In Iraq, diarrhea and respiratory infections account for 2/3 of the child deaths, and 21% are chronically malnourished.

Meanwhile, a renowned Iraqi epidemiologist is prevented from telling American or Canadian audiences about an Iraq epidemic of child cancers and birth defects. (See below.)

New York Times, April 18, 2007
Iraq’s Public Health Services Severely Strained, Group Says

ROME, April 17 — It goes without saying that war is bad for your health. But a compendium of new public health statistics, released Tuesday by the World Health Organization, quantifies just how desperate the situation has become for Iraqis.

There are the obvious risks of car bombs and other violence that now kill an average of 100 people a day, according to the report from the W.H.O.’s Health Action in Crises group. But beyond that, there are a host of other problems created by years of conflict: 70 percent of Iraqis lack regular access to clean water, and 80 percent lack toilets that do not contaminate water sources, according to the report.

As a result of these multiple public-health failings, diarrhea and respiratory infections now account for two-thirds of the deaths of children under five, the report said. Twenty-one percent of Iraqi children are now chronically malnourished, according to a 2006 national survey conducted by UNICEF, which puts them at risk for both stunted growth and mental development.

The statistics are being presented by the W.H.O. at an international meeting on Iraq on Tuesday and Wednesday at the United Nations High Commissioner for Refugees in Geneva.

“There has been so much violence for so long that the result is inevitably this kind of complete social decay,” said Dr. Les Roberts, a principal researcher in a series of public health surveys on mortality among Iraqi citizens whose controversial results have been published in the British journal Lancet.

He says he believes that some of the new data vastly underestimates the human tragedy. “The W.H.O. has done a great job in walking a tightrope,” said Dr. Roberts, who was formerly at the Johns Hopkins Bloomberg School of Public Health and now heads the program on forced migration and health at Columbia University. “They are telling the world that the Iraqi health situation is really bad and likely to get worse, but doing it within the political constraints of respecting government numbers.”

He said, for example, that the report of 100 deaths a day from violence was “a gross underestimate,” placing the probable tally at several times higher.

Dr. Khalid Shibib, of the W.H.O., said that most of the public health figures were “better a few years ago” because “loss of electricity and displacement of people have led to a deterioration of our public services and lack of access.”

“If the environmental situation continues to deteriorate, there will be increased diarrheal diseases, such as cholera,” he said. “Also, if there continues to be so many displaced people who are crowded together — maybe living with relatives — there will be a great rise in respiratory diseases, maybe even tuberculosis.”

The Health Action in Crises group said doctors and nurses were fleeing the violence and chaos of Iraq, although Dr. Shibib said there were no official numbers. As a result, clinics and hospitals are understaffed and undersupplied.

The report cites the Iraqi government as saying that almost 70 percent of critically injured patients die in the hospital because of lack of staff, drugs and equipment.

To make matters worse, pregnant women and the injured and ill in parts of Iraq, including Baghdad, are afraid to risk the trip to the hospital for security reasons, the report said. Dr. Shibib said the problem was complicated by divisions between Shiites and Sunnis that led Iraqis to fear that they would not be treated at certain facilities.

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Globe and Mail (Toronto) 4-18-2007
U.K. won’t let B.C.-bound author of child cancer study land


Special to The Globe and Mail

After he couldn’t get a visa to tell Americans about an alarming rise in cancer levels among Iraqi children, a renowned Iraqi epidemiologist has been told he can’t fly through Britain en route to give a similar talk in Canada.

Riyadh Lafta — best known for a controversial study in the respected medical journal The Lancet that estimated Iraq’s war dead at more than half a million — said in an e-mail to his U.S. research colleagues that he had two choices: Fly to England without the transit visa, or turn around and go home.

“[British consular officials] refuse to give us a transit visa just to change airplanes,” Dr. Lafta wrote from Amman to colleagues at the University of Washington, and to B.C.’s Simon Fraser University, where he planned to give a talk on Friday.

“I am sorry you are disappointed, but what can I do?”

University officials were working hard to bring him to Canada through France or Switzerland, but while flights could be arranged, officials have not heard from those countries about whether they would grant him a visa. With Dr. Lafta are scores of documents that will help researchers from Simon Fraser, Washington and Iraq determine how badly the U.S.-led war in Iraq affects children — whether birth defects in Iraq are on the rise, and whether Iraqi children are suffering a tenfold increase in cancers such as leukemia, said Simon Fraser professor Tim Takaro.

“We need this data and, as unpopular as it is, we need to complete this work,” Dr. Takaro said. “It’s extraordinary that the British would have held up something, and it makes me think that they were influenced to do it — we’d love to know why.”

Dr. Lafta had applied for a U.S. visa on July 20, 2006, to speak to students at the University of Washington about the death toll of the war in Iraq. He was helped by a U.S. congressman and a senator, but his application was not approved. His Canadian visa was issued during that time.

Last week, university officials at Simon Fraser approved a plan to bring Dr. Lafta to B.C. His itinerary would have him spend slightly more than four hours at Heathrow Airport in London, a place his colleagues said he has been many times before. He applied for the transit visa four days ago, but it was denied late yesterday by British officials in Amman.

British consular officials said they could not discuss the specific case, but said transit visas are usually issued on short notice, and said Dr. Lafta would have a letter that states the reason for his denial. The Globe and Mail could not reach Dr. Lafta about this letter yesterday.

“I think that I now have two choices: No. 1, to go and try to get in the airplane from Amman without the visa, but this is going to be very difficult,” Dr. Lafta wrote. “No. 2 is to go back home tomorrow.”

Born in Iraq, Dr. Lafta was trained as a physician at Baghdad University College and worked for 14 years for the health ministry under Saddam Hussein, becoming the head of two departments. His name was on the 2006 study in The Lancet.

As a contingency plan, Simon Fraser has invited another author of the study, Les Roberts from the Johns Hopkins Bloomberg School of Public Health.

“I’m proud of the local university for holding this [talk] when others wouldn’t,” said Bill Siksay, the NDP immigration critic.


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