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Home > Programs & Publications > HEALTH CONSEQUENCES OF THE WAR IN IRAQ: Barry S. Levy


Health Consequences of the War in Iraq

Presented at
Department for Professional Employees, AFL-CIO
Lunch and Learn,

 “Health Consequences of the War in Iraq and at Home

For broadcast on Pacifica Radio
AFL-CIO Headquarters
Washington, DC
October 5, 2006


The following was reported by Michael Levenson in the Boston Globe last Friday under the headline: “Swampscott mourns a son.”  

“Hundreds of friends, neighbors, and veterans lined the streets here yesterday to mourn the town’s first resident to die in combat since the Vietnam War, a car-loving former alter boy named Jared J. Raymond. 

“Under a fluttering American flag suspended between the ladders of two fire trucks, two chestnut horses pulled a black caisson bearing the remains of Raymond, a 20–year-old U.S. Army specialist who was killed September 19 when an improvised explosive device detonated near the tank he was driving in Iraq. 

“Dentists in blue scrubs, library workers, elderly people on the senior center porch, firefighters outside a station house, a boys’ football team in blue jerseys -– all watched as Raymond’s flag-draped casket rode past. 

“People wept, saluted, and waved American flags, as bagpipes played and the caisson proceeded from the church where Raymond was baptized two decades ago to the cemetery where he was buried yesterday.” 

Today, I will discuss the disastrous health consequences of the war in Iraq.  But first some background and context.

The current war in Iraq needs to be viewed in the context of at least two other previous wars. First, the Iran-Iraq War from 1980 to 1988, in which the United States sided with Iraq.  In that war, between 500,000 and 1 million people were killed, and another 1 to 2 million people were wounded.  The Iran-Iraq War uprooted 2½ million people and destroyed whole cities.  It cost over $200 billion.

Then, in 1991, came the Persian Gulf War, also known as Gulf War I.  It too took a huge toll.  Tens of thousands of people died.  Many were injured.  And many became chronically ill.  But the numbers of deaths and illnesses during Gulf War I were far exceeded by those that occurred in the several years after the war.  UNICEF estimated about 400,000 excessive children’s deaths occurred in Iraq during the 1990s and the beginning of this decade, largely due to post-war sanctions imposed by the United States and other countries.  These sanctions restricted food and medicine from getting into Iraq for several years until the Oil-for-Food Program began.

In March 2003, U.S. and other Coalition forces invaded Iraq –- the start of the preemptive war that was justified by the Bush administration on the grounds that Iraq possessed weapons of mass destruction and had close ties to Al Qaeda.  Both of these rationales for the war have proven to be false.  Two months after the invasion, President Bush declared that most hostilities were over.  Most of the health consequences of this war, however, have occurred since then.

In my presentation today, I will focus on seven categories of health consequences of the war in Iraq: Direct impacts on health. Adverse effects on health services.  Damage to the infrastructure that supports health.  Refugees and internally displaced persons.  The impact of the war on human rights and the international order.  Diversion of resources.  And, impacts on the physical, sociocultural, and economic environments.

1. Direct impacts on health: In this war, there have been more than 2,700 deaths among U.S. military personnel.  More than 2,500 of these deaths have occurred since President Bush declared that most hostilities were over.  And more than 2,200 of these deaths have occurred since the capture of Saddam Hussein.  Approximately 20,000 U.S. military personnel have been wounded, many with serious injuries that have necessitated amputation of limbs or have caused long-term disability.  There have been many mental health disorders among the troops.  For example, the Surgeon General of the U.S. Army has estimated that 30 percent of returning troops have stress-related mental health problems. 

The toll on Iraqis has been much higher.  A study was performed by researchers at Johns Hopkins University, Columbia University, and the Al Mustan Siraya University College of Medicine in Baghdad.  The study was based on a systematic sample survey of almost 1,000 households.  Using scientifically conservative assumptions, the researchers estimated that about 100,000 excess deaths had occurred among Iraqis since the 2003 invasion.  This study was performed in September – not September 2006 but September 2004 – more than 2 years ago, and many more Iraqis have died since then.  As an indication of this increase in Iraqi deaths, the New York Times recently reported that monthly Iraqi civilian deaths doubled between mid-2004 and mid-2006.  The 2004 study also found that most of the excess deaths were among women and children, that the risk of violent death had increased more than 50-fold since the invasion, and that most of

these violent deaths were the result of air strikes by Coalition forces.

During the past 15 years, there has been significant childhood malnutrition in Iraq.  This peaked during the mid-1990s, largely due to the sanctions on importing food and medicine.  Although malnutrition among children is lower today than in the mid-1990s, about one-fourth of Iraqi children are chronically malnourished and many more are underweight.

2.  Adverse effect on health services: Health services in Iraq have been profoundly affected by the war.  During the initial phase of the war, for example, only two of the hospital emergency departments in Baghdad were functioning. In 2003, 12 percent of hospitals and many other health care facilities were damaged.  The two major public health laboratories were also damaged and looted.  Access to health services has often been restricted, largely due to security issues and inadequate financial resources.  Public health programs have been adversely affected.  Initially, there were shortages of essential medications and the cold chain for vaccines as well as vaccine administration were often disrupted.  Also initially, much

equipment and many vehicles were damaged by looting.  And, in the past 3 years, many health workers have left Iraq.

3.  Damage to the infrastructure that supports health: During both Gulf Wars I and II, there has been widespread damage to water treatment and sewage treatment facilities, which has led to much gastrointestinal illness, including many cases of fatal diarrhea in children.  About half a million tons of raw and partially-treated sewage has been dumped daily into rivers in Iraq.  Food security has been an issue; at times, one-fourth or more of Iraqis have been dependent on the distribution of free food.  Power generation has been unpredictable.  Transportation and communication systems have been damaged or have broken down.  And all of this has led to serious health consequences. 

4.  Refugees and internally displaced persons: Worldwide, there are about 12 million refugees, many as a result of war.  Gulf

War I created about 500,000 refugees; in Jordan alone, there may have been as many as 400,000, some of whom are still there.  The current war has created an additional 500,000 refugees, a number that has doubled during the past year.  But only a small fraction of them have been officially recognized by the United Nations High Commission on Refugees.  And none of these numbers include the many people who have been internally displaced within Iraq, who often face greater risk to their health than refugees, who have left Iraq.

5.  The impact on human rights and the international order: During the regime of Saddam Hussein, there were numerous serious human rights violations.  Many people were killed.  Many became political prisoners.  Many human rights were violated.  We may never know the full extent of these violations.  That being said, I want to comment on four sets of human rights violations concerning the war.  First, the preemptive nature of the war is thought to have violated the United Nations Charter, weakened the UN system, and set a dangerous precedent for the future.  Second, torture and mistreatment of prisoners.  At Abu Ghraib and other prisons, detainees have been physically tortured and psychologically abused.  This has taken the form of beatings, stress positions, food deprivation, exposure to extremes of heat and cold, sensory deprivation, isolation, sleep deprivation, exposure to loud noise, forced nudity, use of dogs to instill fear, cultural and sexual humiliation, waterboarding and other forms of mock execution, and threats of violent death.  This torture and abuse has led to many health problems, including memory loss, difficulty in concentration, headaches, back pain, irritability, depression, nightmares, feelings of shame or humiliation, posttraumatic stress disorder, and death.  Third, women’s rights.  Before the war, women in Iraq had more access to educational and professional opportunities than most other women in the Arab world.  Those opportunities are far fewer today.  And fourth, freedom of speech.  New laws in Iraq criminalize speech that ridicules the government or its officials, and several Iraqi journalists have been criminally charged, under these laws, with offending public officials.

6. Diversion of resources: Over 50 years ago, President Dwight D. Eisenhower said: “Every gun that is made, every warship launched, every rocket signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and not clothed.”  Here are three examples of diversion of resources related to the war in Iraq.

First, about two-thirds of the 330,000 members of the U.S. National Guard have now served in Iraq or Afghanistan, for an average mobilization of 15 months.  Since many police, firefighters, EMTs, and other first-responders in communities across the U.S. are members of the National Guard who have served or are serving in Iraq or Afghanistan, these communities have felt their absence.  This became readily apparent last year when Hurricane Katrina struck.  Many National Guard troops who could have been there to help were not available.  They and their equipment were in Iraq.

A second example.  Many of the resources used to fight the war in Iraq could have been used for health and human services back here in the U.S., especially during a period when there have been dramatic cuts in these services.  We, as a nation, could have used the $204 billion initially approved for the war in Iraq to do any one of the following: Hire more than 3 million elementary school teachers.  Build 24,000 new elementary schools.  Develop 27 million places for children entering Head Start programs.  Provide 40 million university scholarships.  Provide almost 200 million affordable housing units.  Hire more than 3 million port inspects.  Or, provide health services for the 46 million Americans without health insurance. 

And a third example of diversion of resources.  The $204 billion initially spent on the war could have been used internationally to cut world hunger in half, and, for 3 years, provide all developing countries with enough medicines to treat HIV/AIDS, and enough immunizations for all children, and enough clean water and sanitation for hundreds of millions of people in need.

7.  Impacts on the physical, sociocultural, and economic environments: First, impacts on the physical environment.  About 10 to 12 million landmines and units of unexploded ordnance have been strewn throughout Iraq.  About 8,000 barrels of hazardous substances have been stolen or destroyed.  The fragile desert ecology has been disrupted by tanks, military encampments, and battles.    And between 1,000 and 2,000 tons of toxic and radioactive depleted uranium (or DU), which is used to harden shell casings, have been dropped in Iraq by American and British planes during the war, creating a widespread threat to health.

Next, the impacts of the war on the sociocultural environment.  In Iraq, damage to religious and cultural institutions.  Looting of the National Museum.  A substantial increase in crime.  And disruption of everyday life.  Here in the United States, many sociocultural impacts as well, such as the tripling of divorces among U.S. Army officers.  In addition, the war serves as an example to other nations and to people everywhere that violence is the best way to settle disputes. 

Finally, the impacts of the war on the economic environment.  For Iraq, high unemployment and lagging oil production.  For the United States, $378 billion have now been allocated for the war and its cost to our country is now $2 billion a week.  Over the next decade, the total cost of the war could surpass $700 billion, making it the most expensive U.S. military effort since World War II.

So, in summary, the war in Iraq has damaged health directly, adversely affected health services, damaged the infrastructure that supports health, made hundreds of thousands of people refugees and internally displaced persons, violated human rights and the international order, diverted resources, and adversely affected the physical, sociocultural, and economic environments.  In addition, I must add to this list the threat of all-out civil war, which could dwarf all of the health consequences that I have presented today.

In closing, the health consequences of the war in Iraq have been profound.  More profound than statistics alone can convey.  As my colleague Dr. Victor Sidel has often said, “Statistics are people with the tears washed away.”

Now, I ask you to take a moment and think about someone in your life who died prematurely.  Recall the suffering of that person and the anguish of their family and friends.  Then multiply that suffering and anguish by 10, then by 10 again, then by 10 again, then by 10 again, and then multiple it by 10 again.   And now, you may be able to begin to comprehend the disastrous human consequences of the war in Iraq.



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