sludge from the bottom of the tanks has been broken for a number of years, so the contaminants can never be completely removed. Chlorine, fortunately usually available at this plant, is then added to the water, which is pumped into large sand and gravel filters. Due to an acute funding shortage, however, the filters haven’t been changed in years. Inside the treatment plant itself, the pumps and pipes were old and rusted, with water squirting out everywhere.

After treatment the water is ordinarily pumped into water towers, which not only store it but should also create a constant water pressure so that it can be distributed to homes, schools and businesses in the area. Like most of the water towers we saw, however, this one in Qurnah is inoperable, so the village depends upon old, creaking pumps in the water treatment plant to create the necessary water pressure.
Unfortunately, as electricity is cut off for at least several hours a day, there is not enough electricity in Iraq for a constant supply of water.

Once the electricity comes back on, it takes about an equal amount of time to build up enough pressure to start the water moving adequately through the pipes again. During the downtime, sedimentation occurs in the pipes throughout the system leading to cracks and leaks. (Most plants have back-up electrical generators for such power outs, but over 70% of these generators are broken and cannot be fixed because of the economic sanctions.)

As part of a small peace delegation visiting Iraq, I recently went to the village of Qurnah, which lies at the confluence of the Tigris and Euphrates Rivers, the “birthplace of civilization,” if I remember high school world history. By the time they reach Qurnah, the Tigris and the Euphrates have run through most of the populated regions in Iraq. Twelve years after the Gulf War and the imposition of economic sanctions, sewage treatment facilities are in such a state of disrepair that 500,000 tons of raw sewage are dumped into the waterways of Iraq everyday. Much of that passes by Qurnah.

The intake for the small water treatment plant in Qurnah lies in the Tigris River, just above the confluence. When the contaminated water is brought into the holding tanks, it is first mixed with aluminum sulfate, which helps agglutinate the particulate matter so that it can settle out into a sludge at the bottom of the tank. Unlike at similar plants we visited, there usually is enough aluminum sulfate for this first step. When there isn’t, the local engineer just hopes enough particulate matter will settle out anyway. The machine that cleans the sludge from the bottom of the tanks has been broken for a number of years, so the contaminants can never be completely removed. Chlorine, fortunately usually available at this plant, is then added to the water, which is pumped into large sand and gravel filters. Due to an acute funding shortage, however, the filters haven’t been changed in years. Inside the treatment plant itself, the pumps and pipes were old and rusted, with water squirting out everywhere.

After treatment the water is ordinarily pumped into water towers, which not only store it but should also create a constant water pressure so that it can be distributed to homes, schools and businesses in the area. Like most of the water towers we saw, however, this one in Qurnah is inoperable, so the village depends upon old, creaking pumps in the water treatment plant to create the necessary water pressure.
Unfortunately, as electricity is cut off for at least several hours a day, there is not enough electricity in Iraq for a constant supply of water.

Once the electricity comes back on, it takes about an equal amount of time to build up enough pressure to start the water moving adequately through the pipes again. During the downtime, sedimentation occurs in the pipes throughout the system leading to cracks and leaks. (Most plants have back-up electrical generators for such power outs, but over 70% of these generators are broken and cannot be fixed because of the economic sanctions.)

UNICEF reported in February of 2002 that, in the city of Baghdad, “the long-duration of power cuts caused severe damage to the piping network resulting in 18,000 breaks during the 1990 – 97 period compared to 18 during 1985 – 1990” — that is, before the Gulf War. When the power is off and the water pressure absent from the pipes, contaminated water from the surrounding groundwater seeps into the system.

This damage to the public health infrastructure is a direct result of the Gulf War and the subsequent sanctions imposed on Iraq. During the war, water treatment plants were bombed and virtually all electrical power stations were targeted. The complete embargo on trade imposed after the August 1990 Iraqi invasion of Kuwait lasted, for practical purposes, until March of 1997 when goods finally started arriving under the Oil-for-Food Program (OFFP), during which time virtually nothing that broke could be repaired. The OFFP was supposed to bring humanitarian equipment and supplies to the country, but as Joy Gordon has written in Harper’s Magazine, the reality has been very different. Often citing “dual use” concerns (that goods meant for humanitarian projects could be diverted to the military) the US representative to the UN committee in charge of sanctions has consistently blocked or delayed needed equipment. Almost anything can be dual-use, of course. “Truck tires, respirator masks, bulldozers, and pipes have all been blocked or delayed at different times,” writes Gordon.

A humanitarian disaster is the result of what, in essence, has been twelve-years of economic warfare upon the civilian population of Iraq.

In the last decade, Iraq has been “de-developed.” In 1990, the country was moving quickly into the league of developed nations. Universal health care access, free universal education through university, a well-developed infrastructure and sophisticated public health measures brought a relatively high quality of life to most people. The rate of death for children under five was about 5.6%. With the usual rate of improvement, that under-five mortality rate should have dropped to about 3% by 2002. The Gulf War and economic sanctions, however, have devastated the Iraqi infrastructure.

Contaminated drinking water, though just one manifestation of this devastation, has been a central weapon in the war upon the children of Iraq. Under-five mortality is now over 13%, meaning that approximately 10% of Iraqi children die as a direct result of war and sanctions. This means somewhere in the neighborhood of 5,000 children a month (which, over twelve years, means that Iraqi children have died of war and sanctions-related causes in larger numbers than Japanese children in the atomic bombings of Hiroshima and Nagasaki). The majority of these utterly preventable deaths result from diarrhea and acute respiratory infections from the contaminated water. UNICEF estimates that 40% of Iraq’s “drinking water” is contaminated.

When I came to Iraq, I was told to drink only bottled water and not to eat fresh vegetables. The instructions sounded quite reasonable, standard precautions for visiting any underdeveloped country. At dinner one night, however, when we sent the waiter back twice because he brought us bottles of water that had already been opened, I finally asked myself why the Iraqis could drink such water. They’re used to it, was my quick answer to myself. Then it hit me: Before the Gulf War, they had clean water. So how did they get used to it? They got used to it as children by getting sick and too often dying, victims of a deliberate, ongoing, silent war.
If the United States attacks Iraq again, we will be attacking a country already on the brink of disaster, with far fewer reserves than in 1991. We will undoubtedly bomb electrical grids first, immediately knocking out the 70% of water treatment plants that have no functioning backup generator. If we follow the pattern of the first Gulf War, we will hit some of the larger treatment plants directly. The civilian population will have no choice but to drink water even more contaminated with sewage than it is now. That will be only one small part of the devastation, but it will necessarily target the weakest of Iraqis, the hundreds of thousands of children already in danger.

Near Qurnah, while we were touring another water treatment plant, we happened upon a small school in a very poor community of about 5,000. There were no paved roads; most of the children were barefoot; the houses were mostly mud huts. We asked if we could visit and walked in upon the Iraqi equivalent of a twelfth grade class of young women. I introduced myself as an American, and, as usual, got an unfailingly courteous reception. While the depth of bitterness here toward American policies cannot be overestimated, I am still amazed that Iraqis don’t hold their American visitors in contempt. At least on the surface and often at some depth, everyone seems to make an absolute distinction between the American people and their government.

While all of these young women plan on attending university next year, a number of them pointed out that it was hard to dedicate themselves to their studies when they could imagine no future for themselves. I asked if anyone wanted me to take a message back to the United States. One young woman was willing-indeed, eager-to talk. “We want to live the way you do,” she said. “The US government needs to ‘rearrange its beliefs’ about the Iraqi people. They must see us as people and understand that we have been suffering for twelve years.”

I weakly told her that I would do everything I could to return to the US, tell Americans about her suffering, and try to prevent a war. This eighteen-year old girl who had never before met a Westerner looked straight into my eyes and said that they had already heard too many words. All she was interested in was action.

Copyright David Hilfiker