170,000 Iraqi Children Face Death, Health Study Finds

At least 170,000 Iraqi children will die over the next year from disease, inadequate medical care and other Gulf War aftershocks, a Harvard University team estimates in one of the most comprehensive studies of the battered nation’s public health crisis.

The study team, who surveyed medical records and officials at hospitals in all major Iraqi cities, found “epidemic” levels of cholera, typhoid and gastroenteritis, creating a “public health catastrophe” in the country.

The researchers said the war’s effects have caused Iraq’s child mortality rate to double since the start of the crisis last year; the death rate is expected to surge even higher as the hot summer months approach.

The results of the study, funded by the McArthur Foundation and seven other private groups, are to be released this week. A copy was obtained Monday by The Times.

Although the study does not contain comprehensive mortality rates, it estimates that the number of Iraqi children younger than 5 who will die from “delayed effects” of the Gulf crisis will be more than double the number who died in the year before the war. The war has had a particularly devastating impact on children, who are more susceptible to malnutrition and infection by water-borne diseases.

The Harvard team said its projections are based on data collected from records at four hospitals in Iraq. At Saddam Central Teaching Hospital for Children in Baghdad, for example, child mortality soared to 13.3% of admissions in January and February, compared with 3.9% during the same two months in 1990, the report said.

In March, a U.N. representative reported that “near-apocalyptic” bombing by the United States and its allies had plunged Iraq “into a pre-industrial age.” But independent observers said the Harvard study appears to contain the most thorough assessment of the public health consequences of the destruction of Iraq’s infrastructure.

The report does not address directly the question of financial aid to Iraq. But its findings appear likely to prompt renewed calls from international relief agencies for increased humanitarian assistance.

“Contrary to the statements of both the Iraqi government and Western journalists that the health situation is stable and will continue to improve, the study team finds that the state of medical care is desperate and--unless conditions change substantially--will continue to deteriorate in every region and at nearly every provider level,” the report states.

The 10-member study team--three physicians, one public health specialist, two lawyers and four law students--traveled in Iraq from April 28 to May 6 without interference from Iraqi officials.

After surveying the country’s infrastructure, including its medical facilities, water and sewage treatment plants and electrical power installations, the group estimated that Iraq’s public health system is operating “at a fraction of its capacity before the Gulf crisis.”

The team noted a direct link between Iraq’s shattered infrastructure and its increasingly strained public health system. “Without electricity, water cannot be purified, sewage cannot be treated, water-borne diseases flourish and hospitals cannot cure treatable illness,” the report said. The anticipated increases in deaths and disease “are all linked to the destruction of Iraq’s electrical power system in the Gulf War,” it said.

John Usher, a spokesman for the United Nations Children’s Fund (UNICEF), said he has not seen the Harvard report. But he said its findings seemed more expansive and detailed than most reports that have reached his office since the war’s conclusion.

“We don’t have (expected mortality) figures, but we are aware that the situation is critical, especially for women and children,” said Usher. “And, we know it grows more desperate every day with the approach of summer weather.”

Usher said U.N. officials issued a revised appeal for increased aid last week, seeking $415 million more through August. He said that Prince Sadruddin Aga Khan, executive delegate of the U.N. secretary general, made the request at a meeting of international donors on May 15.

“There are more needs than we have (money) available,” Usher said.

Meanwhile, in Baghdad, government and foreign aid officials disagreed Monday on whether the rising number of cholera cases in Iraq constitutes a true epidemic.

Iraqi government figures put the number of reported cases at 94, up from 52 reported on May 9. “It’s an epidemic, a sudden unexpected rise in incidence,” said Ahmad Hardan, a government disease control official. Cases have been reported in 14 of the country’s 18 provinces.

The Baghdad regime has called for the lifting of U.N. economic sanctions so more medicine can be imported. International humanitarian agencies are supplying medicine to treat cholera, typhoid, dysentery and other diseases.

Gianni Murzi, head of the UNICEF operation in Iraq, agreed that more medicine is needed. “All the medicine is being snapped up as soon as it arrives,” he said, adding that UNICEF is arranging shipment of another 70 tons of supplies.

But Murzi denied that cholera, endemic in some parts of Iraq, has reached epidemic proportions. “We still believe it’s under control, he said. “We are monitoring the situation closely. So far it does not show the classical aspects of an epidemic.”

Murzi acknowledged, however, that the 94 reported cases may be only half or less of the actual number. “Certainly we are very preoccupied by it, very worried,” he said.

Talal Ibrahim Allo, a British-trained doctor at the Qadissiyah Hospital in Baghdad’s Saddam City slum, where all of the capital’s 12 cases have been reported, said the disease was not yet out of hand. “We have no problems at all,” he told reporters in Baghdad. “We know how to handle cholera.”

Murzi, the UNICEF official, said Iraqi Health Ministry officials had told him that none of the country’s sewage systems was working properly--ominous news for disease control workers as the summer approaches. He said demands on the country’s fragile power supplies are growing, cutting the percentage of power available for sewage plants.

In Basra and Nasiriyah, two southern cities, foreign relief workers said last week that sewage treatment was at a standstill because of damage to plants and a lack of power. In Basra, raw sewage is being pumped into the Shatt al Arab waterway, the source of the city’s drinking water, one aid official said.

In Nasiriyah, said another, residents are digging down to underground pipes and breaking them to obtain water, raising the risk that water and sewage will be mixed.

Fulwood reported from Washington and Williams from Baghdad.